September 4, 2015
doc fix, F.A.C.S., Gerard Gianoli, Government central planning, HEALTH, M.D., medicare, Medicare Pay for Performance, Pay-for-Performance
Gerard Gianoli, M.D., F.A.C.S.
“In 1814, we took a little trip, along with Colonel Jackson, down the mighty Mississip….”
Like any good student growing up in New Orleans, I learned about the magnificent victory of the U.S. forces over the British in the Battle of New Orleans during the War of 1812. Of course, the Treaty of Ghent ended the War of 1812 before the Battle of New Orleans was even fought. Many have argued that the battle was useless since the war was already over. However, this is not the first or last time that governments have pursued “useless” enterprises.
Government central planning fosters this type of ineptitude. By its design, government is a slow-moving entity that often makes changes only long after that change has become obsolete. This is the nature of government, and it does not matter whether the occupants of the Oval Office or Congress have an “R” or a “D” after their names.
Recently, legislation passed as part of the “Doc Fix” (repealing the “SGR” physician pay cuts) institutionalized a physician Pay-for-Performance (P4P Medicare program called Merit-Based Payment Incentive System (MIPS).) The idea is to pay bonuses to physicians providing higher quality care.
Let’s make the highly dubious assumptions that government can measure quality in medical care and that such a system won’t just lead to “cherry picking” of patients. MIPS still won’t work to identify and reward “quality” physicians with bonuses. Why? Like in 1814, the government is fighting a war that is already over. More
July 21, 2014
Dr Jane M Orient, medicare, U.S. medical system, VA and Medicare, VA services, VA-style incentives, veterans
By Jane M. Orient, M.D.
Executive Director of Association of American Physicians and Surgeons,
“No VA employee, however incompetent, could ever be fired,” stated one physician. Another said, “Incompetence is accepted…, and keeping quiet about it is the accepted norm.”
Most veterans get most of their medical care from private doctors through Medicare or private insurance. Just think what those secret waiting lists would be like if they didn’t!
Still, a VA-like system for all has been proposed as a replacement for our unsustainable current system—at least until the recent scandals broke.
One enormous difference between the VA and Medicare is that veterans are free to go elsewhere—if they pay privately. Some veterans use their VA doctor only to get free medications.
Medicare patients, on the other hand, are trapped. There is virtually no private coverage available to persons over 65 to replace Medicare—President Lyndon Johnson wiped it out to prevent competition with “his” beloved system. There are only policies to “supplement” Medicare. And Medicare patients can’t just pay out of pocket for a “covered” service they can’t get otherwise, say because the Medicare-allowed price is too low—unless they see a doctor who is opted out of Medicare or disenrolled. For doctors, Medicare is all or nothing, so most doctors are still enrolled.
Most people don’t care about that—not yet. Who would want to pay for something that is free?
So it’s a good idea to look at those “free” (taxpayer-paid) VA services. More
April 22, 2014
corruption, Executive Director of Association of American Physicians and Surgeons, Government, graft, health care system, Health Insurance Portability and Accountability Act (HIPAA)., Hipaa, Jane M Orient MD, Medicaid, medical facilities, medicare, Obama, obamacare, tax code, the HMO Act, the Stimulus bill
Contributor & author: Jane M. Orient, M.D., Executive Director of Association of American Physicians and Surgeons
Government can’t fix the “health care system” any more than Obama can take out your tonsils. But it can refrain from tying up or tripping those who are trying to take care of patients. We should start by repealing the mandates—on individuals, employers, medical facilities and professionals, and insurers. No American should be forced to buy a product he does not want or need or feels he cannot afford. No individual or company should be forced to provide services or products to government specifications. The American way is the voluntary way.
April 7, 2014
2.3% medical device tax, chronic lung disease, congestive heart failure, corruption, diabetic coma, Elizabeth Lee Vliet M.D., Government, medicare, obamacare, Part D Medicare, PPJ Gazette, seniors
Elizabeth Lee Vliet, M.D.
“Who would have thought after a lifetime of service to our country in homes, jobs, and communities, seniors would be attacked by their own government with many threats to their savings and lives in retirement?”
“Chaos, cost increases, and turmoil reign since Obamacare took effect. Hidden changes drastically transform Medicare, affecting your ability to get needed medical care—even if you pay out of pocket.”
Here is my list of the Top 9 government attacks on American seniors:
1. CMS proposed a 678-page rule (1-6-2014) requiring enrollment in Medicare for all prescribers of drugs covered under Part D Medicare. Currently, medication prescribers only need to have an active state license permitting prescribing. CMS is restricting Medicare beneficiaries’ ability to use their benefits if they see an independent physician outside “the system.” Independent physicians can see patients but cannot order anything for them. It’s like telling an auto mechanic that he can fix cars but he can’t use any tools.
Even Doctors enrolled in Medicare risk having their enrollment revoked if, in the eyes of the government bureaucrats, they “fail to meet Medicare requirements.” The requirements change almost daily, and Medicare rules are often subjectively interpreted, so this means doctors may avoid prescribing something YOU need rather than risk a Medicare sanction and losing income. More
October 22, 2013
“affordable” care, HEALTH, high quality medical care., Medicaid, medicare, Medicare Parts B and D, obamacare, practice of medicine, Richard Amerling, subsidized insurance
Richard Amerling, M.D.
I remember the days of black-and-white television. When color television sets became available, they were expensive and few could afford them. And few networks broadcast in color, since the audience was limited. At a certain point of supply and demand, sets became less expensive, and networks went all-in for color. The same phenomena occurred more recently with the move to high definition TV. And so it will go with private, high quality medical care.
Years ago I penned the Physicians’ Declaration of Independence, urging physicians laboring under increasingly abusive third party contracts to opt out, to allow them to return to the unfettered practice of medicine. Increasing numbers of physicians are opting out of Medicare, and few participate in Medicaid (full disclosure: as a nephrologist taking care of dialysis patients, I have not opted out of Medicare). Declining reimbursements and ever-greater paperwork and reporting requirements are driving this trend. To a certain extent, this is also happening in the private insurance sphere, and for the same reasons. But what really limits physician opt out is the relatively small numbers of patients who are “self-pay.” With the implementation of Obamacare, these numbers are set to explode. More
June 20, 2011
congressional healthcare, congressional pay, congressional retirement, Congressman Ryan, epa, FDA, Homeland Security, insurance rates, medicare, SPP, USDA
Marti Oakley (c)copyright 2011 All Rights Reserved
Dear Congressman Ryan:
I have seen you many times on Lame Street Media promoting your grandiose plan to kill Medicare. I realize targeting those least able to defend themselves from yet another round of the neo-con movement to redistribute the wealth to the upper 3% while leaving the country in ruins as jobs are shipped out and as corporations plunder the country, is underway.
While helping to spend the country into untenable debt and rolling out the red carpet to foreign investors and corporations who are steadily consuming everything in site, I realize that you have to dispense with any program or initiative which would lend support to the elderly, that class of useless eaters so despised by so many of you.
While railing against Medicare and what it costs the country, you never made mention of what it costs the country to support you while you are in office and even when you leave. For someone whose existence is now predicated upon the parasitic relationship of elected officials dependent on taxpayers, I am surprised that you did not readily identify yourself and the rest of congress as an unsustainable drain on the economy. We can no longer afford to support you people, especially when you contribute virtually nothing to the economy or GDP while availing yourselves of special privileges, perks and financial enrichments.
If you believe that individuals of modest to moderate incomes should be able afford the uncontrolled extortionary healthcare insurance rates, the inflated medical industry charges, and the non-negotiated inflated costs of pharmaceuticals, AND! at the same time save massive portions of our income which is under attack constantly by the IRS as taxes just keep eating up more and more of our income just so that we have some kind of security when we get too old to work………….then I see no reason why you and your cohorts in the District of Criminals can’t do the same on your ever rising incomes which far exceeds what most of us whom you are targeting, earned. More