Paperwork burden to Healthcare

The following article which I would like to share with you today is called The Red Tape Blues by Grace-Marie Turner. Here she highlights a problem that will befall our working force and healthcare if certain aspects of Obamacare (if not the whole) are not repealed.

Employers are confused and fighting mad about the huge costs and paperwork burdens that will hit them as a result of Obamacare.

“We just need to know how much this is going to cost us,” one businessman said at a meeting of the Association of Washington Business in Blaine, Wash., on Wednesday.

But at this point, the answer is just not knowable, since regulators still have to write so many regulations, including what health services employers will be required to cover under mandatory insurance.

Other serious concerns:

● Grandfathering. Business leaders are angry they were deceived and won’t be able to keep their current health-insurance plans, which would let them at least postpone some of the new federal mandates and rules. Sen. Mike Enzi (R., Wyo.) has filed a resolution of disapproval to force a Senate vote over the Obama administration’s too-strict grandfathering rules under the Congressional Review Act. Senator Enzi seeks to use Senate power “to overturn regulations that were drafted in secret, and which would result in more than half of all Americans with employer-sponsored coverage losing their current plan by 2013 — less than three years from now.” The resolution won’t pass this year but expect to see it on the docket again next year.

● CLASS Ponzi scheme. Rep. Charles Boustany (R., La.) has responded to targeted businesses’ concerns about the CLASS Act, the long-term-care program created in the health-care law. In an article in Human Events, he writes that the law requires employers to automatically enroll all of their employees in the program unless a worker opts out through a federal application. The premiums are expected to cost $240 a month for workers and will add huge new paperwork burdens for employers.

● Mandated higher costs. Business leaders are looking at higher costs for the “free” health benefits that were the focus of a White House media blitz this week, including preventive care at no cost to patients, allowing parents to add their 26-year-old “children” to their policies, and no yearly or lifetime limits on insurance payouts.

The Kansas City Star weighed in: “It’s absurd for the administration to pretend those changes won’t result in increased risk for insurers, which has to be covered by premiums. ‘This is a refusal to accept the economic reality of what she [Secretary Sebelius] and the president have caused,’ said Cary Hall, president of Benefits by Design, an Overland Park insurance broker. ‘You cannot expect insurance companies to do these things and not see premium increases.’”

The cost hikes are coming — adding up to 14 percent to the cost of individual policies and 8 percent for group plans, according to some insurance industry estimates.

● Employers will drop coverage. An article from the BNA Daily Report for Executives shows employers are very skeptical about their ability to provide health insurance to workers over the medium or longer term:

“There are huge administrative compliance and cost burdens on employer sponsors,” said Jim Klein, president of the American Benefits Council in Washington. Klein participated in a webcast sponsored by accounting firm Ernst & Young LLP titled Health Care Reform: It’s the Law.

“The future of the employer-sponsored system as a result of a lot of that is very much sort of hanging in the balance, not in the short term, but clearly in the mid- to long term,” he said.

Over time employers may decide to stop offering coverage to employees because it will be cheaper to pay fines under the Patient Protection and Affordable Care Act rather than pay for the cost of health insurance, Klein said.

“Just looking at the numbers, the penalty is less than what it costs you to provide coverage to your employees,” Klein said. On the other hand, he added, “How long do you think that those penalties are going to remain at the level that they are?”

There is “a great deal of skepticism” among employers that the health care law “is in any way going to reduce their costs,” that “I think it’s almost inevitable that virtually no one will have a grandfathered [insurance] plan…”

● Polls that tell the story. Six months after enactment of the new health-care law, the U.S. Chamber of Commerce released a national bipartisan poll showing that nearly eight in ten small-business leaders expect their costs to increase as a result of the new law. Further, a majority say they will be less likely to hire new employees and more likely to reduce current health-care benefits.

“This poll shows that the very small business leaders who are being counted on to grow jobs are deeply unsettled about the present and concerned about the future, and a tremendous amount of that uncertainty is due to the new health care law,” according to Randy Johnson, senior vice president of labor, immigration, and employee benefits for the U.S. Chamber.

American Action Forum also has a new poll out, and it shows that people believe Obamacare will lead to significant changes in their health insurance, and a whopping 82 percent of them believe the changes will be for the worse. The poll listed a number of provisions in the law — including $500 billion in taxes and $500 billion in Medicare reimbursement cuts — and then asked people whether they support the law — 59 percent said they oppose the law, 50 percent of them “strongly.” And by a nearly two-to-one margin, people believe businesses will drop health insurance and dump their employees into taxpayer-funded coverage.

People are not misinformed about Obamacare. They know all too well what is in it! That’s why the chorus of voices demanding repeal continues to grow.

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It is clear that with the hurdles and the expense, many mid-size companies will opt for paying the penalties than to purchase insurance for their employees. thus increasing the number of people uninsured.

What is remarkable is how the legislation was enacted in the first place with 53 percent of people against it.  Current polls place the number of discontented at 61%.  Now it is up to us to erase the “poison ink”.

Can We Afford the Affordable Care Act?

As the Patient Protection and Affordable Care Act becomes entrenched, many of us will discover that it is neither, especially not affordable.

Case in point is the recent hike in insurance premiums by Anthem Blue Cross and Blue Shield in Connecticut. The state insurance department recently approved premium increases greater than 20% for some of its insured policyholders, without an analysis or public hearing.

Justification of rate hikes was the reasoning that escalating medical costs and increased insured bases from the healthcare bill would be necessary. Eliminating the lifetime caps and insuring dependents for an additional 5 years has to be paid by someone after all- the someone being you.

Anthem’s increases range according to plan from .5 percent to 22.9 percent. Originally the company requested a 32% increase, which a public outcry shot down. This increase is occurring at a time when people are uninsured due to the cost (which was far less than current rate scales)

Various insurance companies across the country are formulating plans to follow in Anthem’s footsteps. To stem this cascade, Kathleen Sibelius, the HHS secretary issued a letter to the nation’s health insurance carriers in the form of a veiled threat. The companies must justify any premium increases in line with terms acceptable to the Democratic Party. In other words- play ball our way or go home. Those that do not satisfactorily comply will be totally barred from the government-managed insurance marketplace, which in the long term means going out of business.

So much for the promise that President Obama issued stating that insurance premiums would only go up 1-2%.

Sign me up for that one!

EHR Adoption and the Loss that Comes With It

The following is a response given by me to the question of “Why is there resistance to EHR adoption?”

The issue of EHR adoption is much more complex than just dollars.

For those just starting out or on the hospital staff, adjustment to a new system will be an easy one.

For those who have an active ongoing practice, looking at a record room of ten thousand charts (or more) with 25 pages minimum, gives one shudders in thinking about the logistics of digital conversion.
Still, even this is not a major issue.

Most physicians realize that there is benefit to electronic record systems.

So what is the main objection?

For many it is the loss….the loss of staring into the eyes of your patient and listening- really listening with compassion and empathy as your patient speaks. Whether it is to relate a symptom, complaint or even to share a story, giving a patient your full attention with hands-on evaluation, means a great deal to both patient and physician.

Typing away at the computer screen while a patient talks and looks at the top of your head loses a part of an important relationship between healthcare giver and patient.

For many-this is an objection that can not be overcome.
It is not a question of gain in conversion, it is one of loss.
Another nail in the coffin for the death of personalization.

Security Worries Hamper EHR adoption

According to researchers at North Carolina State University, concern about privacy is what is really holding back EHR acceptance. Worry about making oneself vulnerable to identity theft is at the heart of this issue.

David Baumer, head of N.C. State’s business management department and author of a new study, concurs and validates this concern.  According to Baumer,” EHR acceptance is higher in the European Union, which has tougher privacy rules.”

“We are moving in the right direction in regard to putting better privacy protections in place, but we have a long way to go,” Baumer says. The paper will appear in an upcoming issue of the Boston University Journal of Science and Technology Law. Baumer along with co-authors from Virginia Tech and Georgia Tech call for civil penalties for “inappropriate” sharing of electronic health data. Only then will EHRs reach their potential to cut billions of dollars from the U.S. healthcare sector. (Hopefully)

Guaranteed Issue For Your Health Insurance

As you probably have heard, President Obama is requiring insurers to sell healthcare policies to everyone regardless of their preexisting conditions.

This “guaranteed issue” will be reflected in the extraordinarily high premiums that reflect future expected costs when a patient has an illness.

With “community rating” which Congress would like to tack on to the requirement, the insurance companies will no longer be able to charge higher premiums for high risk individuals.

Averaged out across the board, young healthy people will be paying the same amount for their health policy as older people with medical problems.

Sound fair? Well, that depends on your age.

Because individual mandates where the younger pay for the sicker, older and higher-income brackets, along with guaranteed issue and community ratings, most people are not aware of the fine points of the healthcare reform.

The 20 somethings may have a lower income and would be required to pay more than what would be needed for their healthcare. They might then decide to forego health insurance and merely pay the fine for not having it if it is cheaper than the policy.

Yet for all the debates and rhetoric, the new mandates may actually blow-up and accentuate healthcare problems.

I hope this is not what the government had in mind!

You Can Partner with Google

Google has just revamped their Health system.  UserInterfaces (UI) have become user-friendly.

Now, not only can people with illness use the system, Google is concentrating on the population segment that is healthy and wants to stay that way!

Employers and corporate heads are now “on the same page”- looking for programs that will keep their employees healthy and productive.

The new user interface enables a person to create a personalized dashboard presenting information that is most useful to his/her particular  health and wellness interests and needs, rather than focusing on generic PHR-type functions.

You can select from a variety of pre-configured wellness tracking metrics such as glucose levels,blood pressure readings, caloric intake, exercise, weight, etc.  Goals can then be set and tracked, enabling a charting or trend results during the tracking period as well as adding personal notes to the various entries for a personal journal.

If there is no current health metric listed, one can create one.  This is valuable for the person that wants to track an individual problem like chronic fatigue or what time of day a person suffers from a particular symptom like pain.  The new platform even allows one to track use of pain medication or coffee consumption for instance.

This is something that you may want to check out.

Kudos to you Google with your new GoogleHealth system!


Is Obamacare unconstitutional?

President Obama has been quoted as saying that critics of his healthcare reform legislation are trying to “scare and mislead” the public. Apparently there are many in government that are trying to take the blinders off and explain new policies to the general public.  And in the court system opponents are exposing the bill as being unconstitutional.  More than 20 states are pressing for the bill to be repealed in parts.

According to Rep. Kevin Brady from Texas “If this is what passes for healthcare
 reform in America, then God help us all.” It is feared that Americans have been misled by propaganda spread by lobbyists, and special interest politicians.  There are legislators who voted for the bill without even reading it in its entirety.

This is a reflection of “Maam, Don’t confuse me with the Facts!”

Medical Care “Cyber” Home

As we traverse the paths of healthcare reform in this new century, approaches to medical treatments are different but exciting as we open up to new possibilities- and new realms.

Having care on your web is an understatement.  The “web” you weave will meld information gleaned from healthcare providers, internet services and your advocates or non-physician members of “your team”.

You are now the captain of your health team as you take more responsibility for your own condition by seeking out and implementing information from different sources.  Nutritionists, alternative health guides, naturopaths, homeopaths will all combine with patient internet portals and physicians to provide a myriad of approaches to deal with each condition or situation, making you whole.

“Reinventing Primary Care” found in the May issue of Health Affairs addresses precisely this.

Are you ready for the change?……Because change is coming if not already here!

Medicaid Fraud Went Unnoticed by Patients

Unbelievable as it seems in today’s age, patients came to a private practice in New Jersey and were herded into exam rooms to be evaluated by three members of a physician’s staff.  The only problem is that…they were not physicians!

The fact that they would “evaluate” a patient with no medical training is abhorrent.  How many patients came to that office with real problems and went undiagnosed?  Has the physician so much greed that the conscience is gone?

A New Jersey doctor who duped Medicaid out of nearly $2 million in a fake physician scheme was arrested by federal agents this week and charged with conspiracy to commit healthcare fraud and money laundering.

Dr. Yousuf Masoo, a New Jersey physician allegedly schemed to defraud Medicaid in which three other individuals without medical licenseses–Hamid Bhatti, Hakim Muta Muhammad and Carlos Quijada–treated patients at a practice in Elizabeth then–along with his wife Maruk–billed Medicaid as if he had seen the patients himself.

“Unsuspecting patients were placed at risk through deceit and substandard medical care, while taxpayers were being defrauded of millions of dollars,” Michael B. Ward, Special Agent in charge of the FBI’s Newark Division, said in a statement. “The fact that such a fraud could be accomplished for as little as $17 an hour serves as a reminder for the need for law enforcement to maintain focus in pursuit of healthcare fraud matters.”

People who worked for Masood claim that two-thirds of the patients who came through his doors only saw the three fake doctors.

A real question surfaces however that this can only occur because Medicaid patients are long accustomed to getting ‘the shuffle”.  They seldom see the same healthcare provider twice as few accept their plan and are used to “substandard” care. Needs are not met, questions are not answered and they are in and out of the office, prescription in hand to address their complaints, before they know what happened!

Yes, it is their fault.  They are the guilty culprits.  But, isn’t it the fault of the system as well?

Demand vs. compassion in adopting EMRs-Think Patient Safety


After being kicked around for more than a year, meaningful use has been defined and waiting for implementation.  Yet, many hospitals and physician offices have not been able to employ them yet and  won’t be able to qualify for Medicare and Medicaid bonus payments by 2012 or even 2015, when penalties for non-use start.

Although may consumer groups voice their fervor in keeping the deadlines with strict regulations in the current proposal, ( HIMSS also argued against watering down the regulations) vendors comprising HIMSS would like it to be simplified or diluted  (of course with a desire to see their increase in sales).

“Even with the incentive of billions of federal dollars to cover much of the cost of the transition [to EMRs], doctors and hospitals have been slow to take even the first steps toward conversion. Apparently, they feel little or no responsibility for symptoms that get misdiagnosed because of inadequate information about a patient’s past medical care, let alone the tests that get repeated because no one has a record of the previous results,” according to an editorial at the Boston Globe newspaper.

“The ultimate responsibility belongs to the doctors and hospitals who are putting their own habits ahead of the clearly demonstrated needs of their patients–and of the taxpayers who foot the cost of many medical bills.”

As we reach this new season and new beginnings, let us hope and pray for good health and wisdom for the New Year.  Happy and Healthy New Year to everyone!