As the Tennessee Medical Association puts it, there is now a "certain finality" to the Affordable Care Act following the Supreme Court decision upholding the law. A huge win for the Obama administration, the decision yesterday was like kicking a hornet's nest among conservatives. The Christian Medical Association said the decision "sounds an alarm across the country to people with faith-based and pro-life convictions" and called on Congress to repeal the law.
An article in Modern Physician characterizes the response among physicians as "mixed," but the vast majority of our MD, DO, PA and RN contacts have come down strongly in favor of the law, in one case saying "The government did something right... 50 million healthier Americans is going to look pretty good here in a few years."
Whichever political side one is on, it is now clear that work can move forward on implementing the law. The Tennessee Medical Association's statement concluded "Today's decision allows us to make more definitive plans regarding reforms to our healthcare system in Tennessee." The sentiment seems to be fairly widespread through the provider side of the industry.
Some states - among them our own Oklahoma - elected to refuse federal funding ($54 million in Oklahoma's case) to establish health insurance exchanges. The decision, taken on the part of Governor Mary Fallin, appears to have been politically motivated, but Oklahoma is, in fact, developing an exchange, without the federal dollars. An agency head, speaking with an Oklahoma radio station, said "It would have been good to have the money, so we could have a more user friendly and effective system, but we'll have something, anyway."
The justices struck down provisions in the law that would empower the federal government to force states to comply with the planned Medicaid expansion or lose all of their Medicaid funding. Now states will be eligible for basic Medicare funding even if they choose not to accept the additional dollars to provide expanded care. Numerous states have sworn to refuse expanded Medicaid funding, but it remains to be seen whether any will ultimately deny this added coverage for hundreds of thousands of their citizens. The federal dollars are being offered with no required match for three years. Medicaid is often one of the biggest lines in states' budgets, and that share is growing as healthcare costs continue to rise.
Showing posts with label medicaid. Show all posts
Showing posts with label medicaid. Show all posts
June 29, 2012
September 9, 2011
U.S. Doctors Earn Big, Drive Up Costs
According to a new study published in Health Affairs, America's approximately 1.1 million physicians are paid dramatically higher fees than those in all of the other more than 230 Organisation for Economic Co-Operation and Development countries. Per capita, our physicians are paid $1,599; other countries averaged significantly less than that -- about 81% less -- or about $310. The difference, nearly $1,300, is a major factor in driving up U.S. healthcare costs, and, according to the report, is the the main cause of higher overall spending in America on physicians' services.
The disparity comes into stark focus in the area of specialists' fees. While U.S. primary care docs earned significantly higher than their foreign counterparts -- averaging $186,582 annually -- orthopedic physicians earned $442,450. As an example, the study compared physicians’ fees paid by public and private payers for hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States, finding that much higher fees were paid to U.S. orthopedic physicians for hip replacements (70 percent more for public payers, 120 percent more for private payers) than public and private payers paid these specialitsts in other countries. The study concludes that "the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher U.S. spending, particularly in orthopedics."
According to August, 2011 CarePrecise data, of the approximately 1.1 million U.S. physicians, about 35,500 practice as orthopedists and orthopedic surgeons, with another 378,000 specialists practicing in the high fee taxonomies. Only about 160,000 U.S. physicians serve in family practice.
The disparity comes into stark focus in the area of specialists' fees. While U.S. primary care docs earned significantly higher than their foreign counterparts -- averaging $186,582 annually -- orthopedic physicians earned $442,450. As an example, the study compared physicians’ fees paid by public and private payers for hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States, finding that much higher fees were paid to U.S. orthopedic physicians for hip replacements (70 percent more for public payers, 120 percent more for private payers) than public and private payers paid these specialitsts in other countries. The study concludes that "the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher U.S. spending, particularly in orthopedics."
According to August, 2011 CarePrecise data, of the approximately 1.1 million U.S. physicians, about 35,500 practice as orthopedists and orthopedic surgeons, with another 378,000 specialists practicing in the high fee taxonomies. Only about 160,000 U.S. physicians serve in family practice.
August 4, 2011
And They Were So Close to Canada!

Looks like some Medicare patients will go to any lengths to escape the high cost of U.S. prescription drugs. Even if only through opium-induced euphoria.
Michigan: Twenty-six persons have been charged by Federal investigators in a Medicare fraud scam that took in more than $58 million in fraudulent billings and illegally acquired more than 6 million doses of pricy medications. Drugs were used to entice Medicare patients to play along.
The brains of the gang, one Babubhai Patel, ran a network of 26 Michigan pharmacies that bribed physicians to write the prescriptions, many of them opiates and other frequently-abused pharmaceuticals. Physicians recruited grandmas as mules. Medicare patients would knowingly fill the illicit prescriptions, keeping the drugs and handing over their Medicare and Medicaid billing information to the conspirators. Four doctors and ten pharmacists, as well as some of the patients and others, were indicted in the federal grand jury action.
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