70% Of Calfornia's Doctors Expected To Boycott Obamacare

[zztop7]

70% Of Calfornia's Doctors Expected To Boycott Obamacare
“We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” exclaims the president of the California Medical Association, as The Washington Examiner reports, independent insurance brokers estimate 70% of California's 104,000 licensed doctors are boycotting the exchange. “The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating, but they’ve shown no numbers," and if a large number of doctors either balk at participating in the exchange or retire, the state’s medical system could be overwhelmed. “Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” warns one health director. “There aren’t enough primary care physicians, period.”
Via The Washington Examiner,

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.
“It doesn't surprise me that there's a high rate of non-participation,” said Dr. Richard Thorp, president of the California Medical Association.

zz.

 

[Steve Williams]

70% Of Calfornia's Doctors Expected To Boycott Obamacare
“We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” exclaims the president of the California Medical Association, as The Washington Examiner reports, independent insurance brokers estimate 70% of California's 104,000 licensed doctors are boycotting the exchange. “The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating, but they’ve shown no numbers," and if a large number of doctors either balk at participating in the exchange or retire, the state’s medical system could be overwhelmed. “Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” warns one health director. “There aren’t enough primary care physicians, period.”
Via The Washington Examiner,

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.
“It doesn't surprise me that there's a high rate of non-participation,” said Dr. Richard Thorp, president of the California Medical Association.

zz.

As a California physician I can tell you that the best business decision I ever made was to retire 7 years ago. Most of my friends and colleagues continue to practice. I have a very good friend who is a pediatrician. He tells me that reimbursement to him for vaccines and immunization etc are pennies on the dollar. Plus there is now a big shift by patients from doctor to doctor based on insurance changes. This also causes downturns in their practices

 

[MylesBAstor]

70% Of Calfornia's Doctors Expected To Boycott Obamacare
“We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” exclaims the president of the California Medical Association, as The Washington Examiner reports, independent insurance brokers estimate 70% of California's 104,000 licensed doctors are boycotting the exchange. “The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating, but they’ve shown no numbers," and if a large number of doctors either balk at participating in the exchange or retire, the state’s medical system could be overwhelmed. “Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” warns one health director. “There aren’t enough primary care physicians, period.”
Via The Washington Examiner,

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.
“It doesn't surprise me that there's a high rate of non-participation,” said Dr. Richard Thorp, president of the California Medical Association.

zz.

Hardly an unbiased source. One of the more right wing publications out there.

"When it came to the editorial page, Anschutz’s instructions were explicit — he 'wanted nothing but conservative columns and conservative op-ed writers,' said one former employee." The Examiner's conservative writers include Byron York (National Review), Michael Barone (American Enterprise Institute, Fox News Channel), and David Freddoso (National Review, author of The Case Against Barack Obama).[4]

 

[rockitman]

Obamacare is a disaster Myles. It won't even be financially viable going forward. Sounds like the 2014 elections will be a bloodbath for democrats.

 

[Asamel]

Obamacare may be off to a rocky start but in my view it had to happen. My take on the status quo, as a physician with a business degree, is that things couldn't continue as is. Too many people were uninsured, too much money is spent on too few patients, too much GNP, too much suffering.

Bruce in Pa.

 

[kleinbje]

Actually Rockitman Health care costs yoy have decreased for the first time in decades, that is huge. The fact of the matter is the old system didn't work, the new system doesn't work yet. It is going to take time and will require adjustments and patience. Personally I think that's ok, I believe it is naive to expect something so broad and sweeping to be implemented in a perfectly refined state. As an ED physician I am thrilled that my patients will have better access to followup care, and they will be able to fill the scripts i write them. I think it is bullshit that they are screwing physicians on the reimbursement, big pharma put a lot of money behind President Obama, they usually back republicans, no surprise doc's are the ones losing out. Medicaid reimbursement is criminally low. The bottom line is I would rather live in a country where health care is a right, and hope to get some tort reform so this age of defensive medicine can end.

 

[MylesBAstor]

Actually Rockitman Health care costs yoy have decreased for the first time in decades, that is huge. The fact of the matter is the old system didn't work, the new system doesn't work yet. It is going to take time and will require adjustments and patience. Personally I think that's ok, I believe it is naive to expect something so broad and sweeping to be implemented in a perfectly refined state. As an ED physician I am thrilled that my patients will have better access to followup care, and they will be able to fill the scripts i write them. I think it is bullshit that they are screwing physicians on the reimbursement, big pharma put a lot of money behind President Obama, they usually back republicans, no surprise doc's are the ones losing out. Medicaid reimbursement is criminally low. The bottom line is I would rather live in a country where health care is a right, and hope to get some tort reform so this age of defensive medicine can end.

Obama hardly started screwing docs on reimbursement. Just as Obama was responsible for Katrina. Let's put the blame where it belongs: on the insurance companies. (cost couldn't go on as they were--and the GOPs plan was...oops what plan?)

Many docs I know dumped taking insurance coverage years ago because of reimbursement and the time it takes to get reimbursed. The worst offenders were BCBS and Oxford. Bottom line: like the food industry, the only allegiance these health insurance co's have is to their stockholders. Truth be told, I'd rather see my dollars go to my docs than some stinking stockholder. And if you look at most of this health care cost containment, they only work for the first year, then everyone adapts.

 

[Barry2013]

As a Uk resident who has been following the Medicare debate with some interest, and as a not uncritical admirer of our NHS, I am glad that this issue has surfaced on this site and to be able to engage with some Americans on this.
It seems to me that both systems have their strengths and weaknesses and no system is ever going to be perfect and the challenge is to find the right balance. We spend about 6-7 per cent of GDP on public health care plus an unknown figure on private health care by a small minority which I cannot believe amounts to more than 2 per cent of GDP excluding treatment of wealthy foreign nationals who seek private treatment here. My understanding is that healthcare spending in the USA amounts to 18 per cent of GDP which is around double what we spend. It certainly seems to me that that some of the healthcare in the USA including cancer is the best in the world and at least some of our NHS care is not very far behind with access not limited by income.
What I find difficult to understand is the level of opposition to Medicare among what seem to be a large number of people on modest or low incomes who in many cases I assume, possibly incorrectly, have no insurance cover or only limited cover. That is strengthened by a recent report I read saying the USA would need another 20,000 or more doctors for Medicare to work.
I would not want any US reader to feel that I am in anyway seeking to tell you how you should organise your healthcare - that is for you to decide - but on the basis of my current knowlege of the US I am genuinely puzzled by the level of opposition to Medicare as are a number of doctors I know over here who have experience of both systems.
Any objective comments or insights would be welcome and whilst not an invitation I am not going to take offence if I receive some more robust comments.
I am a great believer in freedom of speech!

 

[cjfrbw]

I seem to have heard that Americans were happy with Medicare, my neighbors have been.

However, it only applies to those over 65. I would have thought that a program extending some kind of Medicare eventually down to 50 year olds and above, with some kind of Obamacare type insurance scheme for those below 50 would have worked out best. The existing VA hospital system could have been expanded slowly to cover the Medicare group above 50 and/or disabled etc. in some type of Euro socialized medicine scheme, with Obamacare insurances for those below 50.

Most chronic and catastrophic medical conditions tend to occur after the age of 50, and the age group between 50 and 65 tend to be the individuals who you hear about most often who are impoverished or bankrupted by medical care.

 

[DaveyF]

As a Uk resident who has been following the Medicare debate with some interest, and as a not uncritical admirer of our NHS, I am glad that this issue has surfaced on this site and to be able to engage with some Americans on this.
It seems to me that both systems have their strengths and weaknesses and no system is ever going to be perfect and the challenge is to find the right balance. We spend about 6-7 per cent of GDP on public health care plus an unknown figure on private health care by a small minority which I cannot believe amounts to more than 2 per cent of GDP excluding treatment of wealthy foreign nationals who seek private treatment here. My understanding is that healthcare spending in the USA amounts to 18 per cent of GDP which is around double what we spend. It certainly seems to me that that some of the healthcare in the USA including cancer is the best in the world and at least some of our NHS care is not very far behind with access not limited by income.
What I find difficult to understand is the level of opposition to Medicare among what seem to be a large number of people on modest or low incomes who in many cases I assume, possibly incorrectly, have no insurance cover or only limited cover. That is strengthened by a recent report I read saying the USA would need another 20,000 or more doctors for Medicare to work.
I would not want any US reader to feel that I am in anyway seeking to tell you how you should organise your healthcare - that is for you to decide - but on the basis of my current knowlege of the US I am genuinely puzzled by the level of opposition to Medicare as are a number of doctors I know over here who have experience of both systems.
Any objective comments or insights would be welcome and whilst not an invitation I am not going to take offence if I receive some more robust comments.
I am a great believer in freedom of speech!

Barry, your inquiry as to opposition to Obamacare can be summed up in two words...."vested interest".
Those that are screaming the loudest as to why Obamacare needs to fail or be stopped are IMHO true hypocrites. So long as their own health care is paid for by others or they are covered by some "perk" they see no reason to change. Ask these same people IF they lost their coverage and were put into the same position that so many in this country had/have to contend with ( can we say "pre-existing condition", among so many other disgraceful regulations that the insurance industry has relied on for so many years to screw the public) and I suspect you would see these very same people change their minds...RAPIDLY.

 

[amirm]

As a Uk resident who has been following the Medicare debate with some interest, and as a not uncritical admirer of our NHS, I am glad that this issue has surfaced on this site and to be able to engage with some Americans on this.
It seems to me that both systems have their strengths and weaknesses and no system is ever going to be perfect and the challenge is to find the right balance. We spend about 6-7 per cent of GDP on public health care plus an unknown figure on private health care by a small minority which I cannot believe amounts to more than 2 per cent of GDP excluding treatment of wealthy foreign nationals who seek private treatment here. My understanding is that healthcare spending in the USA amounts to 18 per cent of GDP which is around double what we spend. It certainly seems to me that that some of the healthcare in the USA including cancer is the best in the world and at least some of our NHS care is not very far behind with access not limited by income.
What I find difficult to understand is the level of opposition to Medicare among what seem to be a large number of people on modest or low incomes who in many cases I assume, possibly incorrectly, have no insurance cover or only limited cover. That is strengthened by a recent report I read saying the USA would need another 20,000 or more doctors for Medicare to work.
I would not want any US reader to feel that I am in anyway seeking to tell you how you should organise your healthcare - that is for you to decide - but on the basis of my current knowlege of the US I am genuinely puzzled by the level of opposition to Medicare as are a number of doctors I know over here who have experience of both systems.
Any objective comments or insights would be welcome and whilst not an invitation I am not going to take offence if I receive some more robust comments.
I am a great believer in freedom of speech!

We are a firm believer in that too . Good comments and I expect folks to engage constructively. I am very curious in comparisons of the UK system to US. Let me tell a personal story.

My mother was diagnosed with lung cancer. She did not have insurance. When the results of the biopsy came, the doctor pulls me and my brothers aside and delivers the bad news. We ask what treatment there are. He said if we had insurance he would put her immediately on chemotherapy. I said we will spend our last dollar if we had to give her the treatment she needs. The oncologist says that is not necessary since statistically it does not result in any kind of improvement and she would be subjected to a lot of discomfort.

My other brother lived in UK so we flew her there to see him. Understandably he was very upset and would not accept the diagnosis and insisted that we see their private doctor there. We did and they sent her to get some additional ultrasound/scans done. We went to the hospital there and I was amazed how old the hospitals were there compared to US. We sat on $2 chairs for hours before she got the test even though she was scheduled to come then. We walked through all of these old hallways and went into a room with a modern scanning system. Had I not seen that, I would have thought we were in some third world country hospital compared the US! Now the good part. No one asked us for a dime. Here she is as a visitor and no one even stopped to ask us to pay for the tests. I recently did a CT scan in US and my deductible was something like $1,500!

Anyway, the results of the test come back and we see the private doctor again. He immediately agrees with the US diagnosis and says that the only thing we should do is keep her comfortable with pain killers. I mentioned to him what the US doctor said about using Chemo if we had insurance. He gave me this shocked look and said "that is inhumane. There is no data that says there will be any improvements and it would just bring her misery."

To me the UK system worked right. The US one also did but for a non-insurer that got the real message. Had we had insurance we would have been subjected to useless and painful situation for my mother.

 

[DaveyF]

Amir, the UK system worked correctly. However, let me ask you a question...what would you have done IF there was a treatment for your mother that would have saved her? ( at an enormous price).Let's say you did have insurance and they wouldn't pay for the treatment, or you didn't have insurance as it was prohibitive to acquire in the first place.. You would have paid for the treatment, as you said. Problem is that may have bankrupted you. This is the crux of what I see is wrong with the old system in the US. Too may people NOT on insurance as they cannot afford to be, and/or the corporate insurance companies having the ability to make decisions regarding medical procedures and the "coverage" of same to preserve their profit margins.

 

[jazdoc]

The UK has an expensive healthcare system that already rations care, delivers poor service and has bad outcomes. The good news is that the NHS is the 3rd largest employer in the world, trailing only the Chinese Red Army and the Indian National Rail Service. If Amir's mother had been treated for her lung cancer in the UK, it would have been in a system that offers some of the worst lung cancer survival statistics in the Western world: http://www.cancerresearchuk.org/can...ay-contribute-to-poor-UK-lung-cancer-survival

This is consistent with poor outcomes across all types of cancers:
http://news.sky.com/story/1177844/cancer-survival-rates-are-truly-depressing
http://www.theguardian.com/society/2012/oct/03/ovarian-cancer-survival-uk-study
http://www.dailymail.co.uk/health/article-2001248/UK-cancer-survival-rates-worst-Western-world.html

Lest you think the NHS treats grandma and grandpa with diginity, the latest NHS scandals:
http://www.telegraph.co.uk/health/h...arve-and-die-of-thirst-on-hospital-wards.html
http://www.telegraph.co.uk/health/h...ose-on-Liverpool-Care-Pathway-never-told.html

In order to control costs, the NHS rations care:
http://www.independent.co.uk/life-s...-nhs-begins-rationing-operations-2327268.html

At least the system is 'fair', healthcare bureaucrats get treated like everyone else:
http://www.dailymail.co.uk/news/art...-dies-operation-cancelled-times-hospital.html

 

[MylesBAstor]

The UK has an expensive healthcare system that already rations care, delivers poor service and has bad outcomes. The good news is that the NHS is the 3rd largest employer in the world, trailing only the Chinese Red Army and the Indian National Rail Service. If Amir's mother had been treated for her lung cancer in the UK, it would have been in a system that offers some of the worst lung cancer survival statistics in the Western world: http://www.cancerresearchuk.org/can...ay-contribute-to-poor-UK-lung-cancer-survival

This is consistent with poor outcomes across all types of cancers:
http://news.sky.com/story/1177844/cancer-survival-rates-are-truly-depressing
http://www.theguardian.com/society/2012/oct/03/ovarian-cancer-survival-uk-study
http://www.dailymail.co.uk/health/article-2001248/UK-cancer-survival-rates-worst-Western-world.html

Lest you think the NHS treats grandma and grandpa with diginity, the latest NHS scandals:
http://www.telegraph.co.uk/health/h...arve-and-die-of-thirst-on-hospital-wards.html
http://www.telegraph.co.uk/health/h...ose-on-Liverpool-Care-Pathway-never-told.html

In order to control costs, the NHS rations care:
http://www.independent.co.uk/life-s...ces/facts-figures/lung-cancer-fact-sheet.html

 

[zztop7]

Many decades ago I worked for years in a so-called Premium / five star / Internationally known & respected university hospital on the east coast. I saw many patients Butchered.

I have told my wife that if I ever end up in a hospital with a major problem & the doctors want to start cutting away parts, she is NOT to give permission. I have warned her that if she does; I am going to cut the same parts out of her. She knows I am totally serious & I have read her this email.

I plan to go out in one piece; not on the basis of excessive surgery/treatment [e.g. chemotherapy] to line other people's pockets.

zz.

 

[rbbert]

Hardly the last word, of course, and the information is from 2000, but the US doesn't look so good compared to the UK (or practically any other developed nation)

http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000

 

[rbbert]

But we sure spend a lot of money for that result
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

 

[Mosin]

I have three stories to tell.

#1
Some of you may be familiar with the brand Incognito. It was, or is, a name associated with tonearm wiring that belonged to Eclectic Audio, a company owned by my friend, Garth Phillippe. Garth was originally from the US, and after twenty-five years abroad, he and his wife who is a German citizen decided to move to the States. Shortly thereafter, he discovered that he had cancer. That is when he discovered his insurance would not cover him because the disease was determined to be preexisting because he had been receiving treatment in Germany for the symptoms, although the Germans had failed to make a proper diagnosis. He could not afford to pay out of pocket, so he returned to Germany to take advantage of that system. After he arrived, he was put on a waiting list for a couple of months, but finally saw one Dr. Lyons, a true gem in every sense of the word. This Dr. Lyons had the brilliant idea of designing a magical tumor zapping machine, and my desperate friend was to build it. That's when he contacted me for my help in learning how to work eBay. The zapper was built, it didn't work, and my friend died. Both systems had failed him miserably; one because of an insurance company that looked extra hard to find a way to disallow him, and one because of an incompetent bureaucracy that failed to diagnose a problem that was readily discovered here, prolonged his wait for care, and then assigned a quack to treat him. Neither system worked in his case, although the US one might have, if only his insurance had covered his care. He may have been able to find a workaround, but he wasn't familiar enough with our medical system to know how to go about it, and no one offered to help who may have known.

#2
A doctor who was trained in Scotland lived across the street from me for a few years. He told me a bit about how the UK system compares to what we have here now.

In no particular order:

Beds are limited, but doctors tend to fill them with the less sick because those patients require less care.
Medical devices are limited, too. Diabetic pumps, CPAP machines, etc. are luxuries, and not commonplace.
Private hospital rooms are virtually unheard of there.
Doctors see a contracted number of patients per day, and then go home, regardless of demand.
If someone needs longterm care, the bed could be anyplace in the UK.
People are given medicine to take at home that only a doctor or nurse can administer here.
The selection of drugs there is severely limited when compared to what is available here.
Certain surgeries are scheduled to certain times because of budget constraints.
Only union members can do certain things, regardless of circumstance.

How much of this is true? I know only what he told me, but things will be different, very different.

#3
My wife's knows a doctor who retired as an OB-GYN because he didn't like delivering babies, and he couldn't make it as a gynecologist otherwise because his malpractice rates exceeded his income. I don't know if that was because he was in with a group of other doctors, but dropping one part of his practice resulted in the remainder not being profitable enough to continue. Lawsuits haven't been addressed in any new scheme that I have heard about, but they aren't a problem in Canada or Europe. Are we about to get one-half of a system?

 

[MylesBAstor]

I have two stories to tell.

#1
Some of you may be familiar with the brand Incognito. It was, or is, a name associated with tonearm wiring that belonged to Eclectic Audio, a company owned by my friend, Garth Phillippe. Garth was originally from the US, and after twenty-five years abroad, he and his wife who is a German citizen decided to move to the States. Shortly thereafter, he discovered that he had cancer. That is when he discovered his insurance would not cover him because the disease was determined to be preexisting because he had been receiving treatment in Germany for the symptoms, although the Germans had failed to make a proper diagnosis. He could not afford to pay out of pocket, so he returned to Germany to take advantage of that system. After he arrived, he was put on a waiting list for a couple of months, but finally saw one Dr. Lyons, a true gem in every sense of the word. This Dr. Lyons had the brilliant idea of designing a magical tumor zapping machine, and my desperate friend was to build it. That's when he contacted me for my help in learning how to work eBay. The zapper was built, it didn't work, and my friend died. Both systems had failed him miserably; one because of an insurance company that looked extra hard to find a way to disallow him, and one because of an incompetent bureaucracy that failed to diagnose a problem that was readily discovered here, prolonged his wait for care, and then assigned a quack to treat him. Neither system worked in his case, although the US one might have, if only his insurance had covered his care. He may have been able to find a workaround, but he wasn't familiar enough with our medical system to know how to go about it, and no one offered to help who may have known.

#2
A doctor who was trained in Scotland lived across the street from me for a few years. He told me a bit about how the UK system compares to what we have here now.

In no particular order:

Beds are limited, but doctors tend to fill them with the less sick because those patients require less care.
Medical devices are limited, too. Diabetic pumps, CPAP machines, etc. are luxuries, and not commonplace.
Private hospital rooms are virtually unheard of there.
Doctors see a contracted number of patients per day, and then go home, regardless of demand.
If someone needs longterm care, the bed could be anyplace in the UK.
People are given medicine to take at home that only a doctor or nurse can administer here.
The selection of drugs there is severely limited when compared to what is available here.
Certain surgeries are scheduled to certain times because of budget constraints.
Only union members can do certain things, regardless of circumstance.

How much of this is true? I know only what he told me, but things will be different, very different.

Boy a blast from the past. I remember and miss Garthe. Truly a really nice guy and he imported my magazine into Germany.

And sadly, those with money from many countries from Europe come to the US to be treated. I remember my chairman who was from Greece had many patients who paid cash on the barrel from his country.

 

[amirm]

Amir, the UK system worked correctly. However, let me ask you a question...what would you have done IF there was a treatment for your mother that would have saved her? ( at an enormous price).Let's say you did have insurance and they wouldn't pay for the treatment, or you didn't have insurance as it was prohibitive to acquire in the first place.. You would have paid for the treatment, as you said. Problem is that may have bankrupted you. This is the crux of what I see is wrong with the old system in the US. Too may people NOT on insurance as they cannot afford to be, and/or the corporate insurance companies having the ability to make decisions regarding medical procedures and the "coverage" of same to preserve their profit margins.

Yes, we would have paid to bankruptcy. And full agreement with the failure of US system. When I left Microsoft and faced getting our own insurance for the first time, the reality set in of how terrible the situation is. I had some foot pain and my insurance would not cover the medication for it. It is just a tube but it costs a cool $60. My foot doctor says similar medication exists in Canada over the counter for $20 and that it is available in most of the world that way. I currently go to two specialists who only take one insurance plan and mine is not one of them. I have easily spent $5,000 or more with them already. I keep arguing with their accounting department who keeps trying to double charge me. They are shocked every time that someone would even question the bill! They keep asking me, "don't you have insurance?" As if it is not my problem if I do. I remind them that I do not and need to know why they keep charging me extra.