Is there a doctor in the house? Not for long.

Doctors like me have to go. That much is clear. Even though we have done nothing wrong.

The problem is simple: I was trained to provide the best care possible, to everyone, all the time—regardless of race, ethnicity, sex, sexual orientation, wealth, power, position, politics, cost, cleanliness, friendliness, consciousness, or anything else.

 

Hippocrates Frustrated - ICD-10-Patient-Care-Impact-Frustration

 

A Simple Recipe for Care

Mine was a simple recipe. And it worked every time.

I was taught to consider only that person sitting in front of me needing my care. I was not burdened with considering the needs of society or the world. I was not charged with correcting past societal injustices by others—whether based upon race, ethnicity, religion, social status, sex, sexual orientation, or any other characteristic.

Health care, I was told, is too important an arena for mean-spirited revenge. As an ER physician, I have kept gravely injured murderers alive so that they can stand trial for their crimes against others, many of whom I pronounced deceased myself. I have even been called to testify in some of those trials. It is not, I was told, my place to judge. And so I did not judge—anyone. I had my opinions, but they never left my mind. Nor did they influence the care that I provided. It made my job easier. And it was more fair, because who is to say that my personal judgments would always be correct? Most certainly they are not. Of that, I am acutely aware.

I was not asked to make my treatment decisions based upon cost or in such a way as to save anyone money or make anyone money. Though I was aware that a lot of money was being spent and made by someone based upon the decisions that I made, that someone was not me, and it could not be me. Those were the rules. I was glad for those rules. They, too, made my job easier.

I was not expected to fret over whether what I wanted to give the patient was affordable in a societal sense. To the contrary, I was intentionally blinded to the money involved lest the independence of my medical decision-making be compromised. I liked it that way. I still do.

I was taught that it was not up to me to choose the winners and losers in the raffle of life. I was assured that if I just did my job, and fought my hardest, for every single patient, the rest would take care of itself. And until Obamacare came along, for the most part, it did.

In other words, I was taught to practice medicine like it says in the Hippocratic Oath that we traditionalists still take seriously.

For that I am grateful. It does, however, make me like a fish out of water in this brave new post-Obamacare America.

medicare-frustrated-doctor

No Country for Old Doctors

Because of my training and resulting philosophy, there is no place for me in the post-Obamacare healthcare delivery system. You see, we traditional physicians are unwilling to ration care. We are unwilling to ration care, because we know better than to do so. We recognize the inherent cruelty, immorality, and self-defeatism in our being transformed from caregiver to executioner, if only through the passive withdrawal of care. Or at least most of us do.

I still feel that it is not my place to judge. And yet Obamacare will force me to do just that—to judge my fellow man not even according to my own guiding principles, but rather according to the impersonal, cruel yardstick of a federal government hundreds of miles away from where both me and my patient sit, and lie, and struggle.

And so we traditionalists must go. It’s either that or change—in big, oath-shattering ways. We must become controllable. We must forgo exercising the very judgment for which we are trained in favor of the ill-intended edicts of self-serving, non-medically trained government bureaucrats, politicians, and insurance industry and Wall Street fat cats.

Some of us will simply leave and never look back. Medicine is a funny discipline. Once we leave it, though we retain the knowledge and skills, we rarely return. To return is far too painful. And so we continue to sit it out.

Doctor's Back in Green Scrubs - Handcuffed

Many will claim to be retiring early. If pressed, they will talk of spending more time with the grandkids, gardening, or traveling around the country in that RV that has been parked in the backyard for years. That is a much easier conversation.

While they may end up enjoying their retirement years, that is not why they left. I can promise you that. They left because they are unwilling to change. They left because they are unwilling to do their government’s bidding, hurting their own patients in the process. They left because they are unwilling to work as government robots. They left because they are unwilling to work for free, and under constant threat of financial ruin, imprisonment, or both—which is what the government now demands.

Those who cannot or will not leave the profession will change. Many will become unrecognizable, though they will look the same on the outside.

That is bad for us physicians. It is even worse for you, our patients.

The Brave New World of Obamacare

In case you doubt me, consider these facts:

The Affordable Care Act specifically gives certain nurses the right to introduce themselves to patients as “Doctor.” Why would that be, except to confuse the healthcare consumer about who—and what—their provider really is?

And lest you think this will be the exception rather than the rule, consider this:

According to a new study, the healthcare workers anticipating the greatest job growth over the next decade are not physicians or nurses. They are not therapists or any other trained medical professionals. Rather, the three healthcare job categories anticipating the greatest growth over the next decade (by quite a large margin) are:

(1) with 555,000 new jobs and 38.1% ten-year job growth: home health aides, who make an average of less than $22,000 per year and who have no formal education or training;

(2) with over 458,000 new jobs and 26% ten-year job growth: personal care aides, who make an average of $20,000 per year and who have no formal education or training; and

(3) with 599,000 new jobs and 17.6% ten-year job growth, nursing assistants, who make an average of less than $26,000 per year and who are required to obtain only a postsecondary nondegree.

Hmmm . . . All of the high-growth healthcare jobs are as untrained aides and assistants. Go figure.

Why is this concerning? Because once this anticipated job growth takes off, and once they all don white coats and introduce themselves to you as “Doctor,” you will not know the difference, that’s why.

And there is a difference. That is not being elitist. It is a fact.

As an emergency physician with literally decades of education and training behind me, I am trained to save your life in the event of an emergency. It is what I do. It is what I love doing. With all due respect to the wonderful job that they do under my supervision, a home health aide, personal care aide, or nursing assistant can do little more than call 911—even from iElder Care - Holding Hands - end-of-life-800 - RESIZEDnside the hospital. That is neither a criticism of them nor an exaggeration of my skills. It is a fact.

Even so, in a few years’ time (if not sooner), you will have no way of telling me from them. In fact, if things stay on their current course, I will not be around. And so you will be left with them. Unsupervised. Good luck with that.

Don’t get me wrong: They will smile sweetly, hold and stroke your hand gently, and hug you warmly. They will make you feel both valued and appreciated. They may even bring you your medications and take your vital signs. Will they save your life? No. Will they cure, or even provide you with a concrete way to manage, your disease? Not likely. Are they me? Absolutely not. And yet you will be left in their unsupervised, if kind, care. And that is a dangerous place to be.

A New Breed of Doctor

Of course, lots of folks will still be walking the halls of hospitals and clinics wearing long white coats and introducing themselves as “Doctor.” Some will be nurses and nurse’s aides, and some will be other ancillary staff.

Some will be actual physicians—with MDs and everything. The difference is that they will be educated in a way that is completely foreign to me. Those who are already practicing but unwilling to retire early will be “re-educated” along with them. That process has already begun.

Together they will be taught to consider medicine as not a personal, but rather a societal endeavor. They will be taught to practice “population-based medicine.” They will be charged with practicing “outcomes-based medicine” (which will function to exclude the sick and the elderly from receiving care, because their “outcomes” are less likely to be good despite exemplary care). They will be expected to address—and remedy—”health disparities” by making it easier for some (the historically disenfranchised) to access care, while preventing others (the historically favored) from doing so. In that way, they will be taught to deliver “medical justice” through the care that they deliver to real human beings, all of whom are innocent of any of the historic wrongdoing ostensibly being rectified.

They will be taught to practice medicine that is judgmental rather than accepting, that is punitive rather than comforting, and that is redistributive rather than fair.

In fact, this is already being done behind the closed doors of the nation’s predominantly liberal progressive institutions of medical higher education.

Don’t believe me? Consider this:

A New Breed of Medical School

The Affordable Care Act explicitly provides for the establishment and federal funding of government-run medical schools, ostensibly to meet anticipated “physician shortages” caused by the passage of the law itself. The statute furthermore explicitly provides that government-run medical schools will emphasize affirmative action in their admissions and advancement policies.

Loyola Stritch - Dreamers to Doctors - Promotional Ad 01 - D2D-Screening-Flyer-Web-2

To make matters worse, there is already a movement afoot throughout the existing medical school community advocating for unrestrained affirmative action that will ensure that the country’s euphemistically labeled “Dreamers”—meaning the children of illegal immigrants who are themselves in the United States illegally—are allowed to attend and graduate from the American medical school of their choice regardless of accomplishment and promise—and, apparently, citizenship. No doubt, they will also do so for free. Unlike your kids and mine.

I ask you: Do you want your surgeon to be a product of affirmative action—much less an illegal immigrant who is also the product of affirmative action? Call me crazy; but I’m guessing not. And yet he or she will be. And you will never be told the truth.

And the defendant is . . . no one.

If, Heaven forbid, you were to die on the table, your family will simply be told that nothing could be done. Only it could have, in the right hands. But they won’t know that. No doubt, your family will be told the tragic news by a sincere, tearful nurse’s aide who will actually believe the script that she has dutifully memorized. After all, she has neither the education nor the training to know better. And so her conscience is clear as your family breaks down before her.

Your distraught family may not even be told that much if—as the federal government tends to do—it does away with the ability of patients to sue those who provide care once those who provide care are all government bureaucrats rather than private folks like me. Ever wonder why the VA Health System can get away with providing such notoriously substandard care? That’s why—because no one can sue them. Because they are the federal government. Get my drift? It will be no different with Obamacare. Mark my words.

And how can you sue an ilGavel on White Background 01 - judicial-reformslegal immigrant? Do they even fall under the jurisdiction of the United States courts? What’s to keep them from fleeing back to wherever they came from? Again, you get my drift. Again, mark my words: This is not the last you have heard of this.

In fact, there is already serious talk among state and federal politicians and the medical elite regarding the establishment of a taxpayer- and physician-funded “funds” from which patients injured in the course of medical treatment are automatically reimbursed according to government tables and charts and projections. Whoopee!, the American people are told. No more lengthy, expensive, and exhausting trials! No need to prove your case! Just get in line for the cash that Uncle Sam is ready to dispense! After all, if you say you’re hurt, we can assume that your doctor screwed up, can’t we?

Are we all together on this?

I certainly hope not.

Think of such funds as strict liability for doctors like me. If you treat patients, you will pay them for their bad outcomes, regardless of the quality of your care.

While such a model benefits those who suffer minor injuries (or are not actually injured at all), it discriminates against those gravely injured by provider misconduct, who necessarily lose their right to sue in exchange for a pittance payment too small to cover their future medical bills. In the process, it deprives both patients and physicians of that most sacrosanct right, the right to a trial before a jury of their peers.

Finally and most importantly, it directly incentivizes hospitals and physicians not to provide serious care to old and gravely ill Americans, whose outcomes are notoriously bad despite quality care—precisely because they are elderly and ill, with depleted reserves. In a system of strict liability for bad outcomes, those folks represent too much risk. In fact, resulting payouts are a given. And so they must be let go. And they will—be let go, that is.

The worst part? No one will be the wiser.

It is the perfect plan for the perfect scam. It is also the recipe for government-sanctioned murder.

Kaiser to the Rescue: The Medical School of the Future

As we learned this spring, there is yet another wrinkle in the re-education of America’s physicians. And it’s a doozy.

It seems that the medical schools of the future will also be run by the very insurance and health administration fat cats who dutifully climbed into bed with the Obama administration and helped shove Obamacare further down your throats.

Kiaser Permanente Sign 01 - la-fi-kaiser-permanente-20151204

Indeed, the first such medical school will be run by none other than the health insurance and healthcare delivery giant Kaiser Permanente. The new school, which will be located in Pasadena, California, will enroll its first students in 2019. Look it up.

So . . . the medical schools of the future will be run by the federal government and administered by the same corporate giants that already control the health insurance, healthcare administration, and healthcare delivery markets—in other words, the fattest of the Wall Street fat cats. And now they will control medical education as well. Even though they are the very individuals who stand to gain the most—and it’s a lot—from the denial of your care.

It is the ultimate self-serving, inside-dealing, corrupt monopoly. And it will kill us all if we let it.

Pretty Words for Ugly Actions

Yesterday, I published a blog post entitled, “Bad Influence: The 100 Most Influential People in Healthcare.” In that post, I decry the fact that that annual list is full of politicians and Wall Street fat cats and contains not one—not one, in a list of 100—practicing physician.

In the number 2 position, right under Barack Obama, is Bernard Tyson, Chairman and CEO of Kaiser Permanente and longtime Obama—and Obamacare—supporter.

Kaiser Permanente Sign 02 - KaiserPermanente05102012 - RESIZED

Upon announcing its plans to build the first government- and corporate-controlled medical school, Kaiser issued a press release stating: “Demographic changes in the U.S. population have created increasingly diverse communities. Physicians in the 21st century require cultural competency and fluency in order to meet the needs of their patients and to best serve their communities.”

Sounds reasonable, right? After all, who isn’t for “cultural competency and fluency?” And who doesn’t want to “serve their communities?”

Edward M. Ellison, MD, Kaiser’s Executive Medical Director, was quoted as stating, “We have an opportunity, even an obligation, to redesign medical education and be a catalyst for change.” He further opined that new generations of Kaiser-trained physicians “will be well-prepared to meet the total health needs of communities across the nation, including the necessary work of addressing health disparities.”

So . . . the new generation of Kaiser physician will “be a catalyst for change” and focus upon meeting “the total health needs of communities across the nation.” He or she will also strive to address “health disparities.”

Warning: That is liberal government-speak for “Gullible young doctors will be taught to consider society’s needs over your needs, and they will be taught to use your health care to correct historic injustices for which you are not responsible.” That, in turn, is code for “They will be taught to practice medicine in such a way as to make us rich and you sick.”

Please keep in mind that a bleeding heart cannot keep you alive for long.

Indeed, by their own admission, Kaiser’s stated mission is the very definition of redistribution and social engineering through health care. It is the main—and by far the most important—argument against Obamacare and socialized medicine.

It gets worse:

The same day as the press release, the LA Times published an article about Kaiser’s plans. As one of Kaiser’s most important objectives, Ellison told the paper, “Kaiser plans to train students as emergency medical technicians when they arrive at the school,” after which it will send them out “into the community, visiting patients’ homes.”

Hmmm . . . That seems suspiciously like they plan to provide a lower level of training, get the students out into the field quickly (where many of them will remain, having gotten accustomed to making money and having decided not to return to the classroom to become a doctor), and at the same time keep patients at home and away from the ER and hospital. That can be very dangerous, particularly in the hands of a wet behind the ears recent college graduate with no real medical school training.

That, too, is the very definition of intentionally rationing care by blocking patients’ access to that care. Because with all due respect, a young college kid with a medical bag and a stethoscope standing in your living room is about as capable of saving your life as that nurse’s aide dialing 911.

The point is so obvious that even the young LA Times reporter felt compelled to address it.  By way of a passing reference, she noted that critics of Kaiser’s plans worry “that a Kaiser medical school would focus on cutting costs that could negatively affect patient care.”

I don’t think there is any question about that.

History Repeats

The problem is as old as the history of dictators and despots. It is also as filled with the tragedy of needless human suffering and death as are their tales of conquest and defeat through the control of human beings.

Hitler's Physicians - Karl-Brandt Sentenced to Dealth by Hanging - RESIZED

Physician and Nazi Officer Karl Brandt being sentenced to death by hanging by the Nuremberg War Crimes Tribunal, 1947.

Keep in mind that one of the very first steps that Adolf Hitler took was to require all physicians—in both Germany and its German-occupied neighboring territories—to swear an oath promising—innocently enough, it seemed—to treat their individual patients in accordance with their social utility and for the good of German society rather than the individual.

More specifically, the order of the Reich Commissar of 19 December 1941 read in part as follows:

“It is the duty of the doctor, through advice and effort, conscientiously and to his best ability, to assist as helper the person entrusted to his care in the maintenance, improvement and re-establishment of his vitality, physical efficiency and health. The accomplishment of this duty is a public task.”

To their credit, the physicians of the Netherlands immediately recognized the new oath for what it was—a directive to ration care. According to Leo Alexander, MD, Chief U.S. Medical Consultant at the Nuremberg War Crimes Trials, the physicians of Holland recognized Hitler’s oath as “the concentration of their efforts on mere rehabilitation of the sick for useful labor, and abolition of medical secrecy.”

Alexander continued: “Although on the surface the new order appeared not too grossly unacceptable, the Dutch physicians decided that it is the first, although slight, step away from principle that is the most important one.”

They refused to obey Hitler’s order to take the oath. All were stripped of their medical licenses and put out of business. Many were imprisoned. Many were eventually murdered in cold blood for their refusal to take the oath and practice medicine according to Hitler’s directives.

Of those physicians who took the oath, Hitler gradually transformed them from caring healers into cold-blooded killers. They let him, because they had no choice. Soon, they became the monsters Hitler had envisioned—his personal army of killing machines. They became professional torturers, and maimers, and executioners without kindness, or mercy, or compassion, or pity. They became utterly soulless.

A Dark Path to a Dead End

Dark Path 01 - dark_path_2_by_stephariara - RESIZED

We are on that same dark path. It is an overgrown path at first discovered, then cleared (with the help of an optimistic community of believers), by all dictators, despots, and social engineers. It is the same path that, once unburdened of its wild overgrowth, is walked—first enthusiastically, then willingly, then reluctantly, then fearfully—by all civilized societies that embark upon the practice of socialized medicine. All believe that they will be different. None are. Ever.

Kaiser is Obama’s Josef Goebbels. While Kaiser paints happy pictures for young reporters of optimistic young doctors caring for the world, that is propaganda. It is pretty wrapping obscuring a most ugly package. Once that package is unwrapped and the beast springs forth into plain sight, it will be too late. By that time, the beast will be grown, unleashed, and uncontrollable. Just like Hitler’s army of physicians. Even the most casual student of history—and of medicine—knows that.

Heaven help us all. For this sad story will end no better for us than it did for Nazi Germany. Because it never does end well.

That, too, is a fact.

Welcome to Obamacare. I’m sure you’re going to hate it. You’re also going to fear it, for good reason.

Those are my thoughts. Please let me know yours.

Rhonda

moormanmedia.com

#MoormanMedia

 

 

 

 

The New Wage Wars: Physicians and the “Maximum Wage”

There is a new wage war brewing in the United States. The federal government says that doctors are paid too much. Is a “maximum wage” for physicians next?

 

Fight for 15 - ct-minimum-wage-15-dollars-hour-20160420

 

The New Wage Wars

Thanks to Bernie Sanders, this election year has seen a reinvigoration of the liberal Democrats’ ever-advancing war on free markets and at-will employment. Referring to this latest political skirmish as the “Fight for 15,” they seek to mandate a so-called “living wage” that, as we all know, will actually result in the intended beneficiaries losing their jobs. It is a typical liberal Democratic initiative that will punish the very individuals it claims to help.

Ironically, those same liberal Democrats—and the federal government bureaucrats who work for them—have no problem arguing the opposite case when it comes to the country’s physicians. Doctors, it seems, make too much, and therefore should be limited to a federally imposed, one size fits all “maximum wage.”

Unfortunately, in today’s post-Obamacare America, this outlandish and blatantly unconstitutional position has teeth. It is also being enforced at hospitals around the country.

Welcome to Obamacare. The outlook for your future care is very bad, indeed.

Don’t believe me? Sounds outlandish? Well, read on . . .

Making Examples of the Nation’s Hospitals

It was recently announced that Lexington Medical Center located in Columbia, South Carolina will pay the federal government $17 million to settle claims that it paid its employed physicians too much. Sadly, Lexington is not alone. In the last year alone, another South Carolina hospital and two Florida hospitals paid the federal government $72.4 million, $69.5 million, and $118.7 million respectively to settle similar lawsuits. And there are many other stories where those came from.

So . . . what is going on?

 

Dollar Bills with Stethoscope - 50-50-secrets-hospitals-wont-tell-you-doctor-fees

 

The Obamacare Dilemma

Having forcibly shoved Obamacare down our throats, the federal government now has a few very serious problems:

First, doctors, like everyone, cannot, and will not, work for free.

Second, the biggest consumers of Obamacare—that is, the previously uninsured and those who are in the country illegally—have no intention of paying any health insurance premium, no matter how ostensibly “affordable.” For its part, the federal government has no real recourse aside from penalties that those same folks likewise have no intention of paying. Anything more forceful is a political non-starter and would alienate their base of entitlement voters.

Third, because the biggest utilizers of Obamacare are not paying a dime for the privilege, they are spending other people’s money. And we all know how that turns out: costs escalate as quality plummets. It is a basic law of economics, markets, and human nature that no politician or government bureaucrat can overcome.

Between rising healthcare costs (of which physician salaries is a less-than-minuscule component), the need for subsidies, and the tendency of the subsidized to overspend (among other factors), any way you slice it, Obamacare is simply unaffordable.

To add to the government’s problems, healthcare is also notoriously difficult to regulate in the trenches. After all, the practice of medicine involves highly skilled and trained professionals making constant (and often snap) judgments involving both art and science. How is a government bureaucrat with a degree in political science going to keep up, much less catch the healthcare “bad guys” in the act, when he doesn’t even understand their language?

Finally, many in the country still respect physicians. Most actually love their own physician. With marching orders to divide and conquer, how is that same government bureaucrat to turn physicians into villains, much less public enemy number one?

The Federal Government’s Solution

All of these problems are solved by the federal government’s newest tactic in its 100-year war on physicians: Suing hospitals for paying their employed physicians too much. While the rest of the country argues over raising the country’s minimum wage, physicians are quietly being clubbed over the head by a federal government intent upon applying a “maximum wage” restriction to them alone.

Of course, such a thing is frankly unconstitutional. Of course, that never stopped the D.C. powers that be.

PAY ATTENTION TO THIS:Doctor in Scrubs Rubbing Eyes - RV-AO258_DOCTOR_GR_20140829105746
This is how doctors will have their pay effectively lowered, and lowered, and lowered until such time as they become dramatically underpaid and thus are forced to quit practicing medicine. This, of course, will solve the Obamacare problem of physician compensation—especially when the government makes good on its promise to replace physicians with those with less training and experience, who in turn will accept lower wages—for a time. Then they will quit, and someone even less qualified will be hired. They, too, will accept less, until they, too, quit, at which time someone even less experienced—and less expensive—takes over. They, too, . . .

You get the point: It is a never-ending downward spiral of increasing ineptitude. After all, you get what you pay for. Health care is no exception to that universal rule.

You will be told that physicians are willingly leaving the country at the mercy of a doctor shortage because they are greedy and do not care about your needs or your health. In actuality, they are being forced out by a federal government that is driving them into forced servitude and personal poverty. When it comes down to a choice between practicing medicine and sending your children to college, or between practicing medicine and paying the light bill, then things can get very oppressive very fast. And for the nation’s physicians, they are—at lightning speed.

Calling in Reinforcements

The whistleblower nature of these lawsuits also solves the enforcement problem. By effectively incentivizing disgruntled physicians—who are in so short supply these days—to snitch on their colleagues for their own personal gain, it turns physicians into the federal government’s eyes and ears—and expert witnesses—on the hospital floors.

Nowhere is this effect more apparent than in the Lexington case. Lexington paid the federal government $17 million to settle claims that it paid its employed physicians to refer patients to the hospital for the care that they needed. One neurologist employed by the hospital collected a paycheck from the hospital, yet sent his patients elsewhere for care. Of course the hospital “pressured” him to utilize their facilities—they were paying his salary! After he was fired, he went to the federal government, which promptly filed a whistleblower lawsuit on his behalf. According to the government, paying the neurologist’s salary gave the hospital no right to pressure him into treating his patients at the hospital. That paid his salary. I kid you not.

The tattling physician’s take? A cool $4.5 million for doing absolutely nothing. He will never have to work another day in his life. He also gets his revenge against a former employer. No doubt, he was motivated by bitterness over the hospital’s having purchased his practice and turned him into an employee. Of course, the necessity of such a mutually distasteful employment arrangement was the fault of neither the hospital nor the neurologist. If you must blame someone, blame Obamacare—and the same federal government that shook down Lexington for $17 million while throwing a “finder’s fee” of $4.5 million to the newly wealthy tattle-tale. It’s a sweet deal for both. For you and me? Not so much.

White Coat VillainsDoctor in Scrubs and Handcuffs - fake cancer doctors

Finally, lawsuits like the one in South Carolina assist the federal government in its never-ending quest to vilify doctors and hospitals so that it can continue to punish and control them at will and with the public’s approval. They allow the federal government to take a public “victory lap,” at the same time giving the public the impression that it is “cracking down” on “bad doctors” and “bad hospitals.” You know the drill: Publicly vilify your target, excoriate them in the oh-so-compliant press, then take them out. That is what is happening here.

And best of all for the government, it is a rigged game—an unfair fight. Since they are the federal government, they simply pressure the hospitals until they have to settle. The hospitals have no choice. Guilt, and the breaking of laws, has nothing to do with it.

Show Us the Money—Or Not

In case you were wondering, absolutely none of the money collected from these sham lawsuits will be used to fund the care that you receive. Instead, it will go straight into the pockets of: (1) the government bureaucrats who approve the lawsuits; (2) the government lawyers who bring them, pretending to practice law while knowing that all of the cases will settle; (3) the judges who approve these forced and planned extortions masquerading as settlements; and, of course, (4) those who contribute nothing yet continue to receive Obamacare subsidies while the rest of us working stiffs are priced out of the insurance marketplace altogether and, eventually, denied the care that we need for our troubles.

This, of course, allows for greater redistribution. It works out for everyone—except you and me.

Bad Medicine

None of this improves the quality of your health care. Nor will it lower the cost of that care. But then again, as I have warned many times over, Obamacare has nothing to do with the quality or cost of your care. To the contrary, the law is designed to destroy the care that you receive. And it is doing just that.

Here is the point:

Hospitals are now being sued by the federal government for paying their employed physicians too much.

How can that be?

So-called “whistleblowers” make millions of dollars—for some, tens of millions of dollars—for doing nothing more honorable than snitching on their former employers—again, for ostensibly committing the “new crime” of paying physicians too much for doing one of the most difficult jobs in the world.

Ask yourself: Exactly how much is too much? How much is a good physician worth? Is physician compensation one size fits all?

What if we suddenly said that CEOs could not be paid “too much” regardless of their qualifications and value to the companies they run? Or attorneys? Or painters, plumbers, or roofers? Or the guy who mows your lawn? Or you?

That’s right: No one would stand for it.

Somehow, when the victims are physicians, it is just fine. Go figure.

So . . . In a world where employed physicians’ salaries are already dropping precipitously, how long will it be before physicians are making less than any other professionals? Or, for that matter, your local manual laborer?

That’s right: Not long.

And when that happens, how many of the best and the brightest academics are going to choose to go into medicine in return for a government-mandated “maximum wage?” How many are going to be willing to go through decades of medical training, stay up endless nights, work countless weekends, miss important events in their own families, and risk being sued at every turn—again, in exchange for a government-mandated “maximum wage” that will be far less than their college classmates are making? How many will forgo caring for their own family’s needs so that they can care for the needs of others?

Most importantly, how many will be there to respond to the call when you need them?

That’s right: None.

Welcome to rationed care, compliments of the federal government.

The Obamacare ride is getting bumpy. Better hold on tight.

If Hillary Clinton wins in November, things will get much worse. Brace yourselves. As the liberal Democrats get their wish of a McDonald’s minimum wage that starts at $15, is indexed for inflation, and goes steadily up from there, physicians—your physician—probably won’t be paid enough to live on.

What do you think that will do to the care that you receive?

That’s right: It will destroy it.

Welcome to Obamacare. You’re going to hate it.

Please let me know your thoughts.

Rhonda

www.moormanmedia.com

#MoormanMedia

Obamacare Gets an F: Physicians Give the Law a Failing Grade

Medical Economics - Cover - Health Care Reform F - 072516 - cover-10[1] - RESIZED

 

Grades Matter

Grades matter. They are also telling. Obamacare has just been put to the test, and the results are not good. Obamacare has failed—miserably.

Late last month, while the nation recovered from the Republican and Democratic National Conventions and continued to obsess over every new investigation of Hillary Clinton and every regrettable utterance by Donald Trump, the results of a stunning survey were released.

While the nation slept, one of its scariest boogeymen looked it straight in the eye; and the American public did not even blink.

 

Hippocrates Frustrated - ICD-10-Patient-Care-Impact-Frustration

 

Surveying America’s Physicians

Medical Economics is a leading journal of the medical profession. Recently, the magazine’s editorial board surveyed hundreds of practicing physicians across the nation. With the help of healthcare industry experts, including healthcare policy analysts and policymakers and physician advisors, the magazine’s editorial board devised a list of eight major policy initiatives of Obamacare. Items listed were among the largest, most sweeping promises used to sell Obamacare to physicians and healthcare consumers—you know, you and me as the individuals with the power to make or break the new law—and vote politicians into, and out of, office.

Physicians surveyed were engaged in the day-to-day practice of medicine. They were asked to grade each Obamacare promise based upon whether that promise had been kept, whether the stated goal had been achieved, and whether that element of Obamacare assisted them in their day-to-day work as a physician. They were asked to grade each element between a low of 0 (not at all) to a high of 10 (very much).

In the cover article of the magazine’s July 25, 2016 issue, pictured above, the magazine’s editorial board revealed the results of that survey.

They were dismaying, but not surprising.

That’s Obamacare with an “F”

It is now official: Six long years in, America’s physicians give each element of Obamacare an F.   medicare-frustrated-doctor

It is worth noting that practicing physicians do not give each element of Obamacare an F as in, say, a 64, 60, or even 55 sort of F—in other words, the sort of F that says, “If you had just tried harder, everything would have been okay; so better luck next time.”

No. They gave each element of Obamacare an F that is in the 20s or 30s—you know, the kind of F that in school would have caused you to be held back, grounded by your parents, or most likely both. In other words, each element of Obamacare examined received a “you-didn’t-even-try-so-there-won’t-be-a-next-time” sort of F.

Even more telling, as the article’s authors note, individual survey respondents did not differ much in their evaluations—or their grades. Indeed, the physician respondents were uniform to a physician in their perceptions of the massive failures of Obamacare.

Again, the results are disappointing but not surprising to those of us who have struggled under Obamacare’s false promises and egregious mandates for six years now.

Results Rundown

Since most of you have no reason or desire to subscribe to, much less read, Medical Economics Magazine, here is a rundown of the specific Obamacare promises considered, their respective grades (both number and letter), and verbatim quotes from physician respondents:

1.   Medicare bonus for primary care services  

     The Obamacare promise: Obamacare-mandated Medicare bonuses for primary care services will more fairly compensate primary care physicians by closing the gap between reimbursement for primary care services and payment for specialist services, which have historically be compensated at much higher rates despite a relative equality of services, training, and education. This would have amounted to an effective raise for primary care physicians while leaving medical specialists’ payments intact. It was proposed as a win-win for all physicians as well as their patients.

     PHYSICIAN GRADE: 33 = F  

Physician comments:

      “It is totally meaningless.”                                                 

      “It was a silly Band-Aid.”

2.   Medicaid-Medicare parity

       The Obamacare promise: Obamacare-mandated payments to primary care physicians providing services under Medicaid will be reimbursed at the same rate as the same services under Medicare. This would have amounted to an effective raise for physicians caring for the Medicaid population while keeping Medicare reimbursements stable. Again, it was proposed as a win-win for everyone. 

      PHYSICIAN GRADE: 34 = F

Physician comment:

       “Once again a short-term fix for long-term problems which mandates one and then walks away to  leave someone else holding the bag.”

3.   Increased coverage through healthcare insurance exchanges 

      The Obamacare promise: Under Obamacare, more Americans will be provided health insurance coverage thanks to the healthcare insurance exchanges.

      PHYSICIAN GRADE: 35 = F

Physician comments:

      “Coverage is shockingly bad, and at a high price.

      “[M]ore coverage does not equal more access.”

       “High deductibles appears to me to be a by-product of insurance companies protecting their assets.” 

       “Why would selling an insurance policy with a large deductible help someone who can’t even afford the premiums? They can’t pay the deductible, so they still can’t afford care. Who made out? Insurance companies. Who lost? Private practice doctors who had to deal with patients who stiffed them for the deductibles on policies. Thanks Obama!

       “[Physicians] have been the ones who have to explain that the patient does have to pay their exorbitant copays—usually we end up with zero and an angry patient.

4.   Physician networks                                           

       The Obamacare promise: Under Obamacare, Americans will enjoy access to a wide range of care from a physician of their choosing. (“If you like your doctor, you can keep your doctor.”) (“If you like your plan, you can keep your plan.”)

      PHYSICIAN GRADE: 29 = F

Physician comments:

      “[Obama said] ‘If you like your plan, you can keep your plan.’ The result? Reduced choice.”

     “Insurance companies are prohibited from cherry picking healthy patients, so they cherry pick physicians who treat healthy patients.”

      “The network delineations in our area are so arbitrary and inappropriate that all they do is impede care.”

      “If I can’t send my patients to specialists within a reasonable travel time, the patient simply can’t go. This is particularly true in rural areas. 

5.   Accountable care organizations  

      The Obamacare promise: Through Obamacare-mandated Accountable Care Organizations (ACOs), Medicare patients will enjoy high-quality, coordinated care.

      PHYSICIAN GRADE: 29 = F 

Physician comments:                                      

      “This is managed care reintroduced under another name. There will be temporary savings then rapidly increasing costs again as the market becomes controlled.”

      “ACOs add layers of work for physicians, reducing our ability to spend time with our patients and adding unnecessary burdens to our already busy schedules. And all of this with marginal if not negligible benefit.”

6.   Outcomes-based reimbursement   

       The Obamacare Promise: Obamacare-mandated initiatives, including outcomes-based provider reimbursement, will ensure patients a higher quality of care.

       PHYSICIAN GRADE: 28 = F 

Physician comments:

      “Let’s start paying lawyers and politicians using a similar grading system.” 

      “Unintended consequence of this in a long run will be that no one will be willing to take care of sick patients, because they will cost the doctor money in reimbursement.”

      “This is a very dangerous game that the government is playing with physician reimbursement and it will be the death of the small practice.”

      “Ultimately could just be a complicated way to cut reimbursement.”

      “The emphasis has moved from the patient to the process.”

      “The problem is that this law does not reward good medicine, it only rewards good recordkeeping.”

7.   Physician ratings via the Physician Compare website

       The Obamacare promise: Obamacare-mandated physician compare websites will allow patients to make more informed choices of providers, at the same time incentivizing physicians to provide the highest quality care possible.

      PHYSICIAN GRADE: 26 = F

Physician comments    

      “We need a site for insurance companies and congressmen as well.”

      “This website constitutes CMS’s engagement in cyberbullying practicing physicians.”

      “[The site is] horribly inaccurate.”

      “It appears to be at random and not vetted at all.”

      “Not all that is important can be measured, and not all that is measurable is important.”

8.   Expansion of health IT

       The Obamacare promise: Obamacare-mandated electronic health records (EHRs) will improve patient care and physician communication.

      PHYSICIAN GRADE: 31 = F

Physician comments:

      “The EHR is the single worst thing among many to happen to medical practice in the past 15 years.”

      “This is the single most detrimental hurdle to practicing.” 

       “Nothing ruins a patient’s experience faster than a computer in the exam room.” 

       “[EHRs] just opened doors to lots of IT vendors who are overcharging because they can!” 

       “[E]verything involved in patient care takes longer.” 

       “I spend a large amount of time as a clerk. Thank you 9th grade typing teacher!

 

 

Obamacare’s Failing Grade

The results are in. They also speak for themselves.

Obamacare’s average? Exactly 30. That’s a dangerously long way from 100—or even the passing mark of 65, for that matter. In fact, it is less than half of passing. Hardly commendable. Not even acceptable.

Imagine what would have happened to you in school were you to take such a dismal report card home.

Obamacare should be held back. Or grounded. Or suspended until improved.

Obamacare is a failure—a massive failure.

In case you wondered what your physician thinks of Obamacare, well, you have your answer.

That is bad news for us physicians, and even worse news for you, our patients.

Welcome to Obamacare. You’re going to hate it. Heck, you might not even survive it.

Please let me know your thoughts.

Rhonda

www.moormanmedia.com

#MoormanMedia