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A Doctor’s Declaration of Independence

It’s plain and simple: If Obamacare was so good for “the people” why wasn’t the president himself along with his backup group in Congress the first to line up and sign up? If it is so beneficial why are threats necessary for coercion?

For example, the iPhone is a great product with many benefits to the consumer. It is not necessary to threaten the people with penalties to be enforced by goons in the IRS to make them go out and purchase it. The people see the benefits and choose to either take advantage and get it for themselves or not.

It’s time to defy health-care mandates issued by bureaucrats not in the healing profession.

by Daniel F. Craviotto Jr.

In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. We strive to do our best even while we sometimes contend with unrealistic expectations. The demands are great, and many of our families pay a huge price for our not being around. We do the things we do because it is right and our patients expect us to.

So when do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it any more?

The Centers for Medicare and Medicaid Services dictates that we must use an electronic health record (EHR) or be penalized with lower reimbursements in the future. There are “meaningful use” criteria whereby the Centers for Medicare and Medicaid Services tells us as physicians what we need to include in the electronic health record or we will not be subsidized the cost of converting to the electronic system and we will be penalized by lower reimbursements. Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist?

This is not a unique complaint. A study commissioned by the American Medical Association last year and conducted by the RAND Corp. found that “Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction.”

In addition to the burden of mandated electronic-record entry, doctors also face board recertification in the various medical specialties that has become time-consuming, expensive, imposing and a convenient method for our specialty societies and boards to make money.

Meanwhile, our Medicare and Medicaid reimbursements have significantly declined, let alone kept up with inflation. In orthopedic surgery, for example, Medicare reimbursement for a total knee replacement decreased by about 68% between 1992 and 2010, based on the value of 1992 dollars. How can this be? Don’t doctors have control over what they charge for their services? For the most part, no. Our medical documentation is pored over and insurers and government then determine the appropriate level of reimbursement.

I don’t know about other physicians but I am tired—tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way I practice medicine. No other profession would put up with this kind of scrutiny and coercion from outside forces. The legal profession would not. The labor unions would not. We as physicians continue to plod along and take care of our patients while those on the outside continue to intrude and interfere with the practice of medicine.

We could change the paradigm. We could as a group elect not to take any insurance, not to accept Medicare—many doctors are already taking these steps—and not to roll over time and time again. We have let nearly everyone trespass on the practice of medicine. Are we better for it? Has it improved quality? Do we have more of a voice at the table or less? Are we as physicians happier or more disgruntled then two years ago? Five years ago? Ten years ago?

At 58, I’ll likely be retired in 10 years along with most physicians of my generation. Once we’re gone, who will speak up for our profession and the individual physician in the trenches? The politicians? Our medical societies? Our hospital administrators? I think not. Now is the time for physicians to say enough is enough.

Dr. Craviotto is an orthopedic surgeon in Santa Barbara, Calif., and a fellow of the American Academy of Orthopedic Surgeons.

• source: WallStreetJournal

Obamacare deals blow to one-doctor medicine

Despite the predictions of fortune tellers in politics and think tanks, we won’t know for years whether the Affordable Care Act, otherwise known as Obamacare, will ultimately leave people sicker or healthier, richer or poorer.

Yet already the law, coming on top of previous legislation, is speeding the demise of an American small-business institution; the one-doctor medical practice.

Their problems began in the late 1990s. Government cost controls steadily eroded revenues while simultaneously boosting costs, by stacking on requirements for paperwork and accounting.

Some doctors adapted by figuring out ways to see more patients. Others just accepted falling incomes.

Now federal health care policy has delivered a major blow to productivity.

In a slow-motion version of the problems that crippled online insurance “exchanges” for months, doctors who see patients under Medicare and Medi-Cal programs have been forced by the phase-in of a 2009 federal “stimulus” law to install expensive, complex software systems that sharply reduce time for patients.

For many doctors, it’s the final straw. Surveys suggest that older physicians are retiring in high numbers. Younger ones are closing practices and taking jobs with integrated health systems.

Nearly 70 percent of physicians say digitizing patient records has not been worth the cost, according to a survey by Medical Economics magazine. This negative cost-benefit view comes even after $27 billion in subsidies to health care providers for the systems.

• source: utsandiego.com

 Half of Georgia’s Insurance Enrollees Haven’t Paid Yet.

Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday.

Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people.

When progressives insist that we’re wrong and Obamacare is more popular than it seems, they’ll point to the enrollment numbers. They dismiss the national surveys, but there’s some indication that Obamacare’s meager support in the polls is actually worse than we think, because it’s being artificially boosted by respondents who are eager to declare the whole thing a success, no matter how their state exchange is actually performing.

• source: NationalReview.com

Latest ObamaCare surprise: Most won’t be able to buy health insurance until end of year

There is yet another ObamaCare surprise waiting for consumers: from now until the next open enrollment at the end of this year, most people will simply not be able to buy any health insurance at all, even outside the exchanges.

“It’s all closed down. You cannot buy a policy that is a qualified policy for the purpose of the ACA (the Affordable Care Act) until next year on January 1,” says John DiVito, president of Flexbenefit which has 2,500 brokers.

That means that with few exceptions, tens of millions of people will be locked out of the health insurance market for the rest of this year.

Although those who failed to buy insurance during the enrollment period could face a government penalty, most will not have to pay that penalty until they do their taxes next year.

• source: foxnews.com

‘The debate over repealing this law is over’: Obama boasts 7.1 MILLION have signed up to Obamacare – but study shows just 858,000 newly insured Americans have paid up!

  • President took a major victory lap and took political shots at Republicans, but ignored shortcomings in his administration’s official numbers
  • Press secretary Jay Carney will only say ‘we’re aggregating a lot of data’ when asked how many enrollees have paid for coverage
  • Carney dodged questions about damning study that showed very few Obamacare customers were uninsured before the law took effect
  • Percentages from a hush-hush RAND Corporation study suggest barely 858,000 previously uninsured Americans have enrolled and paid premiums
  • HHS Secretary Sebelius met a televised challenge Monday about ‘unpopular’ Obamacare with lengthy awkward silence

Others were already insured, including millions who lost coverage when their existing policies were suddenly cancelled because they didn’t meet Obamacare’s strict minimum requirements.

Still, he claimed that ‘millions of people who have health insurance would not have it’ without his insurance law.’

 • source: DailyMail.co.uk

REPORT: KANSAS HOSPITAL LAYS OFF EMPLOYEES DUE TO OBAMACARE

According to KTKA, the cuts at the hospital are due to a projected $3.5 million loss this year. These cuts will result in 10 full-time employees and five part-time employees being laid off permanently and are expected to save the hospital $1 million annually. 

•source: breitbart.com

OBAMACARE NAVIGATORS HELPING PEOPLE ENROLL AT MEXICAN CONSULATES

The Obama administration has been helping to facilitate a series of events nationwide at Mexican Consulate offices to enroll people in Obamacare – and a key activist says the efforts are “our responsibility” regardless of citizenship.

“Whether they’re Mexican nationals or whether they’re United States citizens or whether they’re in transition– and if they’re there it is our responsibility within all of America to educate on the Affordable Care Act,” Enroll America Field Organizer Jose Medrano told Breitbart News on Wednesday.

Under the Affordable Care Act (ACA), undocumented immigrants aren’t supposed to be receiving government-run health benefits or subsidized coverage. However, President Barack Obama told Latinos in early March that the Healthcare.gov website would not be used to find out about an individual’s immigration status.

• source: breitbart.com

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