Obamacare News of the Day

Wall Street Journal: A Doctor's Declaration of Independence It's time to defy health-care mandates issued by bureaucrats not in the healing profession

• [CMS] 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 [CMS - the government agency] 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?
• 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.
• …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.

Washington Post: Aetna: Late Obamacare changes account for half of 2015 premium increases

• Aetna chief executive Mark Bertolini says premium increases in those 17 states, which encompass 132 rating areas, will be quite literally all over the map in 2015. He said those increases will range from "the very low single digits" to "some that will be over double digits."
• Bertolini said about half of the company's premium increases, whatever they turn out to be, will be attributable to "on the fly" regulatory changes made by the Obama administration. He cited as an example the administration's policy of allowing old health plans that were supposed to expire in 2014 to be extended another three years if states and insurers wanted to.

Washington Post: Why the uninsured are sitting out Obamacare

• …nearly 4 in 10 uninsured adults cited affordability as their main reason for skipping health insurance coverage. Twenty-two percent cited employment reasons (they were unemployed or couldn't get coverage through their job), while another 11 percent said they missed the deadline and 9 percent said they just didn't want insurance.
• [from an Enroll America report covering 10 urban areas]…complaints about the lack of affordable health-care options increased each month during the signup period (8 percent of complaints in November, compared to 29 percent in February).

New York Times: Administration Begins Search for New Contractors to Run Health Care Site

• The Obama administration has begun a wide-ranging search for companies to run the online federal health insurance exchange, seeking new talent to prevent a repeat of problems that immobilized the website last fall.
• Nearly six in 10 people — 57 percent — said that the number of Americans signing up for insurance fell short of the government’s expectations. The same proportion agreed with the statement that “there have been so many problems since the law’s rollout that it’s clear the law is not working as planned.” About a third of Democrats believe the law is not working.
• ...Avalere Health, a consulting company, reported Monday that information on prescription drug coverage was, in many cases, not readily available to consumers shopping on the exchanges. Avalere analyzed the data available for 85 plans and found that information on drug coverage was difficult or impossible to find for about half.

Washington Post: Obama's approval hits new low as Obamacare bump fades

• Following some rare good news about the law -- including meeting its sign-ups goal despite a rough launch [this is premature media hype as we still do not know how many people are actually enrolled]-- 44 percent of voters approved of his handling of it. That number is now down to 37 percent, with 57 percent disapproving.
• While 49 percent approved of the law last month, 44 percent approve of it this month -- the lowest that number has been since November. Forty-eight percent of Americans disapprove of the law.