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More doctors and hospitals excluded from Obamacare plans

More doctors and hospitals excluded from Obamacare plans

Health insurance everywhere, but not a doctor to see

More evidence that the Obamacare health insurance offerings are a cruel joke on the public.

We already have covered how there will be few doctors willing to see the millions more Medicaid patients — in many cases people who previously had private insurance.

We’ve also covered how insurance companies have no choice but to hike deductibles and narrow in-network provider networks in order to keep premiums artificially low. It’s all caused by Obamacare’s one-size fits all philosophy, loading up so-called acceptable plans with so many things most people don’t want or need that it raises the cost of insurance to unsustainable levels.

The reimbursement rates are so low for hospitals that even major research hospitals like Stonybrook Medical Center on Long Island are refusing to participate in any of the state health exchange plans unless reimbursement rates are renegotiated.

There is a cruel and heartless bureaucratic pox on the healthcare system, and we’re just in the infancy of seeing the symptoms.

The latest, from CBS News, in how in Washington State the major children’s hospital in Seattle is excluded from all but two of the Obamacare plans (via Marathon Pundit):

This is just the start. The first response inevitably will be a system of forced labor where doctors and other providers will be compelled by force of law to offer services through government plans under threat of license revocation or other punitive measures. And then, when the system is so screwed up it is beyond repair, single payer.

Obamacare is just the gateway drug to single payer.

If you don’t believe me, just listen to Martha Robertson, a Democratic Congressional Campaign Jumpstart candidate in NY-23:

we’ll get to single payer soon, but in the meantime [Obamacare] is what we have to do.”


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This is going to mean major shortfalls in revenue for Hospitals and Medical Practices. Look for lots of bankruptcies.

I talked to a local dentist who told me his revenue was off 20% this last year. Next year will be worse.

    Sozo in reply to Musson. | February 9, 2014 at 6:22 pm

    They aren’t the only ones either. I know of a mid size business in my area that is having to drop health benefits entirely. One bad year is all it takes, and between paying 6-7k a year per employee or paying 2k a head for the penalty, the choice in unenviable, yet obvious for a struggling company. And most ironically, low wage retail workers will qualify for subsidies, while slightly higher income office workers are SOL. From a hiring/retaining employees POV, this is a disaster and will literally drive companies out of business.

I agree with Martha, Obama and his boys have been incredibly successful shifting blame and anger to insurance companies, ‘rich’ doctors and hospitals. Soon we’ll hear that Stony Brook and Westchester Medical Center in NY are excluding these plans because they’re um- racist

“we’ll get to single payer soon”

Because the government has done such a good job with Obamacare that the public will be BEGGING for even more government run health care.

This may not play out the way libs think, Then again, with Republicans concentrating on immigration of all things, maybe it will.

    RickCaird in reply to irv. | February 9, 2014 at 2:07 pm

    I really agree with you. You don’t get more control by screwing up the control you already have. I just wonder what kind of people think that way.

    MarkS in reply to irv. | February 9, 2014 at 3:08 pm

    People will be begging for single payer only out of desperation !

Ideas so good that force is needed for the public to choose it. If the clowns in DC think that the single payer is going to be the answer, then they really are clueless or they intend to have the doctors treat patients at gun point. The ACA is the new slavery law.

Look at the countries with a National Health Service …
( off the top of my head )

All those systems are having severe problems getting/keeping doctors.
Waiting lists to see a specialist run to 6 months long or more.
And you STILL NEED PRIVATE INSURANCE to pay the medical bills.
Don’t get me started on the “Death Panels” built into these systems.
NOTE : “Dr. Kevorkian” would get lots of legal work in those single payer systems.

I have had to use Veterans Clinics ( VA Run ) and Army TMC’s.
You are better off going to a tribal shaman and having him dance around in a grass skirt for a diagnosis. ( More Effective! / Cheaper Too!)

How is ‘single payer’ going to fix any of these -problems-?

Personally, I do not see the mechanism for “The first response inevitably will be a system of forced labor where doctors and other providers will be compelled by force of law to offer services…”

There are good reasons for my skepticism on this issue. Doctors are not powerless people, without the means and intelligence to jealousy guard their interests. I also see that any such move would produce a groundswell of opposition among most of the American public. If licensure were used this way, support for medical boards by practitioners would be quickly undermined.

Doctors really would “go Galt” in a very direct and effective way. I doubt even the mushy brains behind ObamaDoggle will fail to see that.

    Karen Sacandy in reply to Ragspierre. | February 9, 2014 at 11:41 am

    Doctors like to practice medicine, not politics. They’re just as inactive politically as your average bear. Don’t blame them; they have better things to do, like end human suffering.

      Ragspierre in reply to Karen Sacandy. | February 9, 2014 at 11:59 am

      Well, I think your generalizations are way too…general, first.

      How many TEA party types liked doing what it is they did, prior to becoming politically active in the face of what we see as an emergency?

      How many physicians are now serving in the federal and state legislatures?

      I think physicians and other professionals in health care would most assuredly become both angry and active if they were being told they had to be essentially slaves on the ObamaDoggle plantation. Most of them DO care about their patients, and they would see this kind of move as a threat to their practice of medicine. Which, of course, it would be.

      stevewhitemd in reply to Karen Sacandy. | February 9, 2014 at 1:58 pm

      As a doc I can tell you that you’re generally right: most of my colleagues indeed want to practice good medicine, take care of sick people, look after their families, and otherwise be left alone.

      There’s a relatively small proportion that get involved in various political/social activities related to medicine; those doctors are generally (but not always) more liberal than doctors as a group.

      Medical societies generally do a poor job of representing physicians. I think the AMA now represents, in terms of its membership, about 1/3 of all docs. The major specialty societies (e.g., American Heart Association, Radiological Society of North America, American College of Surgeons, etc) are perhaps more representative but are also less political. They will lobby Congress but generally don’t get deeply involved in the big medico-social issues.

      A lot of my colleagues are looking glum, wringing their hands, worrying about their futures, and quietly muttering about the idiots and fools in Washington. But only a handful are ready to man the barricades. Sorry, that’s just the way we are.

    stevewhitemd in reply to Ragspierre. | February 9, 2014 at 2:03 pm

    Some of my colleagues would go Galt, some would not. The service ethic is very strong in us: the people who are attracted to medicine in the first place have a strong belief in serving others, and it’s pounded into us repeatedly from day one of our training.

    So most of us aren’t going to quit medicine. We have patients to consider.

    What I think some will do, particularly the primary care providers in the semi-rural and small town regions, is go cash-only and forego insurance. That’s not practical for specialists (e.g., radiologists working at a hospital) but the family practice and general internal medicine docs could make it work, particularly if they’re in an area where the next set of available docs are in the next county.

    How many would it take in such a situation to force government to change? Don’t know, but as others in this conversation have pointed out, government has the power, and current government officials are socialist enough to think that they can force others to do their bidding.

      Ragspierre in reply to stevewhitemd. | February 9, 2014 at 3:31 pm

      Consider what would have to be done to realize this scenario…

      Either a law, or rule-making, would REQUIRE health-care providers to work for what the feds held out.

      The first is impossible (I submit) coming from this or the next Congress (individual states MIGHT pass something like that). The second (rule-making) would be challenged immediately in the courts, and countered in the legislatures.

      A much more likely scenario would be a carrot approach…the feds offering special funding for medical students on the basis they would be the good little prols who would be interchangeable with Cuban doctors.

      Another, and perhaps collateral, approach will be to simply push primary care down in terms of who provides it, with nurses coming into the role doctors now play. That is already starting to happen (and in some respects that is no bad thing, i.e., your walk-in clinics at the grocery store).

      Economics dictates that, if you push the price of goods down artificially, the market will respond with crappy goods (or services). Just as we see in “single-payer” systems around the world (almost all of which have a parallel system for those with the money/party stroke).

      Hi Steve, thanks for the “insiders” view here (and in your comment above). Many people I know are very interested in self-pay health care, and I’ve started following the self-pay patient blog to keep up with this, it seems to me, rapidly growing aspect of health care.

      Professor Jacobson writes that this Obamacare debacle may devolve into single payer, and that’s the nightmare scenario (one that has been put forward from Day 1 of the Obamacare debate, as noted by Harkin, who tried to rally the base by promising it’s just the “starter home” for single payer). What may help stop that plan, if it’s a plan at all and not merely wishful thinking on the regressive left, is the development of a “second” self-pay health care industry made up of paying patients and their docs. Do you think this is possible or likely?

The doctors should be supported as they go Galt. A guy doesn’t study like a dog for years, rack up mega bills, and then work in a minimum wage job. That’s what Obama is doing to doctors, making them burger flippers with a stethoscope.

The ASSumption that “government option” keeps costs down is absurd. It is the same lie always told about the glorious communist centrally planned state. Half the Olympic money being stolen by the oligarchs in Russia exemplifies how glorious communism really functions. Organized crime unites with government while the proles struggle.

When have public union monopolies ever kept costs DOWN? The tighter grip a single entity has, the more costs RISE. Did unions keep costs down for the big dig in Boston, or for teachers in Chicago? No. Costs skyrocket, productivity and outcomes worsen.

Centralized power means centralized corruption, eliminating any free market competition. That is the stated intent of the left in their “public option”, which out competes private insurers because it is subsidized, not because it is more efficient.

Medicare is used as an example of how well it could work, but there is massive fraud and waste in Medicare, and it only survives because more have been paying in than taking out. Shortfalls are partly made up for, by charging the insured higher rates.

The military is the only place we want central control and command for the whole country. But the left would gladly turn civilian life into servitude to build their communist state.

Bitterlyclinging | February 9, 2014 at 12:17 pm

The Government, under Barack Obama, will see to it that the doctors provide the care, even if it has to be at the point of a gun.
Remember Cass Sunstein, Obama’s first regulatory Czar? His favorite historical figure was Mao tse Tung, and Cass’s favorite Mao quote was “All power emanates from the barrel of a gun.”
Great country, this America, with a Communist dope addled president. What could possibly go wrong?

Remember that Hillarycare would have dictated specialties to medical students, and where they were to practice, and it would have included huge fines and/or prison sentences for doctors who provided care that did not strictly follow government directions.

And we see polls telling us that Hillary Clinton is the most admired woman in America and would handily beat any known Republican …

The ignorance of voters — and the determination of the mass media to keep them ignorant — is one of the biggest problems we have.

    NC Mountain Girl in reply to Radegunda. | February 9, 2014 at 3:35 pm

    Check your polls. She’s not doing as well of late.

      I’d seen the Quinnipiac poll that shows Clinton in trouble, but the CNN poll shows her still comfortable.

      The really disheartening—no, ominous—thing about the CNN poll is the high marks Clinton gets for her disastrous record as Secretary of State. That’s an open invitation to the ruling class to continue liquidating the country for their benefit.

      Neither party seems capable of governing competently, nor, I fear, would the voters recognize competent governance even if it grabbed us by the ___.

Medical care is not a right … it is a commodity. Why do we keep paying for millions of peoples medical care FOR FREE?? If you can’t pay, that’s your tough luck. You should have had insurance. You should have saved for a rainy day. Why do you have the right to pick my taxpayer pocket?


    Observer in reply to walls. | February 9, 2014 at 2:49 pm

    One of Obama’s (many) lies about Obamacare was that it would solve the “free rider” problem. Of course it does not, and was never designed to do so. As the CBO pointed out in its report last week, even after Obamacare is fully implemented, there will still be over 30 million Americans who have no health insurance.

    Furthermore, EMTALA, the federal law that requires hospitals to treat all emergency patients, regardless of their ability to pay and regardless of their immigration status, remains in effect. Nothing in Obamacare changes the fact that millions of poor illegal aliens (and millions of U.S. citizens) will continue to use our ER doctors as their “free” primary care physicians.

    The federal government created the “free rider” problem by (1) regulating charity hospitals out of existence; and (2) passing EMTALA. Then the government insisted we needed to pass Obamacare in order to fix the “free rider” problem that the government had created. Of course, not only will Obamacare not fix the “free rider” problem, it will make it worse. Then we’ll be told that we need yet another idiotic federal law to fix the problems created by Obamacare . . . .

      Ragspierre in reply to Observer. | February 9, 2014 at 3:35 pm

      Right on all counts. But there is this, too…

      Someone who is heavily subsidized is STILL a free-rider, at least by degrees. They are just a government sanctioned free-rider. And ObamaDoggle ALWAYS considered this result.

NC Mountain Girl | February 9, 2014 at 3:34 pm

Eleven doctors are running for the US Senate as Republicans this year. More are running for the House. The doctors running as Republicans far outnumber doctors running as Democrats.

    Juba Doobai! in reply to NC Mountain Girl. | February 10, 2014 at 11:41 pm

    Let’s hope the doctors make laws that do to lawyers what lawyers have done to everyone else. The biggest thing on their agenda should be tort reform, followed by a series of legal steps to impoverish the lawyers. Bind and hang them with their own rope.

Obamacare does not to be repealed formally. It must be defunded by the Republican House in 2016 and rendered a dead letter by the Republican president, by way of wholesale waivers and refusal to administrate the law.

Simply allow each state, or compacts of states, to come up with their own plans while the Obama perversion whithers and rots.

Hopefully, if the GOP takes the Senate, substitute legislation obviating Obamacare and confirming its dead letter status will confirm the burial.

    walls in reply to bildung. | February 9, 2014 at 9:12 pm

    I can’t agree that a Republican president, or any president, refuse to execute the law of the land. That’s what we were bitching about with Obama – for example, his failure to enforce DOMA before it was repealed. His job is to enforce the law of the land regardless of his personal preference.