Comrade Obama’s Health Care Secret Police [Reader Post]

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Back in 1998, Andrew Cuomo sent this country careening down an economic embankment when he sued Accubanc for not making enough bad loans. He punished a bank for not losing enough money and demanded that they engage in practices which were doomed to failure. Barack Obama has plans to force doctors into a similar situation.

Barack Obama is dispatching his secret police to check up on the availability of primary care doctors. They’re called “Mystery Shoppers.”

WASHINGTON — Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of “mystery shoppers” to pose as patients, call doctors’ offices and request appointments to see how difficult it is for people to get care when they need it.

The administration says the survey will address a “critical public policy problem”: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.

Got that? They’re trolling for a reason.

According to government documents obtained from Obama administration officials, the mystery shoppers will call medical practices and ask if doctors are accepting new patients and, if so, how long the wait would be. The government is eager to know whether doctors give different answers to callers depending on whether they have public insurance, like Medicaid, or private insurance, like Blue Cross and Blue Shield.

And why would they need to know that?

In a recent study, the Massachusetts Medical Society found that 53 percent of family physicians and 51 percent of internal medicine physicians were not accepting new patients. When new patients could get appointments, they faced long waits, averaging 36 days to see family doctors and 48 days for internists.

And why wouldn’t a doctor want to treat Medicare or Medicaid patients? Could it be because democrats tried to scalp doctors fees by 25%?

And Obama is laying out a trap:

Eleven percent of the doctors will be called a third time. The callers will identify themselves as calling “on behalf of the U.S. Department of Health and Human Services.” They will ask whether the doctors accept private insurance, Medicaid or Medicare, and whether they take “self-pay patients.” The study will note any discrepancies between those answers and the ones given to mystery shoppers.

This fraud will be protected:

To make sure they are not detected, secret shoppers will hide their telephone numbers by blocking caller ID information.

The point of this charade is clear. Obama will be taking names and there will be punishment- the Cuomo Treatment- a deal you can’t refuse. Doctors will likely be sued by the Obama administration for not taking enough money-losing cases, and/or holding one’s professional license hostage or get a visit from the IRS. The press will say that the outcome was “unexpected.”

Call it “Medical Conscription.”

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I can give you the results right now:

Nobody on earth takes Medicaid.

60% (and dropping) take Medicare, for openings 8 weeks in advance.

Why shouldn’t doctors be held to high scrutiny and standards? When people’s lives are in their hands their priorities should not be “How can I squeeze the most money out of the system?”.
Doctors are, by NO stretch of the imagination, underpaid. They gross some of the most sickeningly high salaries among the most respectable professions. To lie to patients about availability and then to government officials about their discrimination policies is not abhorrent behavior. They should be held accountable for their moral practices more than other professions, not less.

@Thoughtful Academic:
If I was an MD who spent 11 years in school to graduate with anywhere between $100K-1M in loans for school and equipment to start a practice, I will be damned if I allow the this socialist US gov’t , or anyone else, to tell me how much I can earn or which patients to take.

If the feds force the issue, the experienced MDs will either semi-retire, retire completely, or stop taking
gov’t-insured patients altogether. Fewer and fewer students will go to medical school.

Oh, wait, wait, those things are already happening.

Hey Brainless Academic…
This is a market issue… Behaviour that is rewarded will be increased. Psych 101 meets Economics 101… It takes way above average IQ, dedication and persistence to get to be a doctor, not to mention the debts for college, med school, equipment, and so on. Without a reasonable expectation of making enough to pay all those debts and live a well above average lifestyle, why bother with the hassle of being a government medic? Those folks are capable of earning a living any number of ways other than medicine…in a free market, they earn the big rewards because they contribute a vitally needed service to society…fair is fair…not sickening. And most of the decent docs I know do a ton of pro bono work at their own discretion for those who can’t afford specialized care…if they don’t make a better than average living, they won’t be able to afford time to do pro bono care, they’ll be working to see a fast and steady stream of $40 government patients in order to pay their insurance bills.
Your class envy, wealth envy, pee-pee envy is what makes real people sick.

Right now there is no law preventing a doctor from accepting some patients while turning down others.
Operating at a loss is simply bad business.
But it looks like that is Obama’s aim for all businesses, medical or otherwise.
Maybe Obama will try to FORCE doctors to take all comers, whether it makes him/her a profit or not.

Wasn’t there a prediction that ”free” medical care meant enslaved doctors?*

Think there’s a doctor shortage now?
Just wait.

*Yup.
It was Sen. Rand Paul.

With regard to the idea of whether you have a right to health care, you have realize what that implies … It means you believe in slavery. It means that you’re going to enslave not only me, but the janitor at my hospital, the person who cleans my office, the assistants who work in my office, the nurses.

Video here.
http://www.healthcarebs.com/2011/05/12/video-rand-paul-says-to-believe-in-a-right-to-health-care-is-to-believe-in-slavery/

Another trial balloon that Obama had to back away from:

White House dumps ‘secret shopper’ survey of doctors

An un-named HHS spokesperson:
“After reviewing feedback received during the public comment period, we have determined that now is not the time to move forward with this research project.”

UPDATE: The Obama Administration Dumps this “Study”:

Rather than answer Republican questions about their so-called “Secret Shopper” program, the White House abruptly dropped it.

And what were the questions being asked?:

“We have deep concerns regarding the department’s recent plans for a ‘stealth survey,’ its legality, notification to Congress and lack of standards for any misconduct or bad reporting by the staff hired to carry out this work on American doctors and their practice of medicine,” asked Senator Mark Kirk (R, Illinois) . “The cost and proposed clandestine method of collecting information from physician offices are questionable and, therefore, we request details of how this survey would be conducted, how investigators would be punished for misconduct or extortion and how patient/physician confidentiality would be maintained.”

@Thoughtful Academic:

Why shouldn’t doctors be held to high scrutiny and standards? When people’s lives are in their hands their priorities should not be “How can I squeeze the most money out of the system?”.

Just a sec, bucko.

Why should doctors take a loss with every patient?

@Thoughtful Academic:

Why shouldn’t doctors be held to high scrutiny and standards?…………………………………………………………………They should be held accountable for their moral practices more than other professions, not less.

And just who do you propose does that scrutinizing, and holding them accountable? There is a reason doctors are paid healthy amounts for their services. It’s because it is very tough to finish the required training, before one becomes a full-fledged doctor. And the same can be applied to many nursing programs as well. Congress, though, is chock-full of lawyers, who more than likely would be confused as to which side of the tongue depressor to hold. Yet, you support this “secret shopper” program, to check up on doctors and medical offices, that would report to these same lawyers.

The real point is that no profession should be subjected to a bunch of political hacks, with their purpose being to find out how bad you are doing, and then report it to a bunch of people, of which most could never make it in a real job.

And that doesn’t even begin to get into the Constitutional argument of whether or not the Executive branch, or the Legislature, has the power to do such a thing.

I have had the conversation about the massive salaries that doctors make with both my primary care physician, and my cardiologist. The cardiologist told me that when he finally started praciticing, after six years of school, a year of internship, and year’s residency (where he worked 16 hours a day six days a week for around $35K/year) , he was over $250K in debt. His malpractice insurance was at that time (before Texas passed tort reform) around $250K a year due to the type of practice. Now divide that by an office visit of $125 and he would have had to see 2,000 patient appointments just to pay his insurance. That’s 38 patients a week, just for insurance. So yeah, a doctor may make a million bucks a year, but out of that comes his office costs, salaries for staff, equipment, etc.

But I will give you some actual numbers: my primary care physician charges $60 for an office visit. Out of that $60, Medicare reimburses him 80% of $42.33 (which Medicare considers a ‘reasonable and customary’ charge). Basically, he gets $35 out of the $60. Now, maybe Thoughtful Academic would be happy in an almost 40% reduction in his salary, but I damn sure woundn’t. The idea that doctors are all wealthy, greedy capitalist is just bunk. Both my PC and cardiologist do a lot of free work. My cardiologist goes into poor inner-city areas each summer to treat the poor, on his dime.

The Houston Physician’s Journal reported last year that 52% of all Texas doctors no longer take new Medicare patients. They handle what they already have, but won’t accept new patients. That has put a strain on the people that have fled Loonafornia and the Beast Coast who have moved to Texas due to no state income tax on their monthly retirement checks. Anyone moving to a small town like mine is having to drive 60-100 miles to a major city just see a doctor that will take their Medicare and then they complain that they had to spend a lot of time in the waiting room, full of other patients, because there are so few doctors that will take their government insurance.

Doctors also have one of the highest bad debt write-offs of any other profession. Also, as a general rule doctors are not usually astute businessmen, nor is that what they went to school for.

They have a charge off rate as high 1/3 of their receivables. So they do not collect up to 33% and higher of what is owed them

Then factor in paying their dues by working their butts off for years working as intern, residency, etc.

Lawyers, on the other hand……………………………………….some like to think they are above paying or even filing tax returns and recover usually close to all of what people owe them. Surely you will not ask me why.

I speak from experience; I worked for a lawyer that refused my recommendation to file his tax returns and pay his taxes. He currently wears an orange jump suit now in Beaumont, Texas.

Oh, and my comment about collections does not just apply to what the patient owes them. The insurance companies find every excuse, loophole and opportunity to screw the doctor out of what they owe them. I had a doctor that kept going from form-filer to another to get the insurance company to pay him what he was owed. The insurance companies I have as much respect for as your common attorney.

My apologies to the honest attorneys out there. I know most are honest; I have just had the crapiest luck with clients, employers, etc., the last 10 years. Last one I worked for committed fraud on a SBA Loan application, but he was not an attorney; just your everyday crook and embezzler. Answered no on his SBA loan app about any criminal history and had multiple felonies for fraud, embezzlement (>500k and got 10 years probation!) retaliation, criminal trespass, yada yada.

Did I mention that I am very depressed?

@jlfintx:

Oh, and my comment about collections does not just apply to what the patient owes them. The insurance companies find every excuse, loophole and opportunity to screw the doctor out of what they owe them. I had a doctor that kept going from form-filer to another to get the insurance company to pay him what he was owed.

You have no idea what it’s like to fight with them on a day to day basis.

@retire05:

His malpractice insurance was at that time (before Texas passed tort reform) around $250K a year due to the type of practice.

It’s as bad or worse for OB/GYN’s. And lawyers troll the airwaves- “Did you feel upset after your doctor visit? Then you may be entitled to compensation! Call the law offices of Dewey, Cheatem and Howe today!”

we are sure to meet a minimum of 5 crooks in a lifetime,
4 of them from the GOVERNMENT,

Looks to me like the bottom line here is to set us up for wholesale importation of pseudo docs from the t’urd wurld — all of whom will be ‘certifed’ US gubmint choice — they will have guaranteed – and protected – jobs —- meanwhile less and less US people will go to med school — the US med schools will take in many foreign students and receive mega subsidies for doing so from the US taxpayer — all under the “jobs Americans won’t do” BS

Budvarakbar, yes, and AMERICA be given
A FOREIGN NAME WHEN THAT IS DONE
WILL MUSWORLD DO?

If the feds force the issue, the experienced MDs will either semi-retire, retire completely, or stop taking
gov’t-insured patients altogether. Fewer and fewer students will go to medical school.

Oh, wait, wait, those things are already happening.

That’s absolute poppycock! Medical school applications have never been more competitive. The typical Californian with a 3.8 GPA and MCATs of 34 can’t get into a California state med school.

The older generation of doctors, with expectations of massively high incomes, is being replaced by a younger generation, increasingly female, with different expectations.

All around the world, it’s the same great job, with no problems at all finding competent people to do the job, no matter what the compensation levels.

There’s nothing at all wrong with the proposed study. Studies like this are done all the time. It’s in the Medicare contract that doctors must provide the same high standard levels of care to Medicare patients as to other patients. If they don’t want to do this, they don’t have to participate in Medicare. If they are losing money, they don’t have to participate in Medicare. It remains a fact that Medicare has, BY FAR, the largest provider network of any health care plan in the USA and Medicare patients have, BY FAR, the greatest choice of doctors and hospitals.

– Larry Weisenthal/Huntington Beach, CA

Ah, our Loonafornia resident is back I see. Tell me Larry, why are the admissions standards higher for those that want to enter veterianry school than they are for those who enter medical school? Or are you going to give me some crap about lack of available slots?

And no, doctors don’t have to accept Medicare/Medicaid patients. That was the whole point of the sneaky little survey, to try to find out what doctors think their time is worth more than the Democrats are willing to pay them so they could intimidate those doctors.

And it is also true that Medicare has the highest rate of disallowed claims of any major medical health insurance provider in the U.S.

Rates of denied claims according to the AMA’s Health Care Report Card:

United Health Care – 2.68%
Coventry – 2.88%
Humana – 2.9%
CIGNA – 3.44%
Health Net – 3.88%
Anthem – 4.62%
Aetna – 6.8%
Medicare – 6.85%

@retire (#20): Apples and oranges. Medicare is unique among the insurers you list in that Medicare does NOT require pre-authorizations.

Providers (doctors, hospitals, laboratories, pharmacies, etc.) who have contracts with the insurers you list know that, if they want to be paid, they are required to obtain pre-authorization before providing services. Not so with Medicare. The other insurance companies are like nannies. You have to go to them for permission to do anything. Medicare treats providers like adults. Medicare has published coverage guidelines. If there’s a doubt in the mind of the provider, he/she can decide to check it out in advance. But it’s up to him/her to take the initiative. They are not required to do this in advance. If they don’t check it out and if they provide a non-covered service, they run the risk of not getting paid. But they don’t have to check it out in advance if they don’t want to and they don’t need to get pre-authorization in advance, if they don’t want to. Thus, there is significantly less delay in receiving services covered by Medicare than there is in receiving services under private insurance. What’s that conservative line about “treatment delayed is treatment denied?”

It’s a fact that Medicare has the highest degree of consumer satisfaction. I’ve previously posted a link for this. Regular, long time readers of Flopping Aces know that I’ve written an enormous amount on the Medicare issue. To find these, simply Google Weisenthal/Huntington Medicare.

Why do Medicare beneficiaries like Medicare so much?

1. No gatekeeepers. You want to see a specialist, make an appointment to see a specialist. Virtually any specialist you want. If you’ve got a heart problem, go straight to a cardiologist. Not to a family practitioner, if you are sophisticated enough to convince the cardiologist’s appointment clerk that you know what you are talking about and you really do have a heart problem. Got an allergy? Go straight to an allergist. And so on.

2. Largest provider network in the country. More doctors. More hospitals. When my Mom (who lived in Louisville, KY) got lung cancer, she went to NYU Medical center in NY and had her lung resection done by Dr. Harvey Pass (you can google him). He literally wrote the book on lung cancer, and was previously chief of thoracic surgery at the National Cancer Institute. When she developed a metastasis to her lumbar spine (an extremely tricky, serious problem) she received state of the art proton beam therapy at the premier proton beam center in the USA (at Loma Linda University, in California) and the only one qualified and experienced in treating problems like she had. She received her chemotherapy from Dr. Janell Seeger, the person I consider to be the best oncologist within driving distance of her home (being an oncologist myself, I’m in a position to know this). Medicare paid $200K for her treatment, including, when needed, rehabilitation nursing home care. The level of care received by my Mom would have been unavailable to virtually anyone with conventional private insurance, with health care networks limited to a single state or geographic area or list of approved providers. When her battle was over, she had no health care debts. The average patient with private insurance would have had to spend tens of thousands of dollars in out of pocket expenses, to receive care which wasn’t as good.

Medicare beneficiaries have the lowest percentage of personal bankruptcies owing to health care expenses. Medicare provides superior care at a lower overall cost per patient. Get rid of Medicare, and all of us would be burdened with the health care expenses for our parents. More money would be spent on caring for our parents and they’d receive care which wasn’t as good and they’d have less satisfaction with their level of care.

Conservatives speak out of both sides of their mouth. They criticize everything Medicare does to lower expenses (e.g. getting rid of Medicare Advantage — which my mother didn’t have and certainly didn’t need). e.g. “squeezing” doctors. You think that the Medicare should just pay doctors what they want to be paid? No, the way to do this is to keep lowering reimbursements, region by region. Of course, doctors will start to drop out. When the drop out rates get to be too high, then you know when you’ve found the sweet spot in reimbursement. You aren’t paying too much and you aren’t paying too little.

This is a big complicated issue. As I said, I’ve written volumes on it and it’s not productive to go over it all over again.

With respect to vet school and med school, what’s the point? Vet school and med school attract different people, interested in different things. I’ve never known a single doctor who went to med school because he couldn’t get into vet school. My grandfather was a vet, actually. He invented an innovative device for delivering baby calves from milk cows. He was a very smart man, but he had absolutely no people skills and would not have made a very good human doctor.

My statement was that med school applications have never been more competitive, and this is a true statement.

Anyway, it’s not true that vet school admissions are more competitive than med school admissions:

http://dus.psu.edu/students/veterinary_school.html

https://career.berkeley.edu/MedStats/national.stm

– Larry Weisenthal/Huntington Beach, CA

Medicare is beginning its inevitable collapse, like all Ponzi schemes.

Period.

Try getting a new Medicare provider when you move into a new town these days. In Manhattan and Alaska, they don’t exist. Medicare has the worst record of rejecting claims, as correctly noted above.

And wait until the moron younger generation realizes how totally screwed they have been by Medicare.

asset management,
yes the pressure, is from different degrees here at FA,
welcome, and as you continue to read other POSTS, you will find some so hot that they have burned some keyboards never to be recovered again,
bye