You thought you knew how bad Obamacare was? Think again [Reader Post]

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Each year, Congress holds a sword of Damocles over the heads of the medical profession. The “doc fix” is a budget adjustment to bring Medicare fees into the world of reality. democrats love to omit it for the sake of appearances.

Obamacare cuts $716 billion from Medicare. Obama calls it “waste.” Physicians call it reimbursement. What that will do is make finding Medicare providers far more difficult.

The AMA supported Obamacare, on the promise that the law would include a permanent “doc fix.” But Democrats reneged on that promise, owing to the cost of a permanent SGR adjustment: something on the order of $200 billion over ten years, depending on the prescribed growth rate of the fees.

Instead, the Affordable Care Act further reduced fees to health care providers, by $415 billion over the 2013-2022 time frame. As these reductions go into effect, more and more physicians are certain to stop taking new Medicare patients. We already see this problem with the Medicaid program for low-income Americans, where doctors don’t accept Medicaid patients, leading to poor health outcomes.

The Obama campaign offers several lame defenses of these cuts. “The President’s plan doesn’t cut [benefits] by one dime,” insists deputy campaign manager Stephanie Cutter. “He ends taxpayer subsidies to insurance companies, and weeds out waste, fraud, and abuse, which saves the Medicare system $716 billion.”

But Cutter’s assertion the law doesn’t cut benefits only makes sense if you don’t count getting a doctor’s appointment as a “benefit.” And her argument that the provider cuts merely amount to eliminating “waste, fraud and abuse” displays a callous disregard for how the law’s blunt, across-the-board payment reductions affect doctors like Joseph Shanahan, and seniors like Beverly Frake.

About that “free” exam Obama promised you:

If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.

You, the patient, will then have to make a decision.

Do you want your “free” yearly exam, or do you want to pay for a visit which is coded for a particular, new problem? You can have my “free” exam if you only discuss what Obamacare wants me to discuss.

This happened to me personally, as a patient, when I went for my physical. It is the law. If you are complaining of a new problem, then you have to reschedule, since Obamacare is very clear as to what is covered and what is not. Obamacare — intentionally — makes it as difficult to be seen and taken care of as possible.

Patients can be very tricky. I have had patients make an “annual” exam, only to want to discuss and be treated for another ailment. I can’t do it.

I can hear the complaints from you guys already — I become the bad guy. “Why don’t you just take care of the problem, and not bill out any different code? You’re a rich doctor, and we are entitled to free stuff.”

It doesn’t work that way. First, doctors are not rich and, like most of you, actually work terribly hard for a living. Second, Obamacare is the law — and as I said earlier, we are audited all the time now.

Also — I don’t ask for free gas when I go to the gas station, or ask for free food from the supermarket. Additionally, Obamacare has a 23% cut in Medicare reimbursement to doctors and hospitals.

These lower payments won’t cover the cost of staying in practice to take care of the patient.

Sound goofy? You ain’t heard nuthin’ yet:

On top of all of that, doctors will be obligated — that’s right, obligated — to talk to you about things you may have no interest or need to talk about.

You may just want to have a pap smear or check your cholesterol. However, I am now mandated by the government to talk to you about your weight, exercise, family life, smoking, sexual abuse(!), and even to ask if you wear seat belts. And I am mandated to record your answers.

I am a physician. But I need to tell you to wear a seat belt and then record your answer.

And yes, Virginia, there are death panels:

“It was my plan to admit this woman to the hospital. I found out a little later that this same woman had been a patient here just slightly more than 2 weeks ago with a DIFFERENT DIAGNOSIS. I was told that if this woman was admitted, the hospital would not be paid.

The new Medicare rule now is that if the same Medicare patient is re-admitted to the hospital within 30 days, the hospital will not be paid. When they first started this nonsense they said this only applied to patients with the same diagnosis. Now they have “expanded” the rule to include re-admissions for any reason. So if you’re in the hospital for pneumonia, and 3 weeks later, you break your leg…….too bad. Medicare will not pay the hospital to fix your leg.

A little later a man was brought in by ambulance, very sick, in pain, and near death. I did my usual evaluation and treatment, doing my best to ease pain and stabilize this man’s illness. He needed to be admitted. To my chagrin I found out that he had been treated for the SAME problem at a DIFFERENT HOSPITAL about 10 days prior. If I admitted this man, our hospital would be paid nothing. I admitted the man.

My friends I am caught in a terrible position. I could have given treatment to both of these people and sent them out. There is no doubt that both of them would have died. Oh, I could also be sued for malpractice, but nobody cares about that.

I am sure that when Mom or Dad die because they could not be readmitted for an illness you will find comfort knowing that Obama is not subject to the same rules.

Now a failure to steer away from the fiscal cliff would mean even more pain for physicians:

As the nation hurtles toward the fiscal cliff, doctors are staring down a much more daunting abyss, a panel of experts said Thursday at POLITICO Pro’s health care breakfast briefing.

Not only do doctors face a 2 percent cut in Medicare reimbursements because of the failure — thus far — to avoid sequestration, but they’re also looking at a 27 percent reduction in pay in the absence of a deal to fix the Medicare payment formula.

The medical profession is under duress:

Gail Wilensky, who led Medicare and Medicaid for President George H.W. Bush, warned that “having this looming out year after year … must really wear on physicians who are actively involved in Medicare wondering what they’re doing being involved in, for them, such an unstable program.”

“All that’s being publicly discussed is reducing payments under the same dysfunctional payment system,” she added.

And keep in mind that Obamacare provides absolutely no relief from malpractice liability. So doctors have the same exposure for less money.

Obamacare will indeed mean that the elderly will have an increasingly difficult time finding a participating provider which in turn means the waiting periods to see a participating provider will be lengthy. Delay in examination means delay in treatment and that will certainly mean many elderly will expire while waiting. It’s one way to cut costs.

Grandma may as well get run over by a reindeer.

DrJohn has been a health care professional for more than 30 years. In addition to clinical practice he has done extensive research and has published widely with over 70 original articles and abstracts in the peer-reviewed literature. DrJohn is well known in his field and has lectured on every continent except for Antarctica. He has been married to the same wonderful lady for over 30 years and has three kids- two sons, both of whom are attorneys and one daughter on her way into the field of education. DrJohn was brought up with the concept that one can do well if one is prepared to work hard but nothing in life is guaranteed. Except for liberals being foolish.

24 Responses to “You thought you knew how bad Obamacare was? Think again [Reader Post]”

  1. 1

    Liberal1 (Objectivity)

    There are, admittedly, a lot of difficulties with the Affordable Care Act. We could have enacted a less problematic plan, if the Republicans had felt more apathy for the plight of the people who were hurt and killed by the the lack of health care and acted in concert with the Democrats to openly craft a plan with would be good for all. Instead, they, along with some Blue Dog Democrats and Independents—like Joe Lieberman—acted in their own interest to require certain compromises that would present certain problems in the future. Hopefully, we can solve these problems and come closer to a single-payer system. But to do this, we must change the attitudes of many who consider only themselves.

  2. 2


    @Liberal1 (Objectivity):
    Republicans were shut out early in the process. So hurried were the Dems to get this passed no one read it. Now we find out how sloppy it is, including your own comments of dissatisfaction with it, but alas for you its not those who crafted the law being the problem, its those who didn’t that cause you the problem.

    Obama’s solution to the poor was to load states up with new Medicaid patients. That one didn’t pass the supreme court test so the poor will continue to suffer. And one thing we know for sure is that Obama knows how to create more poor people as we’ve watched the poverty rate climb during his tenure.

  3. 4


    @Liberal1 (Objectivity):

    Hmmm. You sound like a certain politician. Always blaming someone else, mostly the opposition, for things they have, and had, no control over.

    It’s almost comical that you want to blame the GOP for how bad Obamacare is. I say almost, because I know their are many more just like you. Obama pushed for this. Pelosi told us we needed it. And the Democrats passed it without any support from the GOP. The Democrats, those progressive leaning Democrats you favor, OWN OBAMACARE. Quit blaming others for the mistakes you and your kind make.

    Single payer? You might like to give up your freedom to the government masters, Lib1, but many of us like our freedom. Keep your filthy hands off of it.

  4. 5


    @Liberal1 (Objectivity):
    You really. re drunk on the collectivist kool-aid. Please explain to me how Obamacare does ANYTHING to provide for extra doctors to see all these millions of new patients? Please explain how if obamacare is so dang spiffilicious all the democrats who voted for it EXEMPTED MEMBERS OF CONGRESS AND THEIR FAMILIES AND STAFFERS from having to participate?
    Let me ask you an even more poignant question. Would you ever sign a contract or mortgage agreement or any other legal document under the philosophy “I have to sign it to see what is in it.”? Recall that is the utterly contemptible stupidity expressed by Pelosi before the House vote on obamacare.
    Explain please how adding 15000 IRS agents provides any additional medical appointments, or how the total absence of ANY limitations on ambulance chasers but all kinds of penalties against physicians and hospitals increases acces to medical care or improves quality of care?
    Obamacare is absolutely marxism in the most pernicious, evil, deceitful, left wing presentation. It does NOTHING to improve quality nor access to care, but does EVERYTHING to give government apparatachiks control over all our lives. It clearly violates the Constitutional right to Freedom of Religion by forcing those of us with religious beliefs prohibiting abortion and artifical birth control to violate our religious beliefs when we pay taxes used to pay for such things. It is despicable, evil in the extreme, and the second greatest fraud perpetrated on the citizens of this country beaten only by the ponzi scheme of social security.
    Support for socialist health care is the sign of a weak, selfish and economically ignorant mind. Look for the government leftist attacks against doctors who refuse to accept medicare and medicaid patients to start. Look for laws outlawing concierge medicine soon after…except for politicians, of course.
    Anyone so shallow-minded to believe that socialist health care is a good thing deserves exactly what they get. Don’t come wailing to me when you have to wait 6 months or more to see a specialist, and are denied treatment because you don’t meet Dr. Emmanuel’s life value criteria.

  5. 6

    Nan G

    I just had my last physical from a doctor I’ve had for almost 20 years.
    He’s retiring this year rather than deal with all Obama’s mandated changes.
    He’s only leaving about 5 years earlier than he’s always planned. (at 58 instead of 62)
    Anyway I’m moving away before next exam, too.
    My doctor did give me a bunch of hints for how to game the ”free” physical so as to sneak in ”new” ailments.
    Everything is SUPPOSED to go in the chart….but remind your doctor how rushed he was last time and then tell your doctor he must have forgotten that you mentioned that foot ailment, or sensitive stomach last time.
    Then insist he follow up and that what he told you last time is no longer working.
    He says he’d fall for it every time and so would a lot of doctors…..wink, wink.

    There’s going to be a huge growth in criminality in the USA as more Americans learn what they must do to game this new system.
    Think USSR and how corrupt it was.

  6. 7

    Scott in Oklahoma

    @Liberal1 (Objectivity)… so, you’re convinced that the single payer system is the way to go. Have you considered these things in forming your opinion?
    1) In a government run single payer system, if “they” decide you’re not going to get a particular treatment, you won’t get it. Period. In the free market, you can get that treatment. It might not be cheap, you might have to beg, borrow or rely on charity to fund it, but you can get whatever treatment you need (as long as the FDA says it’s okay… different subject)
    2) Do you believe in nationalization of what are currently private industries? That’s a yes or no question.
    3) How will the government compensate when all the for profit medical businesses decide it’s not worth it to be in business anymore and shut down? That would include doctor’s offices and small emergency clinics; and probably some larger hospitals as well. And how will the government pay for all that?
    4) Who pays the bill for “free services”? I don’t know any doctors, nurses or med-techs that work for nothing, medical supplies don’t come cheap either.
    5) Giving the IRS more power over our lives was a good thing how?
    and finally…
    6) Have you been to ANY government run institution, ever? Like the SS Office, a VA clinic or hospital, the DMV or the tax assor’s office? How about an IRS office? If so, did you come away from that experince thinking “wow, that was an efficient, well run operation” or did you come away from there thinking “wow, what a clusterf**k, I never want to go there again…”?

  7. 8


    @Liberal1 (Objectivity):

    So you think this obamacare is for the welfare of all? think again. I have read the law. obamacare is for the young and healthy. If you are over 75, you will not get the type of care you are used to. Need an operation?, a new knee, a new hip? forget it. You will be given the pill to ease your pain.

    Death panels? like the article says, yes there are but they are not called that. Once you reach a certain age (which I am unsure if that age has been identified) you will go before a board every five years. If you have a terminal disease or are non-productive (e.g., MS, downs syndrome, etc.) you will have to go before the board more frequently. During these boards it will be discussed if perhaps you need to end your life so that you are no longer a burden on the health care system. You liberals might think that is great, but when it comes to your mother, father, grandmother you might think differently.

    If you are non-productive you have a chance of your health care being stripped away. Remember this health care is for the young and the HEALTHY. If you are non productive and live in a home, you have a chance of being booted out.

    Do you remember when the congressman (can’t remember his name) was debating why abortion was so essential to this law? It is because as he said that new borns only put a burden on the health care system. The democrats and those who support this health care not only condone but encourage abortion.

    You will be limited to how much medical care you can get. It all depends upon your age and whether you can provide something productive. This word productive keeps popping up. This is a term used very frequently during the old USSR days. If you are not productive you are not worth keeping.

    The reason I read the law is that my 48 year old brother has severe MS. He has only use of one arm. He needs care 24/7 and lives in a home. I wanted to know what this law would do for him. He believes that obama did him a favor and little did he know that this law could make his demise a little earlier than he might expect.

    Money. I read an article that federal workers are going to get a voucher to spend on medical insurance and/or doctors. I am not quite sure about this and don’t quite understand so I will have to do some more research. So they are not getting out scott free either. This “FREE” health care is NOT free. Our taxes are going to explode. Even liberals cannot be that damn stupid to realize that they too will be paying the cost, or are they?

  8. 9


    If you think Obamacare will get better, think again. There are lots of union members, who supported Obamacare, that are in for a big shock.

    In 2009, AT&T reported that to insure just the employee, not their dependents, cost the company $10,060 a year. Now, with Obamacare, those Cadillac plans are subject to taxation. We can assume that the health insurance plan that AT&T listed as costing $10,060 will have increased by at least 10% in 9 years. That makes the value of that plan $11,066. Since that exceeds the $10,200 allowable by the government, that plan is taxed at 40% over and above the limit, or $346.40 owed in taxes on that health plan.

    “The tax is paid by the employer either through increased premiums on an insured plan or a surcharge levied by the administration of a self-funded plan. Employers will be forced to either absorb the additional tax or pass some, if not all, of it back to employees in the form of higher premiums.”

    If the coverage is for a family, and it exceeds the government limit of $27,500, which will be easy to do if the employee has a spouse and three kids, anything over that limit is also taxable at 40%.

    Workers have never been required to pay taxes on their company paid-for insurance. Starting in 2018, they will be, at a whopping 40% of anything over the limit.

    Ain’t Obamacare wonderful?

  9. 10

    Wm T Sherman

    @Liberal1 (Objectivity):

    There are, admittedly, a lot of difficulties with the Affordable Care Act. We could have enacted a less problematic plan, if the Republicans had felt more apathy for the plight of the people who were hurt and killed by the the lack of health care and acted in concert with the Democrats to openly craft a plan with would be good for all. Instead, they, along with some Blue Dog Democrats and Independents—like Joe Lieberman—acted in their own interest to require certain compromises that would present certain problems in the future. Hopefully, we can solve these problems and come closer to a single-payer system. But to do this, we must change the attitudes of many who consider only themselves.

    Obamacare was kludged together by the Democratic Party leadership behind closed doors. Republicans had zero input or influence. The Democrat congressional rank and file had zero input or influence. The bill was difficult to pass because although the Democrats had majorities in both houses, a number of Democrats believed (correctly as it turned out) that voting for such an unpopular monster of a bill would cause them to be voted out of office. Hence the arm-twisiting and quasi-illegal procedural gambits by Reid and Pelosi. A majority of the public was against Obamacare before it passed and a majority of the public is against it now.

    You have just provided a false history, from an alternative universe where anyone other than Democratic party insiders had any say in the contents of the bill. Sometimes you ‘progressive’ jagoffs wring your hands about the anger you see in conservatives. If you want a clue about what could possibly be making us angry, review your disgusting Orwellian rewriting of recent history. You know you’re lying. You know that we know you’re lying, and you simply don’t care. You’re like a robot. If you’re not getting paid for this, you’re a fool. If you are getting paid for this, you’re a POS.

  10. 11

    Scott in Oklahoma

    @Wm T Sherman… The scary thing about Liberal1, and the entire crowd of Obama supporters is they are total believers in the crap they spew. It isn’t a “follow the money” deal anymore, they are true believers and want nothing more than to see all that this country was built on cast aside for their own utopian ideals… rainbows and unicorns and all that bullshit. The actually believe they won’t suffer any lifestyle changes, that only happens to those “other people”.

  11. 12


    @Liberal1 (Objectivity):

    The best part about Obamacare is that the Democrats created the mess. They are 100% responsible for it. So when the Obama administration points out that there are sections of the law that they cannot possibly implement (e.g. the CLASS entitlement), or when it bankrupts Medicare even earlier than planned, or when healthcare providers get so disgusted by the mess that they stop taking Medicare or Medicaid patients, then the GOP gets to point directly to the Democrats and say, “Well, they broke it”.

    Democrats own it.

  12. 13


    I’d guess that if Lib1 were playing a pick-up basketball game where 15 people showed up, that the five who didn’t get picked for a team would be the ones that he blamed when his team lost the game. Kinda the same thing, isn’t it?

  13. 14


    Liberals are idiots. Closing medical practice to all insurance and medicare in two months. Good luck finding docs to put up with your assinine antics. Weve cared for free and reduced for most people. Havent taken salary in two years. Drained retirement to stay afloat. screw obama. And enjoy your death panels because theyre here. Most cureable and chronic will die prematurely. You voted for it. Medicine is an art and science. You cant codify every tidbit and demand a result. Maybe enough idiot voters will be eliminated that we can resume in future. 35 years.

  14. 15


    that is unacceptable, where is the FBI, they don’t arrest the TRAITORS of THIS AMERICA ANYMORE?
    just surprise them like you did for the old MAFIA,
    pick them up and put them in gistmo with the TERRORIST, these actions are the same as it,and pronounce THE LORD PRAYER , DELIVER US FROM THE EVILS AND PROTECT US ALWAYS,how long the tolerance will stay,how much can one endure, this is so sad, when will the PEOPLE REACT

  15. 17

    Nathan Blue

    Someone close to me administrates a long-term health care facility (Nursing home). Here’s some of the problems they’ve faced since Obamacare went through:

    Many trusted doctors won’t take new Medicaid patients (due to 30% reduction in payout), so the patient waits longer and gets poorer care.

    Non-nursing staff was cut. Mass layoffs happened in the company, and industry wide.

    The government just slapped this particular company with a lawsuit/fine for providing “overcare” for just about every patient . . . the period being from 2006 to present. What!?
    The charge is a matter of paperwork. Most long-term care facilities go above and beyond what they are being paid to do. This is a government scam, and one that was premeditated in an effort to pay for all kinds of bad bills. This lawsuit is being leveled against all long-term care companies, not just this one.

    In summary, Nursing Homes and their doctors get paid less, people lost or are losing their jobs, and the Homes are being forced to make less revenue while paying out to the government for “fines” accrued over the last six years (yeah right).

    Obamacare is hurting a lot of things, but I wanted to offer how it is affecting long-term care.

  16. 18


    Nathan BLUE
    HE must be denounce so all can see who he is,
    a destructor of jobs

  17. 19


    Long term care gets worse Nathan. As med provider there is new part of the law we are being held hostage. Two years ago we were hit with a “fine”. Third party companies now enlisted to review all charges and make you produce documentation. So, even though the doc does not own the facility, have custody of records or any way to motivate, they are constantly forced to produce patient care records on specific dates. Here is actual case: 3rd party company says we want to see Ms. Johnson’s record for Dec 5, 2006 showing doc signing off on readmit. Ok. So you go to nursing home (which has switched ownership several times). Patient died five years ago. Ok. So look for records. All in archive storage in another state. Order records. (Realize there are usually two or three dozen requests at once.) Get 20 or 30 BOXES holding 6,000 to 8,000 sheets each. Supposed to be alphabetical in chronology. Nothing is correct. Go through all boxes 3 people for several days. One page at a time. Sort and find all but ONE page. The one mentioned. It was some $30 charge for exam which the doc usually never sees due to cutbacks and delays from Medicare. Ok. So you finally send in all the sheets to third party company auditing. They say “its too late”. You had two weeks. Took two months. We had to ask nicely for all records. They don’t care. They fine you. Guess how much? They are now allowed to fine you the entire year’s charges for all Medicare charges made to that facility. Ready. Drumroll. $400,000. I’m not kidding. You try to reason with them. They say appeal. So you appeal. To who? Yes. Same company, same person. Appeal denied. Pay us $400,000 or we sick IRS on you. So you start paying, mainly on charges you never got paid for in the first place. Meanwhile you put in request for judge to review. Two years later no responses. Company knows they are in error. Doc doesn’t own records, have custody, can’t update or produce any records on demand. Was NEVER their patient. Was patient of home. Doc only came in to see patients for the home. So with no control the Doc is held hostage for all charges. Produced every bit of paper otherwise. Now, IRS sends threats. To take everything. Even though $200,000 has been repaid because Medicare cut off ALL reimbursements meanwhile. No one listens. No phone to call. No one in charge. So now DOC who did everything right, provided treatment, followed rules at the time, filed papers, never received payment, is being destroyed with new rules which claim “rich docs” are scamming system. The patient was cared for, all done properly, but records were long gone six years ago into storage by another company which doc doesn’t control. No appeals. No judge. Its time for all docs to realize they are being made into scapegoats. That they have no legal recourse even with lawyers (which cost $50,000 thus far) over a few dollar charge. The system allows the third party to “earn” 20% of everything they recover in “fraud”. This is not fraud. Its paperwork out of someone’s control. No electronic record. Simply a piece of paper. A practice to be destroyed by sick bureaucrats. Joke is on them. Now, shutting off all Medicare to nursing homes. Let the old people find care somewhere else. Good luck dying people. Thank Obama. He did this intentionally. Nursing homes are going bankrupt right and left. All being fined. Not just a few. ALL of them. They are all dying. So old people will literally have NOWHERE to go. Death in the streets. Docs are leaving. Don’t ever blame them. Most have given so much of their time and life it makes your head spin. Total disrespect. Screw this govt. They deserve to reap what they sewed.

  18. 20

    Nan G

    If what #s 17 &19 say is true Obama may have just begun the reinstitution of the large nuclear family!
    When people have babies their grandparents are there to care for them….free.
    When those grandparents got too old to care for themselves, their children and grandchildren will fill the gap.

    Ironic, if true.
    Just the opposite of breaking up families as seems to be Obama’s real goal.

  19. 21


    they need to go in front of a judge all of them and be imprison for life,
    or shot.
    that is the OBAMA THUGS AT WORK,
    you should all write your GOVERNOR AND SEND YOUR COPIES TO HIS OFFICE,
    that shouldn’t be happening in AMERICA,
    how come the ignorants vote for him again, is boggle the mind,
    something is going to happen, there is to much of that and other abuse happening.

  20. 22


    Rationing,death panels,full access to your bank account,full access to your medical records,cutting employee hours, diminished number of doctors,can’t sue the government for malpractice.Just a few fun facts associated with O care.Not only these but we will be taxed to death ,some predicting up to 50% after full implementation.Obamacare is 2000 plus pages and almost four feet tall steaming pile of socialist manure whose soul purpose is to control Americans.

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