January 1, 2013 - Obamacare/Medicare

You are right. My wife lost her job a few months ago as a nurse at a doctor's office that was 90%+ Medicare. The doctor saw what was coming and moved out of state to a non-Medicare practice. She just recently found another job.

There will be a definite shortage of doctors, no doubt about it.

 

We will be switching to christian healthcare ministries in order to avoid obamacare a d our monthly premium going
to fund abortion .

 

A big part of this situation is the evil use of the "non profit" tax break by hospitals. http://seattletimes.com/html/localnews/2019600338_facilityfees04m.html had a front page story two Sundays ago. See below.

Non-profits stuff management pockets while passing ALL costs on to their customers. If hospitals were regulated as utilities rate increases would have to be approved by the utilities commission and expansion costs would come out of profits. None profits can generate more profits than for profits but they make the profits disappear in employee wages and benefits. That is as much the reason for high medical costs as unions might be.

----------------------------

Why you might pay twice for one visit to doctor
More patients are being confronted with hospital "facility fees" for routine doctors' office visits. Hospitals say the fees are needed to cover overhead as they consolidate and buy clinics and practices, but the trend has spurred calls for more scrutiny.

By Carol M. Ostrom
Seattle Times health reporter

The facility fee, by the numbers
Medicare Payment Advisory Commission does the math
This 2011 example of Medicare rates shows different payments for a midlevel routine visit to a physician's office and to a clinic or office licensed as a hospital outpatient department.

Service in physician's office:

• Payment to physician: $68.97

• Total: $68.97

Service in outpatient department:

• Payment to physician: $49.27

• Payment to hospital: $75.13

• Total: $124.40

Source: Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy, March 2012.

For more information
Starting Jan. 1, hospitals and clinics must notify patients about facility fees: http://1.usa.gov/U0WlLR


Joanne Silberner stood at the podium, about to referee a CityClub panel on health-care costs.

As a former health-policy correspondent for National Public Radio, Silberner knows a lot.

But, she told the panelists and the audience, she was baffled when she got two bills after a recent visit to a dermatologist.

One bill, for $109, was for the doctor, who saw her in his office at the Roosevelt Clinic. Then, to her dismay, she got another bill — $228 — for using the space.

The care she got seemed identical to an earlier visit with a dermatologist at another clinic — except for the two-bill whammy.

Such add-on facility charges are increasingly common for office visits — even routine ones — as hospitals around the country consolidate and buy independent practices. Clinics and practices operated by hospitals can charge the fees, as Silberner discovered at Roosevelt Clinic, licensed by UW Medicine, a hospital system.

Hospitals that charge facility fees in some clinics include the UW, Swedish Medical Center, Seattle Children's and others. They say the fees are needed to defray overhead such as equipment, staff, medical-records systems, diagnostic imaging and care not covered by insurance or underpaid by Medicare or Medicaid. The fees are justified, they argue, because integrating clinics with hospitals improves care.

The costly trend has caught the attention of the Medicare Payment Advisory Commission. Facility fees for simple office visits, it estimated, will add $2 billion a year to Medicare spending by 2020. For a middle-range doctor's office visit, such fees increase the total charge by more than 80 percent, the commission calculated.

For patients being urged to become choosy health-care consumers, the fees are not only perplexing, they're one more out-of-pocket burden.

Patients with no insurance or with high deductibles may be stuck with the whole bill, which — for a routine visit or minor procedure — can be several hundred dollars.

Even those with insurance don't skate: In addition to the typical flat co-payment of $25 or so for the doctor visit, they'll pay co-insurance, typically 20 or 30 percent of the facility fee, which is often bigger than the doctor's bill.

A month ago, Group Health Cooperative, which as an insurer pays bills when members seek care at outside clinics, fired a shot across the bow: It notified all the hospital systems it contracts with that it will no longer pay facility fees for routine doctor's office visits, and it won't stick patients with the bills, either.

Over the past three years, Group Health says, facility-fee payments for office visits, ranging from $56 to $268, have increased 10 to 15 percent per year and now total about $2 million per year.

"Facility fees demonstrate how the fee-for-service system can inflate cost without in any way contributing to the health of patients," said Group Health CEO Scott Armstrong.

 

Our primary care doctor charges $95-$135 for an office visit. He gets more than the specialists we see. I complained about it once to the feds. The only reason I can see for Medicare honoring the fee is he has a Latino name. Born in Texas though!

 

Medicare bases their payments on the median fees in every state. Florida doctors are paid more than WA doctors because our hospitals generate less wasted time and money.