CMS suspends doctor-reimbursement cuts used to calculate ObamaCare

posted at 12:55 pm on March 30, 2010 by Ed Morrissey

Democrats pushed the CBO to score their ObamaCare plan without considering a parallel effort called a “doctor fix” that would rescind already-scheduled cuts in Medicare reimbursements to providers.  The CBO wound up scoring the bill both ways, thanks to a request by Rep. Paul Ryan (R-WI), and confirmed that the removal of the 21% cuts in reimbursements would make ObamaCare a deficit expander, running hundreds of billions of dollars in the red.  Now we don’t have to wait for the Democrats in Congress to pay off the AMA for its support of ObamaCare, as the Centers for Medicare and Medicaid Services have temporarily suspended the cuts in anticipation of the “doc fix”:

Doctors slated to have their Medicare reimbursements cut 21 percent on April 1 got a reprieve from the Centers for Medicare and Medicaid Services, which is delaying lowered payments until after Congress reconvenes.

The agency, which administers the U.S. health program for people 65 years and older and the disabled, has ordered that claims submitted on or after April 1 be held for an added 10 days before being paid, said spokesman Peter Ashkenaz. That’s on top of the 14 days the Baltimore-based CMS usually holds claims. …

Unless Congress postpones or scraps the cuts, the average reimbursement for a colonoscopy would fall to $294.57, compared with the current national rate of $374.20, said Ellen Griffith, a CMS spokeswoman. For a typical visit to the doctor’s office, the reimbursement would fall to $51.70 from $65.67 for an established patient, she said.

The problem with the price-fixing scheme is that it’s narrowing the list of providers.  Doctors can’t pay for their own costs now, and cutting reimbursements by 21% will only make the situation worse.  It will force more providers out of the Medicare/Medicaid markets, the latter of which Congress expanded to include millions of new clients, which actually makes the situation worse for providers who want to remain part of the Medicaid system.  The flood of new patients will displace those covered by private insurance, which will force them to go out of business or get out of Medicaid.

Of course, we knew that before Congress began to debate ObamaCare — and so did the Democrats.  The AMA agreed to support their efforts only if Democrats rescinded those cuts.  Instead of recalibrating the bill using honest accounting, they claimed deficit reductions that only exist without the doctor fix.  For months, Democrats kept the rescission parallel to the overhaul of the health-care system to maintain the illusion of fiscal responsibility.

On April 1st, the illusion ends.  When those cuts don’t go into effect, ObamaCare becomes a deficit-expanding program — and that’s assuming that the rest of it works as advertised, a very large assumption that flies in the face of experience from every government entitlement program ever created.


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Comment pages: 1 2

None of the teapartiers are actually contributing to elections.

AnninCA on March 30, 2010 at 1:52 PM

None of them?
None at all?
And where is this scientific information coming from?

Badger40 on March 30, 2010 at 1:57 PM

I think the public gets the real story. Government is loaded with politicians, on both sides, who promise and don’t deliver.

AnninCA on March 30, 2010 at 1:26 PM

What promises are the r’s makeing but not delivering on???

SHARPTOOTH on March 30, 2010 at 1:36 PM

That’s just Ann’s habitual way of filling up space with inane platitudes.

AsianGirlInTights on March 30, 2010 at 1:57 PM

The Tea Party movement already figured this out months ago. My suggestion for Obama’s first book after leaving office should be titled, “How I Bankrupted the United States of America…………and, made it a second class world power”

SC.Charlie on March 30, 2010 at 1:57 PM

ladyingray on March 30, 2010 at 1:53 PM

I guess they could add other things to it, but the Doctor Fix, this year and prior years has always been about forestalling the programed cuts. They could pass a bill that removes the programed cuts, but it would still not change the overall cuts (not all physician related) in Obamacare.

Aviator on March 30, 2010 at 1:57 PM

I used to feel sorry for the democrats that they were such mental cases, now I flat out hate their stinkin, rotten guts.
tessa on March 30, 2010 at 1:32 PM

My moment was election day 2008 when I realized how stupid they are as a group.
Where possible I have disassociated myself with anyone I know who voted this guy in.

FireBlogger on March 30, 2010 at 1:58 PM

I caught Greta’s show last night. She points out a very good point.

None of the teapartiers are actually contributing to elections.

That’s the problem with populism. No money.

So we’ll see.

AnninCA on March 30, 2010 at 1:52 PM

Two words: Scott.Brown.

ladyingray on March 30, 2010 at 1:59 PM

And how much of that can get written off as charity by them?
And how long can you afford to give away your services for free?

Badger40 on March 30, 2010 at 1:56 PM

Zero
Not for long. You still have employees and an office to pay for.

Aviator on March 30, 2010 at 2:00 PM

My moment was election day 2008 when I realized how stupid they are as a group.
Where possible I have disassociated myself with anyone I know who voted this guy in.

FireBlogger on March 30, 2010 at 1:58 PM

Note that they still carry an 80% approval rating for Sir Liesalot.

cntrlfrk on March 30, 2010 at 2:00 PM

Smells like snake oil.

scalleywag on March 30, 2010 at 2:01 PM

Thugs run this country, don’t kid yourself into anything higher than this.

Schadenfreude on March 30, 2010 at 1:14 PM

I, Tuco Ramirez, will tell you something. Those politicians think they are better than we are. Where I came from, if one did not want to have to do actual work for a living, one became a politician or a bandit. They chose their way, I chose mine. Mine was harder! I don’t remember for how long, but I tried the political path! I tried, but it was no good! My standards may be very low but I do have some standards. Now I am going to tell them something… they became politicians because they are too cowardly to rob the way I do.

Tuco on March 30, 2010 at 2:01 PM

second class world power”

SC.Charlie on March 30, 2010 at 1:57 PM

You are more positive than I am

cntrlfrk on March 30, 2010 at 2:02 PM

That’s the problem with populism. No money.

So we’ll see.

AnninCA on March 30, 2010 at 1:52 PM

Doug Hoffman, Scott Brown, Sarah Palin,…

Nevermind, it’s impossible to argue with someone who doesn’t care about facts.

cs89 on March 30, 2010 at 2:05 PM

OT, but where the anninca is the thread to discuss the murder of the AZ rancher by illegal aliens?????????

HornetSting on March 30, 2010 at 2:05 PM

very large assumption that flies in the face of experience from every government entitlement program ever created.

Obama to the American people:
“In yo’ face, sucka!!!”

I wonder if he plays basketball like he governs.

UltimateBob on March 30, 2010 at 2:06 PM

Two words: Scott.Brown.

ladyingray on March 30, 2010 at 1:59 PM

Whatever. Ann doesn’t deal in facts. She just knows what she thinks about her opinion as the spokesperson for the great independent multitudes that she represents.

AsianGirlInTights on March 30, 2010 at 2:07 PM

AAPS is filing suit against ObamaCare…

ladyingray on March 30, 2010 at 2:07 PM

You got gamed. The government was never going to cut Medicare. They just ‘cut’ it in ObamaCare to game the score. They were always going to correct it with the ‘doctor fix’.

ladyingray on March 30, 2010 at 1:41 PM
This does nothing to the cuts enacted in Obamacare. The Doctor Fix does not change that. It fixes prior acts.

Aviator on March 30, 2010 at 1:50 PM

Two points:

First, as CBO repeatedly pointed out, the Medicare cost projections used to finance the health care bill assumed that a 21% cut for physicians would be allowed to go into effect. As CBO wrote in every report, the scores shouldn’t be believed if one didn’t believe that the 21% cut would happen.

Second, consider the irony here. The Administration is over-riding previously-legislated cuts in Medicare, and adding the spending to the deficit. Meanwhile, we’re being asked to believe that the future cuts in Medicare spending needed to finance the health care coverge expansion will actually take place. That representation is rendered absurd by the refusal to allow even the old-law cuts to happen.

The fact that this is a long-planned override of current-law cuts doesn’t make the case for the health bill’s financing, it fatally undermines it. Why will future Congresses and Administrations respect the cost-savings intended in “current law” if even the enacting Congress and Administration did not?

You couldn’t pick a more vivid demonstration of the reality that the so-called cost savings used to finance this massive cost expansion will never, in fact, occur.

Chuckles3 on March 30, 2010 at 2:09 PM

Indiana’s on board with the legal challenge now too.

http://www.jconline.com/article/20100330/BUSINESS/3300331

cs89 on March 30, 2010 at 2:10 PM

I, Tuco Ramirez, will tell you something. Those politicians think they are better than we are. Where I came from, if one did not want to have to do actual work for a living, one became a politician or a bandit.

Or Teacher / Professor

Wade on March 30, 2010 at 2:13 PM

She just knows what she thinks about her opinion as the spokesperson for the great independent multitudes that she represents.

AsianGirlInTights on March 30, 2010 at 2:07 PM

The thinks too little…

ladyingray on March 30, 2010 at 2:18 PM

ladyingray on March 30, 2010 at 1:59 PM
Whatever. Ann doesn’t deal in facts. She just knows what she thinks about her opinion as the spokesperson for the great independent multitudes that she represents.

AsianGirlInTights on March 30, 2010 at 2:07 PM

I’ve always suspected that these ‘independents’ that mccain and company try to bring to their side by bending over for the other side are somewhat like anninca.
Pretty Vacant.

HornetSting on March 30, 2010 at 2:20 PM

Aviator on March 30, 2010 at 2:00 PM

Huh. I really thought there was a charitable tax deduction in there somewhere.
This is even more outrageous.
No wonder Drs are dropping the pateints that have this coverage.
Even if I am sick & dying, I cannot expect a Dr to pay my bill.
This is what my family, my community, & the churches & nonprofits are for if I am indigent.
And I should not expect 5 star accomodations if I can’t pay for it.
Unbelievable.

Badger40 on March 30, 2010 at 2:22 PM

None of the teapartiers are actually contributing to elections.

That’s the problem with populism. No money.

So we’ll see.

AnninCA on March 30, 2010 at 1:52 PM

how did you come to THAT conclusion?

Willie on March 30, 2010 at 2:24 PM

Friends don’t let friends try to argue with anninca. All you will get is platitudes and a headache.

search4truth on March 30, 2010 at 2:25 PM

She just knows what she thinks about her opinion as the spokesperson for the great independent equivocating fence sitting multitudes that she represents.

AsianGirlInTights on March 30, 2010 at 2:07 PM

That’s more like it.

OT, but where the anninca is the thread to discuss the murder of the AZ rancher by illegal aliens?????????

HornetSting on March 30, 2010 at 2:05 PM

I had a student tell me about this today.
Gotta find this.
Those people are under such assault they can hardly make a living, as if ranching makes you a living anyway.

Badger40 on March 30, 2010 at 2:25 PM

Huh. I really thought there was a charitable tax deduction in there somewhere.
Badger40 on March 30, 2010 at 2:22 PM

Somebody like Jimbo would say “You did not get paid, so you did not have to pay taxes on it. See just like a tax deduction.”

Aviator on March 30, 2010 at 2:26 PM

I’m SHOCKED! SHOCKED that Congress would rescind the cuts they PROMISED that they would make!

GarandFan on March 30, 2010 at 2:28 PM

A $297.54 colonoscopy? I’ll bet the technician is Goatse Man. Goatse Man would do it that cheaply. It’s the “why he’d do it so cheaply” that should bother you.

Sekhmet on March 30, 2010 at 2:30 PM

Badger40 on March 30, 2010 at 2:25 PM

Thanks Badger40. That’s definitely better! *LOL

AsianGirlInTights on March 30, 2010 at 2:31 PM

Aviator on March 30, 2010 at 1:47 PM

Just so that I am better informed- I believe most doctors wait up to 4 months to be fully paid- from insurance and the patient portion for even small amounts. Would that also be the true timeline to receive Medicare/aid reimbursement from the government? Or does the government “give” themselves even more time than that?

(The above is just my personal observation about how long it takes for our insurance company to get their paperwork to us so that we can check it against the doctor’s statement. Then there is the 30/60/90 day before a doctor can send it to claims? I am betting that many divide up what they owe and make smaller payments over the next 90 days)

It would not shock me if the Dems push the AMA, leftist though they be, and doctors under the bus and don’t rescind the cuts. I think they truly believe that it is doctors gouging the system. And we already know that they are going to premium control the insurance companies to a death spiral.

I keep wondering if it is only lawyer money that keeps them from going after lawyers. What info, what pamphlets, are lawyers and their lobbyists feeding them, knowing that it reaffirms their socialist/communist views?

journeyintothewhirlwind on March 30, 2010 at 2:39 PM

None of the teapartiers are actually contributing to elections.

That’s the problem with populism. No money.

So we’ll see.

AnninCA on March 30, 2010 at 1:52 PM

Uhhhh…..WHAT????

Where are politicians getting their money, then? By magic? Or is Washington just printing up the stuff and passing it out equally?

I’m so tempted to dump out a glass of water and watch you walk on it. Sheesh!

Liam on March 30, 2010 at 2:40 PM

IF congress actually applies the ‘pay go’ that Nancy Pelosi has promised, the ‘doc fix’ would NOT raise the deficit.

Look for ANOTHER MAJOR TAX INCREASE to become the next discussion item.

Well, after they discuss the tax increase for the new PERMANENT 2+ year unemployment extension.

Freddy on March 30, 2010 at 2:41 PM

AnninCA on March 30, 2010 at 1:52 PM

You only need money to win an election when people are unaware of the issues.

The issue this November is simple – our economy is a clogged toilet and the Democrat’s “plan” is to take another big donkey dump into it.

You don’t need a weather man to tell you that the wind is blowing.

Not when there’s a big, stinky donkey sitting on the crapper.

NoDonkey on March 30, 2010 at 2:43 PM

Illegal Immigrant Suspected in Killing of Arizona Rancher

Happened Monday night. Suspected illegal smuggler who then fled south, back to Mexico.

If Ogabe and Demorats pass amnesty for the illegals…well…I can’t say cause I don’t want to get banned.

GrannyDee on March 30, 2010 at 2:46 PM

I like the PayGo idea. /sarc

It’s like a pay toilet from Hell when you have a stomach flu, a john with a sign saying, “Pay now, go later.”

All these trite little sayings and catchy slogans do nothing to solve the endless problems government creates. What’s really needed in America is more people and less government.

What was that John Lennon song–Power to the People?

Liam on March 30, 2010 at 2:46 PM

GrannyDee on March 30, 2010 at 2:46 PM

The poor undocumented visitor undoubtedly just wanted his 40 acres and a mule.

I say, give him the mule we have occupying the Oval Office.

And he can have the 40 acres Al Gore’s estate sits on.

NoDonkey on March 30, 2010 at 2:48 PM

If Ogabe and Demorats pass amnesty for the illegals…well…I can’t say cause I don’t want to get banned.

GrannyDee on March 30, 2010 at 2:46 PM

Amen.
Got Pitchforks?

HornetSting on March 30, 2010 at 2:50 PM

This cut is nothing new. Annual cuts to Medicare payments have been programmed for years. It is just part of the shell game played by congress, the cut is counted in deficit calculations then congress “delays” the cuts until the next year. This kicking the can down the road has been going on for sometime. The more rank dishonesty was to separate this from Obamacare to game the CBO numbers.

I’ve posted this before but here it is again.

CBO Explaination
Like others have said, I doubt they forgot. It was mostly likely a bait a switch deal. (Make the claim it’ll reduce the deficit when it was pretty obvious it wouldn’t)

Dave_d on March 30, 2010 at 2:50 PM

I caught Greta’s show last night. She points out a very good point.

None of the teapartiers are actually contributing to elections.

That’s the problem with populism. No money.

So we’ll see.

AnninCA on March 30, 2010 at 1:52 PM

You’re both delusional, then.

Scott Brown?

Governor Christie?

Another governor (name escapes me)?

Midas on March 30, 2010 at 2:52 PM

Another governor (name escapes me)?

Midas on March 30, 2010 at 2:52 PM

Governor of Virginia.
Watch out, you’ll make ann’s head explode.

HornetSting on March 30, 2010 at 2:59 PM

GrannyDee on March 30, 2010 at 2:46 PM

The poor undocumented visitor undoubtedly just wanted his 40 acres and a mule.

I say, give him the mule we have occupying the Oval Office.

And he can have the 40 acres Al Gore’s estate sits on.

NoDonkey on March 30, 2010 at 2:48 PM

Bravo! And he can have Algore, too, along with the 40 acres.

GrannyDee on March 30, 2010 at 3:00 PM

Midas on March 30, 2010 at 2:52 PM

It’s typical of the Left to make statements, merits irrelevant.

For example, the Left has been saying for years the Pubs have ‘no solution’ to the health-insurance problem. But the Pubs do! Only because the Dems don’t like the Pub idea is to them–Dems–no idea exists. It’s like a six-year-old who wants a pony and, when, the parents say they have no place to barn the animal, the kids says ‘my parents hate me!’

AnninCA thinks that, because she listens to the worst on Fox, she’s somehow savvy, leaning Right when in the end she’s ______. (insert your adjective-of-choice)

At risk of getting in Dutch here, Fox is slowly being co-opted toward the Left. I don’t trust FNC any more than I would listen to a thing on MSNBC.

Liam on March 30, 2010 at 3:01 PM

Watch out, you’ll make ann’s head explode.

HornetSting on March 30, 2010 at 2:59 PM

If I could watch that happen like in the movie Scanners, I’d donate $100 to Obow!

Liam on March 30, 2010 at 3:03 PM

Dave_d on March 30, 2010 at 2:50 PM

I got that and yes looking at the record it probably will happen. I am coming from the angle that Nancy counted on the AMA looking at the history of them never making the doctor cuts that they said they would and giving their approval of Obamacare. But Nancy and the communist Dems are going to do something historical. Historically bad, but historical nonetheless. You see, she , Obama and the others have whipped up doctor envy and now she is going to give them their revenge.
And truthfully, I don’t know which is worse for our future: less doctors or more unpayable debt.

journeyintothewhirlwind on March 30, 2010 at 3:07 PM

Anyone see the piece that I did yesterday, about a prediction there might be 40,000 fewer doctors by 2020?

Liam on March 30, 2010 at 3:08 PM

AnninCA thinks that, because she listens to the worst on Fox, she’s somehow savvy, leaning Right when in the end she’s ______. (insert your adjective-of-choice)

Liam on March 30, 2010 at 3:01 PM

Liam! :D

AsianGirlInTights on March 30, 2010 at 3:11 PM

Anyone see the piece that I did yesterday, about a prediction there might be 40,000 fewer doctors by 2020?

Liam on March 30, 2010 at 3:08 PM

I haven’t yet. Where did you post it?

AsianGirlInTights on March 30, 2010 at 3:12 PM

AsianGirlInTights on March 30, 2010 at 3:11 PM

Hi! Long time, no see.

As for Ann, and most libs, really, they aim for the lowest common denominator. Sick, really. Life is meant to be enjoyed, I say. Not something to merely ‘survive’.

Liam on March 30, 2010 at 3:14 PM

I haven’t yet. Where did you post it?

AsianGirlInTights on March 30, 2010 at 3:12 PM

I didn’t post it. It was something passed-through.

I admit, the figure of 40,000 is most likely overblown–big-time. But let’s say that’s 90% off. Ten percent is 4,000 fewer doctors.

Not good…

Liam on March 30, 2010 at 3:16 PM

Liam on March 30, 2010 at 3:16 PM

I work in healthcare and I see the contractual write-offs…we will lose many doctors. No one works for free.

ladyingray on March 30, 2010 at 3:23 PM

journeyintothewhirlwind on March 30, 2010 at 2:39 PM

Depends where in the country you are. There are different regions and they use different intermediaries to process claims. Where I am, about a year and a half ago the intermediary changed and no one (Doctors and Hospitals) got paid for many months. Huge problem, some providers were pushed to the brink of insolvency. In general, anybody that is collecting in one month is doing well. The scam is they question or reject part of the bill and then the fight begins. In essence they pay what they want to pay and then you have to keep going back to get what you are owed. Billing and collection expenses account for 40% (last figure I saw) of office overhead.

Aviator on March 30, 2010 at 3:23 PM

I admit, the figure of 40,000 is most likely overblown–big-time. But let’s say that’s 90% off. Ten percent is 4,000 fewer doctors.

Not good…

Liam on March 30, 2010 at 3:16 PM

It is scary. Where did that prediction come from?
On the face, it actually sounds plausible I think.

AsianGirlInTights on March 30, 2010 at 3:24 PM

In essence they pay what they want to pay and then you have to keep going back to get what you are owed. Billing and collection expenses account for 40% (last figure I saw) of office overhead.
Aviator on March 30, 2010 at 3:23 PM

And once Obamacare is in full swing, you wanna bet those AMA docs that supported O-care are on a priority list and get paid first?

It’s all part of positive reinforcing servitude training.

And then, if Medicare/Medicaid falls apart entirely, the sooner Obama can enact his emergency universal single payor.

Where are the docs gonna go? England? Canada? Once the US medical establishment goes kaput, there’s nowhere to run, nowhere to hide.

marybel on March 30, 2010 at 3:34 PM

marybel on March 30, 2010 at 3:34 PM

There are many off-shore hospitals in various stages of being planned and/or built. I personnally know of the Bahamas, Cancun, Turks and Caicos, Trinidad Tobago and a few others. I am helping to plan and develop them. They saw a huge opportunity to attract Americans, Canadians and Europeans who get the “get in line” spiel. Costs will be much less because of no malpractice and the governments are loosening their standards to allow American docs to practice there. You can fly first class there have your procedure and recuperate on an island for the cost of your deductible and co-insurance in the states.

hip shot on March 30, 2010 at 3:41 PM

On the face, it actually sounds plausible I think.

AsianGirlInTights on March 30, 2010 at 3:24 PM

I personally find the figure to be seriously overblown. Are there even 40,000 doctors in the Country?

Details aside, O-Care is a disaster. It will, no matter what libs say, cut availability. Costs will increase–end of story no matter what libs claim.

Maybe it might not have worked to cut costs, but the Dems shut out the Pubs and all they proposed. The DEMS refused to take a peek. They had their minds made up, and that was that for them.

Did the Dems even run a cost-analysis by the CBO to see if the Pub plan had actual merit? No, they didn’t.

If this country loses 4,000 doctors over the next ten years, what does that say about the Dem plan?

Oh, I know! Doctors are racists!

Liam on March 30, 2010 at 3:43 PM

hip shot on March 30, 2010 at 3:41 PM

I and a few other physicians I know have saying for several years this would happen.

Aviator on March 30, 2010 at 3:47 PM

If this country loses 4,000 doctors over the next ten years, what does that say about the Dem plan?

Oh, I know! Doctors are racists!

Liam on March 30, 2010 at 3:43 PM

More than 4,000 would be lost by normal attrition in ten years I would wager. Much more loss due to Obamacare.

Aviator on March 30, 2010 at 3:52 PM

Aviator on March 30, 2010 at 3:52 PM

I’m staying on the low side, which is bad enough–a ‘boon’ to the trolls who come here only to insult us all and for no other reason as they’ve stated. If it’s worse, though…

Liam on March 30, 2010 at 4:02 PM

hip shot on March 30, 2010 at 3:41 PM:

Thanks bunches! Great concept. Good for you and your entrepreneurial foresight.

Maybe now my husband will be happier about that Mexican time share south of Cancun that we’ve had for many years! That cheered me up some.

Are there any docs going to Cabo as well?

marybel on March 30, 2010 at 4:02 PM

Liam on March 30, 2010 at 3:43 PM

There are a lot more than 40k physicians in the U.S. 240,000 members in the AMA alone. Don’t have hard #s for total practicing physicians, but wouldn’t be surprised if it’s in the low millions. (Would still be < 1% of U.S. population, after all).

http://en.wikipedia.org/wiki/American_Medical_Association#Membership

cs89 on March 30, 2010 at 4:10 PM

cs89 on March 30, 2010 at 4:10 PM

It is somewhere a bit north of 850k IIRC.

Aviator on March 30, 2010 at 4:37 PM

cs89 on March 30, 2010 at 4:10 PM

Thanks! I don’t have an accurate tally of MDs in the country so, having not looked that up, I went by the lowest math for the moment.

If 40,000 do quit, and those numbers aren’t made up by new doctors…Well, the extrapolation is downright terrifying if it comes to pass.

And all thanks to O-Care!

It’s funny, you know–I’ve read Leftists post how ‘great’ it is that we Cons lose our liberty. What they miss is that they, too, will suffer more than we will. Worse, they’ll be the ones crying and simpering the loudest and longest.

If I’m stuck watching my beloved United States sink, I’m going to enjoy, in a sense, watching the libs who helped bring it about whining and crying, demanding their ‘fair share’.

Many might listen, but few will be pitching in to alleviate their pitiful self-imposed plight.

Liam on March 30, 2010 at 4:40 PM

No one works for free.

ladyingray on March 30, 2010 at 3:23 PM

But when it comes to medicine & food, the public expects those involved producing those things to certainly work for no profit.
You know approx 70+% of the Farm Bill is for food assistance programs like Food Stamps? It does not go to farmers at all.
The govt should quit feeding people & let them feed themselves.
Of course without the govt subsidizing food production in any way, you would notice a large rise in the cost of your food products.
This would cause a huge amount of belly aching from not only the welfare crowd, but the AnninCaing AnnicCA types who try to be a little conservative & a little liberal.
Then your eggs would probably be $6/doz etc.
Large agriculture businesses, as well as small, can receive the govt subsidy $ to make your food so it’s cheap.
Now look at how they villify Drs for trying to make a living & pharmaceuticals for trying to make a profit.
It’s crazy to demand certain businesses to work for free.

Badger40 on March 30, 2010 at 4:47 PM

Maybe now my husband will be happier about that Mexican time share south of Cancun that we’ve had for many years! That cheered me up some.

Are there any docs going to Cabo as well?

marybel on March 30, 2010 at 4:02 PM

You are braver than I. Mexico scares the heck out of me.
They just don’t seem to have much control over the anarchy.

Badger40 on March 30, 2010 at 4:49 PM

Ron Wood makes another cameo appearance! (See picture, over Pelosi’s left shoulder.)

Dopenstrange on March 30, 2010 at 4:51 PM

Dopenstrange on March 30, 2010 at 4:51 PM

I thought that was Roddy McDowell in a new sci-fi flick.

NoDonkey on March 30, 2010 at 4:55 PM

The agency, which administers the U.S. health program for people 65 years and older and the disabled, has ordered that claims submitted on or after April 1 be held for an added 10 days before being paid, said spokesman Peter Ashkenaz. That’s on top of the 14 days the Baltimore-based CMS usually holds claims. …

Well, the local carriers that CMS contracts to pay claims do not “hold” claims for 14 days; that is the maximum time allowed for the carriers to process and pay claims. But beyond that point, what this section refers to is a common practice called a “claims pend”. If a major change in contractual reimbursement is either anticipated or has been approved but not yet loaded to the claims processing system, a temporary pend is placed on claims so that they will not have to subsequently be reprocessed after the new reimbursement rates are loaded.

A 10-day pend is not normally too disruptive of provider cash flow if it’s a normal commercial carrier but could be disruptive since this is Medicare. But two additional issues come into play in the particular case:

1. The reimbursement rate in this case is not a normal commercial arms-length negotiated rate but is one that is subject to the whims of the political process. This is the second time the supposed reimbursement fix was supposed to be accomplished. What’s to say this won’t get delayed again by the politicians? Then what will CMS do? Continue the claims pend and really stir the pot of provider resentment? Release the claims and risk a meltdown in claims processing turnaround when they have to be reprocessed to any new rates?

2. Most commercial carriers have many physician contracts tied to a % of current CMS physician fee schedule. Claims that would be adjudicated to those schedules could be effected as well. For instance, the very large commercial carrier for which I work announced just such a claims pend about 20 minutes ago. So some providers will get the double whammy.

I wouldn’t want to be a provider once these insurance exchanges get going; problems like this will only intensify as more and more reimbursement is subject to the whims of the political process. But I think that point has already been duly noted by some providers and they are making alternative career plans come 1/1/14.

Tongueboy on March 30, 2010 at 5:00 PM

You are braver than I. Mexico scares the heck out of me.
They just don’t seem to have much control over the anarchy.
Badger40 on March 30, 2010 at 4:49 PM

We have been vacationing in Mexican time-shares for probably 20 years. Tourism is their major source of revenue so the Mexican government makes sure tourist areas are safer than you can imagine. The anarchy and danger are in the border towns, which we avoid. We also avoid the youthfully nutty spring break, but that’s just a timing issue.

If we could afford it, we’d take our grandchildren every year, as they just love it there…but we have too many and airfares are expensive. Mexican resort towns are beautiful.

The Mexican people I have met are friendly, helpful, and welcoming to Americans and the overwhelming majority speak bery good English as well. The food is wonderful, the weather fabulous, sandy beaches, mariachis and folklorico dancing… and you don’t have to be a millionaire to afford it. We have met many Americans from all over the US there.

One trip and you’d lose your actually unfounded fear.

marybel on March 30, 2010 at 5:09 PM

One trip and you’d lose your actually unfounded fear.

marybel on March 30, 2010 at 5:09 PM

Well my cowboy flat-lander husband has always dreamed of lounging on a beach next to clear blue waters for a week.
But I guess for now we’ll have to stick w/ the ol’ camper in the mountains of MT or the Black Hills of SD for now.
That is, until we make enough $$ to stay away long enough so we can really enjoy ourselves.
Every time we leave home for vacation, our vehicle breaks down, the cows &/or horses get loose or something dies.
Vacation is always a disaster for us.
But we are gluttons for punishment.

Badger40 on March 30, 2010 at 5:22 PM

Dopenstrange on March 30, 2010 at 4:51 PM
I thought that was Roddy McDowell in a new sci-fi flick.

NoDonkey on March 30, 2010 at 4:55 PM

Gee, now that you mention it… :)

Dopenstrange on March 30, 2010 at 5:25 PM

Badger40 on March 30, 2010 at 5:22 PM

Hope you get to that sandy Mexican beach someday. One of the nicest couples we ever met on vacation were from ND. They were farmers who had big machinery and did itinerant harvesting for smaller farms. The tall beautiful wife, operated a combine! They were there with her mother, a very spry 83 year old wo loved to party, and taught everybody to play dominoes.
What lovely, down to earth, fun loving people!

…and they weren’t the least bit afraid of being in Mexico.

marybel on March 30, 2010 at 5:54 PM

I personally find the figure to be seriously overblown. Are there even 40,000 doctors in the Country?

Liam on March 30, 2010 at 3:43 PM

Just from a quick search on Google, the number seems to be somewhere between 800,000 ~ 1,500,000. I don’t know how accurate that is. It seems plausible though.

AsianGirlInTights on March 30, 2010 at 6:03 PM

Aviator, Tongueboy, and Ladyingrey,
Thanks for sharing your work knowledge with me. I really do appreciate it. As you can probably tell I have a high expectation that Obama and company’s relationship with the AMA and it’s doctors will be ruined. I am not sure if I am basing it off what he did with Pharma to get their approval and then backtracked or just a gut feeling that the man makes and keeps promises to noone.

Aviator- is it a good guess that the Chicago area doctors have a higher percentage of claims paid within 1-2 months than other areas?

journeyintothewhirlwind on March 30, 2010 at 7:32 PM

hip shot on March 30, 2010 at 3:41 PM

Good to know. Why do I suddenly see a government tax equal to the amount of the “gold” plan being levied on all flights to these locations?

journeyintothewhirlwind on March 30, 2010 at 7:36 PM

They just don’t seem to have much control over the anarchy.

Badger40 on March 30, 2010 at 4:49 PM

In general, they don’t have a handle on much of anything. Crime and corruption run rampant there…but even the crooks have a vested interest in keeping a semblance of order. Especially in tourist spots, as was mentioned.

For the average person, however, it’s a whole ‘nother shooting match. Quite often literally. The country is gorgeous, the food yum-tastic and the people good at heart…but I wouldn’t feel safe there if I were cloaked head-to-toe in Kevlar. It was unnerving in the extreme when my sister went down there on a missions trip.

Dark-Star on March 31, 2010 at 12:22 AM

What promises are the r’s makeing but not delivering on???

SHARPTOOTH on March 30, 2010 at 1:36 PM

I seem to remember a whole bevy of Republicans that spent money like a drunken sailor on shore leave even while they talked from the side of their mouths about fiscal responsibility. If I remember right this was a big part of the reason that the Republican In Name Only acronym was coined.

Hawthorne on March 31, 2010 at 1:06 AM

According to a study by the World Health Organization on Health workforce, infrastructure, and essential medicines the USA has 730,801 physicians as of 2009.

http://www.who.int/whosis/whostat/EN_WHS09_Table6.pdf

Hawthorne on March 31, 2010 at 1:22 AM

72% of physicians feel that a public option would have a negative impact on physician supply, with 45% feeling it will “decline or worsen dramatically” and 27% predicting it will “decline or worsen somewhat.
24% of physicians think they will try to retire early if a public option is implemented.
The physicians take a decidedly more cautioned approach to reform than the president:

62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.

It is here

It will be plus for Philippines as many great Filipino doctors and nurses will come home. With rate of Growth and not being effected by world recession very much, the Philippines is on a path to first world status in 10 years.

Ed Laskie on March 31, 2010 at 3:04 AM

Philippines is a great bargain right now. It is pulling it self out of poverty and freedom still exists for most part.
It was one of few countries that still saw growth when rest of world was sinking. Very nice earthquake all cement steel reinforced beautiful homes being built every day.

Ed Laskie on March 31, 2010 at 3:10 AM

I’m begging you,delete that photo. It’s just to damn early for all that uglyness. This is O/T but can somebody please get E.Holmes-Norton a bag with eye holes. GOOD GOD!!!

nukeemnow on March 31, 2010 at 9:23 AM

hip shot on March 30, 2010 at 3:41 PM

Awesome news!
Question does Pinnochios’ “Kill the Babies and Old People Plan”

apply to all 57 States? Perhaps theres’ seven or so missing states that doctors could go to and not be affected by the
“Kill the Babies and Old People Plan”!

dhunter on March 31, 2010 at 10:02 AM

They don’t plan on losing any doctors. They just plan on replacing them.

That’s why there are things in the bill about giving priority and funds to places that will promote minorities in medical school.

That’s also why they have grabbed the student loan industry.

Put it together. We will have doctors, just different ones. Substandard ones, you might say. Who will work for the government, and dispense treatment as per government guidelines.

And there’s probably no end to the number of lesser-qualified people who would just love to play doctor, for the prestige alone.

Alana on March 31, 2010 at 12:09 PM

f I’m stuck watching my beloved United States sink, I’m going to enjoy, in a sense, watching the libs who helped bring it about whining and crying, demanding their ‘fair share’.

Many might listen, but few will be pitching in to alleviate their pitiful self-imposed plight.

Liam on March 30, 2010 at 4:40 PM

me too.

Alana on March 31, 2010 at 12:12 PM

marybel on March 30, 2010 at 5:54 PM

&

Dark-Star on March 31, 2010 at 12:22 AM

I can see both sides of this.
Honestly, I’m not sure if I can really ever feel comfortable leaving the United States.
Even going to Canada has worried me.
When I lived in TX I did go across the border once & that was enough for me, but I can see the appeal of the resort towns.
I am just not sure I ever want to risk leaving this country bcs I admit, I’m a little paranoid.
I’m even watchful when my flights divert me through the MN Airport-that place is like a foreign country.

Badger40 on March 31, 2010 at 2:00 PM

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