November 12, 2013, - 3:52 pm

It Gets Worse: Doctors Can’t Afford to Stay in Biz Under ObamaCare; Still Don’t Know Which Doc is in Which Network

By Debbie Schlussel

I’m not going to be able to take a full day of [ObamaCare] exchange patients and keep my doors open.

–Michelle Berger, MD, an Austin, Texas ophthalmologist.

obamagloves

Bend Over: Doctor Obama of the University of Community Organizing Medical School is Ready to Operate on You

It’s bad enough that the ObamaCare website, Healthcare.flub, is still a bleeping disaster. Now, it turns out that doctors are in the dark about which doctors and hospitals are in which providers networks. So much for Obama’s BS claim that “if you like your doctor, you can keep your doctor.” It’s as true as his “if you like your plan, you can keep your plan.” In fact, your doctor doesn’t know if he/she can still see you. And those who do are balking at the rates they’ll be paid. In many cases the payments are so low that doctors don’t know if they’ll be able to remain in business under ObamaCare. This is the socialized medicine we feared but that Obama said wouldn’t happen. Well, it’s happening. The death panels, the death sentences for those with cancer, the docs who can’t set their own prices. It’s all here.

More than a month after HealthCare.gov and 15 state-based exchanges opened for business, consumers and even physicians are finding it isn’t easy or even possible sometimes to find out which doctors and hospitals are in the plans’ provider networks. “Some states, they have it, and for some, it isn’t available. It ‘s a big unknown for the patient,” says Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, whose members manage doctors’ practices. “It’s very much up in the air.”

That means insurance shoppers often can’t choose plans that their doctors participate in — or that include doctors near them. It also means doctors may not be able to confirm they’re in a plan when consumers ask them. While consumers may now occasionally find a doctor listed on their commerical insurance plan isn’t accepting patients or is no longer on the network, at least they can reliably find provider lists and doctors at least know what plans they currently participate in.










Gilberg says he wouldn’t buy a plan “if I didn’t know if my physicians were in the network or the hospital was in the network.” . . . The uncertainty stems from the general glitchiness that remains for some state exchanges and the federal site, HealthCare.gov, which is selling plans for 36 states that didn’t set up their own exchanges. It’s also due to the fact that insurers are still deciding what doctors they want on their networks and often haven’t even informed doctors if they are including them on their networks.

Some insurers have clauses in contracts with their existing doctors that say the doctors have to participate in any plans the insurers offer in that state. Doctors who don’t want to participate on the exchange plans might have had to opt out, which some may not have realized, says Sam Unterricht, a Brooklyn ophthalmologist who heads the Medical Society of the State of New York. And many doctors and hospitals are still negotiating with insurers over rates.

A survey released last week by the New York medical society found 40% of 405 doctors said they didn’t know how they wound up on insurers’ exchange plans. Just 6% said they chose to be on plans and 16% said they had to participate as part of a contract. The rest said they declined to participate. Three quarters of the doctors said they had never received a fee schedule from insurers for the plans.

In an attempt to cut costs, insurers are also cutting the number of hospitals and doctors they include in networks, and that’s a process that may continue through December. . . . In one rural area of Tennessee, there will only be two insurance carriers, and one isn’t listing any doctors yet. Another is a new co-op insurer and is still building its medical network, says broker J. Darlene Tucker, based in Scotts Hill, Tenn. . . .

Some doctors say they’re still waiting to hear what rates insurers are paying — or they are appalled they are so low. Michelle Berger, an Austin-based ophthalmologist, says she has only heard from one of the insurance companies she works with and she signed a contract to be on Blue Cross of Texas’ exchange plans. She did so before she saw the fees she would be paid, which she says are only slightly better than Medicaid. “I’m not going to be able to take a full day of exchange patients and keep my doors open,” she says. . . . In Sugarland, Texas, internal medicine physician Elizabeth Torres says she doesn’t know what plans she’s listed on, but she does know her profit margins are so thin she won’t be able to accept many patients at rates that are lower than Medicare. . . .

Around some other states:

• In New York, broker James Schutzer found a 2,025-page spreadsheet of doctors when he looked up hospitals on the NY State of Health exchange recently. When he went on Empire Blue Cross’ site, he got the same spreadsheet and a “Find a Doctor Alert” that noted the individual and small group health products are “under construction.”

Unterricht says the accuracy of the provider lists will be suspect, too, because doctors may unwittingly be on an insurers list since they already accept their commercial plans. “Some may not accept new patients right away, and some may not accept new patients at all,” he says.

• In California, the provider network for individual plans became searchable Wednesday, and there’s still no access to the plans for small businesses in the Small Business Health Options Program or physicians in the networks. The state had to start from scratch building the medical network because there was no consistency in medical coding, says Sacramento broker Laurie Rood. Programmers didn’t realize each insurance company had a different physician code.

Yup, it’s a giant clusterbleep disaster. And it’ll only get worse. Who the heck will go into medicine when payments are so low? Not the best and brightest. You want the local loser from community college to do your heart transplant? Good luck with that.

Keep Bending Over for Doctor Obama. And while you’re at it, BEND OVER SOME MORE.

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31 Responses

Debbie,

I CAN’T STOP LAUGHING!

Here is a possible solution:

http://www.medretreat.com/

The fools who elected these bozos should be imprisoned for stupidity.

Dennis

Dennis on November 12, 2013 at 4:14 pm

Scares the hell out of me as both doctor and patient

Lisa on November 12, 2013 at 4:15 pm

A lot of doctors are already leaving the field of medicine as a result of Obamacare. Converting their paper patient records to electronic records are costing doctors from $30,000 on up to over $100,000.

Many doctors love their independence, and will not take orders from a government bureaucrat.

Jonathan E. Grant on November 12, 2013 at 4:18 pm

    In Canada, medical care is contracted privately but the government picks up the health care tab. Private health insurance is actually illegal.

    That’s the direction in which we appear to be headed.

    NormanF on November 12, 2013 at 5:01 pm

Debbie,

Please advise if there are facilities in ISRAEL offering MEDICAL TOURISM SERVICES and if he accept payments from U.S. Insurance Carriers?

I think Persimmons are in season now, aren’t they?

ps: I’d like to try Israeli Falafel per a blip you mentioned some time ago about how good they were!

Dennis on November 12, 2013 at 4:22 pm

    I don’t think American Insurance plans are accepted here, Dennis. I know it is a problem for tourists who get sick and don’t have travel insurance, but there is medical tourism. http://www.isra-medix.com/
    I actually had no idea it was this developed but please come and help our economy ;) Whatever clinic you choose for your specific need can address insurance/payment with you.
    I also believe that Dental Tourism is quite high and we have very good dentists although they tend to push implants. Dentures are virtually a thing of the past.

    Bat Devorah (ha neviiah) on November 12, 2013 at 11:36 pm

      Good Morning Bat Devorah,

      Hope all is well and a big THANK YOU for the info.

      I have sent the LINK to a good friend who does have an ongoing medical situation in hopes he will investigate this option.

      Stay safe…

      Dennis on November 13, 2013 at 7:47 am

        You’re welcome Dennis. Good morning! I hope our friend finds the help she needs. We also have a lot of excellent complimentary medicine here.

        BTW, I took the liberty ofanswering because Debbie is a busy woman and doesn’t see posts every day and I’m here.

        Be well.

        Bat Devorah (ha neviiah) on November 13, 2013 at 10:42 am

Unfortunately, Obama and the Dems will have an answer to this. Sooner or later, the subsidies will be in place, and many millions of these people will get medical welfare. I would bet that a disproportionate number of those having problems are considered by demographic experts (Democrats of course) to be Republicans.

And right, the doctors in the program will be bottom of the barrel. Lots of foreigners, affirmative action minorities, Muslims, etc.

Little Al on November 12, 2013 at 4:30 pm

    “And right, the doctors in the program will be bottom of the barrel. Lots of foreigners, affirmative action minorities, Muslims, etc.”

    You bet, Little Al. The expenses for a US medical school are so high, and the number of years so great, that there will be a decrease in the number of American-born-and-educated doctors.

    skzion on November 12, 2013 at 5:32 pm

And unfortunately the Obamacare mess and the March of the Death Panels is affecting medical standards and guidelines. Any new pronouncement by a medical organization that one guideline or test is or isn’t necessary will inevitably have to be looked at by the patient (victim) in a political context.

e.g. are PSA tests necessary?
should there be LDL guidelines for statin users?
dietary requirements?

Little Al on November 12, 2013 at 4:35 pm

A lot doctors will go to work for the government – if they’re not doing it already. The poor already have single payer health care via Medicaid.

Its only a matter of time before the rest of the population gets folded into Medicaid. Good luck with finding affordable private health insurance in this country – if you can find it at all. And the taxpayers will cough up the cash to cover your medical expenses.

Welcome to the wonderful world of Obamacare.

NormanF on November 12, 2013 at 4:58 pm

At least you won’t have to worry about the proctologist….you’re already getting reamed, and will continue so, on a daily basis.

IceNoMore on November 12, 2013 at 5:01 pm

Too many idiots were transfixed by this guys empty b.s. and still are. It’ll hit home when they are the ones diagnosed with cancer and can’t get the right treatments or meds. What a bunch of idiots that stand behind this moron. Just shows how divided and dumb the other side is. Just pathetic. Doctors usually aren’t real keen on people from the gov or insurance companies getting in their business. Way true.

samurai on November 12, 2013 at 5:01 pm

    Death panels are already here, samurai. Hospitals can’t wait to pull the plug already, with “doctors” and “nurses” in cahoots with administrators so as to keep length of stay down and cut costs. Now just imagine what will happen with BarkyCare.

    skzion on November 12, 2013 at 5:35 pm

      Absolutely correct, Skzion. HHS Sec said before Congress “…Some Live, and Some Die.” regarding that 12-YO who needed a lung transplant. There are heaps more of Kathleen Sebilius’ in Gubmint now than ever before.

      That 12-YO was able to get a lung transplant and live, but NOT due to Kold Kathleen.

      (Ann Counter said something yesterday that reminded me of Sebilius’ saying regarding that 12-YO…Howie Carr asked her how she felt about the internet-tax (bill…I assume because they are trying to primary Enzi(R), a supporter of it and she’s against that because Liberal Ann is stuck about 20 years behind on the GOP…) and she said she doesn’t care about it (a Liberal thought) and that “some will win, and some will lose” so we see now where Ann is getting her (Libtard) inspiration from these days. Any Conservative buying her books is a total retard and should just go fill Donk.)

      Skunky on November 12, 2013 at 8:15 pm

        Skunky,

        You’re right girlfriend about that female scumbag Suckbilius. That poor 12 year old would’ve died without that transplant but the Wicked Witch of the West didn’t care. As for Ann Coulter the poor girl will do and say anything to hawk her latest book. I’m sure she’s smart enough to know how freaking stupid she sounds but many fools are still buying her crap. She will also have suckup CINOs like Vannity show casing her mug on TV.

        Ken b on November 13, 2013 at 12:42 pm

          KenB, I am so tired of that blonde smart-ass. I never thought I would detest her more than Libtards but I do now.

          Of course it will take 99 years for some Conservatives to catch up to what a Libtard she is. They still think of her as a Conservative prize-fighter. Not anymore. She knows it too, or she would not have named her dumb book such a retarded (and eff you) title.

          And Santa says blame the doctors but I say blame the VOTERS. Obama-Putin was elected TWICE. The first time, even before he won, the SMART ONES knew what his heart’s desire was (single payer). There was NOT a lack of clues and/or facts of what would happen. In fact, people have been covering up/hiding for him nicely in many ways and many forms since before 2008. (All presidents have psychological profiles but SURPRISE, SURPRISE Obama-Putin hasn’t had his yet…how are they gonna cover that he’s a malignant narcissists at best or a psychopath at worst????)

          Elections have consequences. We got what we deserved by what we did as a nation. THAT is the bottom line.

          Skunky on November 13, 2013 at 3:59 pm

Obamacare’s primary purpose is to increase the government database for identification and IRS thuggery.

“Undocumented” types and people already on government dole= will still be able to stagger into any ER at any hospital in the country and be treated for free, just like they always were under local and medicaid apparatus.

However, working people who have somehow managed to stay under the radar will now be ferreted out and be subject to IRS scrutiny and prosecution if they have any contact whatsoever with the medical system.

*That* is the true reason behind electronic medical records (EMR) – so that the government (IRS, primarily) can cross reference and inspect every person’s SSN and their medical history.

DS_ROCKS! on November 12, 2013 at 5:04 pm

They will never get it. They will be blaming Bush and the Republicans on their death beds. The Democrats already blame everybody else for the screwed up system the put in not working. The retardation and brain deadness of the Liberal is in zombie mode right now. They will flat out tell you something didn’t happen that was reported in their own liberal media. There is nothing that can be done for people like that.

RT on November 12, 2013 at 5:08 pm

Yeah

And what about the promised insurance premium reduction of $2500?

Yeah

Who got that?

ebayer on November 12, 2013 at 5:15 pm

All the quality doctors will go to a cash-practice model.

luagha on November 12, 2013 at 5:36 pm

    luagha, they tried that in Massachusetts and the legislature is working on having a license to practice medicine tied to a doctor’s acceptance of Romneycare patients. A legislator in Virginia is being preemptive about this and is already proposing that ALL doctors practicing in the state accept ALL government-backed insurance – or they can’t practice medicine.

    I read a really good article about a group of docs in Massachusetts who had a big practice, but found that they were spending so much money paying people to fight with insurance companies, and also with the prospect of having to shell out close to a million $$$ to install electronic medical records management systems in order to be reimbursed, that they left that practice and opened a cash-only practice. They charge $40 for an office visit, with lab tests and X-rays additional. The patient has to pay cash when the services are received. They said they are happier and making more money (what they take home) than they were in the big, complicated practice. They can also spend as much time as they want with each patient. Now Massachusetts intends to make this illegal.

    And we wonder why so many docs are retiring at the end of this year.

    MIGirl on November 12, 2013 at 7:14 pm

please PLEASE don’t think for a minute that obamacare is about health care. it never has been and is not intended to be.

just the amount that was spent on the computer program could have provide every person in the USA with between one and two million dollars depending on what reported costs were.

the administration does not care that the program doesn’t work ..they just funnel another bunch of money to their cronies.

they want the economy of the USA to collapse and obamacare can do that on it’s own. but just to make sure obama has doubled the debt on top of that.

while you conservatives hide behind your outrage the USA dies.

while you argue that this or that isn’t right and it needs to be overhauled the USA dies.

while you think there will be a saviour the USA dies.

while you think that you will vote the socialists (read communists because that is what they really are …the stalin/mao type)out the USA dies.

I am sure many of you know what needs to be done …I doubt any will do it.

while the USA dies the NSA reads this.
Dear NSA …what do you think your future is going to look like?

General P. Malaise on November 12, 2013 at 10:59 pm

Doctors brought this upon themselves, Debbie. For years, they told the federal government to make us stop smoking; stop eating (whatever ‘poison’ was/is the flavor of the day), etc. Doctors drove huge nails into the coffin of what used to be our free enterprise system; all in the name of “public health”.

For example: the proposal to mandate the removal of trans fat from food may sound like a healthy idea, but it takes all the risk out of large food corporations making the switch to healthier ingredients. It also makes it impossible for a small business to start from the ground up with the market advantage of healthier products (without trans fats) at competitive prices. Once the FDA mandates elimination of trans fat for all food processors, the risk of investment for big corporations is gone. That’s one of many ways doctors kill the free market.

Did doctors really think the federal government would never turn the tables on THEM? (That’s a rhetorical question.)

Once upon a time, doctors were largely white and male. Now, thanks to affirmative action, half the graduating class of a medical school is female. Do you know how many of these women will opt for part time jobs and early retirement to raise families? How will we fill the gap?

The United Way answered this for us last year. They have a program which will “fast track” licensing and citizenship for foreign-born doctors. I don’t have to tell Debbie what that means.

The doctors brought this on themselves, folks. Don’t kid yourselves.

There is NO Santa Claus on November 13, 2013 at 8:38 am

There will be good healthcare available as long payment is received in the form of cash. Many offices already demand payments upfront to stay in business.
Of course the system will evolve into tipping for healthcare providers, legal or not!

Steve Gardality on November 13, 2013 at 10:04 am

    Steve:

    Back in the 1980′s when Jews first started escaping the Iron Curtain, this is precisely the way they told me the health system worked.

    There is NO Santa Claus on November 14, 2013 at 12:17 am

What a disaster! I’m not surprised though. These freaking Obama idiots are so full of themselves that they (WAY) overreached this time and have created a nightmare for the American people and a political nightmare for themselves. Hopefully, Obamacare will be repealed. If not, hopefully, we’ll get conservative Repubs to take back the Senate and get a larger majority in the House and then the Presidency in 2016.

I can hope, can’t I? Or are the thought police going to come after me?

David on November 13, 2013 at 12:11 pm

The trainwreck that is Obamacare is so bad that it know has dumbcrats like Bill Clinton speaking out against it. We really know that he’s only doing that to give is wife ample cover for when her fat butt runs in 16. Obama for his part thinks that the non LOFO voters are so stupid that we don’t remember his latest lies about keeping your doctor or your policy. This crap sandwich is starting to stink to the point that even the dense Obamabots are figuring it out. That and the fact that policy cancellation notices are going out. Doctors are closing up shop not wanting or being able to work under the “Affordable Healthcare Act”. Debbie’s right with the way it’s going only the slubs will be going into medicine while our best and brightest will become teachers and government emplyees (ok those last two jobs were jokes but really this situaion is not funny). Obama will never do what is in the best interest of the American people. He and the other dolts in his administration feel that they know what’s best for us lowly rubes. He will see that his precious Obamacare moves full speed ahead despite the fact that his polls numbers are falling faster than Biden’s IQ. If this mess doesn’t get fixed soon it will spell disaster for the dummycrats next year. Provided the repubics don’t blow it which is also likely to happen.

Ken b on November 13, 2013 at 1:44 pm

I received a letter from my PCP’s office last week informing me that he is no longer practicing there. “….no further information on that..” is the answer I get when asking what happened to him or asking about his whereabouts. His name has been erased from every linked website I find in a basic Google search. He’d uttered to me one time maybe 6-8 months back of his disillusionment of the changes that were coming his and my way. I just wish he’d gave proper notice and a recommendation to someone new rather than just “gone”.

MrC_5150 on November 13, 2013 at 7:42 pm

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