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Friday, March 28, 2014

Cruising the Web

Representative Mo Brooks read aloud a letter on the House floor from a doctor about what the real experience of doctors is under Obamacare. This is what is really happening on the ground because of the federal government's interference.
The medical profession has never before remotely approached today’s stress, work hours, wasted costs, decreased efficiency, and declining ability to focus on patient care.

In our community alone, at least 6 doctors have left patient care for administrative positions, to start a concierge practice, or retire altogether.

Doctors are smothered by destructive regulations that add costs, raise our overhead and ‘gum up the works,’ making patient treatment slower and less efficient, thus forcing doctors to focus on things other than patient care and reduce the number of patients we can help each day.

I spend more time at work than at any time in my 27 years of practice and more of that time is spent on administrative tasks and entering useless data into a computer rather than helping sick patients.

Doctors have been forced by ill-informed bureaucrats to implement electronic medical records (“EMR”) that, in our four doctor practice, costs well over $100,000 plus continuing yearly operational costs . . . all of which does not help take care of one patient while driving up the cost of every patient’s health care.

Washington’s electronic medical records requirement makes our medical practice much slower and less efficient, forcing our doctors to treat fewer patients per day than we did before the EMR mandate.

To make matters worse, Washington forces doctors to demonstrate ‘meaningful use’ of EMR or risk not being fully paid for the help we give.

In addition to the electronic medical records burden, we face a mandate to use the ICD-10 coding system, a new set of reimbursement diagnosis codes.

The current ICD-9 coding system uses roughly 13,000 codes. The new ICD-10 coding system uses a staggering 70,000 new and completely different codes, thus dramatically slowing doctors down due to the unnecessary complexity and sheer numbers of codes that must be learned.

The cost of this new ICD-10 coding system for our small practice is roughly $80,000, again driving up health care costs without one iota of improvement in health care quality.

Finally, doctors face nonpayment by patients with ObamaCare. These patients may or may not be paying their premiums and we have no way of verifying this. No business can operate with that much uncertainty.
Here is some more information on how the new coding for classification of diseases is affecting doctors' offices have to master a quintupling of the codes that they have to enter into the computer for the particular disease or injury for which they are treating a patient. As Dr. Brian C. Joondeph points out, this is not a partisan issue since this has been in the works since before Clinton's presidency. It is a matter of federal government overreach.
Third, will the insurance companies recognize each of these new 68 thousand codes, correctly match them to billed procedures, and promptly pay the providers? If I treat a patient with macular degeneration with a monthly dose of a $2,000 drug, I now bill a single code, which insures that I will be paid. Under the ICD-10, there will be 20 codes, specifying which eye(s) and severity, that allow payment. Will every insurance company have each of these codes in its computers? Will it recognize each code? Remember that these are the same insurance companies that don’t even know who has actually paid their insurance premiums.

The American Medical Association announced this week that ICD-10 implementation will cost three times as much as originally estimated. The “costs of training, vendor and software upgrades, testing and payment disruption” could be $225,000 for a small medical practice and over $8 million for a large practice. How do medical practices of marginal profitability absorb these costs? With physician reimbursement rates set to grow at only half a percent per year over the next five years, far below the true rate of inflation of close to 10 percent, the financial writing is on the wall. This will accelerate the demise of private practice, already underway due to ObamaCare. Come October 1, “The doctor is in” may be a phrase of historical interest only.

Harry Reid is such a bad liar. He is now denying that he ever went to the Senate floor and said that the Republicans were lying about stories of people suffering because of Obamacare. Doesn't he know that C-Span records what he says on the Senate floor? Allahpundit juxtaposes the two videos of Reid calling such horror stories lies back on February 26 and his denial that he ever said that a month later.

Matthew Continetti has more covering the sleaze that has been Harry Reid as he has used his position in the Senate to enrich members of his own family.
That Harry Reid’s political and influence operation includes his five children has been known for some time. A few weeks ago, when I first heard Reid accuse private citizens of being un-American, I dredged up a Los Angeles Times article from 2003 with the headline, “In Nevada, the Name to Know Is Reid.” Chuck Neubauer and Richard T. Cooper’s meticulously researched and reported article begins with the story of the “Clark County Conservation of Land and Natural Resources Act of 2002,” a land bill of the sort that puts people to sleep. “What Reid did not explain” when he introduced the bill in the Senate, Neubauer and Cooper wrote, “was that the bill promised a cavalcade of benefits to real estate developers, corporations, and local institutions that were paying hundreds of thousands of dollars in lobbying fees to his sons’ and son-in-law’s firms.” I wonder why he left that part out.

Firms tied to the Reid family, the Los Angeles Times reported, earned more than $2 million from 1998 to 2002 “from special interests that were represented by the kids and helped by the senator in Washington.” How much more have they earned in the 11 years since this article was published? Land, energy, water, gaming, and mining—the Reids manage a diversified portfolio. They are not financial investors but political ones. Reid’s four sons are lawyers, as is his son-in-law. They make their money furthering the interests of paying clients, clients operating businesses in the state represented by Reid.

Those businesses are not necessarily American. After a 2011 trip to China Harry Reid began touting the virtues of ENN Energy Group, a Chinese firm that sought to build a $5 billion solar farm in Nevada. Reid’s son Rory represented ENN, though Rory claimed in a 2012 Bloomberg article never to have discussed “the project with my father or his staff.” Somehow, though, commissioners friendly with the Reid family agreed to sell property to ENN for one-sixth of the land’s appraised value.

The senator repeatedly expressed his support for the project. But ENN could not find a customer for its energy, and dropped its plans last June. In another instance Reid pressured Homeland Security officials to approve the visas of Chinese casino investors represented by Rory Reid. Rory’s brothers should not feel left out, however. Hoover Institution scholar Peter Schweizer says Papa Reid has “sponsored at least $47 million in earmarks that directly benefited organizations that one of his sons, Key Reid, either lobbies for or is affiliated with.”

Who could have been surprised, then, when the Washington Post in 2012 “uncovered nearly 50 members who helped direct millions of dollars in earmarks to projects that either held the potential to enhance the surroundings of a lawmaker’s own property, or aided entities connected to their immediate family,” and one of those members was Reid. The Post zeroed in on an almost $22 million earmark, passed close to a decade ago, that financed a bridge over the Colorado River. The bridge connects the gambling resorts of Laughlin, Nev., to Bullhead City, Arizona. Harry Reid owns 160 acres in Bullhead. (links in original)
Chris Cillizza points out that Americans have changed their opinion of President Obama's supposed competence.

Here are "six ridiculous arguments offered during yesterday's Hobby Lobby hearing."

Read the amicus brief from P.J. O'Rourke and Ilya Shapiro on why lying about politicians should not be criminalized for political "truthiness" as an Ohio law does. It is first-class snark, but also an important question. The footnotes are particularly fun. For example, here is footnote 15
15. Driehaus voted for Obamacare, which the Susan B. Anthony List said was the equivalent of voting for taxpayer-funded abortion. Amici are unsure how true the allegation is given that the healthcare law seems to change daily, but it certainly isn’t as truthy as calling a mandate a tax.
Lovely. I look forward to the case, Susan B. Anthony List v. Driehaus, which will be argued before the Supreme Court on April 22.

Charles Krauthammer lumps deserved derision on Barack Obama's remarks about Putin and Russia's armed annexation of Crimea.

Replicating successful schools has become a rallying cry for politicians and education policy specialists. It is now an issue in the District of Columbia mayoral race as one candidate vows to try to copy the success of the most popular D.C. public middle school. As this local news report points out, policies that work at a school dramatically different in its demographics from the rest of the District's schools may be very difficult. Instead the report points to the achievements of the most successful charter school, D.C. Prep, in the area which includes 80% lower-income students. It also is the school where my daughter teaches and we've been very impressed with the work the teachers there are doing with their students. And for a smile to start your day, check out this video of the school's 4th graders as they prepare for the D.C. standardized tests next week.
And check out this informational video and see if you don't want to hug Jahari and you aren't eager to see what becomes of this child. And then ponder how there are some politicians and teachers' unions that would like to shutter such a successful school and send these children back to a regular public school. Fortunately, D.C. is much more welcoming than Mayor de Blasio to charters.

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