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Home » California doctors don’t ♥ Obamacare

California doctors don’t ♥ Obamacare

The New Neo Posted on by

California may have one of the better state Obamacare websites, but it sure doesn’t seem to have one of the better rates of reimbursement for doctors. And that may have big consequences:

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said…

California offers one of the lowest government reimbursement rates in the country — 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.

In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.

In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.

Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That’s driven many doctors to just say no.

They’re also pointing out that Covered California’s website lists many doctors as participants when they aren’t.

“Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy.

As I’ve said before, the websites are turning out to be somewhat of a Potemkin village: a facade of something rather than the real thing. California seems to be a particularly egregious case, and it’s an important one because it is one of the most populous (and liberal, I might add) states in the union. If California fails to enroll a lot of people, it can’t end up very good for Obamacare. And if California does end up enrolling a lot of people and there are far too few doctors to serve them, it can’t end up very good for Obamacare.

I also wonder whether putting those doctors on the website as network participants when they are not was in fact an accident, or whether it’s a form of mild coercion that will soon become not-so-mild.

[NOTE: Regarding the title of this post—now that I’ve learned how to use HTML to make a heart, I seem to be doing quite a bit of it.]

Comments

California doctors don’t ♥ Obamacare — 8 Comments

  1. The evil tonsil-snatchers are just some eggs that need breaking. For The One’s Omelet.

  2. “I also wonder whether putting those doctors on the website as network participants when they are not was in fact an accident, or whether it’s a form of mild coercion that will soon become not-so-mild.” neo

    Bingo.

    Drafting Docs
    Look for doctors to be conscripted to treat Medicare and Medicaid patients.

    “The Obamacare price-fixing authority, the Independent Payment Advisory Board, is explicitly charged with reducing Medicare spending, but it is also legally forbidden to do so by reducing benefits, which leaves physicians’ compensation as pretty much the only meaningful source of cuts.

    Kathleen Murphy, a Democratic candidate for the Virginia state house, proposed exactly that during a recent candidates’ forum. Hers is the voice of the future.

    And it is not without precedent: In Canada, it was long illegal for doctors to accept payment for services that patients would otherwise receive for “free” (there’s no such thing as free health care) under the country’s national health-care system, though in reality that law was only half-heartedly enforced.

    In the long run, the fact that physicians have a choice about whom they see and where they practice is the most significant challenge to the full implementation of Obamacare. The logical thing – politically and economically – is to eliminate that choice. You don’t have to formally nationalize the health-care industry; you just nationalize 40 percent of each physician’s practice and call it his “fair share.”

    Doctors, like all licensed professionals, are utterly at the mercy of the state. Obamacare effectively has put the federal government and the states in the insurance business (for the healthy, young, and middle class for the first time), which means that the powers that control physicians’ licensing now have economic interests that are adverse to those of the doctors themselves.

    It is easy to imagine yet another episode of “fair share” rhetoric being deployed to conscript doctors in trying to make this unworkable mess work.

    Senator Warren’s totalitarian analysis – that the government has a claim on your property in the present and future because it exerted a claim on the property of others in the past – is entirely applicable here: Ambulances move on public roads, the government supports medical research, etc. You didn’t build that. So here’s your federally mandated portion of money-losing Medicare and Medicaid patients. They won’t call it conscription; they’ll call it shared sacrifice.

    The only long-term means of achieving Obamacare’s twin objectives of lowering health-care spending while increasing access to medical care is to force providers to provide on the government’s terms, in effect making government employees out of physicians. That or a free market, but we all know how the Democrats feel about that.” – Kevin D. Williamson

  3. Of course doctors will be coerced to treat whoever the government says, just as their judgement will be subjected to bureaucratic whim. The result will be simultaneously a disaster, a travesty, a tragedy–and avoidable.

    This prognosis is almost three decades old:
    Medicine: The Death of a Profession

  4. What has not been mentioned is a second way in which providers (physicians and hospitals) will be hurt if they participate in health exchange plans: enrollees have a 90-day grace period, whereby their enrollment continues for 3 months without patment of the monthy premiumn, and payors are not required to reimburse providers for services rendered during that period. Providers on the other hand will be left having to collect from patients months after the service was provided. Since real-time validation of enrollment is thus insufficient, the only strategy for providers is to demand proof of payment for premiums at the time of service.

  5. It was mentioned before that the Left’s control of healthcare was merely to ration health resources so that only the rich and politically connected can have access to it.

    Some Leftist operatives or readers probably thought that was not true.

    After all, who can imagine that an Affordable Healthcare designed to make everyone enroll, would end up destroying the medical resources and limit supplies only to those approved by the IRS and Obama’s regime?

  7. When do we get out the pitchforks that Hussein Obama loves to threaten others with?

    Hmmm?

  8. Next time a conservative business owner or individual like the Plumper starts speaking out of turn for his peasant status, not only will the IRS, ATF, and EPA come down on them like a house of lead, but their healthcare will be denied and they will be prevented from accessing any medical resources.

    That’s one way for a death panel to be enforced.

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