sunset from behind the wire

sunset from behind the wire

Monday, December 2, 2013

Chatting with Baby Sister

My sister works as an administrator in a hospital in Washington State. We don't talk all that much but we did over Thanksgiving. I asked her about the impact that ObamaCare has had on her corner of the healthcare industry. Again, this is not a nationwide or global perspective -- just her view.

"Progressive Propaganda" 
Baby Sister said that in October, they laid off 500 employees essentially because of ObamaCare and the reduced money that the hospital plans to take in. Her hospital is one of those which will accept ObamaCare insurance. Essentially it's a vast expansion of Medicaid with very low reimbursement schedules that most doctors don't accept -- and neither do most hospitals. She said: 
  • "We're working a skeleton crew now, since it's the only way that we can balance the budget. We're not the government. We can't spend money that we aren't taking in."
  • "Patient care will be as good as it can be when you consider the circumstances."
  • "A lot of doctors who used to send their patients here (to her hospital) aren't doing it anymore. You know, a lot of doctors* won't be participating in the Affordable Healthcare Plan. It's sad to see the best go away and the doctors who are strapped for business and accept the ObamaCare packages, still here." 
I countered that the law hadn't gone into effect fully -- why is she seeing this now?
  • "We have to anticipate, and that's part of the problem. The President (of the USA) is flip-flopping and driving the insurance companies crazy. The law says one thing and that's bad enough, but he changes the law on a whim about every third day with this or that regulation of legal stipulation being waived or kicked down the road."
  • "House Speaker Nancy Pelosi's bizarre 2010 claim that 'We have to pass the bill so you can find out what is in it,' doesn't even make sense now because we have a 2000 page law that changes based on the President's take on political polling. We have no idea what new (and strange) changes will come to pass a week from now or a month from now. If we don't plan for the worst, we could end up in the red and you can't run a business like that."
What about the website?
  • "The hospital website works and the insurance company's websites work. It's just the government website that doesn't work." 
How affordable is the Affordable Healthcare Act?
  • "A survey, which polled more than 3,000 doctors, also found that 80% of physicians say Americans currently insured will have to pay more under ObamaCare while 76% see overall health care costs rising due to the ACA."
  • "I think that overall, it will cause the cost of healthcare to spiral upward for a few years, but in the end, I think that it will be unpopular enough that people will elect Republicans to fill seats formerly held by Democrats and the ACA will be repealed, and costs will settle down as a measure of predictability returns to the insurance market. Unpredictability, which we're seeing with the President's way of conducting business, will inevitably cause insurers to pad their numbers and costs will go up as a function of cause and effect."
  • "The Board of Trustees made the decision to accept ACA insurance and they're very touchy about it. There is an unwritten rule that if you criticize it, you won't work here long. The mood is very strange for a hospital where we're usually joking and cynical about everything. Now I know what working in a Soviet Era hospital must have been like."
My sister has been a Democrat in the past. She said that she's changed her party affiliation. "You know (she said, as if I didn't know this) Central government planning has never delivered on its promises and there's no reason to think it ever will." 

* Fact Check - 44%



17 comments:

  1. LL - my wife has worked in medical billing for the past 15 years and has asked me to help her write her letter of resignation. She's had enough. She got sucked into the Medicaid billing side of the practice because no one else would handle it w/o quitting (it truly is a nightmare) and the Obamacare side side is even worse. Her doctors decided not to accept Obamacare but other changes coming due next year are just as bad. I was hoping she would last another two years until I retire but there's no way I'm dealing with this stressed out female all by myself.

    She goes on and on just with the major changes - like this one: the doctors cannot get paid right away even at the lessened rate. They have to wait months before submitting the bill. Then if the subscriber (patient) misses an installment payment on his policy, the doctors have to reimburse the government for the entire bill. This goes on until God knows when. It is a nightmare for doctors as it relieves basically all responsibility of the patient for payment of services and makes reverse billing a regular part of an already screwed up system. People have no idea how much the doctors have to struggle with government programs (and some probate ones too!) in order to get paid. That's why so many doctors are refusing to participate in these programs. They end up working for nothing.

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  2. Alright - that's "private" not"probate."

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    1. That's why so many doctors are refusing to participate in these programs. They end up working for nothing.

      Baby Sister said that she thought that ObamaCare was set up to ruin the healthcare system in America. There was no other explanation that she could come up with. I left that off my initial blog post because I didn't want her to be viewed as 'extreme'. Based on your story/your wife's ordeal with the problem, it makes what my Baby Sister said seem mild.

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  3. This ACA is like an episode of Hogan's Heroes, a plot that's far fetched, with outlandish premise and all bad theater. The goal is to destroy the current healthcare system and replace with single payer, like Canada. Ever notice that the citizens from up north come south for their care?

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    1. Where will the Canadians go? It's going to be a crisis for the Canadians.

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    2. Hogan's Heroes made me laugh...this makes me cry.

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  4. This is chilling. I pray that the Republicans dominate in 2014 and 2016 to reverse this mess as soon as possible.

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    1. I don't know whether it's too late or not for a partial fix in 2014 and final repeal in 2016. How badly damaged will things be by then?

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  5. People are "changing to Republican." Why didn't they have enough brains to start out that way?

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  6. Replies
    1. The charismatic mulatto isn't nearly as cool when you figure out that he's been lying about EVERYTHING for the past five years.

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  7. Yep, that reality check IS getting some folks attention... And the reason for the push off to 15 on the small employer and a lot of other stuff is to minimize that knowledge of real impacts prior to the 14 elections...

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    1. Correct, the Democrats are trying to ease pain into those times between elections in the hope that nobody will remember where the pain came from in the first place.

      And if we're that frigging stupid, maybe we deserve to all just pay massive dollars for medicaid.

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    2. The Democratic Party plans to blame George W. Bush for as long as they can.

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  8. The healthcare industry is how I've made a living for the past 30+ years. I make/market an employee and time management designed specifically for hospitals, nursing homes and clinics. Obama's effect on that industry has been devastating. This past year alone I've had 3 facilities simply close there doors. Probably 30% have dropped employee insurance plans in an attempt to remain solvent. About the same amount refuse Medicare and even more refuse Medicaid. For my company personally we went from an average of a system a month prior to the signing of the ACA in March 2010 to 3 systems since March 2010 . . . 3 systems. They had little money before the ACA . . . they have virtually none now with huge reductions in reimbursements, huge increases in system requirements . . . we are about to pay a terrible price for this folly.

    Maybe it's time to move on to something else . . . just hard to let go of a life's work. Heavy sigh . . . Hope and Change . . .

    Wish your little sister the best, tough industry she's in right now.

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    Replies
    1. The worst part of the whole mess is that it would seem to have been conceived to fail and trash the whole healthcare system.

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