Archive for the ‘Reform’ Category

Nothing is Certain Except Death and Taxes (and ObamaCare Ain’t Helping)

taxesIn a 1789 letter from Ben Franklin to Jean-Baptiste Leroy, Mr. Franklin said “… in this world nothing can be said to be certain, except death and taxes.”

Yes, it’s that time of year again. Tax time.

This is second year of what will likely be annual occurrence: increased taxes to pay for ObamaCare.

You see, when the President and Congress “cooked” the budgetary scoring for ObamaCare. President Obama stated in a joint session of Congress in 2009 that ObamaCare would cost $900 billion over ten years. More specifically, he said, “Now, add it all up, and the plan that I’m proposing will cost around $900 billion over 10 years.”

However, just a few weeks ago, the non-partisan Congressional Budget Office (CBO) has revised its cost projections. At $2.6 trillion, the new price tag is almost three-times more than what president promised.

So how are we going to pay for ObamaCare. You guessed it: Higher taxes. And once again, Ben Franklin was correct. Nothing is certain except death …

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Obamacare: Two Steps Forward, One Step Back

Friend and fellow blogger, Wayne Oliver, give a harsh critique of the Affordable Care Act (ACA) / Obamacare.  I felt compelled to respond and add my thoughts to the conversation, from the perspective of an executive working in the industry.

To begin, I think it fair to say that most people don’t fully understand the law.  Last September, the Washington Post stated that 62 percent of Americans said that they don’t have the information they need to understand the law.  Furthermore, most Americans, or 55%, disapprove of the way the President is handling the implementation of the new healthcare law.  So, it’s not a surprise that there has been loud objections by pundits and general disapproval by the public.  It is a complex law and, by most measures, the Administration has done a poor job of explaining it.  Yet, it doesn’t mean that there isn’t substance there.  In fact, a number of changes have already helped millions of average Americans and has the potential to transform how …

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ObamaCare: One Step Forward, Two Steps Backward

flaD AND STETHISCOPEI have been rather vocal in my opposition to the Affordable Care Act (or ObamaCare). There have been too many problems, too many issues and too many unintended consequences.

According to a report released this week by the non-partisan Congressional Budget Office (CBO), ObamaCare will “reduce the supply of labor by the equivalent of roughly 2.3 million full-time workers through 2021.”

Just as the economy is attempting to recover, we are moving forward with the implementation of a federal healthcare disaster that will kill even more jobs.
There is some good news. There is a new, legitimate “repeal and replace” movement led by US Senators Orrin Hatch (R-Utah), Richard Burr (R-NC) and Dr. Tom Coburn (R-Oklahoma). This “repeal and replace” effort has substance and includes many thoughtful, private sector based reforms and includes some of the provisions of ObamaCare that address access to health coverage.

The new Patient CARE (Choice, Affordability, Responsibility, and …

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What are the positive aspects of the Affordable Care Act?

The debate will continue for quite a period-of-time whether the Affordable Care Act achieved its objectives and was cost effective. While political parties and individuals posture the pro’s and con’s of the Affordable Care Act, there are some positive aspects.

Whether you loved or liked the previous healthcare insurance business model, the Affordable Care Act addressed three notable deficiencies. The following are those deficiencies and how the Affordable Care Act addressed them:

First – people with pre-existing medical conditions could not purchase insurance or it was cost prohibitive.

People with pre-existing medical conditions were not able to purchase insurance or the price was cost prohibitive. A number of individuals have pre-existing clinical conditions through no fault of their own. It could be a matter of genetics or other factors beyond their control. It is unreasonable to penalize individuals under these circumstances and put them at a financial disadvantage.

Second …

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The Health System of Tomorrow – More Guts, Not More Information

I had the pleasure of attending the US News Hospital of Tomorrow conference last week in Washington, DC. Right in the midst of the heated debate around the failures and successes of the Accountable Care Act and the less than stellar rollout of Healthcare.gov, leaders from many of the top health care provider systems across the US congregated to share their insights about how the health care delivery system will look in the future. While there was passionate dialogue about how to best solve our current problems, the common consensus was clear amongst most of the top executives – the shift from volume to value based care will ultimately reduce costs, improve quality, and expand access.

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What is a Patient-Centered Medical Home (PCMH)?

Guest Blogger:  Wayne Hoffman, MD – Healthcare Consultant

Many of us grew up getting our health care through our family doctor or pediatrician – the doctor who knew everything about you and your family, and helped keep you healthy. He or she was the one you went to see no matter what was wrong with you, and for your annual check-up. Somewhere along the way we have lost that ideal. Health care now is fragmented, illness (not wellness) focused, expensive, and doesn’t always deliver the best outcomes. There is now an exciting new model of care that is beginning to sweep the country – the Patient-Centered Medical Home or PCMH. The term was first coined by Pediatricians in the 1960s, but has only recently been expanded to all of Primary Care. In 2007 the four main primary care organizations (American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and the American Osteopathic Association) got together and developed the joint principles …

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So What If You Like Your Health Insurance Plan?

obamacareKyle Wingfield was one of the very first to be right. The AJC opinion page editor hit the nail directly on the head in his column on October 31, 2013 entitled, “Real-life Trade-offs Belie ‘If You Like Your Plan’ Claim.”

Most of us clearly remember President Obama saying, “If you like your health insurance plan, you can keep it.” Truth of matter is that it is simply not the case for millions of Americans and an estimated 400,000 Georigians.

Whether it is employers who have decided to get out of the health insurance business entirely or individual health insurance plans that some federal bureaucrat has determined does not pass ObamaCare’s muster, the reality is: If you like your health insurance plan, you may NOT be able keep it.

More reprehensible is the fact that we now know that the president knew what he was saying was not the truth while he was saying it.

So while the president has thrown everyone from Verizon to House Republicans under the bus for the early failures of …

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Where is there equity in the Affordable Care Act

As the clock counts down to the launch of the healthcare exchanges, various groups are looking for a way to avoid participating in the Affordable Care Act. The media recently showed labor union leaders meeting with President Obama in the White House looking for tax subsidies or an exemption from the Affordable Care Act. Their argument is that the requirements and associated costs will financially ruin the unions.

Another example is Congress voted to exempt themselves from the requirements of the Affordable Care Act. As congressional members developed and promoted the Affordable Care Act, they discussed how the average citizen could have the same level of healthcare coverage as our lawmakers. It is a great talking point that appealed to everyone. The message conveyed is the benefits Congress receives should be available to the average citizen at the same cost level. Somehow, that concept got lost in the constructing of the Affordable Care Act. When lawmakers understood how the …

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We Can Provide Better Healthcare at Lower Costs

heartbeatAs the healthcare world braces for the cost and regulatory implications of ObamaCare, there are other changes approaching on the horizon. An information technology boom is underway that could impact us all.

Healthcare is playing catch up with respect to incorporating technology into the workflow patterns of healthcare workers including physicians and nurses. Transportation, corporate America, small family businesses and even state and local governments have adopted technology solutions.

The airline industry became more efficient by using on-line reservations, on-line check-in and kiosks at airports for boarding passes. McDonald’s and most other fast food restaurants have used technology to more effectively manage workers and the workflow process resulting in better service for their customers. The banking industry embraced technology in a big way as more Americans are using on-line banking services, ATMs and mobile solutions which in turn make banks more efficient and gives …

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The Healthcare Reform Law that Inequitably Treats Healthcare Providers

A recent article published in Modern Healthcare[1] highlights how CMS interpreted a rule within the healthcare reform law that is putting healthcare providers at greater financial risk. To summarize, healthcare providers could incur unreimbursed costs for services delivered to a consumer that has discontinued paying their insurance premium. See below for a detailed description of this scenario.

It appears that the business of delivering healthcare to a community is becoming more financially challenging. When you consider the increasing number of patients looking for care, reimbursement rates declining, no limits on malpractice suits and increasing regulatory burdens, it should be no surprise that in the future we see more healthcare providers filing for bankruptcy, looking for a financial bailout, selling their business, delivering limited services or discontinuing operations.

Here is the scenario that puts healthcare providers at greater financial risk due to CMS’s …

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