This week in Medicine September 27, 2014

Four worthwhile news items this week are worth repeating.

1. The failed, not secure federal website has so far cost $2.1 billion dollars (Bloomberg News 9/24,Wayne) and to date $73 billion has been spent to implement the Affordable Care Act (The Hill 9/25, Viebeck). Remember the government doesn’t earn money, only prints it and collects it from us.

2. The Hospitals are starting to ask for money in advance of your admission. Bloomberg BusinessWeek (9/26, Tozzi) reports that health insurance deductibles are rising, shifting risk to those covered and increasing the chances hospitals and physicians won’t be paid. Meanwhile, with the increasing complexity of insurance policies, “Americans are having a harder time understanding how their plan choices will affect their finances.” In 2012, hospitals provided $46 billion in uncompensated care, about six percent of their expenses, according to the American Hospital Association. In response, many hospitals are seeking to have patients pay upfront 30 to 50 percent of what they’ll owe. Some offer incentives for paying early or work to arrange no-interest payment plans. Part of this is an effort “to avoid the damage to their reputations” inflicted by aggressive debt collection practices.

3. And a spin master’s view – “Administration says Hospitals will save $5.7 billion from unpaid bills due to health law” (Kaiser Health News 9/24/14, Carey). A seemingly triumphant boast. So who do you think now has paid the $5.7 billion? The loss from “uncompensated care” has been passed on to tax payers through adding 3x more people to welfare (Apple health in Washington) and by the Federal Government guaranteeing the health insurance industries losses.

4. “Physicians feeling over-worked, abandoning independent practice. A new workforce survey shows physicians are feeling over-extended and shifting toward hospital employment” (Medical Economics 9/19/14 Ritchie) The article goes on to say 81% of the 20,000 physicians surveyed describe themselves as “over-extended” or “at full-capacity”. In 2008 62% of doctors were in independent practices, today it is only 35%, just 6 years later.

5. SUMMARY: So what have you gained from $81 billion being spent? Higher premiums, higher out of pocket costs, less spending dollars, frustrated doctors and the closure of many independent practices. Not sure how that works for you, but with a looming 60,000 doctor shortage who are the work horse of this system, I would be concerned.


  1. Nancy Shepard says

    Hi Dr. Paul,

    Thank you for all the information you provide for us. I was in the insurance industry for 10 years in the 80’s. I even worked for Lewis County Blue Shield (if you remember them). Bob Holland worked there then. I was a claims examiner for them. After hearing you talk, and reading your blog, I was surprised to see how things have changed in the insurance industry since then. I know I’m not alone when I say that your dedication to TRUE healthcare is very much appreciated. I’m glad I have a doctor who would rather spend his time treating people instead of filling out government paperwork.

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