Unaffordable Care Act Unaffordable

And now an unseemly I told you so to end the year.

A Robert Wood Johnson Foundation study found the “Affordable Care Act” hasn’t made health care affordable.

Wotta surprise.

I’ve mentioned how bad this law is before.

The Unaffordable Care Act was passed based on per capita health care costs of $7,825 under the Bush Administration. Obamacare promised to save us money. So far, per capita health care has cost $8,054 in $2009, $8,299 in 2010, $8,553 in 2011, $8,845 in 2012, $9,146 in 2013, and it is expected to come in at $9,458 in 2014 and $9,800 in 2015, all under the Obama Administration.

Lib’ruls who can’t do math promised that when government runs this market your premiums would decrease. Mr. Obama promised a $2,500 a year drop.

How’d that work out for you?

And now the Unaffordable Care Act’s bait and switch has left consumers scrambling in 2016. Again.

I really really wish I had been wrong.


Check out our sampling of the ObamaDon’tCare Observations here.
 

Will Pediatric Care Be Maintained in our Community?

In Another Doc Gorn we saw that Dr. Laura Bellstrom closed her pediatric practice in St. Albans, Vermont. She’s number four in a county that had 11 pediatricians at the beginning of the year.

Will pediatric care be maintained?

Yes, it will. NMC and local physicians have been working to ensure that the greater Franklin County community will continue to be well-served by dedicated, caring Pediatricians and Family Practice Specialists. We had hoped to make an announcement of our efforts after all of the contracts were signed, but a recent press release from the Vermont Pediatric Association has created confusion and additional concern in some patients, so I need to take this opportunity to explain how we are proceeding.

The latest round of cuts to the Medicaid reimbursement to physicians has made it even more challenging for private practice physicians to stay in business and has increased the financial losses hospitals carry for the physicians they employ. This hits particularly hard in areas such as ours which have a high percentage of residents on Vermont’s expanded Medicaid program. For Pediatrics, it is a dramatic impact. I believe this has been a driving force in the decisions of four local Pediatricians to leave practice in our area and move out of state, close practice, or seek employment in Chittenden County.

Fortunately, a strong core of Pediatricians and Family Practice specialists continues to care for our community as they have for decades. Pediatrics is a vital preventive, primary care service. With the changes in the healthcare system threatening the sustainability of private practices, NMC has had to get involved to help maintain access to this necessary care.

For weeks, we have been in discussions with the physicians of Mousetrap Pediatrics (Dr. Chip Chiappinelli, Dr. Deanne Haag, Dr. Roya Mansoorani, Dr. Stacy Strouse, and Dr. Heidi Zvolensky) regarding employing them as “Northwestern Pediatrics.” They are currently reviewing the final contracts and have a letter drafted to send to their patients explaining the transition. We have worked closely with them to ensure the transition is as seamless as possible for their patients. We are currently working through the details of medical records transition, billing transition, etc. The great news is, we expect that these trusted physicians will continue to care for their patients. The office locations in St. Albans, Enosburg, Swanton, and MVU will stay the same. Their telephone numbers will stay the same. Nearly all of the familiar faces in the offices will stay the same. This will be a strong step in ensuring access to exceptional Pediatric care in our community continues.

At the same time, we are working with our Medical Staff to recruit additional physicians and advanced practice providers to our community. I am thrilled to announce that one of our strong pediatrician candidates has recently signed a letter of intent to join our staff in 2016. We also have additional strong candidates reviewing the opportunity and we are working to see if one of the physicians might reconsider with the stability of employment at NMC now a possibility.

At 1.9%, our projected operating margin to keep NMC healthy for Fiscal Year 2016 is lower than it has been in years. It is razor thin.

While this is promising news for our community, it is at the same time concerning for our hospital. We offer more “stability” than private practice, but we are not immune to the negative impact of reduced reimbursement. At 1.9%, our projected operating margin to keep NMC healthy for Fiscal Year 2016 is lower than it has been in years. It is razor thin. Taking on additional losses due to reduced reimbursement threatens that margin and our stability. We made this point to the Green Mountain Care Board, the State’s regulators of healthcare, at our budget hearing. Earlier in December, we made this point to our local Legislators, who act on the Medicaid budget. As we reform Vermont’s healthcare system, we must make it less costly through prevention of illness, elimination of waste and duplication, and prudent investment — not through underpayment of the physicians and advanced practice providers caring for the people of our communities.

I look forward to finishing our work with the Pediatricians and our Medical Staff to preserve and expand access to care in our community for children. I apologize to the patients of Mousetrap that this communication was necessary in advance of the letter from your physician; we just could not let parents who were hearing rumors continue to worry as we worked. If you have any questions regarding access to care for children in our community, please call NMC’s Community Relations Office at 802.524.1280. We will do our best to answer your questions and ensure you have the access to care you and your family need.

— Jill Berry Bowen


Jill Berry Bowen is the Chief Executive Officer of Northwestern Medical Center in St. Albans, Vermont. NMC is a 70-bed, private, not-for-profit, accredited community hospital. Dick Harper served on the NMC Board of Incorporators for a decade. This op-ed also appeared in the St. Albans Messenger.

 

Another Doc Gorn

Medicaid cut payments by 20% back on the first of January this year.

I'm from the Government
Dr. Laura Bellstrom closed her pediatric practice in St. Albans, Vermont, last week. She’s number four in a county that had 11 pediatricians at the beginning of the year. We have seven now. I know half a dozen of her now-former patients from North Puffin alone.

Yeppers, between ObamaDon’tCare and “expanded” Medicaid, we’ll cover everybody, absolutely.

Oh. wait.

The Guardian reported on the little costs that rack up thanks to what the Unaffordable Care Act doesn’t cover. Family members now have to pay for their own coverage. The co-pay for an asthma inhaler cost $7 before Unaffordable Care Act. “Then it went to $30. Then $60. Now it’s $100, every month.” A friend is fighting the mental fog of Lyme disease. Her insurance won’t pay for a treatment that will get her off Doxycycline therapy.

Kaiser reported that the “family glitch” in the Unaffordable Care Act means many mostly middle-income Americans remain uninsured because they can’t afford their insurance at work but make too much to qualify for the income tax prebate “subsidies.”

Several million did get coverage through the Medicaid program in states that opted to expand it. Now, since Medicaid ain’t paying its bills, look at what happens.

For the record.
Voting for the Unaffordable Care Act in the House: Florida Democrats Corrine Brown, Kathy Castor, Alan Grayson, Alcee Hastings, Ron Klein, Kendrick Meek, Debbie Wasserman Schultz, Robert Wexler plus Vermont’s sole representative, Democrat Peter Welch.
Voting for the Unaffordable Care Act in the Senate: Florida Democrat Bill Nelson plus both of Vermont’s senators, Democrat Patrick Leahy and “Independent” Bernard Sanders.

Dr. Laura Bellstrom. Gone. Three other pediatricians. Gone.

6,000 kids in northwestern Vermont lost their docs this year.

Six thousand.

Pediatricians are in the spotlight now, but similar problems face primary care providers for adults, said, Vermont Health Access commissioner Steven Costantino.

Shrinking provider networks under the Unaffordable Care Act mean you not only can’t keep your doctor, you may not find a doctor.

The solution hasn’t changed since the Unaffordable Care Act passed in 2009.

1. Do not raise taxes to pay for care. Do not raise government “fees” to pay for care. (Politicians are suggesting both. Again)
2. Throw da bums out.
3. Do not raise premiums to pay for care. (Politicians are suggesting that, too. Again)
4. Throw da bums out.
5. Reform the health care system. It’s still broken.
6. Did I mention, Throw da bums out?

Merry Christmas.

 

Price Hike

Comcast CEO Says “You Can’t Keep Raising The Price Forever,” But Does It Anyway.

He’s not alone.

Federal Reserve officials continue to avoid raising short-term interest rates because inflation remains “stuck at exceptionally low levels,” according to the Wall Street Journal.

Say what?

Inflation: a sustained increase in the general level of prices for goods and services.

The Social Security Administration will to announce that there will be no Cost of Living Adjustment on Thursday, when it releases the Consumer Price Index.

Say what?

The lack of a COLA means that older people will face higher health care costs. Younger people already are.

The Unaffordable Care Act was passed based on per capita health care costs of $7,825 under the Bush Administration. Obamacare promised to save us money. So far, per capita health care has cost $8,054 in $2009, $8,299 in 2010, $8,553 in 2011, $8,845 in 2012, $9,146 in 2013, and it is expected to come in at $9,458 in 2014 and $9,800 in 2015, all under the Obama Administration.

“Oddly, I’ve been spending more and getting less for everything but driving around,” my roofer friend Dean “Dino” Russell told me. “Milk for my cats is up to $4.79 a gallon. I don’t even buy beef anymore.” Hamburger sold for about $2.19 per pound at his Publix in 2008; it was “on sale” for $4.79 this week. And gas may be cheaper than a year ago but it hasn’t come back down to the kind of prices we had for more than a decade.

Dino won’t even talk about how much his health insurance or windstorm insurance costs.

I ran the numbers for Dino’s neighbor, Ralph. Ralph is 38, single, lives in Miami, and earned $46,494 last year, so that’s the basis for his Obamacare premium. He paid $370.40 per month ($4,444.80 total this year). His insurance company received a 16% increase for 2016.


Speaking of price hikes…

Pants on Fire• I have the misfortune of contracting with “Citizens” Property Insurance Co. I don’t know how they came up with the name with a straight face. “Citizens” was established by the Florida Legislature as a not-for-profit insurer of last resort. It quickly became the largest insurer in the state and about the only place we can get windstorm insurance.

I paid !@#$%^Citizens $2,455 for wind storm coverage in 2008. The price has risen more than health care every year. I paid !@#$%^Citizens $4,489 for wind storm coverage in 2015.

“It’s the higher water damage claims in the Keys”, a Citizens rep said. “Otherwise we would have reduced property insurance rates for most homeowners here.”

OK. Wait. !@#$%^Citizens insures against wind storm damage. They refuse to pay for water damage, referring those to FEMA or your homeowner’s policy. And the last major hurricane to hit South Florida was Wilma in 2005. In fact, Fitch upgraded their bonds to “AA-” thanks to !@#$%^Citizens’ successful efforts to reduce its exposure to claims by lowering and transferring risk not to mention the small fact that there have been no hurricane losses over the past nine years.

Pants on Fire• I paid !@#$%^Comcast $742.59 for basic cable and Interwebs in 2008.

“Our rate hasn’t changed,” a !@#$%^Comcast rep told me.

OK. Oh, wait. I paid !@#$%^Comcast $1,169.10 for basic cable and Interwebs in 2015. I guess a 57% increase isn’t actually a rate change. The Baud rate has mostly stayed the same though.

Pants on FireElsewhere, Verizon says it will raise the price of its remaining unlimited data plans by $20. Again.

“Verizon will not increase the price on any lines with an unlimited data plan that is currently in a two-year contract,” the company said.

“When this happens, I will probably leave Verizon,” Liz Arden said.

Verizon has been wallowing in extra money from all the customers who own their own phones but pay full subsidized phone prices for service. “The only people left on unlimited plans are people like me [who own their own phones] so VZW’s been pocketing all that extra cash,” she notes.

We can leave !@#$%^Verizon. We’re stuck with !@#$%^Citizens. We’re stuck with !@#$%^Comcast.

Can you hear me now?

It turns out most companies raise prices for only two reasons: when they can do it without alienating their customers and when they don’t care about alienating their customers.

Verizon and Comcast and Citizens don’t care if they alienate customers. In fact, Citizens wants to drive customers away but it, like Comcast, is the only game in town.

Despite consistently ranking among the bottom ten companies in the world, Citizens, Comcast, and Verizon are breaking the banks financially. Citizens is a “non-profit.” They can levy 10% emergency assessments on nearly every policy holder in the state forever and in an unlimited amount to pay off bonds. Comcast reported $8.38 billion net income on $68.78 billion sales. Verizon reported $4.22 billion net income on $127.08 billion sales.

Wouldn’t it be loverly if we thought not doing business with these laughing stocks would change their behavior?

“It would work better to punish them,” Ms. Arden said.

Oh, and by the way? Gas prices will rise in January.

 

Down. Again.

Vermont Health Connect is offline for another software upgrade. The website went dark last night so the latest, newest, greatest, most perfect software can be uploaded. Again.

Let’s recap.

September 16, 2014
The Vermont Health Connect website was taken down Monday night and will remain offline to correct functionality problems and allow for improvements to data security, state officials said.

January 5, 2015
Management of health coverage through Vermont Health Connect continues to be rocky. The website continues to rely on manual back-end processes when someone’s household income has changed or when a dependent has been added or removed from coverage. People signing up for health coverage online for the first time seem OK. But for people who had a change in circumstance or some other issue carried over from the previous year, problems can take weeks or even months to resolve…

May 29, 2015
Vermont Health Connect user applications and accounts will be unavailable until Monday to allow for system upgrades, according to state officials. Once deployed, the new technology is expected to allow customer service staff to process customer requests more quickly.

October 1, 2015
The website went dark Thursday night so the latest new software can be uploaded. Again. It will stay offline until Monday. The latest upgrade came because customers still can’t make some simple changes to their personal information online; other functions will be added over the coming weeks leading up to the Nov. 1 start of open enrollment when Vermonters will sign up for 2016 health insurance plans.

The Unaffordable Care Act gave Vermont’s nearly $200 million to build a state exchange from scratch. $144 million has been spent so far.

Every state that has tried has struggled to build its own health insurance exchange but a report last month rates Vermont more functional than almost all others.

“We are thrilled to be where we are,” Gov. Shumlin says.