I can give a real life story. Mother in law is bedridden and the victim of strokes. She went to hospital. Sent home. When she went back to hospital, the doctor is mad because she will be fined for readmitting someone within 30 days.
The doctor insists that the family put MIL in hospice if they want oxygen, which MIL cannot breath properly without. Hospice says they will only come if they can administer heavy morphine and stop most treatments.
I work for a small business. Owner is already scaling back some employees’ hours to 29/week in preparation for the upcoming penalties. I suspect he is going to have to drop health insurance for us fulltimers in order to save his business.
I’ve been looking on the internet to see what’s happening in Virginia, trying to figure out what to do, but everything is in limbo and nobody can make plans for health care for 2014.
If 0bama is re-elected, providers will leave Medicare in droves. The low reimbursement and regulations are just not worth it. Audits, compliance costs, electronic records will force most small groups and solo practices to drop out of the system. That leaves Medicare patients with providers at big hospital corporations, and other government agencies such as the VA. Access will be very tough.
Some groups may adopt a hybrid approach by assigning procedural specialists to Medicare, but keeping the primary care providers out of Medicare. That way they can charge market rates for the evaluation and medical management which is undervalued. Then, they will refer to the procedural specialists (who take Medicare) within the group, as long as the margins still make sense.
Damn it people....eat your peas..../ S