Cardioligists say F.U to Obama's Medicare cuts

[Magox]

http://www.bloomberg.com/apps/news?pid=206...id=apv3pcTOWVjk

 

Cardiologists Crying Foul Over Obama Medicare Cuts (Update1)

 

 

Aug. 28 (Bloomberg) -- An Obama administration plan to cut Medicare payments to heart and cancer doctors by $1.4 billion next year is generating a backlash that’s undermining the president’s health-care overhaul.

 

While President Barack Obama and members of Congress have spent August debating health insurance and medical costs at public forums, specialists are waging what one advocate calls a “tooth and nail” fight against a separate initiative to boost the pay of family doctors, and cut fees for cardiologists and oncologists. The specialists, in newspaper columns and meetings with lawmakers, say patients will lose access to life-saving care, from pacemakers to chemotherapy.

 

The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama’s broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief.

 

“Our 37,000 members are fighting tooth and nail on these other issues rather than fighting thoughtfully for expanding access,” said Jack Lewin, 63, chief executive officer of the Washington-based American College of Cardiology.

 

The cuts could have the unintended consequence of rationing care, especially in rural regions with a large number of Medicare patients, doctors said. In other areas, specialists may decide to pull out of Medicare, or ask patients to make up the difference with higher out-of-pocket payments, said Alfred Bove, president of the American College of Cardiology.

 

“A fair number of cardiologists are looking at the accounting and saying ‘we can’t afford it,’” Bove said in a telephone interview.

 

Some oncologists in rural areas may stop offering chemotherapy in the office, forcing patients to travel to more- distant hospitals, said Allen S. Lichter, 63, CEO of the 27,000- member American Society of Clinical Oncology in Alexandria, Virginia.

 

Cuts ‘Impossible’

 

The cuts would be “impossible” for some small-town cardiologists who rely on Medicare patients, said Zia Roshandel, a heart doctor in Culpeper, Virginia. The town of 10,000 people is about 60 miles southwest of Washington.

 

Roshandel and two partners see perhaps 50 patients a day at his practice, the local hospital and a community clinic for the indigent, the 40-year-old said in a telephone interview. Medicare accounts for two-thirds of their clientele, he said.

 

Already squeezed by government and private insurers, Roshandel said he has cut office hours, forgone paychecks and shifted his 12 workers to a high-deductible insurance plan over the past two years. The latest proposal would push him out of private practice altogether, most likely to a hospital in a larger community less reliant on Medicare, he said.

 

‘Close the Office’

 

If the proposal stands, “the bottom line is I’m going to close the office,” he said. “This is impossible for me to survive. If my partners and I don’t get a salary and run it for free, maybe then we can survive.”

 

Medicare would reduce reimbursements for some of Roshandel’s most common procedures, raising the amount patients will need to pay up front, he said. The government would cut the $251 it pays for an echocardiogram, a sonogram of the heart, by 40 percent, he said. The rate for a cardiac catheterization, another test, would drop by a third to $249.

 

Those reductions include an additional across-the-board cut of 22 percent for all physicians mandated by federal budget rules. Legislation passed by three committees in the House last month would eliminate that cut, at a cost of $200 billion to U.S. taxpayers. Even so, if Medicare goes ahead with its tilt toward primary care, cardiologists will suffer, Roshandel said.

 

Tensions are rising among doctors, said Ted Epperly, 55, president of the American Academy of Family Physicians in Leawood, Kansas, in a telephone interview. Epperly runs a family practice in Boise, Idaho, and teaches at the University of Washington School of Medicine in Seattle.

 

Specialist colleagues have implied his support for the Medicare changes may cost his students, he said.

 

While family-care students typically spend parts of their three-year residencies training with specialists, “What I’ve heard is ‘maybe we just won’t have time any longer to teach your residents,’” Epperly said.

 

The ACC is offering a sample letter to patients, asking them to write Congress. “I am concerned that my physician may no longer be able to treat me or other Medicare patients,” the letter says. The campaign has extended to fliers, posters and even the on-hold message the group plays for callers to its Washington office, which asks the public to fight “drastic pay cuts for cardiology.”

 

the flip side:

 

Cancer specialists made similar warnings three years ago when reimbursement was cut for the drugs they used, said Nancy M. Kane, a professor at the Harvard School of Public Health in Boston and member of the Medicare Payment Advisory Commission, a panel of outside advisers to Congress.

 

“As far as I know we have not seen a drop in the number of oncologists since then,” Kane said. “People are not screaming that they don’t have access to oncologists.”

 

The pay shift would help right a financial imbalance that keeps young physicians out of family care, said Epperly, of the family doctors’ group.

 

Average total compensation for family doctors ranged from $150,763 to $204,370 a year, according to a 2008 survey by Modern Healthcare magazine. Cardiologists fetched from $332,900 to $561,875. Radiation oncologists, cancer doctors who specialize in radiation therapy, earned $357,000 to $463,293.

 

“If we don’t invest more in primary care, we won’t have the resources to offer more access,” Epperly said. “Our system is very good at getting people to do what they’re paid to do. That’s why specialists are doing all the things they do, because they’re paid gobs of money.”

 

Looks like it is getting tougher by the day for this thing to go through the way the W.H originally had envisioned, specially with the debacle of the recent W.H Deficit estimations.

[ExiledInIllinois]

Of course, if you were a doctor would you want to make less. I know a guy who has one leg and needed a hunk of plastic for his artificial leg... Granted, just the piece of plastic for the upper part of his prosthetic device. Cost? 10 grand! 2 out of his pocket (he has health insurance and pays probably about 200 bucks every two weeks). A PIECE OF PLASTIC. His device cost something like 80k... Granted it has a electronic chip in it that the doctor can tweek and make adjustments with reagrd to his other leg and gait... You know ho much that costs to plug into a computer? 5 grand? Can't the doc just plug it into a 500 buck Dell computer?

 

Oh, he lost his leg as a teen (about 18 years ago) because a drunk hit him on his way to school in the morning.

[DC Tom]

You know ho much that costs to plug into a computer? 5 grand? Can't the doc just plug it into a 500 buck Dell computer?

 

He probably does. It's probably the software that costs a mint.

[Chef Jim]

Of course, if you were a doctor would you want to make less. I know a guy who has one leg and needed a hunk of plastic for his artificial leg... Granted, just the piece of plastic for the upper part of his prosthetic device. Cost? 10 grand! 2 out of his pocket (he has health insurance and pays probably about 200 bucks every two weeks). A PIECE OF PLASTIC. His device cost something like 80k... Granted it has a electronic chip in it that the doctor can tweek and make adjustments with reagrd to his other leg and gait... You know ho much that costs to plug into a computer? 5 grand? Can't the doc just plug it into a 500 buck Dell computer?

 

Oh, he lost his leg as a teen (about 18 years ago) because a drunk hit him on his way to school in the morning.

 

And god forbid the doctor get compensated for his work/expertise.

[IDBillzFan]

And god forbid the doctor get compensated for his work/expertise.

It'll be much better when anyone can by an artificial limb for a few hundred dollars. I mean, it's just plastic.

 

Of course, by then, you'll be able to count the number of doctors who can get you the plastic leg on the plastic hand of a bad woodshop teacher, but hey...it's all about affordable health care.

[Magox]

Of course, if you were a doctor would you want to make less. I know a guy who has one leg and needed a hunk of plastic for his artificial leg... Granted, just the piece of plastic for the upper part of his prosthetic device. Cost? 10 grand! 2 out of his pocket (he has health insurance and pays probably about 200 bucks every two weeks). A PIECE OF PLASTIC. His device cost something like 80k... Granted it has a electronic chip in it that the doctor can tweek and make adjustments with reagrd to his other leg and gait... You know ho much that costs to plug into a computer? 5 grand? Can't the doc just plug it into a 500 buck Dell computer?

 

Oh, he lost his leg as a teen (about 18 years ago) because a drunk hit him on his way to school in the morning.

hook, line and sinker.

 

When you can't beat'em, demonize'em.

 

right out of the Liberal Locotoad handbook.

[Kelly the Dog]

It's impossible to survive on $450,000 + a year. I don't see how people do it.

[IDBillzFan]

It's impossible to survive on $450,000 + a year. I don't see how people do it.

Damn you, successful people! Damn you to hell. We won't stop until EVERYONE earns the same amount of money!!! Because when everyone's poor, no one is poor. It's sheer genius!!!

[ExiledInIllinois]

hook, line and sinker.

 

When you can't beat'em, demonize'em.

 

right out of the Liberal Locotoad handbook.

 

 

Hey, if it good for Wal-Mart employees, it is good for my phucking cardiologist.

 

They should be demoized. You think a 10,000 dollar piece of plastic (my above story) is acceptable? A 5 dollar computer chip for 5 grand? Of course you do, you work for big insurance or are a doc with a hand in the pie. And gov't gets blamed? The Navy for a 1,000 dollar toilet seat? 500 buck hammer.

 

A thin piece of plastic? I guess there are a lot of college degrees to pay off.

 

This IS exactly why gov't exists... For the interest of protecting people from these demons and crooks!

 

Where is Sinclair Lewis when you need him! Where is the real Martin Arrowsmith!

[Kelly the Dog]

Damn you, successful people! Damn you to hell. We won't stop until EVERYONE earns the same amount of money!!! Because when everyone's poor, no one is poor. It's sheer genius!!!

Fukk the sick and the poor. Just charge and make and gouge as much money as you possibly can off them when they're down and most vulnerable. I totally understand how you think, LA, I just don't understand how you can live with yourself.

[ExiledInIllinois]

Damn you, successful people! Damn you to hell. We won't stop until EVERYONE earns the same amount of money!!! Because when everyone's poor, no one is poor. It's sheer genius!!!

 

I hear what you are saying. So you are saying that the gov't should get charged a 1000 dollars for a toilet seat and the legless citizenry public 80,000 for a fake leg.

 

Whatever douchebag. In the name of succes gouge em'!

[DC Tom]

Hey, if it good for Wal-Mart employees, it is good for my phucking cardiologist.

 

They should be demoized. You think a 10,000 dollar piece of plastic (my above story) is acceptable? A 5 dollar computer chip for 5 grand? Of course you do, you work for big insurance or are a doc with a hand in the pie. And gov't gets blamed? The Navy for a 1,000 dollar toilet seat? 500 buck hammer.

 

A thin piece of plastic? I guess there are a lot of college degrees to pay off.

 

This IS exactly why gov't exists... For the interest of protecting people from these demons and crooks!

 

Where is Sinclair Lewis when you need him! Where is the real Martin Arrowsmith!

 

First of all, that is NOT why government exists.

 

Second...I don't think you know what goes in to a micro-controlled prosthetic limb. A $5 computer chip?

[ExiledInIllinois]

Fukk the sick and the poor. Just charge and make and gouge as much money as you possibly can off them when they're down and most vulnerable. I totally understand how you think, LA, I just don't understand how you can live with yourself.

 

 

Same here. The word for these kinds of people is:

 

Hypocrite

[ExiledInIllinois]

First of all, that is NOT why government exists.

 

Second...I don't think you know what goes in to a micro-controlled prosthetic limb. A $5 computer chip?

 

And you wonder why you don't get any respect.

 

 

Ya... Maybe not 5 dollars... Who really cares... Like it is going to mean something to the customers they are bleeding dry. Any other industry, the public would have told the medical profession to get phucked. They make the auto industry look like Romper Room.

[Magox]

Fukk the sick and the poor. Just charge and make and gouge as much money as you possibly can off them when they're down and most vulnerable. I totally understand how you think, LA, I just don't understand how you can live with yourself.

You are right Dog.

 

we need to have 'medical pay czar'.

 

So what is fair $450,000, $350,000, $250,000, $150,000?

 

While we are at it, we need to have a 'prescription drug czar'.

 

We also should have a 'law czar', !@#$ing scumbag lawyers making so much money, we need to regulate their pay as well.

 

!@#$ it! We just need a Czar to regulate everyone's pay. No one should be making lots more than what the average Joe is making, and if we can't do that, then let's tax the hell out of him. It's just not right.

 

I'm surprised Dog, really.

 

Like I said, right out of the Liberal Locotoad handbook, if you can't beat'em, demonize'em.

[ExiledInIllinois]

You are right Dog.

 

we need to have 'medical pay czar'.

 

So what is fair $450,000, $350,000, $250,000, $150,000?

 

While we are at it, we need to have a 'prescription drug czar'.

 

We also should have a 'law czar', !@#$ing scumbag lawyers making so much money, we need to regulate their pay as well.

 

!@#$ it! We just need a Czar to regulate everyone's pay. No one should be making lots more than what the average Joe is making, and if we can't do that, then let's tax the hell out of him. It's just not right.

 

I'm surprised Dog, really.

 

Like I said, right out of the Liberal Locotoad handbook, if you can't beat'em, demonize'em.

 

And they should be demonized. I didn't create the problem... Greed did.

 

 

We had a labor hiring and firing Czar in BFLO during the 1940's... And ya, medical care is AT a crisis level.

[DC Tom]

And you wonder why you don't get any respect.

 

Because I don't believe in "We're the government, and we're here to protect you"? When a large portion of the Constitution is dedicated specifically to protecting us from government?

 

And you wonder why you don't get any respect?

 

Ya... Maybe not 5 dollars... Who really cares... Like it is going to mean something to the customers they are bleeding dry. Any other industry, the public would have told the medical profession to get phucked. They make the auto industry look like Romper Room.

 

You care. You specifically suggest the consumer is being gouged on high-end, custom-made medical devices without knowing a damned thing about their design, manufacture, or maintenance. Or, for that matter, even caring that there are less expensive alternatives - not every prosthetic limb is, or has to be, microchip-controlled with an artificial skin analogue and driven by nerve impulse control. You're basically using an example that's akin to someone buying a Lexus when a Chevy would do just as well, then you're bitching about how they can't afford the Lexus because they're being gouged by Toyota, and should have it subsidized.

[ExiledInIllinois]

You're basically using an example that's akin to someone buying a Lexus when a Chevy would do just as well, then you're bitching about how they can't afford the Lexus because they're being gouged by Toyota, and should have it subsidized.

 

No... If the Lexus is 500,000 dollars compared to the Chevy maybe I would agree with you. I mean, my God... Does he even need a leg? Just put a wooden peg there. The Chevy is the wooden peg.

[Chef Jim]

It's impossible to survive on $450,000 + a year. I don't see how people do it.

 

Because you'll probably never see income like that in your lifetime you need to begrudge the people that have found a way to do so. Awesome job.

[Magox]

Funny how on the campaign trail B.O was talking about wanting to unite everyone. I think I can safely say this, there hasn't been a president that has had such a polarizing effect on the American public in a very long time.

 

examples such as race, class warfare, and big government/socialism issues to just name a few.