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Curmudgeon's Corner

cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner

ObamaCare Revisited

U.S., Healthcare, Political, Quality of Life

Jay Weber discussed a letter from Nick Turkal, MD, the CEO of Aurora Health Care this morning and it is available here if you’d like to read it for yourself.  This letter was sent to “All Caregivers” in the Aurora system and it discussed the coming changes following the passage of ObamaCare and also as the result of the ‘fiscal cliff’ actions taken just days ago.  This gives us a view of what we can now expect for health care impacts on a system-wide basis.

Aurora will see a minimum of $13 million less in government reimbursements in 2013 and expects more such reductions in the future.  The recently dodged bullet called ‘Sustainable Growth Rate’ is the reduction in physician reimbursements for the delivery of Medicare services.  Had that not been dealt with as part of the ‘fiscal cliff’ actions, Aurora would’ve seen another $78 million in reimbursement reductions in 2013.

Yet another part of the equation is the ‘sequestration’ action that was delayed as part of the ‘fiscal cliff’ action.  That would’ve hit the Defense Department and also would’ve hit health care cost reimbursements.  That would’ve cost Aurora another $23 million in 2013.  This has been postponed for two months, so it will again have to be dealt with in short order.

Turkal points out that the Aurora system will live in an uncertain world for some time to come and that it is also seeing charity care on the rise given the effects of the recession.  Every system is exposed to the same conditions.

For the moment, Turkal advised, this means a freeze on hiring for most open positions, a further careful look at budgets to find those nice-to-have (my term) things that can be done without and the discontinuing of some positions.

Aurora is not alone in this dilemma; everyone in the health care world, with very rare exception, is facing similar problems.  This is the beginning of the necessary reactions to the world that our Congress has created and which it perpetuates.

People are going to feel the impact.  Doctors were widely noted as saying they’d have to reconsider their continuing in their profession if there was no way for them to prosper.  The primary care physician ranks, already too small to handle the influx of those who will have health coverage in addition to the loads currently faced, will be hit harder as more doctors move into specialties.

We are moving into a new world and there is not a good road map yet available with which we can plan our individual routes.  Much of ObamaCare has yet to be fleshed out completely.  The law was largely an overall structure but without any of the detail resolved.  That was left up to Secretary Kathleen Sibelius and the multitude of people she has hired to help her flesh out the skeleton.

Many entities in the health care system that were told they needed to support the new law since they’d make a lot of money as the result are now seeing the truth.  Hospital associations were supporters.  Insurance company’s associations were supporters.  AARP was a supporter.  Pharmacy companies were supporters.  All thought they’d found the ‘Mother Lode’; instead they found fool’s gold.

Our President and our Congress sold us all a bill of goods.  As more and more of this bill of goods sees the light of day, we can better understand why this had to be passed in the dark of night without anyone really knowing what was in the bill.

Maybe we’ll learn a lesson from this debacle, and, then again, maybe not.  We seem to be very slow learners.

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