For the first time in a decade, the number of uninsured children in the United States increased in 2018. Apple Health seemed like the quintessential success story because it expanded Medicaid coverage for children — in Kitsap County alone, the number enrolled grew from 9,000 to over 21,000 in the last 10 years. However, Medicaid reimbursement also decreased by more than 35 percent, after a federal provision that kept Medicaid payments on par with Medicare expired in 2015. Some states set aside funding to maintain rates equal to those of Medicare, but Washington was not one of them.
Nonprofit hospitals, in general, are facing challenging times. And that challenge is going to reverberate through our county, whether that means a major facility on a new construction timeline or further corporate creativity to reduce health care costs.
During the same period, the U.S. maternal mortality more than doubled, skyrocketing from 9.8 to 21.5 maternal deaths per 100,000 live births. That’s six times higher than most Scandinavian countries and three times higher than Canada and the United Kingdom. In the U.S., around 700-900 women die and another 65,000 experience life-threatening complications during or after childbirth. By any standard, the U.S. has the worst performance on this crucial measure of any country in the developed world.
The patient was on the state Medicaid insurance and required a so-called prior authorization, or PA, for Ciprofloxacin. Consisting of additional paperwork that physicians are required to fill out before pharmacists can fill prescriptions for certain drugs, PAs boil down to yet another cost-cutting measure implemented by insurers to stand between patients and certain costly drugs.
Prior Authorizations: Who is Responsible for the Death of a Patient when Insurers Practice Medicine?
In July, 2009, the family of Massachusetts teenager Yarushka Rivera went to their local Walgreens to pick up Topomax, an anti-seizure drug that had been keeping her epilepsy in check for years. Rivera had insurance coverage through MassHealth, the state’s Medicaid insurance program for low-income children, and never ran into obstacles obtaining this life-saving medication.
Only 6% of physicians practice in rural areas, yet they serve 16% of the population. Kitsap County has 443 physicians, equivalent to 2.4% of the state total and is one county experiencing a shortage of primary care physicians. Kitsap County falls below the state average in every primary care specialty across the board.
Tapeworms represent third parties who have ingratiated themselves into the patient-physician relationship in the interest of the almighty dollar. As the distance has grown between patients and physicians, costs have spiraled out of control. By inviting extra layers of bureaucracy, CMS and other corporations are essentially slapping lipstick on the tapeworm and trying to make CPC look as attractive as Direct Primary Care, but that is an illusion.
Just over a year ago, I met Dr. Shulkin in his office while working in Washington DC on behalf of independent physicians. A highly esteemed colleague of mine previously worked at the same hospital with Dr. Shulkin and scheduled a meeting to discuss healthcare reform. My colleague asked for a “wing woman” and I happily tagged along. Knowing their shared history, an exchange of pleasantries seemed far more likely than the haranguing with insults that ensued. In my opinion, Dr. Shulkin was one of the most pompous men I have ever encountered.
Our Government should be Of the people, By the people and For the people – not Of Target, By Amazon, and For Berkshire Hathaway. Being seen by a midlevel provider at a big box retailer cannot save money. Lawmakers sponsoring H.R 5138 are doing the nation a grave disservice by sponsoring this atrocious legislation.
While the American Board of Medical Specialties (ABMS) argues MOC participation makes for better doctors, no credible proof supports this assertion; only initial board certification has been scientifically validated. Seven states already eliminated MOC compliance to maintain licensure, physician hospital employment, or insurance contracting, however this same freedom must be extended to the other 43.