Where Have I Been....

Well I admit, after many many months, I have returned to write some more. I guess the frustrating part about writing blogs is that I haven't figured out how to get people to read my blog! And, of course, hence the circular reasoning...no one reads what you post so why bother posting!



Sooo where should I begin...Obama care has done nothing for my patients or my practice...people still come to the ED with and without insurance whether they need to be here or not...but time will tell...



Perhaps the most frustrating part of the health care reform act is the placement of patients into Medicaid-like plans...Yes, people will be insured...but insurance does not equal access. Take for example the current standing for Medicaid...in my state physicians are paid almost the lowest in the country to the tune of approximately $27 per patient for an ED visit...but when you factor in operating expenses, malpractice, benefits for physicians, billing costs, etc. the $27 does not even cover the overhead. Sooo...how can you expect ED physicians to cover their expenses? Some will argue that $27 is better han nothing (and I agree that is true) but if the volume of patients visiting ED's increases and these patients would never have been in the ED because they did not have insurance, then the loss experienced by physicians will even be greater. This does not take into account the fact that the physician needs to cover his malpractice premiums to have the privilege of caring for patients covered by Medicaid...and they have the right to malpractice claims if the patient suffers a bad outcome (regardless of who is to blame)....

More to come on Medicaid and access issues...dealing with reality...