Local Impact....9/28

You might have wondered why I started covering the national health care issue, rather than more local problems. The latest poll that came through might be a reason. Currently 48% of the surveyed population are rating the health care system we have as good or excellent, as opposed to 29% last year. And, we're going into a congressional recess.

What does that mean, locally? With the announcement of the possibility of increased taxes on the "middle class", there is a real chance that the health care bill will stall, if not fail. Medicare cuts have already been projected. What are most of the Essent hospitals dependent on? Federal programs.

PRMC is currently, if I'm not mistaken, considered as part of the metroplex in Medicare reimbursement levels. The new cuts will leave the rural rates alone and cut into metro. So, a quandary: Will the new rates drop below the rural, equal them, or stay above? How much of a cut will PRMC take? Hmmm?

Quite possibly Nashville was sitting back, confident that a lot of the self-pay/no-pay would now be covered, pushing their revenue levels up. Now, the projection might not be so rosy...possibly equivalent to a lump of coal in their stocking.

Damned If You Do....9/3

Remember, years ago, when the Medicare renewal was let slip through the cracks and the reimbursement rates went to rural, rather than that of the metroplex? Well, under what is being cussed and discussed in Congress, that might be a good thing in the future.


Apparently, rural hospitals and physicians (medically under served areas) will not sustain the level of cuts that are being proposed to current Medicare levels. My take is that they are afraid of the egress of physicians from those areas to more profitable practices.


Understand, this is proposed, not a done deal.


So, PRMC and the other Essent hospitals might actually make out better. Who'da thunk it?


But, here is the kicker: While the percentage of insured would go up, the levels of reimbursement would still go down. The plan still doesn't cover everyone of those that are 'counted' in that 46, 47, or 50Million that is being bandied about.


What will happen, is more taxes--tax the wealthy will descend to tax the working. And I'll foretell something additional: Both Social Security and Obamacare both become means tested. So, if you've been responsible, saved, and invested in your retirement--tough. We're giving it to the ones that overspent their income (you saw it in the home loans, why not here as well?) All others pay cash.


All I'm saying, is that those who ignore history are doomed to repeat it. We've seen the examples: Federal programs with spending 300% over their estimates. Bailouts for the poorly managed (corporations as well as family finances.) Earmarks attached to "essential" funding...and we're willing to turn our health care to those people (who aren't crazy enough to opt for the same program)?

The Ayer is a Bit Stale....2/23

Dr. Cerel has come to view, as of late. A few comments stored up directed me to two locations. The Mass Board of Registration, and "rateMDs".

The Mass Board of Registration had this to say:
Hospital Discipline:
This section contains several categories of disciplinary actions taken by Massachusetts hospitals during the past ten years which are specifically required by law to be released in the physician's profile.

1. Facility: Nashoba Valley Medical Center
Action Begin Date: 2/10/2005
Action End Date: 6/20/2005
Action: Other

Basis or Allegation:

• Failure to follow internal by-laws, rules, etc.


• Interpersonal skills/personal behavior


• Delay in treatment


• Lack of informed consent-surgery related


• Failure to prescribe

-
-------------------------------------------------------------------------------
2. Facility: Emerson Hospital
Action Begin Date: 2/17/2005
Action End Date: 3/16/2005
Action: Suspension of right or privilege

Basis or Allegation:

• Failure to follow internal by-laws, rules, etc.

--------------------------------------------------------------------------------
Board Discipline:
This section includes final disciplinary actions taken by the Massachusetts Board of Registration in Medicine during the past ten years.
--------------------------------------------------------------------------------

1. Date: 3/16/2005
Case #: 2007-024
Action: Practice Restrictions

I would say that he's on staff, with no restrictions, other than what was imposed by the Mass Board. Unless there's something current, the last action was three years ago. However, that put him on training wheels. Wonder when that ends?

RateMDs.com had this:

He has privleges in one hospital, and is rated 2.3 on a 5pt scale.