Thursday, March 23, 2006

late morning

…And Why Isn’t Canada A Good Idea?

This story is about my insurance company.  I’d already decided that I’d have back surgery basically as soon as possible, but this story clinches it.  It’s disgusting that insurance that we pay for is going to pay out less than Medicare. (Sorry about the formatting of the story - even in the print version, it looks crappy.  Fitting, I suppose, for a crappy story)
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Signs in Dr. Lisa Haworth’s office on Wednesday delivered bad news for about 1,400 of her patients: “As of June 1, 2006, we will no longer accept Blue Cross Blue Shield.”

The company recently informed Haworth and 2,000 other physicians and specialists in its Nevada provider network that it will lower by as much as one-half what it reimburses them for some 50 services, such as consultations and office visits. The new rates take effect June 1.

In some cases, the company’s rates will fall below what Medicare pays, physicians said.

“Unfortunately, I have to run a business,’’ Haworth said Wednesday. “I can’t afford a reduction like that, so I had to make a difficult decision and drop that insurance. I don’t want to lose patients, but this kind of puts us in a bind.’’

If Haworth’s patients want to stay with her, they will either have to change insurance providers or pay more out of their own pockets for her services.

The 251,000 Nevadans insured by Anthem Blue Cross Blue Shield might face similar choices. The company, which is a subsidiary of WellPoint Inc., insures about 157,000 residents of Clark County.

David Meyer, a Haworth patient since 2001, said he won’t be able to afford the higher out-of-pocket costs. He and his wife, Martha, will likely find another family physician.

“I’m not only giving up my family care doctor but my rheumatologist as well,’’ said Meyer. “It doesn’t feel good to walk into your doctor’s office and read a sign that essentially says you can no longer be their patient. I like having someone who knows me.’’

Another patient, Patricia Towne, said she’s staying with Haworth.

“I’m not changing doctors—no way,’’ she said Wednesday as she signed in for an appointment.

But Towne said the changes are “aggravating and very upsetting.” Towne said she talked to her employer, who called the company, and “they couldn’t give her any answers.”

“I learned because one of my friends told me,’’ she said.

Anthem Blue Cross Blue Shield officials said they don’t know how many of their 4,000 network providers will remain with them once the rate changes take effect.

Dr. William E. Bannen, regional vice president of health care management for Blue Cross, said Wednesday the company alerted about 2,000 providers of the changes by mail, but had not notified its members.  (How nice, having to find out by reading the local newspaper)

Bannen said providers were given 30 days to make a decision and another 90 days to cut ties with Blue Cross.

While it’s not the largest health insurer in Nevada, Blue Cross has the state’s largest provider network.

Bannen said he expects some doctors won’t accept lower payments from the company.

“If we lose five or 10, it’s not a huge deal,’’ he said. “We have to be competitive. ... And in order for us to be competitive, we needed to revise our pricing structure with the other larger health care insurers. ...

“There is going to be a lot of pain in this process for our providers and for our individual members, but this is something we have to do to stay competitive.’’

But Dr. Michael Colletti, a Las Vegas rheumatologist, and Haworth said they don’t understand Blue Cross’ explanation of the changes. Both physicians said other insurers are not announcing lower rates.

“I’m not having that problem with any others,’’ said Colletti who stands to lose 10 to 15 percent of his patients over the rate change. “Any insurance company I’m going to be a part of should be matched or closely matched with Medicare reimbursements.’’

Haworth said she doesn’t accept patients whose insurance provider reimburses less than Medicare.

If this is a trend among health insurers, physicians aren’t going to be able to survive, Colletti said.

As an example of how his reimbursement rates will be affected by Blue Cross’ decision, Colletti said he is paid about $87 for a Medicare patient’s office visit. For a Blue Cross patient’s office visit, he will receive just $47 after the June 1 rate change.

For consultations, Colletti said, Medicare reimburses him about $218. Blue Cross is proposing $153.

Dr. Rudy Manthei, an ophthalmologist and chairman of Keeping our Doctors in Nevada, said he doesn’t blame Blue Cross for trying to stay competitive. He said Blue Cross is one of the few insurance providers that has paid reasonable reimbursement rates.

The problem is with others, such as Sierra Health Services, which he said has leverage with physicians because of its size.

“Now, the other insurance companies are having a hard time with costs. In order to compete, they are dropping their rates down to Sierra’s levels,’’ Manthei said.

The concern now, Manthei said, is that the quality of care might go down because physicians will have to see more patients and do more procedures to offset the lower reimbursements. In the process, doctors will spend less time with their patients and think twice about purchasing newer technology, he said.

“This creates a vicious cycle, and physicians are in no position to work a deal. It is illegal for us to collectively bargain. It will take federal legislation to change that,’’ said Manthei, who plans to no longer accept Blue Cross.

In the last four years, the federal government has reduced Medicare rates by about 18 percent, Manthei said. The problem for patients and doctors has been compounded by health insurance carriers dropping their rates to Medicare levels, he said.

Haworth said it was painful to have to put up signs telling patients she would no longer accept Blue Cross. But if she kept the insurance provider she would have to take on 40 to 50 more patients.

“I want to spend time with my patients,’’ she said. “With family practices, we build relationships. I know that person. I know how their bodies work; and when you change a person’s family physician, they have to start all over again building that trust and respect.’’

Officials with the state’s Department of Health Services and Insurance Division said Wednesday the agencies have no jurisdiction over health insurance contracts.

“They are proprietary,’’ said Van Mouradian of Nevada’s Division of Insurance.
http://www.reviewjournal.com/lvrj_home/2006/Mar-23-Thu-2006/news/6501020.html

Wednesday, March 22, 2006

late morning

Idiot of the Day - Abstinence Progams & Bush

New story from HuffPo - “The Community-Based Abstinence Education grant program was enacted by Congress in 2001, and $391.7 million has been appropriated for it.”

So, $391.7 million to tell people not to fuck? Seriously? Maybe if they passed out those millions to people who needed it, people wouldn’t be having sex to forget that the administration doesn’t really give a shit about them.

This administration throws money away left & right, but all they seem to care about is lining their own pockets and those of their cronies.  Clinton left office with a huge surplus, and Bush in a very very very short period of time decimated the budget.  Now, we’re pretty much up to our eyeballs in debt to China.  To CHINA!  We need CHINA to loan us money, so we can throw it away in Iraq (hello!  Iraq never attacked us...just a reminder), which is accomplishing NOTHING.  Nothing but death and destruction, that is.  Plus, it’s a nice bonus recruitment ad for terrorism.

South Dakota is outlawing abortion, even in cases of incest or rape - yeah, because most people want to raise a baby that looks like their rapist.  Where are the laws requiring these right wingers to adopt all of these babies?  What, they’re not passing those?  You mean it’s all about saving children, but not about them having good homes afterwards?  I’m shocked.

And how come the only people standing up to Bush are Helen Thomas, George Clooney, Arianna Huffington, and Charlie Sheen?  What are our elected officials afraid of - the loss of their cushy pension?  Why is Hillary Clinton so damned wishy-washy?  I’m telling you right now, I will never vote for Hillary Clinton, so the Democrats better not even think of running her.  You know, because only my vote counts.

Sunday, March 19, 2006

lunch time

Happy Birthday, Dad!

Friday, March 17, 2006

evening

Happy (yesterday) Birthday, Mom!

Blrrrggghhh, I am SO ready for menopause.  Today, we were supposed to go out for birthday/St. Patrick’s Day lunch with my parents.  I felt so lousy that I was up for about thirty minutes to have some cereal, then I took the heating pad to bed with me and didn’t get up again until around 6p.  What a horrible waste of a day.  I’m not going to ever have any children, and if I do, it’ll be the old-fashioned way.  God will put them in me.  I don’t need working parts.

Maybe I can stay awake for my dad’s birthday, on Sunday.  On the bright side, their birthday present was delivered today, so now we can give it to them the next time we see them.

Monday, March 13, 2006

late afternoon

Awesome - Las Vegas Wranglers Make HuffingtonPost.com

Now, I really wish we had tickets for that night.  It’s probably sold out now, and the publicity will make it so you have to get there too early to be in the first thousand.  Alas, our dogs wouldn’t stand for us leaving them that long.

“Dick Cheney Hunting Vest Night” The Latest PR Stunt…
Associated Press | March 13, 2006 at 09:11 PM

READ MORE: Dick Cheney, Halliburton
A minor league hockey team is spoofing Vice President Dick Cheney’s recent hunting mishap with a plan to distribute bright orange hunting vests printed with the words, “Don’t Shoot, I’m Human.”

The Las Vegas Wranglers plan to distribute 1,000 vests to fans arriving for Friday’s game as part of a promotion dubbed “Dick Cheney Hunting Vest Night” at the Orleans Arena.

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