The Galen Institute reports that, as of March 7th, Obamacare regulations encompassed 20,000 pages. This is almost as many pages as Medicare's billing regulations for doctors, and the same for Medicaid. Adding these to Tricare and Champus policies, Obamacare brings the pages of governmental rules and regulations that healthcare workers must know and follow to 75,000.
With a predicted shortage of 67,000 doctors by 2014, the last thing the medical profession needs is more regulations for doctors to read and follow. Even if the Obamacare documents are meant as reference material, like volumes of an encyclopedia, the fact that we're all responsible for knowing the contents will render the practice of medicine more impracticable, if not impossible, for solo doctors.
When Senate Minority leader Mitch McConnell unveiled this so-called "Red Tape Tower" there were hoots and applause in Congress--riotous laughter--"because of the incredible burden this law is placing on the health sector and the economy."
Why is it that everything the government does, has to be so complicated? However much I support a national health plan, I can't help wondering if the complexity of Obamacare, like the insanity of our IRS tax codes, is a deliberate attempt to entrap anyone the government wants to catch in a net of criminal activity.
Taking care of Medicare patients happens to be, I discovered while seeing patients in my solo medical clinic, a booby trap. Since Medicare is a federal insurance program (funded by each tax-paying American but "managed" by the government) doctors who agree to see Medicare patients put themselves at risk for felony charges, if they misinterpret insurance guidelines, or--even worse--when federal agents misunderstand those 20,000 pages of Medicare rules, and then base an attack on a doctor (whom they can profit, by raiding and "taking back" money for government coffers) on convenient ambiguities which are everywhere in Medicare's compendium of rules.
Medicare rules aren't static--the organization adds new guidelines, including many changes in coding rules, every two months. These changes create more tremors in the shifting ground on which physicians ply their trade. "Updates in coding guidelines" (as they're termed) used to be sent to all Medicare providers for free via snail-mail--but five or six years ago Medicare imposed a subscription charge for them, and most of us forgot about updates.
The last thing a doctor wants to do at the end of a busy day with patients is to read dozens of fine-print pages about changes in medical billing for a single insurance carrier. Medicare's updates went electronic, but then I found myself forgetting about them, and so did my billing personnel. So I paid for the written subscription, because I didn't want to miss new codes, and I knew that getting paid depended on accurate, meticulous billing.
It didn't help, did it, for me to keep abreast of Medicare? I learned about new ways to code for the services I was providing, and I applied them--but it seems only to have gotten me into trouble. I was billing more than my colleagues, and using codes hardly anyone knew about. They were correct, but I became an outlier by taking Medicare at its word. Too much knowledge is a dangerous thing.
Coding and billing is a full-time job, rife with risk, even for a big team of specially trained clerks-- and the new Obamacare rules and regulations will add to this job, big-time. Even if doctors hire more billing experts, to ensure compliance with all these new rules, they still bear ultimate responsibility for errors. Think about how useful this could become for people in the doctor's milieu, not just government agents who want to stage a coup for publicity, but employees who are less than honorable. A disgruntled billing clerk could transmit erroneous claims, then report the doctor for "a pattern of overbilling." Such employees, if skillful at covering their role in this kind of plot, might even garner a whistleblower fee, when doctors decide to plea-bargain as a way to cut their losses in costly litigation.
There has never been a better time to retire from medicine than now, for doctors. The world of medicine, especially the business of medicine, is too rife with danger and complications for solo docs to survive. We have become targets for so many money-mongering people--lawyers, patients, regulators, the media, and government agents--that practicing medicine is a scary proposition these days.
I am glad to be watching from the sidelines, sad to see solo doctors falling by the wayside, and extending my condolences to those who struggle, and seem to be drowning in the turbulent waters of regulatory change.
With a predicted shortage of 67,000 doctors by 2014, the last thing the medical profession needs is more regulations for doctors to read and follow. Even if the Obamacare documents are meant as reference material, like volumes of an encyclopedia, the fact that we're all responsible for knowing the contents will render the practice of medicine more impracticable, if not impossible, for solo doctors.
When Senate Minority leader Mitch McConnell unveiled this so-called "Red Tape Tower" there were hoots and applause in Congress--riotous laughter--"because of the incredible burden this law is placing on the health sector and the economy."
Why is it that everything the government does, has to be so complicated? However much I support a national health plan, I can't help wondering if the complexity of Obamacare, like the insanity of our IRS tax codes, is a deliberate attempt to entrap anyone the government wants to catch in a net of criminal activity.
Taking care of Medicare patients happens to be, I discovered while seeing patients in my solo medical clinic, a booby trap. Since Medicare is a federal insurance program (funded by each tax-paying American but "managed" by the government) doctors who agree to see Medicare patients put themselves at risk for felony charges, if they misinterpret insurance guidelines, or--even worse--when federal agents misunderstand those 20,000 pages of Medicare rules, and then base an attack on a doctor (whom they can profit, by raiding and "taking back" money for government coffers) on convenient ambiguities which are everywhere in Medicare's compendium of rules.
Medicare rules aren't static--the organization adds new guidelines, including many changes in coding rules, every two months. These changes create more tremors in the shifting ground on which physicians ply their trade. "Updates in coding guidelines" (as they're termed) used to be sent to all Medicare providers for free via snail-mail--but five or six years ago Medicare imposed a subscription charge for them, and most of us forgot about updates.
The last thing a doctor wants to do at the end of a busy day with patients is to read dozens of fine-print pages about changes in medical billing for a single insurance carrier. Medicare's updates went electronic, but then I found myself forgetting about them, and so did my billing personnel. So I paid for the written subscription, because I didn't want to miss new codes, and I knew that getting paid depended on accurate, meticulous billing.
It didn't help, did it, for me to keep abreast of Medicare? I learned about new ways to code for the services I was providing, and I applied them--but it seems only to have gotten me into trouble. I was billing more than my colleagues, and using codes hardly anyone knew about. They were correct, but I became an outlier by taking Medicare at its word. Too much knowledge is a dangerous thing.
Coding and billing is a full-time job, rife with risk, even for a big team of specially trained clerks-- and the new Obamacare rules and regulations will add to this job, big-time. Even if doctors hire more billing experts, to ensure compliance with all these new rules, they still bear ultimate responsibility for errors. Think about how useful this could become for people in the doctor's milieu, not just government agents who want to stage a coup for publicity, but employees who are less than honorable. A disgruntled billing clerk could transmit erroneous claims, then report the doctor for "a pattern of overbilling." Such employees, if skillful at covering their role in this kind of plot, might even garner a whistleblower fee, when doctors decide to plea-bargain as a way to cut their losses in costly litigation.
There has never been a better time to retire from medicine than now, for doctors. The world of medicine, especially the business of medicine, is too rife with danger and complications for solo docs to survive. We have become targets for so many money-mongering people--lawyers, patients, regulators, the media, and government agents--that practicing medicine is a scary proposition these days.
I am glad to be watching from the sidelines, sad to see solo doctors falling by the wayside, and extending my condolences to those who struggle, and seem to be drowning in the turbulent waters of regulatory change.
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