Combs Spouts Off

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Archive for June 23rd, 2010

More doctors turning away Medicare patients

Posted by Richard on June 23, 2010

Remember that Presidential promise, “If you like your doctor, you can keep your doctor”? Well, if you’re a Medicare patient, that may not be true for long. Congress hasn’t acted to rescind a 21% reimbursement cut that took effect last week (they removed the so-called “doc fix” from the Obamacare bill in order to maintain the fiction that it would reduce health care spending). Since Medicare reimbursements averaged only 78% of private insurance payments before the 21% cut, more and more doctors are refusing to take new Medicare patients or opting out of Medicare entirely:

The number of U.S. doctors refusing new Medicare patients has increased to record levels as low government payment rates force them out, statistics show.

USA Today notes the doctors’ exodus comes just six months before millions of baby boomers begin enrolling in the federal government healthcare program.

“Physicians are saying, ‘I can’t afford to keep losing money,'” said Lori Heim, president of the American Academy of Family Physicians.

AAFP reports 13 percent of doctors who responded to a survey said they didn’t participate in Medicare last year, up from 8 percent in 2008 and 6 percent in 2004.

The American Medical Association said 17 percent of more than 9,000 doctors surveyed said they restrict the number of Medicare cases, and the rate rises to 31 percent for primary care physicians.

Shortages of primary care physicians already alarm many experts, and the seniors group AARP says record numbers of doctors refusing Medicare will make matters worse.

So “you can keep your doctor” is just as false as “you can keep your health care plan” (emphasis added):

Employers would lose grandfathered status if they switch insurance companies — unless the plan is covered by a union contract or the employer pays claims out of its own funds and uses the insurer only to administer the plan.

It isn’t clear how much the restrictions on co-payments and deductibles will save consumers, because health plans can still raise premiums. The rules issued Monday say plans would relinquish grandfathered status if they reduce the percentage of the premium they pay by more than five percentage points. The broader health-care law includes checks on unreasonable increases, which have not been defined.

The administration estimated that by 2013, health plans covering as few as 39 percent and as many as 69 percent of employees could lose protected status. For small employers, the total could be as high as 80 percent; for large ones, it could reach 64 percent.

The picture isn’t actually as rosy as the Washington Post tries to paint it. The hundreds of pages of restrictions and regulations in the Obamacare bill, coupled with the implementation rules announced last week, coupled with the rules yet to come, will ensure that existing “grandfathered” plans become unprofitable and untenable, and they will go away. That, as I’ve argued before (for instance, here and here), is part of their plan to force everyone into a single-payer system.

If some insurance companies try to maintain their existing plans by emulating Medicare — cutting reimbursements for health care providers — they’ll find themselves between the same rock and hard place that Medicare is now in: providers will simply stop providing under those conditions. Unless the government steps in and forces them to do so.

And if the government forces health care providers to provide their services against their will — well, I recall something Ayn Rand said about socialized medicine decades ago (I’m paraphrasing): Do you want your life in the hands of a doctor who resents being forced to treat you? Do you want your life in the hands of a doctor who doesn’t?

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Magic in the palm of your hand

Posted by Richard on June 23, 2010

It was only a couple of years ago that Polaroid stopped making film for the instant cameras it discontinued two years earlier. For some reason, I thought it was longer ago. In any case, there are people who are seriously nostalgic for the little prints that developed like magic in the palm of your hand.

Kevin Connolly of the BBC has written a nice look back at Polaroids, Dr. Edwin Land, the genius inventor who created the magical process more than 60 years ago, and the artists like Andy Warhol who embraced the process. And for those of you who share the nostalgia, he points out that Polaroids aren't dead yet:

The sheets of shiny card on which the instant photographs materialised were each in their own way tiny laboratories where 35 different components and chemicals combined to produce a minor miracle.

Consumers loved them and they sold in millions all over the world – bringing competitors like Fuji into the market too.

On the face of it, that should be that. The Polaroid camera ought to be remembered as a powerful tool for photographic artists and an iconic consumer product of the past – as outdated as the hand-mangle or the hula hoop.

In theory, digital photography has superseded the Polaroid camera as comprehensively as the CD eclipsed the wax cylinder.

Except that Polaroid photography just refuses to die.

If you still have a Polaroid 600 or SX-70 gathering dust in the basement and want to resurrect the magic — and don't mind paying a premium price (about $3 per picture) — you can order black and white film today from the Impossible Project. They say color film will be available soon. 

In this era of fauxtography, there is something appealing about a picture that you know hasn't been manipulated, that captures just what the photographer put in it. Maybe photojournalists covering the Middle East for Reuters, the AP, and AFP ought to be required to do so using Polaroid cameras and instant film.

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