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Dear Docs 4 Patient Care Supporter
We have just returned from Washington, DC. A group of our doctors met with policy experts and with members of Congress. I went to Washington feeling angry, tired, and somewhat deflated after the charade in Congress last Sunday, but returned with renewed enthusiasm and determination, because of what we learned. THIS IS NOT OVER!!!
For the past year, we have witnessed politics at its worst. A partisan, Democrat majority, led by Nancy Pelosi and Harry Reid, forced its will on the American people, ignoring a clear message sent by 2/3 of Americans and 83% of doctors (Sermo survey), that they were strongly opposed to this severely flawed plan. Just several weeks into this new law, we have discovered hidden surprises buried in this 2700 page monstrosity. What is clear is that this law is not about health care reform, but is instead a massive government grab of money from individuals and business and a government takeover of healthcare. This latter point is not hyperbole. The law states on pages 148-9 that the Secretary of Health & Human Services is your boss. Kathleen Sebelius is responsible for coming up with the clinical protocols that you must follow if you wish to contract privately with an insurance company that participates in the healthcare exchange. You now work for the federal government. They are in your examination room with every patient.
What has happened sickens me; both the process and the end result. The good news is that the majority of America feels the same way. It is an aberration that a small minority of extremists can frame the argument and force their will on the majority. We need to see to it that this injustice is corrected.
There are 2 ways of doing this- judicially and legislatively. Both will be important. Many lawsuits already have been filed, contesting the constitutionality of this law. 13 states are in the process of passing laws that challenge whether the state law supercedes what is interpreted as an unconstitutional federal law.
The other way is by wresting control away from a far left leaning, Democrat majority. Those who are responsible for taking away the healthcare rights of Americans need to be punished by firing them at the ballot boxes. If Republicans regain the majority in the House and Senate and then regain the White House, then this law can be repealed, and then replaced, with a plan that makes sense for all Americans. By regaining the House in 2010, the provisions specified by this bill will be de-funded, and hence neutralized. By retaking the Senate and White House in 2012, this abysmal law can be repealed and replaced. We must all work tirelessly to make sure that this happens.
Now to Docs 4 Patient Care. We need D4PC more now than we did before. You must all wake up and realize what has happened. This is just the beginning of what promises to be a full assault on our profession. The government is coming after all of us with Pay for Performance and Comparative Effectiveness. They will force us to put all of our practice data into their computer systems to monitor us. They will force us to adhere to protocols made up by bureaucrats or we won’t be able to practice. They plan to drastically reduce what we are paid. They will turn oversight of doctors to hospitals who will benevolently distribute professional fees to us through mechanisms like episodic care and Accountable Care Organizations. As we struggle to fend off this assault, doctors will still be left “holding the bag” when it comes to medical liability. Just this week, 2 states (Georgia and Indiana) had caps on awards on malpractice cases overturned by state supreme courts.
Where were your specialty societies and state medical associations during this debate? They had ample opportunity to keep this from happening, but they failed miserably. They failed you and your patients. And where was the AMA? They are an accomplice to Obamacare. Without their support, passage of this bill would not have occurred.
What you need to do now is to support Docs 4 Patient Care. You might ask why? What has Docs 4 Patient Care done so far and why should I give them any money?
We have done 2 things. We have developed a new relationship in Washington that other medical organizations and PACS have not had. We are looking at the big picture regarding medicine. By doing this, we are not allowing Congress to split us up and pick us off by specialty. This is what they have relied on up until now and why we are in this situation now. This is what the AMA should have been doing. D4PC has given doctors as a whole a political voice. We have friends now in Congress who support what we are doing (Reps Tom Price, Phil Gingrey, Paul Broun, Phil Roe, Mike Burgess, Sen. Tom Coburn- all MDs; Rep.Eric Cantor, Rep. Joe Barton, Sen Jim DeMint, etc), want us to succeed, and will help us in every way possible.
We have also given doctors a voice in the media. We have developed relationships in radio, TV, print and internet news media. (We have friends there as well who want to see Docs 4 Patient Care succeed in replacing the AMA. People like Sen. Fred Thompson, Hugh Hewitt, Mike Gallagher, Dennis Prager and Bill Bennett, just to name a few). We are bringing our cause to the people which we need to do in order to win the war of public opinion. This strengthens us in Washington, where the ultimate battles to regain control of our profession will be waged.
What is it worth to you to save your career and your profession? What would you do to protect the healthcare system for you and your family? I think that its worth a lot more than we are asking of you. We have done the heavy lifting for the past year. We need your help now. The time has come for you to get off the fence and protect your interests. Go to our website right now ( www.docs4patientcare.org) and become a $1000 member of D4PC. You can give more if you can or you can become a $250 member. For most of you, it is a tax deduction as a business expense. We need to get to 30,000 doctors by the end of this year. We need critical mass to make a difference. We need your money to build up this organization. We will help you by giving you the tools that you will need to recruit other doctors in your area and also your friends around the country. We need you to educate your patients about who was responsible for this mess that we are now faced with and what they must do in November to begin the process of undoing it.
I am urging you; no begging you to do something that most of you don’t do as doctors. I need you to trust D4PC and believe that we can make a difference. But we can’t do it without you.
Hal
Hal Scherz MD
President & Founder, Docs 4 Patient Care
*Contributions or gifts to D4PC are not tax deductible as charitable contributions. However they may be tax deductible as ordinary and necessary business expenses. Please check with your tax preparer.
Massachusetts law would turn doctors into serfs
April 27, 2010 by Don Watkins
Throughout the health care debate, we have been arguing that the push for government control of health care is driven by a certain moral view: the view that need is a claim. That view is typically taken to be noble and benevolent, and one of Ayn Rand’s most controversial conclusions is that it is in fact vicious and unjust. Well, the latest proposal out of Massachusetts seems designed to prove Rand’s point.Massachusetts, you probably know, passed a bill very similar to ObamaCare a few years back. Well, shocking news: the state is now hemorrhaging money. To stop the bleeding, it is clamping down on doctor reimbursements for Medicare and Medicaid, which has meant fewer and fewer doctors willing to accept Medicare/Medicaid patients. The state’s solution? Force them.
Every health care provider licensed in the commonwealth which provides covered services to a person covered under “Affordable Health Plans” must provide such service to any such person, as a condition of their licensure, and must accept payment at the lowest of the statutory reimbursement rate…
As one doctor noted :
So what this means is that in order for doctors to become licensed in Massachusetts, they will have to agree to accepting the payment rates imposed by the government, even though those payments may not cover their actual expenses for the care rendered.
Unbelievable.
But it isn’t unbelievable–not if you view need as an entitlement. If a Medicare patient’s need of health care entitles him to it, then why should a doctor have the right to refuse service just because the doctor won’t make money? Wouldn’t that be selfish and greedy?
There is nothing noble or benevolent about political thugs forcing doctors–the men and women without whom all of our health care needs would go unfulfilled–to sacrifice their time, their energy, and their wealth to anyone’s need.
Remember: the morality of need means serfdom for doctors
Here's the bill:
SENATE DOCKET, NO. 2188 FILED ON: 7/23/2009
SENATE . . . . . . . . . . . . . . No. 2170
The Commonwealth of Massachusetts
PRESENTED BY: Richard T. Moore
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled:
The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying bill:
An Act Relative to an Affordable Health Plan
PETITION OF:
NAME:
DISTRICT/ADDRESS:Richard T. Moore Worcester and Norfolk Michael O. Moore Second Worcester Stephen M. Brewer Worcester, Hampden, Hampshire and Franklin Susan C. Tucker Second Essex and Middlesex The Commonwealth of Massachusetts In the Year Two Thousand and Nine An Act Relative to an Affordable Health Plan.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. "Statutory Reimbursement rate" means, with respect to payment to a health care
1 provider for services rendered to any person covered under an "Affordable Health Plan", one hundred and
2 ten percent of the Medicare reimbursement rate for those services as if there were rendered to a Medicare
3 beneficiary not taking into consideration any beneficiary cost sharing. For services or supplies for which
4 there is no Medicare reimbursement amount, the amount as determined by the Division of Health Care
5 Finance and Policy to be consistent with Medicare payment polices at a one hundred and ten percent level
6 and approved by the Commissioner of Insurance.
7 (a) As a condition of doing business in the commonwealth, a carrier that offers health benefit plans to
8 eligible small businesses and eligible individuals, as defined by chapter one hundred and seventy-six J,
9 shall offer an "Affordable Health Plan" to all eligible individuals and small businesses, both within the
10 Connector, for such carriers participating in the Connector, and for all such carriers outside the
11 Connector. This "Affordable Health Plan" shall contain benefits that are actuarially equivalent to the
12 lowest level benefit plan available to the general public within the Connector, other than the young adult
13 plan. Payment for all services, other than outpatient pharmacy benefits, for all providers under
14 "Affordable Health Plans" shall be consistent with the requirements as included in paragraph (b).
15 (b) Claims for services shall be adjudicated at the in-network benefit level or, if applicable under the
16 terms of the plan, the out-of-network benefit level based on the participation status of the provider in the
17 carrier’s network. Every health care provider licensed in the commonwealth which provides covered
18 services to a person covered under "Affordable Health Plans" must provide such service to any such
19 person, as a condition of their licensure, and must accept payment at the lowest of the statutory
20 reimbursement rate, an amount equal to the actuarial equivalent of the statutory reimbursement rate, or
21 the applicable contract rate with the carrier for the carrier’s product offering with the lowest level benefit
22 plan available to the general public within the Connector, other than the young adult plan, and may not
23 balance bill such person for any amount in excess of the amount paid by the carrier pursuant to this
24 section, other than applicable co-payments, co-insurance and deductibles.
25 (c)Providers shall not attempt to recoup such excess amounts by increasing charges to other health benefit
26 plans or other payers. The Division of Health Care Finance and Policy shall monitor provider charges to
27 ensure compliance with this section and report any non-compliance to the Attorney General. The
28 Division of Health Care Finance and Policy shall promulgate regulations enforcing this subsection, which
29 shall include penalties for noncompliance.
30 (d) Existing contracts between providers and carriers shall comply with the requirements of this Section as
31 to the reimbursement rate and providers must provide services to individuals under "Affordable Health
32 Plans" under such existing contracts with carriers. A provider that participates in a carrier’s network or
33 any health benefit plan may not refuse to participate in the carrier’s network with respect to the
34 “Affordable Health Plan”.
35 SECTION 2. Section 1 of this act shall be repealed upon such date determined by the
36 Commissioner that a common payment methodology has been implemented across all public and private
37 payers across the commonwealth
What have you done today to speak for patients and save your profession? Please visit www.docs4patientcare.org.
Respectfully,
The Executive Board of Docs4PatientCare.org
We have just returned from Washington, DC. A group of our doctors met with policy experts and with members of Congress. I went to Washington feeling angry, tired, and somewhat deflated after the charade in Congress last Sunday, but returned with renewed enthusiasm and determination, because of what we learned. THIS IS NOT OVER!!!
For the past year, we have witnessed politics at its worst. A partisan, Democrat majority, led by Nancy Pelosi and Harry Reid, forced its will on the American people, ignoring a clear message sent by 2/3 of Americans and 83% of doctors (Sermo survey), that they were strongly opposed to this severely flawed plan. Just several weeks into this new law, we have discovered hidden surprises buried in this 2700 page monstrosity. What is clear is that this law is not about health care reform, but is instead a massive government grab of money from individuals and business and a government takeover of healthcare. This latter point is not hyperbole. The law states on pages 148-9 that the Secretary of Health & Human Services is your boss. Kathleen Sebelius is responsible for coming up with the clinical protocols that you must follow if you wish to contract privately with an insurance company that participates in the healthcare exchange. You now work for the federal government. They are in your examination room with every patient.
What has happened sickens me; both the process and the end result. The good news is that the majority of America feels the same way. It is an aberration that a small minority of extremists can frame the argument and force their will on the majority. We need to see to it that this injustice is corrected.
There are 2 ways of doing this- judicially and legislatively. Both will be important. Many lawsuits already have been filed, contesting the constitutionality of this law. 13 states are in the process of passing laws that challenge whether the state law supercedes what is interpreted as an unconstitutional federal law.
The other way is by wresting control away from a far left leaning, Democrat majority. Those who are responsible for taking away the healthcare rights of Americans need to be punished by firing them at the ballot boxes. If Republicans regain the majority in the House and Senate and then regain the White House, then this law can be repealed, and then replaced, with a plan that makes sense for all Americans. By regaining the House in 2010, the provisions specified by this bill will be de-funded, and hence neutralized. By retaking the Senate and White House in 2012, this abysmal law can be repealed and replaced. We must all work tirelessly to make sure that this happens.
Now to Docs 4 Patient Care. We need D4PC more now than we did before. You must all wake up and realize what has happened. This is just the beginning of what promises to be a full assault on our profession. The government is coming after all of us with Pay for Performance and Comparative Effectiveness. They will force us to put all of our practice data into their computer systems to monitor us. They will force us to adhere to protocols made up by bureaucrats or we won’t be able to practice. They plan to drastically reduce what we are paid. They will turn oversight of doctors to hospitals who will benevolently distribute professional fees to us through mechanisms like episodic care and Accountable Care Organizations. As we struggle to fend off this assault, doctors will still be left “holding the bag” when it comes to medical liability. Just this week, 2 states (Georgia and Indiana) had caps on awards on malpractice cases overturned by state supreme courts.
Where were your specialty societies and state medical associations during this debate? They had ample opportunity to keep this from happening, but they failed miserably. They failed you and your patients. And where was the AMA? They are an accomplice to Obamacare. Without their support, passage of this bill would not have occurred.
What you need to do now is to support Docs 4 Patient Care. You might ask why? What has Docs 4 Patient Care done so far and why should I give them any money?
We have done 2 things. We have developed a new relationship in Washington that other medical organizations and PACS have not had. We are looking at the big picture regarding medicine. By doing this, we are not allowing Congress to split us up and pick us off by specialty. This is what they have relied on up until now and why we are in this situation now. This is what the AMA should have been doing. D4PC has given doctors as a whole a political voice. We have friends now in Congress who support what we are doing (Reps Tom Price, Phil Gingrey, Paul Broun, Phil Roe, Mike Burgess, Sen. Tom Coburn- all MDs; Rep.Eric Cantor, Rep. Joe Barton, Sen Jim DeMint, etc), want us to succeed, and will help us in every way possible.
We have also given doctors a voice in the media. We have developed relationships in radio, TV, print and internet news media. (We have friends there as well who want to see Docs 4 Patient Care succeed in replacing the AMA. People like Sen. Fred Thompson, Hugh Hewitt, Mike Gallagher, Dennis Prager and Bill Bennett, just to name a few). We are bringing our cause to the people which we need to do in order to win the war of public opinion. This strengthens us in Washington, where the ultimate battles to regain control of our profession will be waged.
What is it worth to you to save your career and your profession? What would you do to protect the healthcare system for you and your family? I think that its worth a lot more than we are asking of you. We have done the heavy lifting for the past year. We need your help now. The time has come for you to get off the fence and protect your interests. Go to our website right now ( www.docs4patientcare.org) and become a $1000 member of D4PC. You can give more if you can or you can become a $250 member. For most of you, it is a tax deduction as a business expense. We need to get to 30,000 doctors by the end of this year. We need critical mass to make a difference. We need your money to build up this organization. We will help you by giving you the tools that you will need to recruit other doctors in your area and also your friends around the country. We need you to educate your patients about who was responsible for this mess that we are now faced with and what they must do in November to begin the process of undoing it.
I am urging you; no begging you to do something that most of you don’t do as doctors. I need you to trust D4PC and believe that we can make a difference. But we can’t do it without you.
Hal
Hal Scherz MD
President & Founder, Docs 4 Patient Care
*Contributions or gifts to D4PC are not tax deductible as charitable contributions. However they may be tax deductible as ordinary and necessary business expenses. Please check with your tax preparer.
Massachusetts law would turn doctors into serfs
April 27, 2010 by Don Watkins
Throughout the health care debate, we have been arguing that the push for government control of health care is driven by a certain moral view: the view that need is a claim. That view is typically taken to be noble and benevolent, and one of Ayn Rand’s most controversial conclusions is that it is in fact vicious and unjust. Well, the latest proposal out of Massachusetts seems designed to prove Rand’s point.Massachusetts, you probably know, passed a bill very similar to ObamaCare a few years back. Well, shocking news: the state is now hemorrhaging money. To stop the bleeding, it is clamping down on doctor reimbursements for Medicare and Medicaid, which has meant fewer and fewer doctors willing to accept Medicare/Medicaid patients. The state’s solution? Force them.
Every health care provider licensed in the commonwealth which provides covered services to a person covered under “Affordable Health Plans” must provide such service to any such person, as a condition of their licensure, and must accept payment at the lowest of the statutory reimbursement rate…
As one doctor noted :
So what this means is that in order for doctors to become licensed in Massachusetts, they will have to agree to accepting the payment rates imposed by the government, even though those payments may not cover their actual expenses for the care rendered.
Unbelievable.
But it isn’t unbelievable–not if you view need as an entitlement. If a Medicare patient’s need of health care entitles him to it, then why should a doctor have the right to refuse service just because the doctor won’t make money? Wouldn’t that be selfish and greedy?
There is nothing noble or benevolent about political thugs forcing doctors–the men and women without whom all of our health care needs would go unfulfilled–to sacrifice their time, their energy, and their wealth to anyone’s need.
Remember: the morality of need means serfdom for doctors
Here's the bill:
SENATE DOCKET, NO. 2188 FILED ON: 7/23/2009
SENATE . . . . . . . . . . . . . . No. 2170
The Commonwealth of Massachusetts
PRESENTED BY: Richard T. Moore
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled:
The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying bill:
An Act Relative to an Affordable Health Plan
PETITION OF:
NAME:
DISTRICT/ADDRESS:Richard T. Moore Worcester and Norfolk Michael O. Moore Second Worcester Stephen M. Brewer Worcester, Hampden, Hampshire and Franklin Susan C. Tucker Second Essex and Middlesex The Commonwealth of Massachusetts In the Year Two Thousand and Nine An Act Relative to an Affordable Health Plan.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. "Statutory Reimbursement rate" means, with respect to payment to a health care
1 provider for services rendered to any person covered under an "Affordable Health Plan", one hundred and
2 ten percent of the Medicare reimbursement rate for those services as if there were rendered to a Medicare
3 beneficiary not taking into consideration any beneficiary cost sharing. For services or supplies for which
4 there is no Medicare reimbursement amount, the amount as determined by the Division of Health Care
5 Finance and Policy to be consistent with Medicare payment polices at a one hundred and ten percent level
6 and approved by the Commissioner of Insurance.
7 (a) As a condition of doing business in the commonwealth, a carrier that offers health benefit plans to
8 eligible small businesses and eligible individuals, as defined by chapter one hundred and seventy-six J,
9 shall offer an "Affordable Health Plan" to all eligible individuals and small businesses, both within the
10 Connector, for such carriers participating in the Connector, and for all such carriers outside the
11 Connector. This "Affordable Health Plan" shall contain benefits that are actuarially equivalent to the
12 lowest level benefit plan available to the general public within the Connector, other than the young adult
13 plan. Payment for all services, other than outpatient pharmacy benefits, for all providers under
14 "Affordable Health Plans" shall be consistent with the requirements as included in paragraph (b).
15 (b) Claims for services shall be adjudicated at the in-network benefit level or, if applicable under the
16 terms of the plan, the out-of-network benefit level based on the participation status of the provider in the
17 carrier’s network. Every health care provider licensed in the commonwealth which provides covered
18 services to a person covered under "Affordable Health Plans" must provide such service to any such
19 person, as a condition of their licensure, and must accept payment at the lowest of the statutory
20 reimbursement rate, an amount equal to the actuarial equivalent of the statutory reimbursement rate, or
21 the applicable contract rate with the carrier for the carrier’s product offering with the lowest level benefit
22 plan available to the general public within the Connector, other than the young adult plan, and may not
23 balance bill such person for any amount in excess of the amount paid by the carrier pursuant to this
24 section, other than applicable co-payments, co-insurance and deductibles.
25 (c)Providers shall not attempt to recoup such excess amounts by increasing charges to other health benefit
26 plans or other payers. The Division of Health Care Finance and Policy shall monitor provider charges to
27 ensure compliance with this section and report any non-compliance to the Attorney General. The
28 Division of Health Care Finance and Policy shall promulgate regulations enforcing this subsection, which
29 shall include penalties for noncompliance.
30 (d) Existing contracts between providers and carriers shall comply with the requirements of this Section as
31 to the reimbursement rate and providers must provide services to individuals under "Affordable Health
32 Plans" under such existing contracts with carriers. A provider that participates in a carrier’s network or
33 any health benefit plan may not refuse to participate in the carrier’s network with respect to the
34 “Affordable Health Plan”.
35 SECTION 2. Section 1 of this act shall be repealed upon such date determined by the
36 Commissioner that a common payment methodology has been implemented across all public and private
37 payers across the commonwealth
What have you done today to speak for patients and save your profession? Please visit www.docs4patientcare.org.
Respectfully,
The Executive Board of Docs4PatientCare.org
