How will the new Health Care Bill impact Derm?

[dermhopefully]

---

Members do not see this ad.

Anyone know? I haven't read through this thing but it does make me nervous.......it looks like it is going to pass on Christmas Eve now....

 

[sore eye asses]

We'll all be rich with the new plan!! Unspeakably, filthy rich!!!

The new plans are geared to provide all sorts of dermatologists to all sorts of people, but the bottom line is that we'll be raking in more dough than we know what to do with.

I plan to burn some for warmth, use some for toilet paper, and the rest to buy up the remaining elephants in captivity and start the world's first all elephant zoo in my backyard. Come one, come all to The Pachyderm Palace.

 

[werd]

the AAD sends quasi-regular emails regarding this legislation and it's stance regarding the different aspects. the summary from the most recent AAD stance:

"In summary, we are quite pleased that the Senate leadership has responded to several of our concerns with some meaningful changes, particularly the removal of the cosmetic procedures tax, the lack of Medicare age expansion, the removal of specialty payment reductions to pay for primary care bonuses, and the deletion of physician enrollment fees.

However, several of our most significant concerns remain. We strongly oppose the IMAB proposal, and the physician profiling and public reporting provisions in their current form. In addition, physicians will be entirely unable to implement meaningful health system reform unless the flawed SGR payment formula is fully repealed, removing the specter of impending payment cuts of more than 40%."

 

[doctalaughs]

the AAD sends quasi-regular emails regarding this legislation and it's stance regarding the different aspects. the summary from the most recent AAD stance:

"In summary, we are quite pleased that the Senate leadership has responded to several of our concerns with some meaningful changes, particularly the removal of the cosmetic procedures tax, the lack of Medicare age expansion, the removal of specialty payment reductions to pay for primary care bonuses, and the deletion of physician enrollment fees.

However, several of our most significant concerns remain. We strongly oppose the IMAB proposal, and the physician profiling and public reporting provisions in their current form. In addition, physicians will be entirely unable to implement meaningful health system reform unless the flawed SGR payment formula is fully repealed, removing the specter of impending payment cuts of more than 40%."

That is actually a quote from the AMA, not the AAD.

in any case, the legislation will probably impact dermatology salaries negatively but not much... and not much differently than all other specialties. Eliminating the consultation codes for medicare will hurt somewhat.

 

[werd]

the quote is from AAD, not the AMA. specifically,
American Academy of Dermatology
Health System Reform Update Mon 12/21/2009 4:47 PM
posted online at: http://www.aad.org/gov/documents/09_611_HSR_Update_12_21.pdf

 

[Taurus]

There's a provision in there that requires physicians to accept medicare/medicaid if they want to accept private insurance. You wouldn't be able to opt out of govt insurance programs unless you're completely all cash business. Even in derm, I would imagine it very difficult to run a practice that is completely all cash.

 

[asmallchild]

There's a provision in there that requires physicians to accept medicare/medicaid if they want to accept private insurance. You wouldn't be able to opt out of govt insurance programs unless you're completely all cash business. Even in derm, I would imagine it very difficult to run a practice that is completely all cash.

It certainly won't be easy (as it isn't easy even now) but derm is better situated to take advantage of an opportunity like this when compared to hospital-based fields, say anesthesiology or radiology.

 

[Taurus]

It certainly won't be easy (as it isn't easy even now) but derm is better situated to take advantage of an opportunity like this when compared to hospital-based fields, say anesthesiology or radiology.

I agree that derm is better situated. However, this doesn't mean that most derm practices will go unscathed. I think that the vast majority of derm practices will be negatively impacted by health care reform. You'll also see more encroachment from IM, FM, and even NP's for those cash-only procedures like botox.

 

[N-Surge]

There's a provision in there that requires physicians to accept medicare/medicaid if they want to accept private insurance. You wouldn't be able to opt out of govt insurance programs unless you're completely all cash business. Even in derm, I would imagine it very difficult to run a practice that is completely all cash.

Do your patients have private insurance or medicare/medicaid? I am not saying one should keep from treating those who only afford to see a Dr. via medicare/medicaid. But let's think about how worthless that provision may actually be in the end... If you run a practice w/ 50% medicare/medicaid patients then that is what you see. The provision doesn't require this percentage to change, right?

 

[Taurus]

Do your patients have private insurance or medicare/medicaid? I am not saying one should keep from treating those who only afford to see a Dr. via medicare/medicaid. But let's think about how worthless that provision may actually be in the end... If you run a practice w/ 50% medicare/medicaid patients then that is what you see. The provision doesn't require this percentage to change, right?

It sounds like it is up to the HHS secretary. Should be very interesting to see what the final reform bill looks like.

10 Lumps Of Coal In The Health Care Bill

5. Government controls on your doctors' decisions: The Senate bill bars doctors from participating in the private insurance system unless they implement whatever regulations the secretary of health and human services chooses to impose to "improve health care quality" (p. 149). That broad phrase encompasses everything in medicine.

This would be the first time in history that the federal government is given power over how doctors treat privately insured patients.​

 

[asmallchild]

I agree that derm is better situated. However, this doesn't mean that most derm practices will go unscathed. I think that the vast majority of derm practices will be negatively impacted by health care reform. You'll also see more encroachment from IM, FM, and even NP's for those cash-only procedures like botox.

Its certainly possible but I don't see it. Its a huge PITA to break into the cosmetics market now. It won't be as simple as one of the above mentioned doctors or even NPs suddenly deciding to offer those services. Now it would be a completely different story if a group of them banded together with the intention of creating an all-cosmetics type spa.

 

[Taurus]

Its a huge PITA to break into the cosmetics market now.

It's a huge PITA for anyone who doesn't have the connections and has to start from scratch. One of the best cosmetics person locally here is a FP who now does exclusively cosmetics because she's so good.

 

[DRJJ1]

it's a huge pita for anyone who doesn't have the connections and has to start from scratch. One of the best cosmetics person locally here is a fp who now does exclusively cosmetics because she's so good.

derm fees will have to drop because insur fees do not cover non medical voluntary procedures, soooo you figure it out...derm days will only be solicited by the select few or medical necessary procedures,,,,derms better start making house calls too for little johnny cause the days of wine n roses are done !!!!!!!!!!!!!!!!!!!!!!!

 

[N-Surge]

derm fees will have to drop because insur fees do not cover non medical voluntary procedures, soooo you figure it out...derm days will only be solicited by the select few or medical necessary procedures,,,,derms better start making house calls too for little johnny cause the days of wine n roses are done !!!!!!!!!!!!!!!!!!!!!!!

1. Elective services are already not covered by insurance.
2. Dermatologists are already sought after, with people waiting months.
3. Those in academics already do call, for both adults and pediatric patients.

 

[JaggerPlate]

It sounds like it is up to the HHS secretary. Should be very interesting to see what the final reform bill looks like.

10 Lumps Of Coal In The Health Care Bill

5. Government controls on your doctors' decisions: The Senate bill bars doctors from participating in the private insurance system unless they implement whatever regulations the secretary of health and human services chooses to impose to "improve health care quality" (p. 149). That broad phrase encompasses everything in medicine.

This would be the first time in history that the federal government is given power over how doctors treat privately insured patients.​

I've seen multiple people on SDN refute this point when the article first came out.

 

[werd]

derm fees will have to drop because insur fees do not cover non medical voluntary procedures, soooo you figure it out...derm days will only be solicited by the select few or medical necessary procedures,,,,derms better start making house calls too for little johnny cause the days of wine n roses are done !!!!!!!!!!!!!!!!!!!!!!!

your grammar is slightly lacking. i do approve of your use of ",,,," instead of "...." - that's top-notch. the rest just doesn't make much sense to me.

 

[N-Surge]

Probably not as much as this is impacting the US as a whole. I just ran across this today. Can anyone validate the accuracy of this? If it's true it is pretty astronomical...

Does anyone have a comparable breakdown of health care spending in dollars per year in the US since 2001? I'd also like to know what percentages went to Derm. Probably asking too much for that kind of information.

 

[jsmittyund03]

The entire Derm Association of SA is against it...kind of funny when the AMA "supports" it. At least the recent Mass. election proved that there will be a huge change in Congress come Nov.

 

[werd]

health care bill affecting derm? what health care bill?

i wonder which is worse for our congressional majority at this point - passing the bill or not passing the bill. from the beginning, i've wondered why democrats were trying to pass every reform they could think of in the same bill. rather, why not pass the popular reforms that everyone agrees on in one bill, and leave both parties and the nation feeling good about reform... and then try to push through the controversial/ unpopular/ turn-mass.-against-democrats stuff that's more polarizing. by trying to push it through in one big unpopular package, they've jeopardized even the parts of reform that are widely agreed upon.

 

[N-Surge]

Becuase they think it might be easier to get the contraversial stuff through if piggy backed on popular issues, imo. We all know that the precondition issue is off. If anyone wants to be elected next term then they'd do their best to push just that one item through, to make it illegal to hurt insurance payers in this way.