If 0bama is re-elected, providers will leave Medicare in droves. The low reimbursement and regulations are just not worth it. Audits, compliance costs, electronic records will force most small groups and solo practices to drop out of the system. That leaves Medicare patients with providers at big hospital corporations, and other government agencies such as the VA. Access will be very tough.
Some groups may adopt a hybrid approach by assigning procedural specialists to Medicare, but keeping the primary care providers out of Medicare. That way they can charge market rates for the evaluation and medical management which is undervalued. Then, they will refer to the procedural specialists (who take Medicare) within the group, as long as the margins still make sense.
I was at a wedding Saturday, sat next to the husband of a cousin. Very successful guy, late 60s.
I don’t know him that well, but he had few drinks in him and was very talkative.
He told me that in 2007 he had 120 employees, was doing $10million /year in sales. By August of 2009 he was down to 70 employees, where he is now, and is at less than $5 million in sales. No raises, no bonuses. He has absorbed ‘extraordinary’ losses, and had no growth in the interim.
If Obama is reelected he’s going to lay off 21 employees, because 49 is the magic number for healthcare. If he doesn’t do it, he’ll have to go out of business; Obamacare will make it impossible for him to be in business. The costs and regulations on small business are draconian.
There can be no quarter; the very existence of our country is in the balance.
We must defeat Obama, and then repeal his programs.
Possible, but they will have to downsize like crazy. For the healthcare business, all the volume is in Medicare folks.