RE: Re: Effect of National Health Care on Private Practice Physical Therapy Clinics

[Guest guest]

Lori, Please google the Swedish healthcare system and read the article at

www.nationalcenter.org, that is the National Center for Public Policy. The

Swedish system is a FAR cry from a success in my opinion. Yes something has to

be done, but Nationalized healthcare, otherwise knows ans Socialized medicine

does not appear to be a very acceptable alternative. And nationalized anything

is shown over and over to increase sloath and decrease productivity.

Effect of National Health Care on Private

Practice

> Physical Therapy Clinics

>

> Dear Group,

>

> This is more of an information gathering post than an information

giving

> post, so I'll get right to it. In my research over the last few

years of

> politics and political agendas, I have come to the conclusion that

allowing

> the government to enact any plan of Nationalized Healthcare -

outside of

> Medicare, Medicaid, and SCHIP as they are right now - would in

effect put

> all of our private practices out of business. I believe that the

lack of

> choices available to the general public, and the government being

in control

> of yet another failing system in this country would destroy

competition in

> our industry, and would be a great benefit to hospital based therapy

> services, but would be terrible for private practice. I don't know

what it

> is like trying to get credentialed with HMO insurance companies

outside of

> Wisconsin, but in our practice, we have been told in no uncertain

terms that

> we will NEVER be allowed in any HMO network as long as there is a

hospital

> based clinic within 20 miles of us.

>

> Consequently, there are at least 4 hospital based clinics within 20

miles of

> our clinic, and all of our attempts to join HMO networks, so that

we might

> be able to cater to a larger range of patients, has ended in a

denial from

> the insurance company for the very reason listed above. With the

government

> possibly taking over Healthcare for everyone, it becomes easy to

imagine

> that they would want to sped as little money as possible in order

to cover

> as many people as possible, and HMO Health Insurance will become

the norm in

> our industry, making it nearly impossible to serve those patients

unless

> they are willing to pay out of pocket. This is severely unlikely,

being

> that they could just go to the hospital based clinic down the block

and get

> " free " Physical Therapy because it's covered under their taxpayer

funded -

> and capped like Medicare - Health plan.

>

> Not only do we have to worry about the HMO issue, but we also have

to worry

> about the hospitals and their bureaucrats being able to charge less

than

> private practices to " the insurance company " than we can because

they have

> so much more revenue to go around to keep them in business, and

keep us out

> of competition just by undercutting our prices.

>

> So, with that out of the way, I'd like to know how some of you are

dealing

> with the prospect of having Nationalized Health Care... By the way,

if you

> can give me good, viable, verifiable reasons why Nationalized

Health Care

> might actually benefit Private Practices, I might be swayed, but as

yet, the

> best argument anyone can come up with is that the cheapest

insurance pool is

> one where everyone is enrolled. I often hear the same poor

arguments, and

> then I look to countries that have had National Health Care

programs for

> years like Great Britain and Canada, who's patients are literally

flying to

> the United States in droves just to get their healthcare NOW

instead of

> having to wait up to 6 months for a CT scan when cancer is the

likely

> diagnosis. In most cases, if a patient has a possible brain cancer

> diagnosis, 6 months could very well be too late. I don't want to

have that

> risk here in this country... it scares me.

>

> Adam Jeschke

> Optimal PT

> Lake Mills, WI

>

>

>

[Guest guest]

Hi, folks!

I may not have enjoyed a discussion this much since I taught graduate

economics!

Just to clarify in the interest of Evidence Based Practice Management: The

reference to " single payer " meaning you may not be quite supported. The

single payer is a gentle way of saying " the government " .

" Single-payer is basically a way some countries use to provide its citizens

with health insurance. (Sounds very boring, I know. But keep reading!) Its

name comes from the fact that doctors and hospitals are paid by one

organization: a single payer. By having only one payer, you can simplify the

health care system enormously. " (What is single payer? Available at:

http://www.grahamazon.com/sp/what.php Accessed January 18, 2008)

Thanks to Tom Howell for his view. If you really want to see a debate on

the role of a strong central government, read The Federalist Papers. These

were written to clarify the intent of the founders, right around the time if

the Constitution.

As PTs and others anguish over how to pursue their dream, which for some

includes self-employment, we really are on the leading edge of being

impacted by the intersection of the line of rising costs with the flat to

declining line of reimbursement.

Oh yes - Health Insurance Companies are not in business for the altruistic

reasons that many PTs are. They're financial institutions, and their

shareholders expect them to spend far less (on medical expenses) than they

take in.

Best regards,

Dick Hillyer, PT,DPT,MBA,MSM

Dr. W. Hillyer

Hillyer Consulting

The Institute for Rehab Management

700 El Dorado Pkwy W.

Cape Coral, FL 33914

Office

Mobile

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Adam Jeschke

Sent: Friday, January 18, 2008 5:05 PM

To: PTManager

Subject: Re: Re: Effect of National Health Care on Private

Practice Physical Therapy Clinics

Good points ... but switching to a Single Payer system (the Single Payer

being you) would not solve any of our rising costs of health care. What

WOULD solve the problem is opening up the industry to the free market. As

of now, everything is regulated, taxed, audited, and controlled by Corporate

Insurance... In the days before Blue Cross, WPS, Aetna, Humana, and

Medicare, churches ran hospitals, and those that couldn't afford care were

seen pro-bono... This is why we have names like St. Luke's, St. Help of

Christians, St. 's, etc. as names for hospitals... In all this

discussion, I never said it would be good to stay in the current system,

just that nationalizing it, and allowing the government to control it is NOT

anywhere close to the solution.

Adam Jeschke

Optimal Physical Therapy

Lake Mills, WI

On Jan 18, 2008 12:00 PM, s <dosrincatt (DOT)

<mailto:dosrinc%40att.net> net> wrote:

> Dear Listserve,

>

> Great discussion. This has been a topic of great interest for me as

> a father and a business owner. The one thing I do know is that we

> cannot include a 50% tax issue in the argument if we dont also

> discuss the current cost of health care premiums. Those of you who

> are covered by your employer or your spouses employer may not think

> that you are currently being taxed for your healthcare but you are.

> When we look at what we can afford to pay someone we must look at

> the whole wage/salary/benefit package. The cost of our employees

> healthcare is included in that package, it comes out of your

> potential salary. If the cost of your healthcare coverage goes up

> 25% annually and reimbursement goes down 1-5% annually do you think

> that your salary will continue to rise? Do you realize that what I

> as an employer pay out annually to cover the health insurance of my

> employees significantly limits what I am able to pay into their SEP

> IRA's and profit sharing bonuses. YES IT DOES! If their is no

> profit, there is no profit to share!!! YOU ARE CURRENTLY BEING

> TAXED AND YOUR COVERAGE MAY STILL STINK!!!

>

> I dont know the answers but I do know that the current system is

> broken and it starts with the insurance companies. They have had

> their chance and they were too greedy to realize just how good they

> had things. They were more concerned about taking care of their

> shareholders than their customers and they need to suffer the

> consequences. I have friends who are insurance agents who make six

> figure salaries, high school to four year degree graduates who do

> nothing more than sell insurance that make more than the providers

> of the care they sell. Remember, these people are not insuring

> anybody, they take no risk, they simply sell the stuff and they take

> home a bigger piece of the pie than we do. The current system is

> out of order.

>

> Keep up the discussion, thanks!

>

> E. s, PT, DPT, OCS, FAAOMPT

> www.douglasspt.com

>

>

> > >

> > > > In reference to Mr. Jeschke's comments I actually believe

> there

> > are

> > > > advantages and disadvantages in both a socialized healthcare

> > environment and

> > > > in a capitalistic healthcare environment. The bottom line

> depends

> > on whom it

> > > > benefits. It is in the best financial interest of the average

> > consumer to be

> > > > in an environment where healthcare is delivered in a

> socialized

> > manner as in

> > > > most industrialized nations, but it is in the best financial

> > interest of

> > > > myself and other busienss owners/executives (e.g. private

> > practice owners,

> > > > corporate executives (e.g. HealthSouth, Physiotherapy Assoc.,

> > etc.),

> > > > hospital executives, SNF owners and executives, Home Health

> > Agency owners

> > > > and executives, contracting agency owners, and physicians who

> own

> > PT

> > > > practices and CORFs) to do business in capitalistic

> environments

> > where we

> > > > can " capitalize " on opportunties created by healthcare.

> > > >

> > > > If we don't change our business philosophies and policies,

> then

> > others

> > > > will. Although, many business owners are willing to offer

> > employment

> > > > opportunities to physical therapists, assistants, athletic

> > trainers, etc...

> > > > to capitalize on the opportunites described above, few are

> > willing to share

> > > > ownership. To prevent non-physical therapists from OWNING

> physical

> > > > therapists and physical therapy assistants we MUST empower our

> > colleagues

> > > > with partnership/ownership opportunites. When we understand

> and

> > share the

> > > > rewards and losses of owning a physical therapy business, only

> > then we will

> > > > be able to truely understand the implications associated with

> non-

> > physical

> > > > therapists having control of our present and future (e.g.

> impact

> > of

> > > > hospital based clinics).

> > > >

> > > > Dr. Sumesh , PT, DPT, OCS

> > > >

> > > > P.S. Most of my patients wait longer than expected before

> being

> > able to

> > > > see specialists or undergo imaging studies, and a few become

> non-

> > compliant

> > > > with their prescribed medications due to cost and other

> insurance

> > issues. In

> > > > addition, although I have family and friends in many counties

> with

> > > > socialized healthcare none of them have expressed a desire to

> > come to the US

> > > > for healthcare.

> > > >

> > > >

> > > > Effect of National Health Care on Private

> > Practice

> > > > Physical Therapy Clinics

> > > >

> > > > Dear Group,

> > > >

> > > > This is more of an information gathering post than an

> information

> > giving

> > > > post, so I'll get right to it. In my research over the last

> few

> > years of

> > > > politics and political agendas, I have come to the conclusion

> that

> > > > allowing

> > > > the government to enact any plan of Nationalized Healthcare -

> > outside of

> > > > Medicare, Medicaid, and SCHIP as they are right now - would in

> > effect put

> > > > all of our private practices out of business. I believe that

> the

> > lack of

> > > > choices available to the general public, and the government

> being

> > in

> > > > control

> > > > of yet another failing system in this country would destroy

> > competition in

> > > > our industry, and would be a great benefit to hospital based

> > therapy

> > > > services, but would be terrible for private practice. I don't

> > know what it

> > > > is like trying to get credentialed with HMO insurance

> companies

> > outside of

> > > > Wisconsin, but in our practice, we have been told in no

> uncertain

> > terms

> > > > that

> > > > we will NEVER be allowed in any HMO network as long as there

> is a

> > hospital

> > > > based clinic within 20 miles of us.

> > > >

> > > > Consequently, there are at least 4 hospital based clinics

> within

> > 20 miles

> > > > of

> > > > our clinic, and all of our attempts to join HMO networks, so

> that

> > we might

> > > > be able to cater to a larger range of patients, has ended in a

> > denial from

> > > > the insurance company for the very reason listed above. With

> the

> > > > government

> > > > possibly taking over Healthcare for everyone, it becomes easy

> to

> > imagine

> > > > that they would want to sped as little money as possible in

> order

> > to cover

> > > > as many people as possible, and HMO Health Insurance will

> become

> > the norm

> > > > in

> > > > our industry, making it nearly impossible to serve those

> patients

> > unless

> > > > they are willing to pay out of pocket. This is severely

> unlikely,

> > being

> > > > that they could just go to the hospital based clinic down the

> > block and

> > > > get

> > > > " free " Physical Therapy because it's covered under their

> taxpayer

> > funded -

> > > > and capped like Medicare - Health plan.

> > > >

> > > > Not only do we have to worry about the HMO issue, but we also

> > have to

> > > > worry

> > > > about the hospitals and their bureaucrats being able to charge

> > less than

> > > > private practices to " the insurance company " than we can

> because

> > they have

> > > > so much more revenue to go around to keep them in business,

> and

> > keep us

> > > > out

> > > > of competition just by undercutting our prices.

> > > >

> > > > So, with that out of the way, I'd like to know how some of you

> > are dealing

> > > > with the prospect of having Nationalized Health Care... By the

> > way, if you

> > > > can give me good, viable, verifiable reasons why Nationalized

> > Health Care

> > > > might actually benefit Private Practices, I might be swayed,

> but

> > as yet,

> > > > the

> > > > best argument anyone can come up with is that the cheapest

> > insurance pool

> > > > is

> > > > one where everyone is enrolled. I often hear the same poor

> > arguments, and

> > > > then I look to countries that have had National Health Care

> > programs for

> > > > years like Great Britain and Canada, who's patients are

> literally

> > flying

> > > > to

> > > > the United States in droves just to get their healthcare NOW

> > instead of

> > > > having to wait up to 6 months for a CT scan when cancer is the

> > likely

> > > > diagnosis. In most cases, if a patient has a possible brain

> cancer

> > > > diagnosis, 6 months could very well be too late. I don't want

> to

> > have that

> > > > risk here in this country... it scares me.

> > > >

> > > > Adam Jeschke

> > > > Optimal PT

> > > > Lake Mills, WI

> > > >

> > > >

> > > >