Correct Re: Doctors comment to Obamacare

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I meant to say do NOT....

 3.   Modify the prompt payment law from 45 days to 21 days and  As many of the clinics do NOT have the luxury of the tax waivers and rebates as the insurances do, thus creating a distinct disadvantage in this health care system.



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On Jul 1, 2012, at 12:45 PM, "Thomas Shieh, MD" <doctorshieh@yahoo.com> wrote:

> Hi Everyone
>
> I have received some emails asking about our doctors reaction to the supreme court decision on obamacare.
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> I can make this short statement before i board the plane on my way back to guam from california.  Please excuse typos and grammar, iPhone keys are small so please correct grammar and typos if you publish.  I just wanted to respond to inquiries.
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> Here-
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> "The Guam Medical Association is the largest medical healthcare organization comprised of over 185 health care members and we take this recent decision very seriously.  We will release a more detail response next week.
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> We all agree that the benefits of coverage for up to 26 yrs under parent plan is good, and increase limits of coverage along with ridding of pre-existing condition requirements, however you can rest assured that the insurance companies will find ways to limit or deny coverage and increase rates, some way some how.  The worse thing and is already occurring is insurance companies interfering with care by denying procedures that the doctor feel is needed for patients.  Will address two main issues today.
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> Issue 1:  Obamacare is a health systems change that affects every single individual with mandates and penalties that essentially translate into additional taxes if one do not buy insurance.  This can give the insurance companies certain advantages in guam if we are not careful.  Local insurances already are getting tax waivers and rebates, they now may try to increase their premiums as people are forced by law to buy their product. Guam must becareful and watch for unjustified rate increases.
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> Possible solution:  1. Establish an independent elected Health Insurance Commissioner, a person who is independent from appointments, and do not accept contributions from health insurance carriers.  This office will be and advocate for patients and their doctors, and to have authority to approve or reject any health premium increases. 2.  Allow competing off island insurance to enter Guam but need to ensures provider participation. 3.   Modify the prompt payment law from 45 days to 21 days and  As many of the clinics do NOT have the luxury of the tax waivers and rebates as the insurances do, thus creating a distinct disadvantage in this health care system.
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> Issue 2:  The anticipated expansion of MCAID.  The supreme court ruled that each state cannot be penalized for non-participation in the expansion.  Though it is anticipated that Govguam's public health will participate and increase the pool of qualified MCAID patients but the issue will be two folds, gov Guam cost and the lack of doctors accepting MCAID.  Reason is due to low reimbursements that cannot keep up with cost of running a medical clinic and delay in reimbursements.  Providers currently are limiting their percentage of MCAID patients and access to appointments are limited.
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> This expansion may not be good for insurances as more people qualify for MCAID coverage they will not buy insurance and this decreasing the number of privately insured pool.  This reduction and shift will limit access for patients because there are not enough doctors who accept MCAID on Guam.
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> Possible Solution: One way to Bring willing participating providers onboard with public health increasing and improving their customer service and outreach to local doctors.  Often, clinics are left in the dark when MCAID office are not communicating well and service to providers are not well received thus resulting in too much administrative work for the doctors when that administrative time could be spent taking care of patients instead.  Reimbursement rates has to meet up with inflation and meet the cost f running a medical clinic on island, it's much higher than running an office compared to the rest of the states.  Until there is enough health providers willing to accept MCAID, we caution Guam's opting in to this MCAID expansion because access to care will still be limited.
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> We will address 3 other key issues at another time.
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> As you can see from the two issues above.  This act is to reform not health access for patients but it also reforms health insurances.  These two critical issues will have to be discussed.
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> On Wed. July 18, we will have the key leaders on Guam in one room to discuss and debate ObamaCare and how it will affect Guam.
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> Ok.  Boarding now.  I will check my emails if you have further questions tonight as I land in HNL.
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> Sincerely
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> Dr Shieh
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> Sent from my iPhone