Achieving Highest Quality Care for American Heroes – VA to Vets Series by Dr. Wax

IP4PI Founder Dr. Craig Wax has published a trilogy of op-eds devoted to American Veterans:

VA to vets: Delay, deny, wait till they die.”
As a physician, I have the privilege of knowing and helping thousands of individuals. One patient in particular stands out as a victim of government’s malignant ineptitude. He is an affable, hardworking 71-year-old male, who is a veteran of the Vietnam War. There was no Veterans Day parade for him but scorn and disdain, given the anti-war sentiment at the time.
Read more: http://www.washingtontimes.com/news/2015/dec/1/craig-m-wax-va-vets-delay-deny-hope-they-die/

More VA delaying, denying, and more vets dying.
This is the second installment of my VA mistreatment and stonewalling veterans series. These experiences were shared by a patient, who is a Vietnam veteran.
Read more: http://m.washingtontimes.com/news/2016/jan/31/craig-m-wax-more-va-delaying-denying-and-waiting-u/

A Veterans Affairs reform that can work.
I have been heartened in recent months to see moves towards exactly this solution, which was previously touted by Dr. Ben Carson. Executive branch officials working on this issue have given strong indications that they see Tricare as the model for veterans healthcare.
Read more: http://www.washingtonexaminer.com/a-veterans-affairs-reform-that-can-work/article/2603066#!

What’s the AOA doing to combat insurer discrimination against OMM/NMM?

Friend of IP4PI Dr. Domenick Masiello shares correspondence with the AOA:

From: Domenick Masiello
Date: February 26, 2017
To: “Doss, Yolanda” <ydoss@osteopathic.org>
Cc: “Wooster, Laura” <lwooster@osteopathic.org>

Subject: Re: Issues in OMM/NMM

Well, I guess now I have to respond point by point. I am staring at my wall, looking at the 2 AOA board certifications that I have. One is Family Practice and osteopathic manipulative treatment and the other is a separate, different certification called Special proficiency in osteopathic manipulative medicine, C-SPOMM. So, Yolanda, there are actually 3 certificates flying around NOT two. Now we have a residency so there is also Neuromusculoskelatal medicine/OMM. the Special Proficiency is NOT a FP certification. I should know, I didn’t just speak to somebody with 20 years experience, I actually possess these certificates and have been in practice for 30 years! there is no gold standard, just confusion created by the AOA and its various certifying boards. I didn’t say that insurance carriers or hospitals recognized any DO claiming to be a specialist in OMM, I just said that some FPs advertise themselves as such, thereby adding to the confusion for the public.

Yolanda you did offer to help with Aetna over a year ago – it just would have been nice to hear back on the issue. You sort of kept that to yourself until recently about 9-10 months later. Aetna is not the only insurance company that doesn’t recognize our OMM specialty. I have had problems with Connecticare, Empire in NY, Oscar/magnacare in NY in addition to Aetna in NY and CT. In fact none of the exchanges in NY recognize OMM but they do have acupuncture and chiropractic listed in EVERY exchange! Recently I even tried Liberty Health Share, a Christian healthcare cost sharing provider. They would have me contact them for approval first before every visit and then submit treatments plans like a PT because they don’t know what I do.   You haven’t heard about other instances of this insurance problem because many DOs who do manipulation are not members of the AOA. Some doctors who completed their OMM residencies chose not to sit for the exam and many more have cash businesses as I did for the past 29 years. You also don’t have any outreach to folks like me so why would you hear from us. last summer I begged and pleaded for a specialty specific email blast for AOA members to no avail. You assume we will be contacted by our specialty boards but we are not and you assume that we will be contacted by our state societies but many of us are not members of those societies because they don’t serve our needs as traditional osteopaths.  recently, at a meeting of the Bergen County osteopathic Society in NJ, it was suggested that perhaps this less than ideal treatment of physicians board certified in OMM might be because of our minority status within our own profession. Most AOA members are FPs and they have the loudest voice and the rest of us are a minority within a minority profession. Also that the creation of a board certification for manipulation may have been experienced by the FPs as a threat to their insurance reimbursement. Ultimately, the point is not that you are working on it but how does this kind of thing happen in the first place? OMM should be your top priority because that is what makes us different despite our small numbers. Continue reading

Real life stories of the ACA nightmare # 14 – another physician lost to ObamaCare

“I spoke to a friend…who is about 50. She is a psychiatrist who works part time and had to submit her “retirement” this year. Her husband who works full time is no longer covered by his employer for insurance so as I understand it, she decided to stop working so they could make less than $60,000 to qualify for one of the lower deductible ACA plans. So we are losing another physician to Obamacare.”

Posted with permission

Real Stories of the ACA nightmare # 12- “Two out of three ain’t bad” – Meatloaf

A Canadian physician writes: “54 year old woman. Diabetic, hypertensive, high cholesterol. On Atorvastatin, Ramipril, Metformin. Presents to me with HbA1C of 8.9 – I adjust Metformin. Next visit, HbA1c is better, closer to 7.8. But BP is 190/100. I adjust the Ramipril. Next visit A1C is 7, BP is 135/80. Patient tells me not to check cholesterol. Because, she finally admits, she can only afford 2 out of 3 medications at a time, and she’s picking and choosing which ones to take depending on how horrified I am at the visit. But the cholesterol drugs are so expensive and her heater broke, so she needs a new heater, and she doesn’t want to know my reaction if she stops her statin.”

Posted with permission from the across the border

Real stories of the ACA nightmare #11 – it was like the insurance covered nothing

“I went to an Administrative meeting…and my boss hands me a check. It’s 3 months worth of my insurance premiums…as she had cancelled insurance for all employees due to ‘inadequacy’ under the new ACA rules, and replacing our policies would require a tremendous rate hike. The kicker: I had just come from my dermatologist where I had been diagnosed with 2 melanomas, and I was scheduled for surgery in a week. Not only was my visit not covered by insurance (she absolutely should have told me sooner!) but I then had to obtain my own insurance through the ACA and wait 6 months for surgery…while that cancer just sat there. Fortunately, it didn’t spread (18 stitches in my back, 10 in my thigh for the area removed) but my out of pocket was $2500…it was like the insurance covered nothing…why did I even bother waiting…”

Posted with permission

Real Stories of the ACA nightmare # 10 – “Free” care is awfully expensive

“I saw a patient that I met for the first time three months ago who is originally from Canada. She was in for her pre-op visit. She is in awe of the fact that she got surgery in three months. In Canada under a single payer system it would have taken at least three years she said. And her income tax rate was at about 50% to cover the programs.”

Posted with permission