70% Of Calfornia's Doctors Expected To Boycott Obamacare

Tyler Durden's picture

We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” exclaims the president of the California Medical Association, as The Washington Examiner reports, independent insurance brokers estimate 70% of California's 104,000 licensed doctors are boycotting the exchange. “The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating, but they’ve shown no numbers," and if a large number of doctors either balk at participating in the exchange or retire, the state’s medical system could be overwhelmed. “Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” warns one health director. “There aren’t enough primary care physicians, period.”


Via The Washington Examiner,

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.


“It doesn't surprise me that there's a high rate of nonparticipation,” said Dr. Richard Thorp, president of the California Medical Association.




California offers one of the lowest government reimbursement rates in the country -- 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.




“Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy.


“They may be listed as actually participating, but not of their own volition,”




This is a dirty little secret that is not really talked about as they promote Covered California,” Waters said. He called the exchange's doctors list a “shell game” because “the vast majority” of his doctors are not participating




“The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating," notes Mazer. "But they’ve shown no numbers."




Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” he said. “There aren’t enough primary care physicians, period.”




Briscoe professed not to be surprised by the refusal of doctors to participate in Covered California. “It rings true. I’ve been kind of wondering in my head, ‘How are they offering such low premiums?’ ”

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PGR88's picture

If health-care isn't the best example of big-government central-planning (and paying) it into oblivion, I don't know what is

It seems the American Left won't be satisfied until they turn the USA into Cuba or Zimbabwe.

AU5K's picture

In the soviet union, doctors were nationalized and earned basically the same wages as everyone else.  They were expected to perform their services for the good of the country and not expect any extra pay for their skills, education or life saving talent.  Sadly it appears that is where we are going.

Mike in GA's picture

It may appear that we are going but we will never get there.  Not in my lifetime or the lifetimes of all those alive today who have breathed as free men. 

The USSR, in your example, went from monarchial, feudalistic, slaveholding government of minimal subsistence level to the Bolshevik revolution to Stalin in less than 10 years.  The Great Butcher institutionalized the "Comply or Die" method of motivation and the rest is history.   In their case, I'd rather be a live doctor working for a menial wage than a dead doctor helping no one. 

Our doctors today enjoy a state of the art that is decades and generations beyond anything in 1920s Russia.  Our guys could not function without the many complex systems that have become the envy of the world. 

Should some .gov asshole, at any level, decide Soviet style care is what we must do, millions would die from its absence.  Included in those millions, I hope, would be the enlightened .gov assholes, at any level, who started it.

FreedomGuy's picture

You seriously want to use the Soviet Union as a model? In the old USSR doctors made less than an executive secretary for politburo members. You like that, too?

Reaper's picture

Are Obama's and Gov.Brown's police going to make doctors treat these patients? In my State, the difference between Medicaid and Medicare is 20% and all the local doctors see Medicaid patients for only a part of one day per week. Most of the enrollees at Obamacare website are into Medicaid. More Medicaid patients + less doctors = longer waits and delayed or denied treatments. WTSHTF, even the Medicaid rabble will turn on Obama.

PGR88's picture

Its too late for California.  They have millions of citizens whose political and economic reference points are life and politics in Oaxaca and Tegucigalpa.   They will choose the first guy who promises them free shit, and they will wind up with Hugo Chavez, Venezuela, and a Vice Ministry of Supreme Social Happiness.


adr's picture

All I hear anymore is how doctors and hospitals can't make any money anymore. But all I see is new medical centers being built all over the place and breaking ground for new expansions everywhere else.

If a hospital can't make money, how can they keep building?

When it costs $1800 to stitch a finger, $5000 to put a cast on a fracture, $200 for a Tylenol, how can the hospital not make any money?

 Sure a doctor might only get $50 for the welfare queen going to the ER for a headache, but its not like it takes any work to diagnose the bitch. 

If I have to go to the doctor it is just to get some antibiotics for an infection. It takes about five minutes and the doctor gets reimbursed $110 for the appointment. $110 for ten minutes is a pretty good rate of return for something that took no effort. My wife is required to go to the doctor every six months to get her asthma medication renewed. There isn't even a medical evaluation done. Just a hello and an electronic renewal of her prescription.

A clinic near me charges $80 to administer a flu shot. That takes about fifteen seconds. 

Perhaps doctors shouldn't believe they deserve to get paid as much as they do. $350k to work an MRI machine. $125k for a nurse practitioner. Sure pay a surgeon $200k, but someone that amounts to nothing more than a paper pusher isn't worth $125k.

RaceToTheBottom's picture

Over 200000-400000 deaths a year are due to preventable medical mistakes performed by medical professionals.

I guess they get paid so much cause the do so much good work.....

/Fucking large SARC

Miffed Microbiologist's picture

May I suggest to you to do some research into the efficacy of flu shots. You may be astounded to find how ineffectual they are. Plus injecting your body with mercury, adjuvants and other chemicals you do not need for longterm health. Think about it. How do you catch a viral infection? By touching mucus membranes. This is how the bodies immune system is initiated. Injecting antigens intramuscularly causes a potential reaction to ALL substances present. Therefore unforeseen reactions can occur. I had a violent reaction to a flu vaccine that made having the flu look infinitely preferable. There I just saved you $80.

Now, address the need for your wife to have asthma medication in the first place. I was a severe asthmatic for 25 years. I had 2 puffs of albuterol every four hours 24 hrs a day for 25 years ( plus other preventative steroids to help prevent attacks) I had at least one severe pneumonia a year. I went on a crusade to cure myself. In the last 5 years I've had no asthma and am on no meds. You have a choice. I listened for years to what modern medicine told me was good for my health. All I got was sicker and with more prescriptions. I finally got the courage to tell them to fuck off and tried to find an alternative way. Take control of your own life and be amazed where it leads.


malek's picture

So these new medical CENTERs are built and owned by the doctors?

You should get your preconceptions readjusted.

bunnyswanson's picture

Large hospitals in communities are consolidating - buying out small rural hospitals and closing them down, then building/adding to their own structure.  It's becoming a monopoly.  Hospitals are said to have begun hiring doctors to work within these medical institutions, so doctors are getting paid by hospital, closing their own offices.  There are articles about this on line.


Doctors spend a lot of time dictating reports, talking to other physicians about their patients, reading investigative studies (lab data, radiology studies), coordinating care.  It is more than just what you see when you visit him.

Randoom Thought's picture

Pretty sure there is plenty of money for doctors and that the doctor patient relationship would be better if they were able to get insurance companies, lawyers and big pharma out of their way so that they can do their jobs and take care of patients.

RaceToTheBottom's picture

Add the AMA to that statement.  The AMA has coddled the DRs for decades

Eugene9876's picture

Very few doctors participate in the AMA. The AMA is an organization that makes the bulk of its money off shuffling and re-shuffling diagnosis ICD-9 and ICD-10 codes, which most doctors want nothing to do with.

Boiling Frogs's picture

17%. 17% of physicians are members of the AMA. My guess is the vast majority if that 17% are in academia plus residents and medical students. I was a member when I was a student and resident because it was FREE and you got the monthly journal (worthless), some other schwag like a textbook and ink pens. Granted medical students aren't yet physicians but I imagine they're included in the head count anyway.

Son of Loki's picture

What doctor would want to practice in Fuki-Saturated Kornifornia where the lifeguards and Tiny-Town Mayors are paid more then family practice doctors from what I've read.

Freddie's picture

LOL!  So true.  Tiny-Town Mayors.  LOL!  The worst was that small town. Bell, CA or something.  They had a population of about 3,000 and city manager was making something like $540,000 a year.    Insanity.

Let's hope Nancy Pelosi's Nor Cal wine vineyards gets lots of Fuki-MOX love.

zebrasquid's picture

Us San Diegoians are glad that the rest of the country, currently enduring sub-zero early winter, so misunderstand life here.

Duude's picture

The Federal government never thought to ask doctors what they felt about this. What government doesn't seem to understand is besides the high cost of malpractice insurance doctors have to pay perhaps another 1/3 of their revenue towards collecting from both insurance companies and the government. Now Obamacare is adding an additional dimension. If an individual stops paying his monthly premiums, he's still covered for 90 days after his last payment. The first 30 days the insurance company eats and the remaining 60 days is left to the doctors to collect from the individual. Besides having to deal with this it creates a new level of moral hazard because an individual can pay for the first 9 months of the year, get covered for all 12, and reapply to another insurance company the next year. This what happens when lawmakers are allowed to design 1/6th of the US economy with legislation.

bunnyswanson's picture

Malpractice insurance in California isn't what it used to be.  The law has changed.  The price is cheaper for malpractice insurance (affordable).  If I recall, to win a lawsuit, you must be dead and the reward will go to children and the amount of damage has been contained. 

Cancer patients will die sooner under ACA - If abnormality is found on a diagnostic test (x-ray), return for follow up of this finding is "in 1 year."  One year is a death warrant when tumor is high-grade cancer cells.  "Studies have found that early detection does not extend life." 

Advoc8tr's picture

Just an obseervation as I am not American but "it is the insurance companies stupid !  How it can cost so much for healthcare over there is beyond most of us. Your doctors aren't generally better than any from our or other western countries and from the comments above they aren't all rich either - where does all the money go then ?

We have had a single payer system here for more than my 40 yrs and it works great ?  A few grand a year rolled into your annual tax return (so it usually get's covered by a portion of your tax refund)  Our GPs are upper middle class, surgeons comfortably so but Doctors are not all millionaires. They are highly respected by most in society and most kids "wanna be a doctor when they grow up"

No one is ever refused any kind of medical care and you only pay full amount for elective stuff like cosmetic and the "top up" which is maybe $30 for a standard consultation. In fact until the insurance lobby finally got its way a decade a go medical care was completely free as most doctors would not charge above the amount proscribed by the gov even though they could.

It has worked for ages, been copied by the UK and others and has not caused any significant blowouts in deficit - we actually used run genuine surpluses not so long ago ?

Finding yourself bankrupt or dead because you have an accident and require medical help is worry you can do without.

Boils down to a single large non-profit insurance scheme run by the government and is evidenced to work long term if done right. It is regualry touched on for change by pollies who owe the insurance companies a favour but they quickly go to zero in the polls so is considered sacred turf generally.

PS.   As a very large buyer our gov gets medicines from companies in USA at a pittance to what they retail to you for .. so they must be charging massive markups to you ... they voluntarily submitt much lower prices to our PBS board who decide what pharmaceuticals gets covered etc ? Single large buyer has more pull.


rustymason's picture

@Advoc8tr, Our health care was the best in the world by far and was very inexpensive before the government became involved in helping us pay for it. Our new "elites" forced on us the socialist system you advocate and this is the result.

DeliciousSteak's picture

Socialist? America has fascist healthcare. It is run by the insurance companies and the racket is protected by the government.

FreedomGuy's picture

Your European healthcare is heavly subsidized by the USA. The reason is that when companies develop anything be it a new MRI machine or medicine they all have their eyes on America as the primary market. Historically they have a bigger market and can make enough money to play ball with the autocratic systems in Europe. Tell me where most of the innovations in medicines have come from for the last 50 or 60 years? Yup, America like most innovation. Your light socialist systems are actually the side game for most anyone who wants to innovate in medicine. All those horrible prices you mention you might note are from nice European pharmaceutical companies. Your nice countries will seize patents if they don't like the price. They also now mandate one price, lowest price or price match of other countries without regards to differences.  

I see many talking about $500 for a stitch and lots of other things in America. There is a listed price and there is the true reimbursement. The true payments are far lower. Plus, when you pay your doctor you are also paying his medical assistant, the receptionist and several admin people you don't see who do all that nasty billing and fighting with your insurance company or the government. when you go to a doctor (in the USA), get a blood draw and a simple prescription you involve a dozen people with various levels of training to get all those "free" things for you and then fight the lawsuits you will launch if you don't like the result. Is anyone besides me incredulous at 2000 page bill that has not a sentence on tort reform? Lawyers, as usual remain untouched. BTW, about 2/3 of Congress is lawyers. Your OBG pays thousands each month just for legal defense.

There is another nasty secret the U.S. government is about to learn, too. That expensive private market has been subsidizing the government for decades. What happens is that doctors, hospitals, nursing homes and others can make enough in the private market to take the lousy reimbursements of the government. Even before ACA doctors limited the amount of medicare they would take and many take zero Medicaid. You can tell a medicaid clinic immediately when you walk in.

For those of you who still think realize what I am positing. Your private American insurance has always subsidized the U.S. government market and even indirectly subsidizes Europe and other countries. America has set the pace in all areas of medical innovation and led the world. We pay Cadillac prices because of the free riders and because we want premium healthcare.

There are reforms that could have been done but they would have been in the opposite direction. They would have to be in the direction of freedom and free, not controlled markets. ACA has just blown those possibilities out of the water. Where I will agree with Advo on is that we could have simply copied some European models that are at least tested, but then Obama and the lefties would have to have been honest about their goals. That would not have passed.

Eugene9876's picture

Exactly. Prior to ACA the insurance companies received direct subsidies (via Medicare) that presumably offset the cost of the private insurance plans. ACA stripped that subsidy, so regardless of the new insurance features, this should drive the cost of private insurance up

scaleindependent's picture

I'm curious.

What country are you from.

kchrisc's picture

Government control of doctors and their careers in 3, 2, 1...

"Sorry doc, you can't retire/stop/quit. You are required to keep doctoring until we say so or you die--for the good of the nation."


"Is it time for the guillotines yet?!"

Boiling Frogs's picture

No it will more likely be...
"Dearest Dr.,
Going forward in order renew your state license you must accept all Medicare and Medicaid patients."

kchrisc's picture

"Winner, winner, chicken dinner!"

NihilistZero's picture


So with everyone either unemployed or losing their insurance and moving to Medicaid, where do these doctors expect to find patients? They better get used to less compensation because their aren't enough 1%ers to keep them in business.  Demand for medical services is high, but demand for those services at the rates these doctors want to charge is quite low.  Welcome to the multi decade deflation Doc...

VinnyTheBlade's picture

They don't need 1%ers.....right now when a doctor that accepts insurance charges $150 for an office visit....they might actually collect $90...and out of that, they have to pay for 2 or 3 full time people who shuffle insurance paperwork back and forth. If the doc goes to no insurance...cash only, and eliminates these employees, they can just charge $50 cash for a visit, and have fewer headaches. This is what is going to happen. People unwilling to pay the $50 cash for an appointment, will simply wait 6 months or more for a routine appointment(if they can even fnd a doctor willing to take their crappy medicaid), or sit 8 hours in the ER waiting to be seen. The majority of doctors that stay in the system and participate in these dubious insurance exchanges will be the crappiest of crappy doctors. The smart ones will go to cash only, or retire.

jpc578's picture

How will the California legislature respond if these doctors go on strike and boycott the exchange? They will pass legislation that will require doctors to accept Medicaid and Obamacare exchange insurance plans. If the doctors retire as a result, the legislature will make a law that requires doctors to stay on the job. California will respond with their version of Directive 10-289. It’s the only way to make healthcare a “right”.

honestann's picture

Yes, and when everyone, including braindead liberals realize the consequences of their actions?

They will demand the most predatory authoritarianism the world has ever seen.

Humans WILL NOT admit their corruption.  They would rather die, and they will.

Except, of course, the top-level predators-that-be, who always win no matter what, because the cops work directly for them, and will round up any doctor they want who still resides in their fictitious nation.

PGR88's picture

Let's hope the whole fucking thing collapses.


The USA needs a major re-set like an Enema on an overweight drug-addict.

rustymason's picture

Most of the doctors I have met, save the two I have now, are complete liberal dipshits -- selfish to the max. They know exactly zero about economics and have always advocated more government interventions to solve any problem, especially medical issues. I wonder if they are beginning to sense something.

honestann's picture

DOCTORS:  Quit.  Retire.  Go on strike!

aicohn's picture

Going on strike ain't an option.  Government will use RICO, etc. to bust it.

And it wouldn't surprise me at all to see the government require doctors to accept obamacare as a condition of licensure.  I think MA does that for their state insurance already.

Early retirement is the route many will take, given the aging of the medical professional population.

Then america will be in a world of hurt with no doctors.

slightlyskeptical's picture

How can this not be total bullshit? Obamacare is run by private insurance companies. Obamacare does not dictate what these insurers pay the doctors.

I hate Obamacare but this is just plain bullshit.


honestann's picture

EXACTLY...  Medical care will be run by predators-DBA-insurers AND predators-DBA-government.  And you think doctors don't know insurers intend to take 80% of every dollar paid, load doctors down with unlimited paperwork (as they already have, in cooperation with government), refuse to pay many claims, and refuse to allow doctors to deliver appropriate care?

Nah.  Doctors know what is coming.

pupdog1's picture

Obamacare was engineered and written by the useless middlemen insurance whores, and it is doing exactly what they designed it to do. They greased the palms of our congresswhores, who haven't even read the thing.

What Big Insurance didn't calculate is the massive national revolt that will arise against them when this thing really implodes--it hasn't even started to implode yet.

Americans are going to start dying from Obamacare due to cancelled policies replaced by policies that are four times more expensive, jammed up their ass at gunpoint by Obama and congress, when they could barely afford their old basic policy. Hundreds of Americans will die, and then thousands, because they simply can't afford the Stasi's demand. If you're in the middle of cancer treatment when you're dropped, tough luck.

And any greased congresswhore who supported this fascist crap--and they are all on the record--will soon realize that there is no longer a future in politics for them. This is an extraordinary national disaster.

A guy I know once said "Five bucks is a lot of money of you don't have it."

DosZap's picture

If you're in the middle of cancer treatment when you're dropped, tough luck.


Yep, AND if you go to the press with it, the D.C machine sicks the IRS on your ass,sad as hell,but just happened.


GumbyMe's picture

Nah, all the doctors need is a good incentive to comply.

Get onboard or lose your license.

jkjacksonhole's picture

They could just demand cash for services up front.

lindaamick's picture

This article does not specify by what means California doctors will boycott Obamacare. 

The most likely boycott seems to be that doctors will refuse Medicaid patients but this is not stated.

For non-medicaid patients that have signed up via Obamacare, the doctors will have no way of identifying them as these people will be using the same carriers as non-Obamacare people and institutions.

VinnyTheBlade's picture

The plans in the exchanges have much higher deductibles than people are used to now. People are in for a rude awakening...especially if they need to schedule a surgery or some other expensive procedure. Doctors have people that usually review the insurance people have before they will schedule procedures. If it isn't an emergency, once they see that the insurance isn't up to snuff...they will not be willing to provide the service without significant up front payment.

SeattleBruce's picture

"But we can’t do it for free. And we can’t do it at a loss. No other business would do that,”
Terrorists, right? Or so deemed by the obammunists.

"Enrollment doesn't mean access."

aicohn's picture

Obama has a great deal for doctors.  Twice the work, half the fee.  Make up for it on volume.

"If you like your patients, or even if you don't, you get twice as many.  Period.".

Now, that's the only promise he's made that I do believe.

aicohn's picture

Next Obama will declare doctors to be enemy combatants and he'll be targeting them with drones.

jkjacksonhole's picture

The only good thing coming from Ca these days maybe a medical boycot of Obamacare by Ca Drs.