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The real problem with Obamacare has little to do with the number of people signing up, and a lot to do with the restrictions on insurance companies and reimbursement rates to doctors.
We see healthcare shifting from a procedure reimbursement, where in this country doctors are reimbursed for how many procedures they conduct, to a world where people will be reimbursed for the outcomes - did the patient actually get better, and what was the total cost of the cycle of care.
Many health care providers, particularly physicians in rural and urban areas, are leaving the Government programs because of inadequate reimbursement rates.
Pay-for-procedure or fee-for-service reimbursement rewards doctors and hospitals for volume - not keeping patients healthy or being efficiency. Pay-for-Performance is clearly one tool that can change the incentives to reward quality.
There's an issue with the Medicare doctor reimbursement rates where at the end of the year every doctor that folks in this country use that provide Medicare services is going to get a 30 percent salary cut.
If you take a look at Medicare, there are things we could do, not just tort reform but truly reform the whole reimbursement system which will help in terms of reducing costs and creating the right kind of incentives for savings.
Doctors cannot afford to provide care at the rate of reimbursement that Medicare insists that they accept.
Whether you are from Minnesota, Wisconsin or any other Northern tier state, you are not going to like the reimbursement formula. The problem we face is that we wouldn't have that formula if a majority of the states didn't like it, and they have the majority of the votes.
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