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The fiscal cliff's orphans: unemployment, Medicare
Yolanda Bynum folds letters telling patients that the Washington DC doctors office where she works is leaving Medicare.
December 7th, 2012
10:28 AM ET

The fiscal cliff's orphans: unemployment, Medicare

By Lisa Desjardins, CNN

Follow on Twitter: @LisaDCNN

Editor's Note: Listen to the full story in our player above, and join the conversation in our comments section below.

(CNN) – There is a hidden, vast other side to the fiscal cliff.

A group of issues that have nothing to do with tax rates, but still represent millions of lives, have been orphaned for attention by Washington's superfocus on taxes.

As tax cuts are set to end, unbeknownst to many, so are unemployment benefits for millions of unemployed Americans. And at the same time, every Medicare doctor is facing a threatened cut in pay. The difference now? Some Medicare doctors are giving up and dropping out of the program.

[5:50] Dr. Alice Fuisz, Washington DC: "What’s tough here is the patients caught in the middle of it. And I don’t think it’s right for the patients to have to pay me when they have medicare benefits and so that’s the tough part."

[:30] Judith Conti, lobbyist and advocate for the unemployed, National Employment Law Project, "What we’re hearing about is taxes. After that, there’s still a whole bunch of issues that still need to be figured out."

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soundoff (97 Responses)
  1. Philly

    This cut in Medicare will not occur as it would bankrupt every hospital in America. Average profit margin a large hospital in this country is around 2 or 3 percent. A drop of that much Medicare revenue would send almost every hospital into massive layoffs, and financial ruin. This is why the politicos can't let us fall over the fiscal cliff. What you're seeing is high drama with no real possibility of the Medicare cut happening. Similarly cutting unemployment off early would eliminate the most effective stimulus program this country has. It is paid for by the employers and employees and all that money goes straight into the economy as people on unemployment use it for necessities immediately.

    I get tired of hearing doctors say they will no longer take Medicare, in most clinics Medicare accounts for at least half their patients, and most of their procedures. Which is were they make the majority of their income, at least in specialty care. If a clinic can survive without Medicare, they must fill in those those schedule gaps with private insurance patients, which means they are a very financially strong clinic, because of the higher private insurance reimbursements, and their backlog of patients to fill in those gaps. Make no mistake if they refuse Medicare, they must think they have the demand to fill all those empty appointments, which means their revenue will bounce up dramatically. Historically physicians fought Medicare and Medicaid, just like they are now fighting Obamacare. I hate to be the bearer of bad news but its about the cash, not about whats best for the poor/elderly/kids. The sad truth of our fee for service healthcare system, is that it is controlled hook, line and sinker by the MDs who, write every order that generates every penny of cash in our bloated healthcare system. Very few people realize it, as doctors are seen as savior, but google the passage of Medicare and Medicaid, the docs fought healthcare for the poor and elderly with every resource available to them at the time. You heard the same arguments against Medicare/Medicaid as you do against Obamacare. That its the harbinger of communism and the loss of freedom for all Americans. Fee for service must end, it is intrinsically corrupt with doctors determining who needs procedures and getting paid to do unnecessary care. I have seen it happen in every clinic I have managed, other than community health.

    December 11, 2012 at 12:47 am | Report abuse |
    • John

      You are an idiot Philly. "I hate to be the bearer of bad news but its about the cash, not about whats best for the poor/elderly/kids." I'm sorry didn't know I was working for free LOL.

      December 11, 2012 at 12:32 pm | Report abuse |
  2. Linda

    Whether we speak of Obamacare or any other health care, the problem is the same: healthcare is a FOR PROFIT industry. There is NO way you can cover everyone with adequate care under a for profit system, because greed always sucks the life out of any for profit system. Health care should not be a business. We need to chuck the entire system, make docs etc cut the apron strings with big business pharma and go back to the days of small, non-profit med groups. Like every other BIG thing in this country, health care is way, way out of hand and there is no other way to fix it.

    December 9, 2012 at 12:24 pm | Report abuse |
  3. krehator

    Don't worry. The top 2% will create more jobs. In China.

    They take $10,000 out of the country for every $1 they put back into it.

    December 8, 2012 at 10:28 pm | Report abuse |
  4. Obama_akbar

    Wait all you Obama dweebs thought the government was going to take care of you for the rest of your lives, soooorrrryy you can never trust government.

    December 8, 2012 at 7:36 pm | Report abuse |
    • lschendel

      Nobody ever thought that. It is just a handy talking point created by Fox. Get the insurance companies out of the middle of the mess and there wouldn't be any problem. Single Payer for All!

      December 10, 2012 at 4:30 pm | Report abuse |
  5. Amber Dru

    Why support more foreign workers then?
    T. Willard Fair, president of the Urban League of Greater Miami, Fla.

    "Amnesty for illegal workers is not just a slap in the face to black Americans. It's an economic disaster,... I see illegal immigration and the adverse impact that it has on the political empowerment of African Americans, and the impact it has on the job market." – to the Miami Herald 4/26/07

    "Think about it this way: If there's a young black man in Liberty City, where I live, who's good with his hands and wants to become a carpenter, which is more likely to help him achieve that goal - amnesty and more immigration, or enforcement and less immigration?

    "Which is more likely to help an ex-convict or recovering addict get hired at an entry-level job and start the climb back to a decent life - amnesty and more immigration, or enforcement and less immigration?

    "Which is more likely to persuade a teenager in the inner city to reject the lure of gang life and instead stick with honest employment - amnesty and more immigration, or enforcement and less immigration?....

    "....The interests of black Americans are clear: No amnesty, no guestworkers, enforce the immigration law." – from testimony before the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law Committee on the Judiciary – US House of Representatives

    December 7, 2012 at 7:59 pm | Report abuse |
  6. Concerned1

    . I am a minimalist at heart I suppose. The big home, big salary, the big ego I just dont understand greed and selfishness. What is happening in medicine will force the private home grown practices out of buisness. The socialization of the health care system is inevitable. Economies of scale and costs will force us to have to sacrifice the level of care in order to provide medical care for everyone. The right to basic food stuffs, basic medical care regardless of what your pay is inevitable for a emotionally maturing society. The sooner we accept this the better. If profits are your primary interest then design and build cars or sell real estate, etc. We used to be a more caring society and the me generation will have to change or fail. I am a conservative, moderate and still advocate for real change to basic fundamental rights Health Care, Food, Shelter. We need to stop beating up on each other and accept that real change will take all of us participating. Off the sopa box, sorry.

    December 7, 2012 at 7:09 pm | Report abuse |
    • CB007

      Thank you, I couldn't agree more.
      One of the things that people fail to realize over and over again as they go on and on about higher taxes is.... if you are already paying for it now – either because your employer is or you are going out-of-pocket – then while it is true your taxes will go up to pay for socialized medicine you won't have to pay for it elsewhere (logically your salary will go up – so you can pay the increased medical-tax or the out-of-pocket expense will end). You aren't actually paying more in the "big picture" in fact with government review many of the tricks insurance companies and big pharma pull will become illegal and many of the frivolous uses/testing will end (hopefully).
      If you want to cut spending that doesn’t benefit the average tax payer then a nice cut in military expenditures and subsidies to other countries would be a great way to start. I get so tired to the running commentary on Fox that despite paying taxes to our government we aren’t actually entitled to receive any goods or services in return, ridiculous! I also tire of the “Loud Christians Conservatives” opposing social services for the poor, or calling them unkind names… it is as if they don’t understand the very religion they follow.

      December 10, 2012 at 8:27 pm | Report abuse |
  7. Mort

    O.K. doctors quit taking Medicare if you wish. However you should not be allowed to put your patients in hospital that recieve any public funds. BTW all of your federal loans are due in thirty days.

    December 7, 2012 at 6:30 pm | Report abuse |
    • Mr. Fair Play

      Obviously an Obama Kool aide drinker who just "assumes" all doctors have loans and such, believe it or not, a lot of doctors finishe medical school w/o taking massive or any loans out. You remind me of an idiot by the name of Mao....

      December 7, 2012 at 7:06 pm | Report abuse |
    • nomad2003

      hospitals can not refuse people by law... even those without insurance... period. There re 600 hospitals closing because of Obamacare requirements and cuts in medicare.

      with feds take over of loans, can not target groups.

      Doctors can just quit practice. Between the medicare cuts and the fines for IDC errors, I know 2 doctors in town that quit practice.

      December 8, 2012 at 12:35 am | Report abuse |
      • Bill

        Not to mention lots of R&D and Pharma companies are willing to pay M.D's big money to work with them. They value M.D's more that PH.D's. So any doctor leaving the practice is still very capable of making a lot of money. it is "us" who suffers.

        Oh, BTW, A lot of countries have Doctors listed as an in demand profession and offer visas to them. So a doc can practice in Canada, the UK etc. Again, we lose.

        December 9, 2012 at 8:59 am | Report abuse |
  8. Dave

    I know Several! doctors that have decided to quit their practice, or stop accepting mm, or have just sold the entire medical group "as mine did". One of the doctors in my family got fed up with it earlier and closed his practice (in his 40's). Obamacare is going to be a ride you will only enjoy if you are on the bottom of the income scale. This country is steadfast pulling everyone and everything down to the lowest common denominator, all in the name of "fairness".

    December 7, 2012 at 6:19 pm | Report abuse |
    • Tee Yung

      I am getting fed up with people blaming their office closings on Obamacare. I urge everyone to read the Affordable Care Act section by section so that you are fully informed on exactly how it impacts providers, insurance companies, and patients. If your office is closing, how in the world could Obamacare be the reason? Your practice is operating at a lost because of Obamacare? Really? Again, this is the accountability problem that exist in healthcare. Everyone needs to be accountable for the role they play in how well or bad their practice has done. How many Docs go to business school to learn many important details of running a business such a medical practice? So, you just make a few phone calls, get a practice up and running and run it on a fly (many of you do this), you loose money, right? Not to mention the contracts with insurance companies, medicare, and medicaid.

      December 7, 2012 at 6:37 pm | Report abuse |
      • gweed

        Tee, since you claim to have actually read the entire Affordable Care Act, I encourage you to immediately contact U.S. Congreewoman Nancy Pelosi as I believe she still is unable to make a similar claim.

        December 7, 2012 at 6:52 pm | Report abuse |
        • Tee Yung

          I have not claimed to have read the entire Act, I have however, taken the initiative to began to read each section, which is posted online for all to see in a very organized fashion electronically.My point is to read and learn about the actual bill before making claims that are not accurate. Everyone is complaining about Obamacare and it is obvious that nearly everyone is misinformed based on the information available through credible resources.

          December 7, 2012 at 8:57 pm | Report abuse |
        • nomad2003

          yea, but did he read all the bills it references? And then the real test.. how about reading all the new regulations being written? about 100 pages per 1 page of bill is the forcast.

          I asked to see the definition of how the exchanges will be run so I could program for them. The government (state and local) do not have the definition written as yet. and it has to be up next year. Yea, right!!!

          December 8, 2012 at 12:49 am | Report abuse |
      • nomad2003

        i have not only read it, I programmed all the garbage for an insurance company... 10 of us for 13 months. total costs so far is 1 billion to implent the obamacare changes...
        do you even know what IDC are? put the wrong one out of 12,000 and you get fined.

        I have to get a blood test done every 4 weeks. The doc office get $3.47 (medicare part b). and they want to CUT this? How do you think that pays for there expenses?

        December 8, 2012 at 12:42 am | Report abuse |
  9. Robert L.

    I would like to interject a new term into this thread that I haven't heard used in a long time when dealing with public welfare, personal responsibility. I hear victim used a lot, I just have too much pride in this nation I guess to believe we are all simply, "victims." If I take a job and spend every penny I earn on cool stuff that has little or no value and then lose my job, I don't think of myself as a victim so much as unwise. My choices probably shouldn't cost everyone else money. I often find myself confused with this "victim" mentality. I realize it is rude to point out that another person is making stupid choices. But I consider it pretty rude for a person who makes those choices to insist that I continue to pay for them and then insists that it wasn't their fault, they were in fact victimized. Most of these situations remind me of an adage I have heard since childhood. "Failing to plan, is actually planning to fail." I am disturbed at the level of pride taken by "victims" in this great society we are supposed to live in. During problems I have had in my life personally, I usually find I can pinpoint if someone else is to blame for a given issue and work through those. The rest of them have all seemed to me to stem from choices I have made, oddly, victim has never come into the picture.

    I don't like to bring up problems that I see without offering a solution so here is a solution I would propose, those of us who have a job, save enough to provide for ourselves in the event that something we didn't anticipate happens and we need those resources. If you are still young, look around you and ask yourself if you want more than you have, start working towards it. Opportunities in life are like turn offs on a road, the further you go down the road, the fewer there are left ahead of you. If you are in school and doing poorly, it may not be all your fault, but you will be living with the after math, not your teachers and not your friends, find a way to fix it. If you are older and don't like where you are in life, look around and find a way to fix it, even if it isn't ideal for awhile. That solution has worked for me so far, even when I was out of work and had to live on my own savings. Let's leave "victim" where it belongs and stop diminishing its meaning.

    December 7, 2012 at 6:17 pm | Report abuse |
    • nomad2003

      great.... personal responsiblity, delayed gratification....
      I find most of those "victums" of default mortgages, kept refiancing and taking the equity and buy toys or vactions... and now cry because of those decisions...

      my mom, a great lady taught me, only borrow money to buy your first house and if if you are bleeding to death you can borrow to pay to patch your self and stay alive. Otherwise go earn the money, save it and then pay for it....
      this included college, amazing how much effort one makes to graduate in 4 years when you have to pay for it.

      December 8, 2012 at 12:56 am | Report abuse |
    • lschendel

      Before you break your arm patting yourself on the back....did my mom and grandma deserve to get Alzheimers? Did my dad deserve to get 30 brain tumors? Be careful about blaming the "victim" You may find yourself in a hospital bed one day.

      December 10, 2012 at 4:35 pm | Report abuse |
  10. SFRich

    Cuts should becoming from reduced salaries and benefits given to congress. These folks are overpaid, overcompensated, and have done little to deserve a dime.

    Why is it that no one is bringing this up?

    December 7, 2012 at 5:58 pm | Report abuse |
    • Dave

      The same reason term limits are not being discussed,everyone thinks the problem is someone elses representative,not theirs. Political office was intended to be a position of service to your country, not a lifelong career choice. Sadly we get just what we deserve with the ignorant voters we have. Do you remember how so many women stated at exit polls that they voted for Bill Clinton because "he had the best butt". That kind of ignorance will continue our decline.

      December 7, 2012 at 6:24 pm | Report abuse |
  11. JM

    I'd like to see how much of the doctor's intake per patient is sent towards malpractice insurance to protect the doctor from lawsuits.

    If perchance we could reduce the number and amount of malpractice lawsuits (which most of the lawsuits only seem to benefit the lawyers), the costs of running a doctor's office would drop. Would that drop be enough to help keep doctors in business? For that matter, making the losing side pay ALL court costs, would surely reduce the number of frivolous lawsuits in the country.

    When I previously worked in Health Insurance, I often saw that doctors would sign up to be a company's personal doctor. The company would pay the rent, utilities, and staffing costs as well as pay a salary for the doctor to see the company employees and families for free. This situation helped reduce the company's health insurance costs, while allowed the doctor to make a good salary without worrying about malpractice lawsuits, rent, staffing payroll, etc. How many doctors are considering becoming an employee of major corporations in order to keep practicing medicine, but to a select group of people.

    December 7, 2012 at 5:27 pm | Report abuse |
    • Doctor

      JM you have the right idea here, but a little bit off.... let me explain.

      Malpractice doesn't necessarily drive up the cost of running a practice. It does diminish a physician's take home salary; however, it is typically not a limiting factor keeping practices afloat, aside from extremely high risk fields, such as OB/Gyn, Neurosurgery, etc.

      Where malpractice does affect the health industry is in the number of tests we order. I order tests all the time because there might be .01% chance that there is something wrong. If I don't get that CT, and somehow it is that .01% chance that came to be, you will sue me (plain and simple). Is your claim necessarily wrong? NO, since it has become the STANDARD of CARE. All doctors here do it. That's why it is ok for me to do it. Thats why insurance pays for it. That's why healthcare in this country costs so much. You will get a $10,000 work up b/c if I don't, I can be sued. Is it medically indicated (not in my opinion), but IT IS the STANDARD of CARE, because in this country, you are not allowed to miss that 0.01% chance.

      Ultimately, this is the reason why we as a country must pay so much for healthcare.

      December 7, 2012 at 5:43 pm | Report abuse |
      • Doctor

        BTW, I make no money on ordering these tests. I do not own the MRI, CT, pathology lab, blood lab, etc.

        I own none of these. I make no money from ordering these tests. In fact, it costs me money.....essentially time I must spend going over these results of these tests when the chances of them being abnormal (pathologic) are immensely small.

        Do you know how many "no concern for pathologic process" (laymen's = "negative") CT's, Xrays, MRI's I read every day?!

        How many normal bloodworks I get back (that I clinically knew was going to be negative)?

        Hundreds!....and I get no reimbursement for ordering these tests, or reading their results.

        December 7, 2012 at 5:48 pm | Report abuse |
  12. Tee Yung

    For those who are bad talking Obamacare, please research the facts of the healthcare bill before you speak on it. Many Physicians complain about how much the are loosing accepting Medicare or Medicaid, yet they do not speak to the role they play in loosing revenue. They hire sub standard staff who lacks proficiency in billing and coding. This is the biggest problem. You hire a Medical Assistant to run the office, do billing, and clinical work, and wonder why you are not making money. Many of Doctor's business practices are inefficient and for that reason, much money is lost. So, Physicians, you must take some responsibility in the fact that you lack adequate business accumen and I do not think that it is fair to blame the government for this. It is your responsibility to set up a practice and maximize your own revenue whether you accept Medicare or not. I do agree on the other points made by physicians, but I work in the insurance industry as a consultant and I see alot of waste and poor business practices that explain why many practices are not doing well.

    You Doctors need to be more innovative in how you deliver care to members rather than relying strictly on reimbursements. Many Doctors are doing so and are doing very well. Many Doctors need to leave their egos behind and listen to other health care professionals when they have ways of improving how you do things. So, many of you are suffering unneccessarily for that reason: your EGOs and lack of ability to keep up with latest technology and innovations and thinking out of the box to make more money. I have actually some ideas, but I am just a Registered Nurse with a MBA, what do I know.

    December 7, 2012 at 5:06 pm | Report abuse |
    • Doctor

      Hi Tee Yung, you are absolutely right in what you say. Doctor's offices need to be efficient and well run, no doubt. You are an MBA, and clearly have business training. And yes, medicare billing, and even private insurance billing is a very complicated system that requires special training etc.

      But let me ask you one thing. When a person goes to their Doctor, would they want them (with what limited free time they have) to become better physicians (ie. read on medical journals, attend continuing education seminars, respond to their patient's concerns in off hours, etc.), or become better businessmen? And remember, I ask you this as a patient. I'm not a businessman. I don't endeavor to make money only and maximize profits, that is not my goal in life. I know what little I know to get by. If you ask the majority of physicians and surgeons, they did not go to medical school to be businessmen. I want to be YOUR Doctor, concerned about your health and your well being.

      Instead, I would offer that rather than making it more costly for us to deal with medicare billing from a training stand point (ie. hiring more specialists, businessmen, office managers etc.), that the government make billing more uniform and streamline, so that someone like myself can do it without hiring unneeded personal. This is something that doctors have been requesting for a long time. Billing reform is sorely needed so we STOP spending unneeded money on gratuitous business and coding training.

      December 7, 2012 at 5:35 pm | Report abuse |
      • Tee Yung

        Doctor,

        I get that response a lot from Doctors. The only thing that I will say to you is that once you start a business, whether you are trained or not to run one, it still is a business. And there is nothing wrong with boosting your bottom line. Why do health care professionals feel guilty about financial rewards? if you maximize your revenues, increase your profits, that is a sign of a healthy business. The patients benefit greatly. You will be able to pay yourself the salary you deserve instead of some sub par salary. You really cheat yourselves and your patient by not at least trying to learn what you can about business.

        December 7, 2012 at 6:24 pm | Report abuse |
  13. Bob

    Good! Let unemployment run out!! Time to put on your big boy pants and get a job and stop sucking this country dry!!

    December 7, 2012 at 4:59 pm | Report abuse |
    • Michael

      What's sucking this country dry, is the CEO's taking all the money. Corporate profits are at an all time high, while wages are at an all time low. These jobs you want people to "put their big boy pants on" and go get, don't pay near enough for a person to have a decent life. As a matter of fact, if you have a couple of kids, they don't even pay enough to afford daycare.

      December 7, 2012 at 5:18 pm | Report abuse |
      • carczarconsultingdotcom

        Affirmative!

        December 8, 2012 at 10:43 pm | Report abuse |
    • Ben

      You do realize that businesses pay unemployment, not the government right?

      December 7, 2012 at 5:36 pm | Report abuse |
    • Leela

      Let's just hope you don't lose your job one day BOB

      December 10, 2012 at 7:34 pm | Report abuse |
  14. BuckUpUS

    It's all going to hit the fan soon, any way in this country. Bring it on ! Greedy corporations and mid-sized business have never been awash in more money,.

    December 7, 2012 at 4:22 pm | Report abuse |
    • lilred60

      Yes!

      December 7, 2012 at 4:26 pm | Report abuse |
    • peick

      Just curious, what do you do for work?

      December 7, 2012 at 4:42 pm | Report abuse |
    • Rick

      Greedy corporations that hire all of those workers. Shame on them for making money. For shame, for shame, for shame!!!

      December 7, 2012 at 4:59 pm | Report abuse |
  15. Brad Ray

    Staff,

    We can anyways find Extreme Examples to support our Positions. The Examples you site are examples that are on one end of the Unemployment Benefits situation.

    But, 2 years of Unemployment is not Factual.

    26 Weeks of Regular Unemployment
    14 Weeks of Emergency Unemployment Compensation Tier 1
    54% of the Regular Claims Maximum Benefit
    14 Weeks of Emergency Unemployment Compensation Tier 2
    54% of the Regular Claims Maximum Benefit
    9 weeks of Emergency Unemployment Compensation Tier 3
    35% of the Regular Claims Maximum Benefit

    63 Weeks is the Maximum! Not Two Years…………………….

    All Emergency Unemployment Compensation Ends December 29, 2012

    December 7, 2012 at 4:16 pm | Report abuse |
    • Rick

      99 weeks, not quite 2 years

      December 7, 2012 at 5:00 pm | Report abuse |
  16. Rob

    A Dr. should loose his licence if he/she refuses to accept paymnet frome medicare.

    December 7, 2012 at 3:57 pm | Report abuse |
    • Doctor

      The reality is this. There is a fixed cost associated with seeing any patient. If this is a simple Doctor's clinic for example, we have to pay for the rent, the nursing staff, utilities, and all the other billing issues that come with medicare. Ultimately, this might cost say $100.00 / patient (made up number, doesn't matter).

      When we see Medicare patients, they CURRENTLY reimburse maybe $70.00 / patient while private insurance from other patients make up the difference. Essentially, ever Doctor you ever go to with Medicare is seeing you essentially at a loss. We're barely making payroll as it is, not to mention all the other expenses. If Medicare were to drop another 30% in reimbursement, this would be devastating to the operation of a clinic.

      Can I tell the nurses here that they lose 30% of their salary overnight? What about the secretaries? What about the cleaning crew? Utilities don't go down in price. Rent never goes down. What about the staff's health care premiums. Do I tell them to go shop for health insurance now?

      Ultimately, the 30% drop is impossible to sustain. We could not run the clinic. It would close. Believe me, I understand the frustration. I am frustrated as well. I don't want our patients in clinic to be on their own. I believe in helping all my patients, including Medicare. But one thing I am not is a magician. I can't make the numbers work. Our colleagues out there dropping Medicare patients are doing so because the threat of these reductions constantly make it impossible to plan ahead for expenses.

      December 7, 2012 at 4:11 pm | Report abuse |
      • Lisa Desjardins

        This is what I was trying to get at some in the story. But I think there is so much more to be done on this topic, as you said Doctor.

        December 7, 2012 at 4:17 pm | Report abuse |
        • Doctor

          Thank You Lisa for doing a story on this topic. It is certainly a forgotten portion of the fiscal cliff.

          One of the biggest travesties of "Obamacare" is that we're so focused on bringing health insurance to millions of people but have forgotten completely about getting ACCESS for these millions as well. The situation highlighted here continues to show the importance of ACCESS. Even with Medicare paid for, these seniors and millions others may not get their care simply because no one nearby takes medicare.

          December 7, 2012 at 4:32 pm | Report abuse |
        • Lisa Desjardins

          Thank you for the kind words, Doctor. You should send me a tweet if you are on Twitter I'm @LisaDCNN. I'll folo you and then DM you my e-mail address so we can be in touch. These are all topics I want to tackle more.

          December 7, 2012 at 4:42 pm | Report abuse |
    • Northstar

      This is a free country, and doctors have the right, as private practitioners – in their own business – to decide whether to accept Medicare patients or not, or even whether to participate in any health plans.

      December 7, 2012 at 4:13 pm | Report abuse |
    • Rick

      A doctors office is no different than any other business. They have to be able to cover their expenses. If not they will be out of business.

      December 7, 2012 at 5:04 pm | Report abuse |
  17. REGinAZ

    Some accuse me of attacking a false conspiracy, of having a “conspiracy theory” mentality. Is there a real “conspiracy”? Well lets consider if there is any merit in thinking there is one, as being supported by the facts, not convoluted by ambiguous numbers. We know that the country’s wealth is becoming increasingly held, more and more, by the few. We know the likes of Grover Norquist exists for the sole purpose of intimidating and coercing Republicans to squelch their individual consciences and to force their firm support for the Party’s positions. We have seen Cheney, Rove, the Koch brothers and several others join in this pressuring of their own to assure unified support for their positions, even to forcing moderates, like Stowe and Lugar, out. We understand that these people and many more like Adelson provide an abundance of mega-millions for the purpose of supporting the candidates they can control and opposing those they can’t (they have even said that they can “make or break’ anyone), as well as for developing and promoting the extensive propaganda used to con the people and manipulate public opinion. We have seen they go to great lengths to provide “puppet” candidates who are committed to “doing as their strings are pulled”; with Norquist even stating that “the next Republican president would only have to be qualified to sign the bills they send him”.

    We hear them spout their scripted propaganda with it being repeated – word for word – by all of their people. We see how they arrogantly fault and stubbornly block all efforts, belligerently withholding bipartisan cooperation, no matter what the cost to the people; even to exaggerating attacks for questionable purpose, like seen with McCain and Graham in their over zealous criticism of S. Rice. We know all of their positions always have real benefit for “the money” who strongly support them. We have seen were people like the Koch brothers initiated, encouraged and funded the Tea Party Movement, the Swift-boat propaganda and the manipulation of the “conservative” Christian, all aimed to sway people in the same single direction. We see the stubbornness and arrogance of the likes of John Boehner, Mitch McConnell, Paul Ryan, Eric Cantor, Michelle Backmann and others as they protect the interests of “the money” and ignore their responsibility to the majority. We saw the concentration by Bush-Cheney on serving only “the money” and experienced the costs of that.

    We can recognize the consistency in all of this and can really feel the organization behind it. We even see the cooperative support from the likes of Limbaugh, Palin, Beck, Hannity, FOXNews and others and wonder how they are compensated. We hear their constant faulting of “liberalness”, blaming government spending, “big government” and the deficit as the only evil but never hear any recognition that our problems are really the direct result of exploitation by the few, that resulted from permissive policies labeled as “conservative”, that encouraged and allowed run-away greed, gross dishonesty and self-indulgence, with the few always walking away with substantial gains and leaving the losses/costs to the majority. Is all of this evidence of a “conspiracy” – everyone will have to decide that for themselves, recognizing that there really is ample justification to consider it. For myself, I’m not against “conservative” policies, I am against having a subservient government catering only to the interests of the few, with “puppet” politicians serving “the money”, their masters, and neglecting their responsibilities to the people.

    December 7, 2012 at 3:39 pm | Report abuse |
    • Brad Ray

      So, What's your Point?

      December 7, 2012 at 3:57 pm | Report abuse |
    • Joe Seattle

      So I take it you really believe the Obama administration stands against these things?
      Fascism is the ultimate tool of the ultra elite, as are you.

      December 7, 2012 at 3:57 pm | Report abuse |
    • passepartout

      Nice post REG, very few see the truth, while most are victims of populist talking points that strike an emotional chord of the listener. But the results are indisputable,wealth amd political power is becoming concentrated in this country with terrible consequences, i.e. the financial crisis. The truly sad thing is that the people don't understand it or don't want to believe it as it goes against long cherished economic, social, and political beliefs. People will not change their thinking until the situation turns grave for the nation. I hope we change before we lose our global economic and political status.

      December 8, 2012 at 6:02 pm | Report abuse |
  18. Josh

    I do believe that Short Term Unemployment is a good thing. I was on Unemployment for 6 months before I found a job. I do not feel sorry for people that are on unemployment for a year or 2 at a time. I took a job in AFGHANISTAN so I could get off of it and make a decent wage. What people have to understand is sometimes you have to move to get a job nowadays. I moved to CA from NC to get a decent stateside job here in the USA. So no sympathy from me.
    I however do feel bad for doctors who are having to take less and less money to continue seeing Medicare patients. That just isn't right at all

    December 7, 2012 at 3:37 pm | Report abuse |
    • Lisa Desjardins

      Really interesting post there Josh.

      You know firsthand, but I'm not clear – do you think there should be no unemployment insurance? Or do you think it should only last a shorter time than it does now? If so, how long?

      December 7, 2012 at 3:44 pm | Report abuse |
      • DC

        Lisa, I think there should be short term unemployment and maybe even a supplemental unemployment program that kicks in afterwards. I know some people who made a certain amount and then it's difficult to find a similar paying job. After the initial unemployment runs out, the person can at least take a lower paying job and get supplemental unemployment for a longer period to help offset the difference. I'm not sure if that exists or not, it's just a thought I had.

        I've been fortunate to not have to file for unemployment but then again I have worked 2 or more jobs at a time to make ends meet during rough times.

        December 7, 2012 at 4:32 pm | Report abuse |
        • Lisa Desjardins

          Good response. Thanks for that.

          December 7, 2012 at 4:40 pm | Report abuse |
    • Samson

      I agree with Josh on a step program. The unemployed should be able to take a PT job and get help making up the difference and also be able to take a FT lower paying job and get a little help making up the difference. Right now (in NY) if you work 3 days your unemployment check goes almost to nothing making it an incentive not take that PT job. Also if there is a wage differential then it would only make sense to have someone working getting a supplemental UEI check to make up a wage difference rather than to have someone capable of working but staying on full UEI for the full term because their high paying job got shipped overseas. I have $8.50 PT hotel jobs open but I cannot get people on UEI to fill them because it would be so much less than what they are collecting. I don't blame them financially.

      December 8, 2012 at 9:40 am | Report abuse |
  19. blake

    Of course the 98% want the 2% to pay for it, especially the entitlement crowd. More benefits, but let someone else pay for it. The problem is that it just reinforces generational irresponsibility and dependence on Uncle Sam. No lasting solutions.

    December 7, 2012 at 3:25 pm | Report abuse |
    • Lisa Desjardins

      Not commenting on the pros or cons but you are right that some (President, Democrats) want to raise taxes on the wealthy in order to prevent cuts in programs for others.

      However, that doesn't apply to unemployment directly. Employers across-the-board are taxed to pay for unemployment benefits.

      December 7, 2012 at 3:36 pm | Report abuse |
    • Taylor

      One side says take benefits I'm not using away from other people. The other side says take money I don't have from other people.

      December 7, 2012 at 3:45 pm | Report abuse |
    • Brad Ray

      Have you paid into Social Security? Are you looking for some kind of re-numeration from Social Security when you Retire? Then you are part of the Entitlement Crowd that you speak of. So you are reinforcing Generational Irresponsibility by your own statements.

      People that pay into Social Security do not consider Social Security an Entitlement!

      Do you have elderly parents that are being turned away by their Doctors because the Doctors can no longer Break Even on the Medicare Payments from the Government?

      This is NOT Generational Irresponsibility; it is your Limited Position of Knowledge!

      December 7, 2012 at 3:47 pm | Report abuse |
      • DaveIA

        Social Security Income would not be an entitlement, ONLY if we simply got back what we paid in. However, the average beneficiary today collects back all contributions plus interest in 6-8 years. Taking more out than we put in, makes it an entitlement, in my view.

        December 8, 2012 at 10:01 am | Report abuse |
    • passepartout

      But it isn't just the two percent who pay for it as out tax system is progressive. Are you to suggest that we have five percent of our population having no want unmet while poor, elderly, and disabled starve? No man lives on an island. You are truly a discompassionate conservative.

      December 8, 2012 at 6:14 pm | Report abuse |
  20. Jack Alex

    BS they are leaving because they are greedy

    December 7, 2012 at 2:51 pm | Report abuse |
    • Lisa Desjardins

      Jack Alex,

      Can you explain more what you mean by 'greedy'? The doctor in the story insists her practice was not going to survive on current Medicare reimbursement rates and threats of cuts. But sounds like you don't buy it?

      December 7, 2012 at 3:02 pm | Report abuse |
      • Rob

        I wonder what kind of salary she gives herself? Could cut back there.

        December 7, 2012 at 3:58 pm | Report abuse |
        • Lisa Desjardins

          It's a fair point, but I think she is unlikely to be able to cut back her salary enough to pay for raises for the rest of her staff as well as increased inflationary costs (office rent, equipment, medical tools).

          December 7, 2012 at 4:16 pm | Report abuse |
        • Northstar

          Most internists do not make that much money. Doctors are seeing more and more patients, the paperwork is onerous. The government is too involved in health care. Obamacare is a monster that everyone will come to find out soon.

          December 7, 2012 at 4:17 pm | Report abuse |
    • thermy1

      IIf it was greed they would be getting all the patients they could. The only entity that runs regardless of profit or loss is Government. In order to push this crap legislation on the people was to make it look like a savings by forcing doctors to take less money for their work.
      If you have a job I hope you are next on the list to have your wages dictated to you.
      z

      December 7, 2012 at 3:24 pm | Report abuse |
      • Kent

        Agree. Lets tell the congressman that we are cutting their pay by 25%. and all their lawyer, banker and corporate friends. also they should also do the "P4P" (pay for performance) that many insurance companies are pushing on doctors. I guess they'd go home empty handed then.

        December 7, 2012 at 3:44 pm | Report abuse |
        • Lisa Desjardins

          That's exactly what the doctor in the piece wished – that Congress' pay would be on the line to the exact degree that hers was and that the decisions would be linked.

          December 7, 2012 at 3:54 pm | Report abuse |
      • Rob

        I don't know about you but i don't set set my own wage, it is dictated to me by my employer.

        December 7, 2012 at 4:00 pm | Report abuse |
        • thermy1

          Employeers do not set the wage. Competition dose. Most people will try to get the most for their labor.

          December 9, 2012 at 10:23 pm | Report abuse |
      • passepartout

        The only "crap" is a for profit health care system that exhibits oligopolistic pricing power. Government needs to get involved with HC consuming 18 percent of GDP. It is a drain on the countrys resources and finances and leaves our people, businesses, and nation at a disadvantage when other industrialized nations health care costs are half our and the heatlh care needs of their entire population are met. But the uninformed continue to see it as an idological argument because it again, goes against their almost fanatical obsession with free market capitalism.

        December 8, 2012 at 6:19 pm | Report abuse |
  21. Lisa Desjardins

    Thanks for the comment Joseph. What do you think of the Medicare doctors' situation?

    December 7, 2012 at 2:49 pm | Report abuse |
  22. Joseph Brunner

    These are all forms of welfare... while its cool to take care of the disabled, the injured, the sick – its a national travesty to give an able bodied person the ability to lounge around when others are working hard and contributing to society.

    Unemployment insurance has become a bridge for the lazy to back to school, take a vacation – a sabatical. All of us do not have those privileges so its is unfair to give a year or 2 of unemployment. there is ALWAYS something people can do to earn money. It may not be the work they want – or the work they feel best "fits" them – but when you have to pay rent and put food on the table foolish pride is not worth running up our national debt.

    December 7, 2012 at 2:39 pm | Report abuse |
    • are122

      I paid in to Social Security 45 years and do not consider it an entitlement. As for unemployment, the tiny bit someone gets compared to past wages is almost nothing. More housing is heading to foreclosure. I didn't think I would ever be laid off. You apparently think the same. What a surprise you might be in for! As for two years, it is long but the economy basically sucks and will probably get worse. Probably why the biggest job gains are in the service (min wage) industry.

      December 7, 2012 at 3:14 pm | Report abuse |
      • H-K

        What do you mean you paid in to Social Security 45 years and do not consider it an entitlement. You're kidding right? I paid into it for 40 years, supported retirees for 40 years, and better damn well get some when I retire!!! I will let the next generation shoulder that burdeon!!

        December 7, 2012 at 3:35 pm | Report abuse |
      • Joe Seattle

        You and your entire generation spent everything you paid in, plus $16 trillion. Explain why some kid just coming into the workforce should pay half of your SS (that's the ratio, one retiree for every worker) while trying to pay down the mountain of debt you created. I'd cut SS off cold and send you all back to work for the rest of your lives, just to give you a taste of what's in store for your grandchildren. How about you get off that high horse and die in the shame you deserve.

        December 7, 2012 at 4:05 pm | Report abuse |
        • Northstar

          We didn't spend it. Congress keeps taking $$ from the Social Security fund to fund all their stupid spending. It should not have been touched, but invested. I paid into it for 47 years and I damn well better get mine.

          December 7, 2012 at 4:22 pm | Report abuse |
        • Northstar

          Basically, sir, you are talking out of your hat and this is not even a decent conversation. To say such horrible things is beyond the pale. The $16 trillion is from Bush and Obama...not from seniors. We've been working out butts off all of our lives.

          December 7, 2012 at 4:23 pm | Report abuse |
      • carczarconsultingdotcom

        Agree. Another 40+ year payee.

        December 9, 2012 at 1:27 am | Report abuse |
    • Brad Ray

      Joseph Brunner,
      Your comments are Harsh. This country is experiencing the Worst Unemployment since the Depression. Some will Argue that the Unemployment Situation is much worse than reported. What happens to those people that are no longer on Unemployment Benefits but are not being counted towards the Unemployment Numbers? They get put in the Not Looking for Work Category. Does that mean They No Longer have to Eat as Well?

      Unemployment Benefits are helping those that have become Victims of this Economic Downturn. It’s not a free ride, as you have to Report your Work Searches each Week, and get Audited as well. Vacations and Sabbatical’s is Not the Norm.

      Life is not fully appreciated until it is Lived, or Paid For.

      December 7, 2012 at 3:27 pm | Report abuse |
      • staff

        Brad his comments may be harsh but are reality! 2 years is too long for these people to be on unemployment and as far as reporting job searches do you know what that entails? wallk up to a place of business and ask them if they are hiring and if they say no then ask them to please sign this form saying I asked you! I have people come to me all the time with this. I have even had these free loaders walk away saying no thanks when I told them that we were hiring.

        December 7, 2012 at 3:52 pm | Report abuse |
        • Rob

          True to a point there are some freeloaders as you call them, but there are many who are just stuck. When someone looses a job that is paying 17. an hour, the unemployment benifits out weigh the 7.45 an hour job, they just can not afford to take a minimum wage job, and those are the so called jobs being created in this country because of the greedy corporate culture. Lay ebveryone off and rehire lower paying people so we can give our execs more money, 6 figures is just not enough for them.

          December 7, 2012 at 4:08 pm | Report abuse |
        • Brad Ray

          Staff,

          We can anyways find Extreme Examples to support our Positions. The Examples you site are examples that are on one end of the Unemployment Benefits situation.

          But, 2 years of Unemployment is not Factual.

          26 Weeks of Regular Unemployment
          14 Weeks of Emergency Unemployment Compensation Tier 1
          54% of the Regular Claims Maximum Benefit
          14 Weeks of Emergency Unemployment Compensation Tier 2
          54% of the Regular Claims Maximum Benefit
          9 weeks of Emergency Unemployment Compensation Tier 3
          35% of the Regular Claims Maximum Benefit

          63 Weeks is the Maximum! Not Two Years…………………….

          All Emergency Unemployment Compensation Ends December 29, 2012

          December 7, 2012 at 4:19 pm | Report abuse |
        • Robert L.

          "True to a point there are some freeloaders as you call them, but there are many who are just stuck. When someone looses a job that is paying 17. an hour, the unemployment benifits out weigh the 7.45 an hour job, they just can not afford to take a minimum wage job, and those are the so called jobs being created in this country because of the greedy corporate culture. Lay ebveryone off and rehire lower paying people so we can give our execs more money, 6 figures is just not enough for them."

          As someone pointed out earlier in this thread correctly, companies are paying that unemployment benefit that is better than you working for minimum wage. So if they are paying for so many to do nothing because it is better than working for less, how exactly are they going to hire more people to...work?

          December 7, 2012 at 6:58 pm | Report abuse |
      • Joe Seattle

        No. They do not have to eat. Maybe if they don't they'll find or create a job.

        December 7, 2012 at 4:07 pm | Report abuse |
    • Northstar

      I ride the train to work every day with a woman who is in a wheelchair. She is there every day going to work too.

      December 7, 2012 at 4:19 pm | Report abuse |
    • passepartout

      Typical conservative nonsense. They take a poor unmployed blue collar worker to task for getting measly unemployment insurance, but they say nothing of the Wall Street types who cheated their way to riches in the housing boom AND got a public bailout.

      December 8, 2012 at 6:22 pm | Report abuse |
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