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  • New Jersey Practice Struggles With Health Care Changes

    For the past 10 years, Joseph and Victoria Schwartz have owned a small endocrinology clinic in Englewood, N.J. Lately they’ve faced their share of challenges — some a result of Obamacare, the health care law that faces a crucial repeal vote in the House this week.

    As small-business owners, health care providers, patients and parents, the Schwartzes have been impacted by recent changes from all angles — and they haven’t liked what they’ve experienced.

    Dr. Joseph Schwartz is the chief endocrinologist and his wife is his office manager. Over the years, their practice has grown to include two part-time physicians, both a full- and part-time physician’s assistant and about 10 additional employees — not to mention thousands of patients who’ve come to the clinic to be treated for various hormone-related disorders like diabetes, osteoporosis and thyroid dysfunction. At the same time, their family has grown, too. They’re about to have their sixth child.

    For as long as Dr. Schwartz has been in practice, his priority has always been his patients: He’s often treated patients who couldn’t afford care for free and Mrs. Schwartz says he jokes he’d be OK if some patients had to pay him in chickens or eggs, as they might have had to do in the days of a “town doctor.”

    But the Schwartzes’ ability to meet the needs of patients and the financial demands of their business has been tested.For example, insurance plans in New Jersey have changed. The various plans the Schwartzes purchased for themselves and their employees last year are no longer available. This year, they had to pay 25.5 percent more per employee in insurance premiums — or about $20,000 more per employee than they paid last year. Many of their patients were forced to change plans, too, which has affected the Schwartzes’ reimbursement rates. Their staff has had to deal with increasingly uncooperative insurance companies that no longer cover important tests their patients need. And every prescription has seemed to require more paperwork.

    “The direction that we’re going is so scary and it detracts from medicine now,” Dr. Schwartz said. “It affects how I practice medicine and where I see the practice going. … When you don’t have confidence in your earning potential for the future, you don’t feel the same confidence to grow and acquire new technology.”

    For now, to cope with increasing costs, the Schwartzes have stopped accepting some insurance plans. They’ve also implemented a hiring freeze. Their part-time secretary would like to become full-time, but they can’t justify the salary.

    “Right now, we’re just trying to stay afloat and not do anything drastic,” Mrs. Schwartz said.

    Their patients have made their own painful decisions to adjust to rising costs. Some have had to switch their own insurance plans — and, consequently, Dr. Schwartz is no longer in their insurance network.

    “I’m losing patients that I wanted to keep, that I’ve had relationships with for years,” he said. “For the patients, that means they have to start a relationship with a new physician, starting from scratch.”

    But Dr. Schwartz refuses to compromise the quality of care he provides his remaining patients.

    “One option would be to see more patients, but we’re trying very hard not to do that,” he said. “We pride ourselves on being a practice that spends a good deal of time with every patient. … We work very hard to give patients the time and attention they need.”

    Despite these challenges, Dr. Schwartz still enjoys his job.

    “The truth is, I love what I do,” he said. “Do I love 100 percent of what I do? No. But 85 percent I love. I love seeing patients, I love treating them, I love endocrinology, I love that we can make a difference in people’s lives. … The vast majority of what I do is just becoming a lot harder to do.”

    Does that mean he’d be happy if one of his six children decided to become a doctor as he did — and as his father did before him?

    “That’s a good question,” he said. “I still in my heart believe that medicine is a noble profession and a wonderful field to go into, but I also feel strongly about having a family and, as medicine changes that ability to really have a solid, consistent income, my reservations are affected by that.”

    Mrs. Schwartz doesn’t have to think twice.

    “I wouldn’t want them going into medicine because I’m just afraid,” she said. “Medicine isn’t what it used to be. … In [my father-in-law’s] days, basically the doctor had a relationship with the patient. The patient paid the doctor. And nowadays it’s so different. It’s a whole different world.”

    Tina Korbe is a staff writer in the Center for Media and Public Policy at The Heritage Foundation.

    Posted in Obamacare [slideshow_deploy]

    6 Responses to New Jersey Practice Struggles With Health Care Changes

    1. George Colgrove, VA says:

      What we need is a high-level private sector summit without the presence of any introverted government official (elected or otherwise), agency, department, unions or any union representative or union workers. Nor should the federal government provide any funding to this summit – which will only add to the huge national deficit.

      This summit has to be open to the media and needs to be populated by health insurance companies, hospitals, health care facilities, health care customers, companies who provide health care benefits to their employees and private sector employees who receive health care benefits.

      This needs to be a few days to a full week to put REAL working groups together to answer the following questions:

      1)What were the original claims that justified the government’s presence in a private sector medical industry?

      2)Were these claims justified, obfuscations or outright lies?

      3)If justified, where those claims addressed by the government’s intrusion into the market?

      4)If justified, what private sector adjustments or modifications that could have been made were ignored by the government?

      5)What are the problems today?

      6)Are the problems being addressed by government intrusion?

      7)Line by line, what are the benefits and/or societal and economic costs of each and every healthcare provisions currently available by the federal government?

      8)What are private sector alternatives to those provisions and could the private sector do a better job?

      9)Where competition remains a factor in the remaining parts of the health care industry, we need to evaluate the cost controls and quality and compare that to where government intrusion has had an effect. Is the private sector doing a better job through competition, providing affordable and quality health care then the government?

      10)If all layers of government were to get out of health care and nothing changed, what private sector provisions are available to the people that ensures everyone has access to health care? (i.e. do hospitals really turn away injured people if they have no health insurance?)

      11)What alternatives are there in companies providing health care benefits to their employees? Could this be done by separate competing independent companies in which the employee’s company just pays a portion of the employee private and portable benefits package?

      12)How can the private sector do a better job providing a Medicare/Medicaid alternative? Or in other words, can the private sector provide health care services to people who have no insurance, the elderly and people with pre-existing conditions in an economical way at the same time ensuring quality health care for those who pay?

      13)If government intrusion in the health care industry has been damaging, to what extent has that damage been?

      14)In the same light as the previous question, take all claims federal officials, unions, and others opposed to the private sector health care solutions and honestly address each, either accepting what were true, and repudiate those that are not. Once these have been addressed, if the private sector has been damaging, to what extent has that damage been? Of those elements, what can the private sector do to solve these problems?

      There are many many more questions to ask. Nevertheless, the result of this PRIVATE SECTOR health care summit in an open and transparent forum would be to set up rapid action research teams to quickly find answers to the hundreds of questions that will pop up during the summit. These answers will be discussed and documented in plain and simple language (6th grade level) complete with references. The results will be made public during the proceedings via the internet to allow people in their homes to ask their own questions and/or comment. If government sympathetic trolls want to chime in this is where they can.

      All of us instinctively know the government solutions are failing economically and socially. With federal officials obfuscating the facts, no one knows for sure what to think. One alarm that has risen is that we are now asking federal government officials if we will be allowed to live! Another basic fact is that if we solve the health care issues, many federal workers will be out of their jobs. It is in the best interest of the federal government that they continue making healthcare a problem to preserve their highly overpaid positions.

      If god forbids, the results of this summit shows that government is the only solution, then at least we know and can move on. However, god willing, with honest, open and intelligent debate occurring on the floor (the primary reason why we should not let self-serving government officials or unions in the halls – they will simply lie and obfuscate) we find that the private sector was doing the right thing all along and that with some additions of new private sector services we could do even better, then we can start moving ahead.

      We need facts that can be simply laid out. The Heritage Foundation has the human and financial resources to head such a summit. With additional influx of investment in such a summit by the industry, the function can be large and productive. It can have the necessary exposure to get people to listen in and watch from their computer screens and TVs. We want every facet of the private sector healthcare industry (including customers) to have their voice without having that voice trampled by the intimidation of federal government officials or unions.

    2. Jeanne Stotler,Woodb says:

      When I first entered Nursing at Georgetown Univ. School of Nursing in 1949, we were told one thing. "LOOK at the whole PATIENT" You need to know why they are sad, or why their children have problems, if they have no heat, Why? Apatient is a complex being, and each is different ad you cannot treat the disease if you do not know the person. The way medical care is going, it's going to rubber stamp each disease and a cure or medicine that fits all. Medicine just doesn't work this way, and this is a road for disaster. I remember te day when doctor's actually talked to you, they knew you by name and knew your mate and your children, they came to your home if you couldn't get to them. My great uncle, and both maternal great grandfathers were MD's and they would be surprised to see how things were going, all had driven horse ands buggies to see patients, my uncle walked a mile in to see a 12 YO boy and remeved his appendix on the kitchen table. Yes we have more to work with but we have forsaken compassion not only for the patient but for the family.

    3. Don Huber, Willis TX says:

      I am 76, have some health problems, which are taken care of by a managed care facility. I have been wondering if our medical problems in this country are so terrible, why is government the solution. Government hasn't done so well in the post office (FedX and UPS seem to be doing well) Amtrack, and other entities that seem to always need money. Thanks to the House for passing the bill last evening. Let's proceed with the above plan to work out the problems. A 2000 page bill that was passed and no one read it won't solve the problems.

    4. Gloria Kravetz says:

      Don't leave out the Professional Health Insurance Agent that also deals with the public and educates them as well.

    5. Pingback: Tweets that mention New Jersey Practice Struggles With Health Care Changes | The Foundry: Conservative Policy News. -- Topsy.com

    6. Eowyn, USA says:

      This article is confusing because the writer did not make clear exactly how Obamacare has impacted the New Jersey doctor's medical practice. The article quotes Dr. Schwartz complaining about changes in private medical insurance policies, but does not connect those changes to Obamacare. So in the end the article wasn't terribly informative.

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