Photo Credit: The Fiscal Times

By Mandi Woodruff. A Portland, Maine family doctor is the latest poster child for private practitioners who are turning their backs on insurers altogether.

In April, Dr. Michael Ciampi stopped accepting all forms of insurance, including Medicare and Medicaid, and started charging for his services a la carte.

“We’re asking people to pay at the time of service just like you would pay at your garage or your lawyer or your plumber,” Dr. Michael Ciampi told the Bangor Daily News’ Jackie Farwell. “Now, I work for patients. I don’t work for the government and I don’t work for insurance companies.”

Primary care doctors are among the lowest paid in the industry, and they’ve seen big cuts to their bottom line recently, as insurers cap physician fees in order to rein in health care costs. Once Obamacare goes into full effect in 2014, it’s predicted that insurance premiums will skyrocket, and all the extra paperwork required will cost private practices like Ciampi’s more time, money and manpower.

A doctor’s income is what the office takes in payments minus expenses or overhead. Physician overhead cover many things but the most expensive cost is the staff necessary to handle insurance coverage. About 20 to 30 years ago this cost used to be around 15 to 30% of revenue. Now for many doctors this insurance overhead has grown to an outstanding 60% or more, with more staff being hired to handle the quickly enlarging piles of paperwork required by Obamacare. Read more from this story HERE.

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Why Docs Are Bailing Out of Health Insurance

By Edward Morrissey. The cost of health care has been a nagging public policy issue for decades, even before the government took on the task of insuring retirees in the 1960s. The issue continued to fester through the Social Security reform of the 1980s and the attempt at a top-down government restructuring of the health-care industry in the 1990s, spearheaded by Hillary Clinton that resulted in a backlash strong enough to end forty years of Democratic Party dominance in the House of Representatives in the midterm elections of 1994.

Republicans mainly punted on health-care reform except to add an expensive prescription-drug government program to Medicare during the early days of the Bush administration, leaving Democrats an open path to finally imposing the top-down restructuring they had pursued for decades in the Affordable Care Act of 2010.

The ACA, known as Obamacare, was passed on promises that premiums would decline by forcing everyone into insurance plans, and that top-down mechanisms like mandates on coverage and the Independent Payment Advisory Board (IPAB) would control costs. That hasn’t proven to be the case, and indeed, both premiums and costs are skyrocketing – just as anyone who understood the impact that mandates would have on risk pools and tax hikes on prices predicted.

As the open enrollment period for 2014 approaches, premiums on individual plans in the Obamacare exchanges for California will double, and will increase 80 percent or more in Ohio. At the end of its first decade in force, the ACA will leave more than 30 million Americans without insurance – the driving issue behind health-care reform for at least the last twenty years.

The problem with all of the health-care industry reforms has been that precise goal: expanding insurance. The widespread use of comprehensive insurance policies insulates end users in the system from price signals, especially on routine care. That eliminates competition on price as insurers use their economic weight to pre-negotiate pricing on every kind of service and product under their coverage, from blood tests to setting broken bones. Providers locked into a specific schedule of reimbursements have no reason to innovate to either lower costs or increase value, and end up having to spend money and time dealing with insurance companies for delayed payments rather than focusing on the patients seeking treatment in their clinics. Read more from this story HERE.