Wednesday, January 27, 2016

California and Schools not on the list

In the past I have said a medical school must be on the California list to ever practice in California.  That is not true anymore.

As of 2013 the state of California has enacted the following rule and it was updated for Jan 2015:


BUSINESS AND PROFESSIONS CODE - BPC

DIVISION 2. HEALING ARTS [500 - 4999.129]

  ( Division 2 enacted by Stats. 1937, Ch. 399. )
  

CHAPTER 5. Medicine [2000 - 2525.5]

  ( Chapter 5 repealed and added by Stats. 1980, Ch. 1313, Sec. 2. )
 

ARTICLE 7. Reciprocity and National Board Diplomate Applications [2135 - 2153]
  ( Article 7 added by Stats. 1980, Ch. 1313, Sec. 2. )

 

2135.7.  
(a) Upon review and recommendation, the board may determine that an applicant for a physician and surgeon’s certificate who acquired his or her medical education or a portion thereof at a foreign medical school that is not recognized or has been previously disapproved by the board is eligible for a physician and surgeon’s certificate if the applicant meets all of the following criteria:
(1) Has successfully completed a resident course of medical education leading to a degree of medical doctor equivalent to that specified in Sections 2089 to 2091.2, inclusive.
(2) (A) (i) For an applicant who acquired any part of his or her medical education from an unrecognized foreign medical school, he or she holds an unlimited and unrestricted license as a physician and surgeon in another state, a federal territory, or a Canadian province and has held that license and continuously practiced for a minimum of 10 years prior to the date of application.
(ii) For an applicant who acquired any part of his or her professional instruction from a foreign medical school that was disapproved by the board at the time he or she attended the school, he or she holds an unlimited and unrestricted license as a physician and surgeon in another state, a federal territory, or a Canadian province and has held that license and continuously practiced for a minimum of 12 years prior to the date of application.
(B) For the purposes of clauses (i) and (ii) of subparagraph (A), the board may combine the period of time that the applicant has held an unlimited and unrestricted license in other states, federal territories, or Canadian provinces and continuously practiced therein, but each applicant under this section shall have a minimum of two years continuous licensure and practice in a single state, federal territory, or Canadian province. For purposes of this paragraph, continuous licensure and practice includes any postgraduate training after 24 months in a postgraduate training program that is accredited by the Accreditation Council for Graduate Medical Education (ACGME) or postgraduate training completed in Canada that is accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC).
(3) Is certified by a specialty board that is a member board of the American Board of Medical Specialties.
(4) Has successfully taken and passed the examinations described in Article 9 (commencing with Section 2170).
(5) Has not been the subject of a disciplinary action by a medical licensing authority or of adverse judgments or settlements resulting from the practice of medicine that the board determines constitutes a pattern of negligence or incompetence.
(6) Has successfully completed three years of approved postgraduate training. The postgraduate training required by this paragraph shall have been obtained in a postgraduate training program accredited by the ACGME or postgraduate training completed in Canada that is accredited by the RCPSC.
(7) Is not subject to denial of licensure under Division 1.5 (commencing with Section 475) or Article 12 (commencing with Section 2220).
(8) Has not held a healing arts license and been the subject of disciplinary action by a healing arts board of this state or by another state, federal territory, or Canadian province.
(b) The board may adopt regulations to establish procedures for accepting transcripts, diplomas, and other supporting information and records when the originals are not available due to circumstances outside the applicant’s control. The board may also adopt regulations authorizing the substitution of additional specialty board certifications for years of practice or licensure when considering the certification for a physician and surgeon pursuant to this section.
(c) This section shall not apply to a person seeking to participate in a program described in Section 2072, 2073, 2111, 2112, 2113, 2115, or 2168, or seeking to engage in postgraduate training in this state.
(Amended by Stats. 2014, Ch. 71, Sec. 2. Effective January 1, 2015.)


This will be hard for many states and the few schools who use the list and who fought to be approved by California. 
I have read the trials some schools went through, legitimate schools, with the California Board to get such approval. These same schools went through the approval process of their own country and the World Medical List. 









Monday, January 4, 2016

Obama Care gets an F minus

Obama Care or the Affordable Care Act gets an F minus, lower grade if I could.

Why? Its not affordable! Let me explain: 

-Subsidies are not calculated right at the Marketplace:
  Example: Mine was 10 times the amount it should have been

- If you are unemployed or making less money pre promotion you will have to pay back
  Example: If unemployed or pre promotion you are under 300% of poverty level you will 
  get a great subsidy, but when you make more money later that year not only will your        
  subsidy change but it may go away and then at tax time you may find you have to pay 
  back what you given when at the lower income! 

The Washington Times Article     



Most filers who received government subsidies to buy Obamacare plans had to pay money back to the IRS this year, according to an H&R Block analysis released Monday that looks at the health law’s first full tax season.
The tax-prep giant studied its own massive customer base and concluded that two-thirds of its filers who got subsidies from Obamacare were overpaid during the course of the year, and owed money back to the IRS on the April 15 deadline.


When you make more money later that year not only will your subsidy change but it may go away and then at tax time you may find you have to pay back what you given when at the lower income! 

-Why would the current administration not revise this failure? Why would want people you are trying to help paying penalties and purposely confused about how much the health care will cost? This is a disaster and, like many Americans, I'm angry I was misled when I purchased my health care coverage. 

-Health insurance that is expensive and covers about nothing
 my plan Cost per month without subsidy: 512.65 a month



Deductible 

Individual$5,200$10,400
Family$10,400$20,800

Coinsurance 

Your Part50%50%

Out-of-Pocket Maximum 

Max Individual$6,400$19,200
Max Family$12,800$38,400
The market place estimated my subsidy to be 488 a month, when I did some math it was about 200 a month..................... my Monthly payment was to be 24.65 and at tax time I would owe the IRS an additional 4,536.00 with penalties and fees for having more than 1,000 due at tax time.

So to avoid penalties of about 1,400 ( a new added tax by our President) 
I'm paying 3,744 a year in premiums for a plan that pays for about nothing until I reach 5,200 in out of pocket. So in one year of bad health I could end up with 8,944 out of pocket to pay for my health care not counting the loss in wages from illness.

This is a disaster and, like many Americans, I'm angry I was misled when I purchased my health care coverage. 

$3,744 a year in premiums for a plan that pays for about nothing, $6,144 a year without subsidy.

Is this truly what everyone wants? 

If my wife and I make 50k a year this is what we are faced when our work does not offer Health care plans.

I want the Affordable Health Care act revised so it makes better sense for all of us. 

-Coverage premiums Capped based on Metal level and Income level

-Lower Capped out of pocket Maxims. 

-During a period of unemployment or lower income, you pay accordingly without the end of year trap of paying back because of increased income.

- Lower Max pay backs at tax time if you can prove it was the Market place fault.
with NO penalties for underpayment of Tax.


Edit: 1/5/2016

Found articles on the rising premium costs and decreasing coverage by the Insurance companies because the Administration neglected tight control over the insurance companies. The current ACA provides such tight control on taxpayers that we are penalized no matter what we do, insurance companies can continue to raise rates and decrease coverage through copays and deductables to not only ensure profits but to increase them.

August 2015  Link   Article 1    



We see trend rates closer to 9%… not at 6%-7%,” Mr. Ratcliffe said.
According to Joe Ellis, Philadelphia-based senior vice president with CBIZ Inc., employer health care cost increases are actually lower than they have been in the past, though he said they are still averaging 7%-8% before plan design changes.
That's a problem for all employers. At a 5% average premium increase after plan design changes, employers are still facing rates “well above inflation,” said Steve Wojcik, NBGH's Washington-based vice president of public policy.



July 2015  Link  Article 2
Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.