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The Plan To Empower Consumers Of Healthcare

 Stanley Feld M.D., FACP,MACE

The only way to empower consumers of healthcare is to allow them be responsible for their health and healthcare dollars.

The delivery of medical and surgical care has progressed markedly in the last sixty years. Life expectancy has also increased.

At the same time medical care has become unaffordable and the cost of healthcare has become unsustainable.

The incidence of obesity has risen every year. Over fifty percent of Americans are obese. The percentage is rising yearly.

Obesity begets many chronic diseases and subsequently the complications of these diseases.

Physicians can treat these complications fairly well but the treatment of these complications comes at a high cost.

How do you decrease obesity in America?

How do you get people to be responsible for their health and healthcare dollars?

One of the key elements in decreasing obesity is to give consumers financial incentives to use the healthcare system efficiently.

ObamaCare went in the wrong direction. Its regulations—including required “essential benefits”—raised prices on these plans and limited their availability.”

The only incentive Obamacare provided was the incentive to overuse the system. This was especially true for patients on Medicaid. They had zero premiums and deductibles.

A second tool for motivating patients to consider price is large liberalized health savings accounts. These tax-sheltered accounts are generally used to pay for the noncatastrophic expenses that form the bulk of medical care.

First, equip consumers to consider prices.”

 Critics always claim this is unrealistic: Are you supposed to shop around from the back of the ambulance?

 The critics use the ambulance excuse argument to eliminate the possibility of consumers using their own judgment to make price decisions.

But emergency care represents only 6% of health expenditures.”

“For privately insured adults under 65, almost 60% of spending is on elective outpatient care. “

The critics argument is that consumers do not know how to shop prices. Consumers are smarter than the critics think. It would be easy to teach consumers to shop prices.”

http://stanfeld.com/the-failure-of-the-republican-establishment-to-repeal-and-replace-obamacare/

“My ideal medical saving account provides that financial incentive to not overuse the healthcare system. The many articles about my ideal medical saving accounts are attached to this link.

Likewise, nearly 60% of Medicaid money goes to outpatient care.”

 Medicaid patients also overuse the healthcare system.

“ For the top 1% of spenders—a group responsible for more than a quarter of all health expenditures—a full 45% is outpatient.”

These patients can be identified as outliers and educational vehicles can be created to decrease this overuse of the system.

In my opinion Medical Savings Account are better than Health Savings Accounts. Medical Savings Accounts take the money out of the healthcare insurance company’s hands and delivers it to consumers.

Both HSA’s and MSAs have the unique advantage of providing and financial incentive to save.

When people have savings to protect in HSAs, the cost of care drops without harmful effects on health. 

 The financial incentive decreases the overuse of the healthcare system.

“ According to a 2012 study in Health Affairs if even half of Americans with employer-sponsored insurance enrolled in this kind of coverage, U.S. health expenditures would fall by an estimated $57 billion a year.”

My ideal Medical Savings Accounts provide an even a greater financial incentive and should decrease costs even further.

“ HSAs should be available to all Americans, including seniors on Medicare. Given that seniors use the most health care, motivating them to seek value is crucial to driving prices lower.”

Scott Atlas has publicized the obvious. This would apply to Medicaid recipient also. The details for Medicaid recipients can be found in my article “My Ideal Medical Savings Accounts Is Democratic. “

The maximum contribution to a MSAs should be raised to $6000 or $7000 dollars. If a consumer get sick and experiences a cost of $6000 he should receive 100% (first dollar) coverage through a reinsurance policy that would cost less than $6000.

There can be many variations on this theme for the consumers benefit.

 When a person with an HSA dies, the funds should be allowed to roll over tax-free to surviving family members.  

This financial incentive should be added to My ideal Medical Savings Account.

“The information that patients require to assess value must be made radically more visible. A 2014 study on magnetic resonance imaging showed that price-transparency programs reduced costs by 18.7%.”

A consumer driven system would force providers to compete for patients. Information on price could easily be provided to consumers by the government and the healthcare insurance industry.

“The most compelling motivation for doctors and hospitals to post rates would be knowing that they are competing for price-conscious patients empowered with control of their own money.”

 In his age of technology and rapid communication telemedicine should be promoted and paid for. One way to do it is to permit physicians to practice telemedicine across state lines.

It would supply instant access to expertize at an affordable cost.

Everything possible should be done to encourage consumer responsibility and provider competition.

The present tax code does the opposite. Consumers’ in-group plans provided by large and small corporations receive their healthcare insurance from the corporation with tax-free dollars.

The larger the corporation the more leverage the corporation has for negotiating the premiums with the healthcare insurance companies.

The younger and healthier the corporate employees are the lower the premiums.

This is where the formation of associations with larger memberships of all ages fits in to lowering the price of healthcare. Large associations would have great leverage in negotiating price with insurance companies. They would also spread the risk.

If financial incentive with my ideal medical saving account was added to the price the association negotiated and the consumer paid for the premium, usage would fall and the cost of insurance would decrease.

Tax deductibility must be given to these “individual” insurance policy holders and association policy holders so they are, in reality, paying for healthcare insurance with pre-tax dollars as the corporate group plan policy holders.

These simple changes in the law would result in an affordable healthcare system that was market driven by consumers. The changes would force providers and the healthcare insurance industry to become competitive.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

 All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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The Failure Of The Republican Establishment To Repeal and Replace Obamacare

« Describing Fake News | Main

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Describing Fake News

Stanley Feld M.D.,FACP,MACE

The front-page headline in the Sunday New York Times on August 26 read;

“Health Insurers Start To Prosper.

The subtitle was; Trump’s Warnings on Affordable Care Act Masks Upside.”

 “Supporters of the Affordable Care Act achieved a major victory this past week when, thanks to cajoling and arm-twisting by state regulators, the last “bare” county in America — in rural Ohio — found an insurer willing to sell health coverage through the law’s marketplace there.”

“So despite earlier indications that insurance companies would stop offering coverage under the law in large parts of the country, insurers have now agreed to sell policies everywhere.”

 A casual Sunday Times reader would respond to this headline and initial paragraph by thinking that President Trump is frightening the public about Obamacare’s failures.

The casual reader would conclude this is just another one of President Trump lies. Obamacare is not failing. He is just trying to scare the public.

The New York Times is telling the public that the insurance industry is going to offer insurance through Obamacare in every county in the country.

The American people cannot trust President Donald Trump.

The causal reader got the message. Obamacare is doing fine. It is not necessary to continue reading the article.

The online Sunday NY Times headline of the dame article was different than the headline that appeared in print.

Trump’s Threats on Health Law Hide an Upside: Gains Made by Some Insurers”

This headline is also misleading. One insurer in a bare county signed up. This does not represent a upside gain or create a competitive market place.

“The Centers for Medicare and Medicaid Services (CMS) reported that 1,476 counties, over 45 percent of counties nationwide, will only have one health insurer on the Obamacare exchanges next year.”

This article is an example of “fake news.” It is totally misleading to the casual reader

Why a single insurance company will sell insurance in that bare county in Ohio is not explained. All the other insurance companies have pulled out of that county.

If the reader got this far into the story he could still be satisfied that Obamacare was not imploding.

However, the article goes on to explain the potential failure of Obamacare.

“But a moment of truth still looms for the industry in the coming weeks under the law known as Obamacare.”

“Companies must set their final plans and premiums by late September, even as the Trump administration continues to threaten to cut off billions of dollars in government subsidies promised by the legislation.”

This is more fake news aimed at blaming Donald Trump for Obamacare’s failure.

The NYT ignores the fact that President Obama promised the healthcare insurance industry the reinsurance subsidy in order to get them to participate in Obamacare in the first place.

President Obama paid the healthcare insurance industry only 12% of what the insurance companies claimed President Obama promised them in their reinsurance package.

President Obama promised the healthcare insurance industry a subsidy through the government backed reinsurance package, if there were cost overruns in Obamacare.

The costs overruns were massive according to the healthcare insurance industry. The legislator only budgeted 12% of that claimed by the healthcare insurance industry.

President Obama could not find the money to pay the remaining 88%.

The industry continues to demand the remaining 88% promised in order to participate in this year’s (2018) Obamacare health insurance exchanges.

All twenty-two of the state run insurance administrative companies that received loans from the federal government have gone bankrupt and have not paid the insurance industry.

Those federal loans will never be paid back to taxpayers.

The Democrats and the mainstream media are trying to blame President Trump for this deficiency in payment and the lack of insurance company participation.

The shortfalls resulted in healthcare insurance premium raises for both the Obamacare health insurance exchanges and the premiums for private group insurance.

Subsequently, most of the healthcare insurance companies have dropped out of providing the insurance through the Obamacare health insurance exchanges.

A third piece of fake news is the success of providing insurance for twenty million enrollees.

The NYT article ignores the fact that Obamacare through the health insurance exchanges only enrollee nine million people in the individual market. Fourteen million lost individual coverage lost their insurance at the onset of Obamacare.

The 22 million additionally insured includes the additional thirteen million were added to the Medicaid roles. Some of those thirteen million are illegal immigrants.

Soon a portion of the financial burden of the Medicaid increase will be dumped on the states.

The Obamacare law requires comprehensive insurance coverage packages for both the individual market and the group markets driving the price of coverage up.

These increases make Obamacare unaffordable. Obamacare is not successful as implied in the New York Times article.

President Trump did not do anything to distort the Obamacare coverage. President Obama did it with his tremendous cost overruns.

It is possible President Obama wanted to prove that an insurance-based healthcare system couldn’t work. It would have to be replaced with a government controlled single payer system.

It is the reason he wanted to include the “Public Option.”

However he placed so many regulations in the way of any possible success.

President Obama believes that the only system that would work is a single party payer system with the government being in control of the money, the coverage and the freedom to choose by the public.

President Obama had no concern for the government inefficiency or cost to the government.

There was no consideration for a more cost efficient and affordable healthcare system.

“The fate of the landmark law, Obamacare, depends in large part on the health of the insurance marketplaces and the ability of insurers to make a viable business out of selling coverage to individuals.”

Healthcare insurers have tried to make a viable business plan out of Obamacare. When the law passed seven years ago, insurers saw a potential bonanza: tens of millions of brand-new paying customers, many backed by generous government subsidies and required by the new law to have health coverage.

The burdensome regulations, lack of coverage flexibility and one size fits all coverage all have cause people not to sign up for Obamacare. They would rather pay the penalty even though they can ill afford it.

On Thursday, Northwell Health, the largest hospital system in New York State, announced that it would shut down its insurance unit, CareConnect, which had been selling coverage in the state marketplace. The move forces tens of thousands of its customers to find another plan for 2018. Northwell’s chief executive put much of the blame on Washington.

As we get closer to enrolling participants in Obamacare for 2018 and the insurance industry’s publishing their premiums more insurance companies are dropping out of participating in the health insurance exchanges.

Most of the startup insurance companies and state sponsored have closed down their business.

The article quoted is fake news.

The article starts off giving the casual reader the impression that Obamacare’s insurance coverage is doing fine.

The reality is It is not fine. Americans have to worry about it. Affordable healthcare insurance will not be available at an affordable price.

The Democrats are happy because then the country will be offered a single party payer system.

The problem is that the federal government cannot afford a single party payer system. At this moment Medicare and Medicaid are not sustainable. A single party payer system will be inefficient and unsustainable.

I don’t know how Mitch McConnell can to say most of the news is not fake news.

The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Gosh

Stanley Feld M.D.,FACP,MACE

The Republicans committing suicide ?

Mitch McConnell is a politician. He goes where the wind blows.

He does not like President Trump. He has never liked President Trump. During the 2016 primary he said he would do everything in his power to prevent Donald Trump from becoming the Republican candidate for President.

He likes President Trump even less now because President Trump criticized him for not being able to pass the simplified repeal of Obamacare.

Mitch McConnell, as Senate majority leader, did promise the people of Kentucky for the past seven years that he would repeal and replace Obamacare

At present Mitch McConnell’s approval rating in Kentucky has plummeted to 18%.

There is a movement afoot to fire him as senate majority leader if he cannot get President Trump’s agenda passed. The house has passed 518 bills; 396 are stuck in the Senate.

Why? The answer is becoming obvious.

“Of the 518 bills or joint resolutions passed by the House since January 2015, only 122 have passed the Senate, according to Congress’s Legislative Information System, which tracks the status of legislation.”

http://thehill.com/blogs/floor-action/281536-nearly-400-house-bills-stuck-in-senate-limbo

t looks like Mitch McConnell is trying to destroy President Trump’s agenda. It also looks like he is helping Chuck Schumer and the Democratic establishment destroy Don Trump’s presidency.

“Mitch McConnell acknowledges that path forward on healthcare is ‘murky’.”

http://thehill.com/blogs/floor-action/senate/347373-mcconnell-path-on-healthcare-murky

Before leaving Washington for recess in August, McConnell indicated that the Senate would leave behind its campaign to replace Obamacare and turn to tax reform.

Nevertheless, one version of legislation to change Obamacare ended up just one vote shy of passage, and McConnell could bring another bill up at any time.”

A GOP push to pass a “skinny repeal” of ObamaCare failed in a dramatic 49-51 vote before the August recess. A broader repeal proposal and measure to repeal and replace the Affordable Care Act simultaneously also failed to get enough votes to pass in the Senate.

Unfortunately John McCain’s vote defeated the bill. John McCain is another establishment Republican who does not like Donald Trump partly because President Trump challenged his heroism.

McConnell has previously acknowledged that the next steps on healthcare are unclear after Republicans campaigned for years on repealing and replacing the Obama-era law.

“Obviously we had a setback on the effort to make dramatic changes on ObamaCare. The way forward now is somewhat murky,” the Senate GOP leader said at a Chamber of Commerce event in Kentucky.”

McConnell added that lawmakers were “going to see” what the negotiations between Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.).

“We have … collapsing individual insurance markets around the country. Requests to continue to subsidize the insurance companies. It’s a pretty controversial subject to subsidize insurance companies without any reforms.”

“So when we get back after Labor Day we’ll have to sit down and talk to them and see … what the way forward might be.”

Mitch McConnell did not seem to try very hard to get even the skinny repeal passed after promising the republicans in Kentucky he would see to it that Obamacare is repealed and replaced.

Since the phone call from President Trump almost two weeks ago Mitch McConnell has gone out of his way to disagree with President Trump. They have not spoken to each other since.

Mitch McConnell said “My view is that most news is not fake, but I do try to look at a variety of sources,” McConnell said at a Chamber of Commerce event in Louisville, Kentucky, according to Time Magazine.

https://www.cbsnews.com/news/mitch-mcconnell-says-most-news-is-not-fake/

This statement is untrue. It also directly contradicts President Trump’s position.

“President Trump has tweeted about “fake news” over 100 times since January, according to the Trump Twitter Archive. In fact, he mentioned the “fake news” in two tweets on Monday, in one replying to a user who tweeted, “Every single day the #FakeNews media try to take you down.”

“You never falter, you always stand strong!” Mr. Trump agreed, tweeting in response that “the very dishonest Fake News Media is out of control!”

Another example of opposing President Trump was the president’s suggestion about the debt ceiling.

President Trump targeted Senate Majority Leader Mitch McConnell (R-Ky.) and Speaker Paul Ryan (R-Wis.) over the debt ceiling.

“I requested that Mitch M & Paul R tie the Debt Ceiling legislation into the popular V.A. Bill (which just passed) for easy approval,” Trump tweeted.

“They didn’t do it so now we have a big deal with Dems holding them up (as usual) on Debt Ceiling approval. Could have been so easy-now a mess!”

The most critical news story appeared in the New York Times on August 22,2017. This does not seem to be fake news. Mitch McConnell had not denied it yet.

McConnell, in Private, Doubts if Trump Can Save Presidency”

https://www.nytimes.com/2017/08/22/us/politics/mitch-mcconnell-trump.html

 

This is ridiculous. Mitch McConnell is a grown man who is supposed to be a master politician. He is playing right into the Democrats’ hand. The Democrats’ goal is to destroy President Donald Trump’s presidency.

For the first time in 37 years we have a President who seems to want to help all the people. Why are politicians in his own party trying to undermine him?

His methodology might be a little weird but he seems to be making progress. Most people believe there is corruption in government.

Are they trying to undermine him because they are part of the swamp?

Most Americans believe the corruption leads to inefficiency and subsequently a failed country.

President Trump has said several important things.

  “All Americans bleed the same color blood and we all should love our country.”

We should all remember Donald Trump won the election. He is trying to do things his way not the way of the lobbyists and the traditional media. If he is wrong neither he nor his party will be reelected.

Whst the world needs now

Let us as Americans try love and not hate. It applies to Democrats, Republicans and the traditional media also.

.

The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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What Was John McCain Thinking?

Stanley Feld M.D., FACP, MACE

I remember when President Obama held a meeting in 2009 with congressional Republicans in the House and Senate to discuss Obamacare before its passage.

This was to get input from Republicans before the Democrats excluded Republican input and were ready to vote in their Democratic Party dominated house and senate.

John McCain offered a constructive comment to improve Obamacare. President Obama’s response was “John I won the election.”

 

Now that Obamacare is an unmitigated failure John McCain voted against a simple repeal of Obamacare.

John McCain ran for reelection in his Senate primary and again in the general election on the platform that he would repeal and replace Obamacare.

 Many forget that he almost lost his primary election to a Republican tea party challenger. He and the Republican Party outspent the tea party challenger.

 http://www.politico.com/story/2016/08/john-mccain-arizona-primary-ward-22751

During his Senate race, he was also anti-Obamacare.

 http://www.politico.com/story/2016/06/john-mccain-obamacare-arizona-224622

In fight of his political life, McCain hammers Obamacare

I think it’s a very strong issue,” McCain told POLITICO about his focus on Obamacare. “Eight of the counties in my state will now only have one [health insurer]. They’re looking at 65 percent increases in their premiums. They’re very upset.”

Why did he vote against the simple repeal? Is he a political hypocrite?

Does he hate President Trump so much that he will do anything to undermine his agenda?

Paul Ryan’s original bill allowed for an easy transition from Obamacare to a replacement bill.

Congressional leaders, especially John McCain, must listen to this lecture.

The traditional media critiques should listen to Paul Ryan’s lecture carefully and report on it fairly.

https://youtu.be/fQ2YIzqEnEY

 

His plan would eliminate many of the Obamacare punitive regulations and permit Health Savings Accounts to grow. It would stabilize the health insurance markets. Some Republicans in the House are still opposed to his bill. They wanted immediate repeal and replace. They could not comprehend Paul Ryan’s subtle strategy.

Speaker Ryan finally got a watered down version of his proposal passed and ready for a joint conference. The Democrats fought it all the way.

In the senate, the Democrats said no to any proposal President Trump supported.

Both Chuck Schumer and Nancy Pelosi said it is the Democrats job to say no to everything in President Trump’s agenda. The job in their view is to destroy the Trump presidency.

http://www.washingtonexaminer.com/pelosi-struggles-to-call-trump-president-whats-his-name/article/2624485

Their plan is to destroy the Trump presidency with the help of the traditional media and the deep state. The deep state consists of Obama administration holdovers and anti-Trumpers in administrative positions. Some are career administrators. It is becoming obvious that they are also the leakers.

Chuck Schumer has done everything in his power to slow down confirming President Trump’s nominees. He has openly admitted this.

The members of the deep state have been leaking classified information to the press about President Trump’s administration. These are federal crimes. Secretary Sessions is starting to do something about catching these leakers.

President Trump has pledged to clean up the swamp. The swamp consists of the deep state plus many Democrats and some Republicans are both houses.

President Trump has the ability to confirm his nominees when both houses in congress are in recess.

By a strange sounding rule, both houses of congress can be considered in session when all the congresspersons are in recess.

Lisa Murkowski (R Alaska) set it up so that while the senate is in recess it is still in session. This is denying President Trump the opportunity to make recess appointments.

Senator McConnell did not do anything to stop her. It looks like the Republican establishment is also trying to destroy President Trump’s presidency.

Why would I think that?

President Trump has not had any cooperation from the Republican establishment to date.

President Trump pledged to clean up the swamp. All of the parties mentioned are the swamp that has hampered the growth of our economy.

I guess John McCain did his job for both the Democratic and Republican political establishment by voting against the simple repeal of Obamacare.

“The Senate GOP’s healthcare bill failure is a political debacle that will compound for years, and the first predictable fallout is already here:

“Republicans in Congress are under pressure to bail out the Obama Care exchanges, even as Donald Trump threatens to let them collapse.

The GOP needs to get at least some reform in return if it’s going to save Democrats and insurers from their own failed policies.”

 “Mr. Schumer may figure he can bludgeon the GOP into surrender because his press-corps buddies will blame the GOP for rising premiums.”

Let’s see what happens as a result of the swamp’s victory.

The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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A Single Party Payer System Will Not Work

Stanley Feld M.D.,FACP, MACE

Why am I opposed to a single party payer healthcare system?

I am concerned about America’s $20 trillion dollar deficit and $180 trillion in unfunded liabilities.

I am also concerned about China being a reliable buyer of American debt.

The deficit should be viewed as a house of cards that might crumble at any time.

Our country has suffered a massive increase in the deficit the last eight years under Barack Obama and Obamacare. The public knows the debt has increased at lease 1 trillion dollars a year.

No one has seen a good accounting the deficit increase. Everyone knows we have had massive inflation even though we have been told that inflation is only one percent.

The public knows Obamacare is imploding.

The public knows about the waste incurred during the Obamacare website roll out and the scandalous contracts to venders. The public knows about the massive increasing in insurance premiums and the massive subsides that were not anticipated.

The Democrats that the people have elected to congress do not seem to care about the deficits created. Now, we have finally realized that the Establishment Republicans do not seem to care about Obamacare failures either.

These officials do not care how much money the government wastes on bad deals at all levels of the economy. Obamacare has made terrible deals with the insurance industry, the pharmaceutical industry and hospital systems.

It has not made a good deal for the middle class or their primary providers namely physicians.

I do not think American healthcare policy makers or congress can afford to make another mistake.

Winston Churchill’s famous quote about Americans stands out here.

“You can always count on Americans to do the right thing after they’ve tried everything else.”

America cannot try something that is destined to fail. Socialism, especially in healthcare, does not work. Our government officials refuse to believe this even though it is demonstrated by our own failed entitlements such as the VA Healthcare System, Medicare and Medicaid.

Government officials refuse to believe that the socialistic universal healthcare systems in the rest of the world are unsustainable.

Britain is the perfect example of this as the system is crumbling.

Socialism does work in the long term.

Winston Churchill said it again.

“Socialism does not work because it is not consistent with fundamental principles of human behavior. The failure of socialism in countries around the world can be traced to one critical defect: it is a system that ignores incentives.”

The key to the solution of the healthcare system problem is to provide incentives to all the stakeholders, especially the consumers.I believe “My Ideal Medical Saving Account” will work to provide universal coverage at an affordable cost.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2012/05/my-ideal-medical-savings-account-is-democratic.html

America does not need a healthcare system that makes consumers dependent on government. It needs a system that makes them independent of government.

Butch Mazzuca is a local Vail Valley Resident who wrote this article about socialism and the healthcare system that appeared in the Vail

Valley News on July 9, 2017.

Mr. Mazzuca has given me permission to republish his article.

“When it comes to socialism, will they ever learn?

http://www.vaildaily.com/opinion/vail-daily-column-when-it-comes-to-socialism-will-they-ever-learn/ 

Editor’s note: Find a cited version of this column at http://www.vaildaily.com.

“Several weeks ago on ABC’s Sunday morning talk show “This Week,” Senate Minority Leader Chuck Schumer told host George Stephanopoulos, “The democrats need a strong, bold, sharp-edged and common-sense economic agenda. … That’s what’s been missing.”

So I find it a bit ironic that seven months after losing the 2016 presidential election, Schumer feels the Democratic Party is still struggling to articulate a coherent message. Meanwhile, the Bernie Sanders-Elizabeth Warren wing of the party delivers a very clear message. Unfortunately for their constituency, it’s about a failed ideology — socialism.

Sanders and Warren are advocates of redistributing wealthlax immigration rules, governmental intervention into health careenergy and business; and the acceptance that Washington should be the final arbiter of all problems.

SOCIALISM HAS INHERENT DEFECTS

While socialism is antithetical to the ideals of the Founding Fathers, it tends to gain its strongest support among the young and those who are uninformed. On the surface, socialism sounds great; it has always sounded great and will continue to sound great within certain precincts. The only problem with socialism is that history exposes it as a bankrupt ideology.

But rather than describing socialism’s failures tenet by tenet, the following apocryphal story illustrates socialism’s inherent defects in an easy-to-understand way.

An economics professor at a local college made a statement that he had never failed a single student before but had once failed an entire class. The class insisted that wealth redistribution, aka socialism, worked because then no one would be poor and no one would be rich — a great equalizer.

The professor then said, “OK, let’s try an experiment.” Henceforth, all grades would be averaged; everyone would receive the same grade, and no one would fail.

After the first test, the grades were averaged and everyone received a B. The students who studied hard were upset but the students who studied little were happy. As the second test rolled around, the students who had studied little now studied even less and the ones who studied hard decided they wanted a free ride, too, so they too decided to study little. The second test average was a D.

Now no one was happy. When the third test rolled around, the class average was an F; and from that point forward, the scores never increased, as bickering, blame and name-calling all resulted in hard feelings with the result that no one would study for the benefit of anyone else and the students all failed the class.

The professor then told them socialism as a form of government always fails because of human nature, i.e., when the reward is great, the effort to succeed is great, but when government takes the rewards away, no one will try to succeed.

HUMAN NATURE IS PART OF IDEOLOGICAL EQUATIONS

Similar to the aforementioned students, the far left consistently overlooks the fact that human nature is part of any ideological equation. They fail to understand that socialism has never and will never work because it’s based on a premise that’s inconsistent with human behavior.

When people work, they expect to be compensated commensurate with their effort and skill level. And capitalism does that more effectively than any economic system yet devised by man. Capitalism provides an incentive for people to achieve because they know their efforts will be rewarded.

Conversely, socialism is a disincentive to achievement because people also know their work is valued only collectively, rather than being valued individually.

Quote of the day: “The inherent vice of capitalism is the unequal sharing of blessings; the inherent vice of socialism is the equal sharing of miseries.” — Winston Churchill.”

Butch Mazzuca, of Edwards, writes regularly for the Vail Daily. He can be reached at bmazz68@comcast.net.

Our politicians should stop fooling around with America’s healthcare system, our fiscal viability, and the welfare of our citizen.

It is time to try something that will work, and not another thing that is doomed to failure.

Elizabeth Warren and Bernie Sanders, you are both dead wrong.

 

The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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They Are Getting There

Stanley Feld M.D.,FACP, MACE

As Obamacare implodes, President Trump is trying to get a Republican congress to repeal and replace Obamacare in an orderly fashion with a minimum of disruption to the present healthcare system.

The Republican establishment in congress is trying to disrupt his goal. All the Democrats are going to stonewall him.

Republicans won both houses of congress because they promised to repeal and replace Obamacare. They had seven years to create a plan. They have failed to achieve a consensus in the Republican caucus.

Democrats are starting to talk about making it easy. They are suggesting congress replacing Obamacare with a government run single party payer healthcare system.

You may recall President Obama told John Kerry and Barney Frank that America would get to a single party healthcare system via Obamacare. He told them not to worry.

The reality of the situation is America is inching its way to a universal single party payer healthcare system.

Medicaid, Medicare and the VA system are already single party payer systems. Each one of these programs has been declared unsustainable.

It is incomprehensible to me that the Republican politicians who the American people elected in good faith are not hearing their complaints

Presently 41.5% of the population is in one of these single party payer healthcare plans. 49% of Americans pay no taxes. This means that 51% of Americans are paying the healthcare bill for 49% who do not pay taxes.

This is the redistribution of wealth that Dr. Donald Berwick said was essential in America.

If fact many of the 49% receive additional monies from the government such as food stamps, free mobile telephone service and free housing.

America is on its way to European socialism, This ideological system has failed in Europe.

The following calculation is how I came up with the percentage of Americans that are in an entitlement healthcare system. I use U.S. agency census data.

The current population of the United States of America is 326,613,397 as of Monday, July 24, 2017, based on the latest United Nations estimates.”

hfo/world-population/us-population/ 

The chart below displays the total number of individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) in the current month (April 2017) and the period prior to the start of first Marketplace open enrollment period or “baseline” period (July – Sept. 2013).

The current enrollment is obviously post Obamacare.

Month Expansion States Non-Expansion States Total
Baseline July-Sept 2013 (Monthly Average) (49 states) 37,069,415 19,733,676 56,803,091
Apr 2017 (preliminary) (51 states) 52,058,495 22,472,507 74,531,002

Medicaid and Chip increased by 22,472,507 since the onset September 2013.

74,531,002/326,613,397 equals 22.81% of the population is on Medicaid so far.

Medicare enrollment is lower than present Medicaid enrollment. As of May 2017, 37,976,052 are on original Medicare and 20,089,220 are on Medicare Advantage or others Medicare plans for a total of 58,065,272 on this single party payer entitlement.

Medicare is an entitlement program with high premiums. The premiums are means tested. People in the upper tax brackets pay over $18,000 a year in after tax dollars premiums for Part B, Part D and Part F.

The people in lower tax brackets pay less. The premium deduction for Part B is taken out of their monthly Social Security check. This creates a burden on their standard of living.

The additional 58,065,272 to the 74,531,002 bring the total percentage of the population on a single payer healthcare system to 40.6%.

(132,596,274/326,613,397= 40.6%)

If the VA healthcare system enrollees are added to the analysis of the number enrollees to a government run single party payer healthcare system the percentages increase.

In Fiscal Year 2014 the total veteran population was 21,619,731. 9,111,955 veterans were enrolled. 6,616,963 veterans used the VA Hospital System. The VA System brings the total number enrollees in a single party payer system to 133,508,229 or 40.9%

9,111,955 + 132,596,274= 133,508,229

133,508,229/326,613,397= 40.87%

https://fas.org/sgp/crs/misc/R43579.pdf

The IHS provides a comprehensive health service delivery system for approximately 2.2 million American Indians and Alaska Natives who belong to 567 federally recognized tribes in 36 states.

https://www.ihs.gov/aboutihs/

133,508,229+2,200,000= 135,708,229

135,708,229/326,613,397= 41.5%

41.5% of the American population is already in a government controlled single party payer healthcare system. President Obama was right. He promised he would get there

Barney Frank and John Kerry did not have to worry. The only problem is that Obamacare is collapsing because it is unsustainable.

It is a pity is Republicans cannot agree to an innovative plan to repeal and replace Obamacare. Maybe the Republican want to have control over the healthcare system and deny Americans their freedoms.

The Democrats don’t care about the welfare and freedoms of Americans or the fiscal health of the nation.

Something needs to be done about this madness now.

The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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The Republican Establishment’s Failure

Stanley Feld M.D.,FACP, MACE

I am coming to the conclusion that the Republican establishment does not want to Repair the Healthcare System.

The Republican establishment has the same goal as the Democratic establishment.

Recently the mainstream media is saying that a single party payer system is looking good.

Neither party has any interest is having consumers control their healthcare dollars. It looks as if both parties want the government to control the consumer’s healthcare dollars.

All the politicians ignore the fact that government control is unaffordable. It also ends up not working.

The best example is the bureaucratic VA Hospital System and its system wide corruption.

A reader wrote:

I have read your last blog post carefully and agree with many of the points put forward but there is a glaring omission.” 

 “How are patients supposed to be responsible for their healthcare dollars when there is absolutely no transparency and no consistency in pricing.”

The lack of transparency is a major defect in our present healthcare system.

Only 20% of consumers use the healthcare system at any one time. Eighty percent of the consumers have not run into the lack of transparency problem in the healthcare system.

Most consumers do not care about transparency because they have first dollar coverage provided by their employer. They think their medical care is free. They believe they have excellent healthcare insurance.

President Obama took care of that notion with Obamacare. The defective structure of Obamacare caused healthcare insurance premiums and deductibles to skyrocket. First dollar healthcare insurance became too expensive for most employers.

Employers stopped providing first dollar coverage. Middle class employees are now noticing that out of pocket expenses have made their healthcare insurance unaffordable. Consumers have tried to compare prices of competitive providers. They have discovered that it is impossible!

Consumers are becoming aware of the lack of transparency. They have been astonished by this lack of transparency.

There is nothing in the new Republican bill that addresses Republican politicians’ awareness that the lack of transparency is a major defect in the healthcare system.

The lack of transparency is only one of the major defects in our healthcare system.

There is nothing in the Republican bill that speaks to the consumers’ responsibility for their health and healthcare dollars. Consumer driven healthcare is completely ignored.

There is nothing in the bill that addresses effective tort reform. The Massachusetts Medical Society survey showed that defensive testing to avoid lawsuits costs the healthcare system between $250 billion to $700 billion dollars a year.

The lack of the development of systems of care for chronic diseases cost another $700 billion dollars a year that our healthcare system does not address. There is nothing in the bill that emphasizes this very important defect in the healthcare system.

The Republican establishment thinks consumers are too stupid to take care of themselves.

The mainstream media likes to tell us that people love entitlements. The public does not want to give up these entitlements.

My question is how come less than 9 million people signed up for Obamacare’s individual healthcare plans last year if they love entitlements?

It is because they cannot afford to buy the health exchange insurance even though 85% of the premiums of those 9 million consumers are subsided by the government. Their high deductibles are not subsidized.

The Republicans are going claim they are promoting health savings accounts. The public is not told the amount of money they can put into a health savings account or whether it will provide first dollar coverage over that amount if they get sick.

There is no financial incentive for consumers to be responsible for their healthcare or their healthcare dollars.

My Ideal Medical Saving Account is a much better idea.

These are only a few of the major defects in the Republican establishment’s concept to fix the healthcare system.

President Obama did some of the awful things to Obamacare through rules and regulations after certain vested interests complained about the law. Obamacare’s rules and regulations have to be eliminated

There were crony waivers that would make one’s blood boil. In fact, elected congressional members got the best exemptions.

It is becoming apparent that congress doesn’t want to fix the healthcare system for the majority of Americans. The congressional establishment wants to control consumers.

Socialism does not work!

Socialsim for blog

Our political establishment does not tell us about the economic result in other countrys’ single party payer universal healthcare systems.

We don’t have to go to other countries. We only have to go to the indigent areas in California were everyone is covered by Medicaid.

The Republican establishment needs to get off the stick before all of them are kicked out of congress.

Just imagine the healthcare systems savings if every consumer were empowered to shop for the best healthcare at the best price.

The result would be a free market healthcare system in which competition would cleanse the system and make it affordable to everyone.

The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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How Can I Be So Misinterpreted?

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