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When Its Not Your Money

Stanley Feld M.D.,FACP,MACE

No one should be surprised at the money wasted by federal government programs. President Obama has been the biggest offender of wasting taxpayers’ money in my lifetime.

He increased the national debt from 10 trillion to 20 trillion dollars.

The volume of regulations, the creation of bureaucratic agencies, bureaucratic czars and the lack of enforcement of existing laws have served to create much of this waste.

However the public is unaware of the amount of taxpayers’ dollars spent because of the lack of government transparency. Congress ought to be standing on every mountain screaming about the waste.

I have observed the opposite. All we have to do is remember how congress marginalized Tom Coburn’s efforts to eliminate waste by eliminating duplication.

Obamacare is no exception to immeasurable waste while it destroys the healthcare system.

Improper payments for Obamacare are soaring because of a defective law and government inefficiency and incompetence.

A study by HHS shows that the improper payment rate for Medicaid will be 11.5% for 2016. It means that more than one out of every 10 dollars spent is wasted on either fraud, errors in payment or accounting inaccuracy.

The pre-Obamacare improper payment rate was 5.8% or one in 20 dollars spent. In 2015 it was reported that the improper payment rate was 9.7%.

This is the waste rate for only 10 million people added to the Medicaid roles.

I would suspect all three reports are an underestimate of the real improper payment rates.

The actual dollar amounts of improper payment rates are increasing because Obamacare has expanded Medicaid enrollment.

As the number of Medicaid recipients increase the wasted dollars will increase.

With President Obama’s new executive order to expand the eligibility of illegal immigrants for Medicaid coverage, the rate and amount of dollars improperly deployed will skyrocket.

To my amazement a lot of intelligent people are ignoring this simple arithmetic.

Medicaid eligibility is increasing rapidly. In 2015 Medicaid enrollment increased by 13.8%. One in five Americans as well as all illegal immigrants are entitled to Medicaid coverage.

I guessed that HHS would blame physicians for the waste. I was correct.

Medicaid reimbursement is so low that physicians have figured out ways to see more patients per day. They are using physician extenders extensively.

These physicians are accused of running Medicaid mills. They are accused of Medicaid fraud.

Then these physicians are put through a costly audit and are penalized. Many get fined for fraud and abuse due to overbilling.

There are many other reasons for this waste. Most important is HHS’ lack of proper diligence in administering the program. It smacks of reasons similar to the VA Healthcare System scandals.

“There’s no particular reason the error rate should be spiraling upward other than overwhelming incompetence.”

On closer look, home health agencies are probably the biggest abuser along with an ineffective bureaucracy that becomes more ineffective as the program grows.

“In recent audits of Medicaid in Arizona, Florida, Michigan and New Jersey, the GAO uncovered 50 dead people who recouped at least $9.6 million in benefits after they died; 47 providers who registered foreign addresses as their location of service in places such as Saudi Arabia; and $448 million bestowed on 199,000 beneficiaries with fake Social Security numbers—12,500 of which had never been issued by the Social Security Administration.”

The problem is not discussed by the traditional mass media. The public has no idea this is occurring.

Medicaid is a single party payer system completely controlled by the government. Patients have no control over which doctors they will see for an illness.

Medicaid is another clear example of the lack of concern or incompetence by government agencies for spending other peoples’ money.

Even worse, the system does not work for patients or physicians. Patients are the most important stakeholders in the healthcare system. They are treated like a commodity.

Medicaid is inefficient and costly.

Twenty percent of our population is now in this system. There is limited access to care and rationing of care.

There is a better way. It is a consumer driven healthcare system using my ideal medical saving account.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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If You Tell A Lie

Stanley Feld M.D., FACP, MACE

If you tell a lie enough times it becomes the truth. President Obama and Hillary and Bill Clinton keep telling the American public that there are 20 million new Obamacare enrollees.

Obamacare advocates believe that Obamacare provided healthcare insurance for 20 million people who did not have healthcare insurance before Obamacare.

These Obamacare advocates have little understanding of the details of this lie. They usually react negatively when I tell them the 20 million new enrollee figure is a lie.

Republicans do not pick this up and call Democrats out about this lie. Perhaps they have no understanding of what is going on.

The lie then becomes the truth.

I follow Charles Gabbe at Charles Gabbe is pro Obamacare. He publishes daily and weekly statistics as well as news in general about Obamacare’s progress and enrollment.

His numbers come from government sources. His numbers are very different than the numbers President Obama, Hillary and Bill Clinton are announcing.

The Obama administration continually manipulates the enrollment figures in order to give the impression that Obamacare has been successful.

President Obama continuously lies about the enrollment figures.

Obamacare has been a total failure because of its structure.

On December 9, 2015 published these enrollment numbers for 2016. publishes government release enrollment numbers weekly. These are the December 9th numbers.

Confirmed 2016 Exchange QHPs: 3,260,356 as of 12/09/15

Estimated 2016 Exchange QHPs: 4.73M as of 12/09/15 (3.60M via HCgov)

Projected Exchange QHPs: 5.76M by 12/12/15 (4.34M via HC.Gov)

Projected #OE3 QHP Selections: 14.70M nationally (11.23M via

Projected #OE3 QHP Selections by State

Maybe 9 million signed up for Obamacare last year. (2015)

What were the 12/09/14 enrollee numbers with 3 weeks to go until January 1, 2015?

Christmas to New Years consumes one week of enrollment. Holiday shopping will consume the other two weeks.

Why did the government reduce the expected enrollment to 5 million when enrollment was 9 million last year (2016)?

Does the Obama administration expect 4 million people to drop out of Obamacare because it is too expensive?

How did the Obama administration’s data given to the CBO cause the CBO to predict an enrollment of 21 million enrollees for 2016?

The 2016 Obamacare enrollment figures barely touch 10 million, not 20 million.

What is enrollment going to be when most of the major insurance companies have dropped out of the health insurance exchanges?

What is enrollment going to be when 18 of the 22 Obama administration created State Co-Ops have gone bankrupt?

President Obama and his administration have mislead Americans about the exact number of enrollees since the very beginning of the first enrollment period starting October 1, 2013. The first enrollment was delayed until November 1, 2013 and extended 6 months.

The American public has been mislead about:

  • The disastrous website development, reason for website crashes and cost of website development.
  • The exact number of enrollees the first year. (9.5 million corrected to 8 million and then re-corrected to 6.8 million)
  • An additional correction that resulted in another decrease of an additional 800,000 enrollees losing Obamacare insurance. The government belatedly discovered these 800,000 were ineligible for subsidies.
  • Decreasing the original predicted enrollees for 2015 from 13.5 million to 9.5 million.
  • The change in the start of enrollment from October 1, 2014 to November 15th to avoid discussion of enrollment around the time of the November 2014 elections.
  • Extending the 2014 enrollment 6 months.
  • Extending enrollment for 2015 for one to three months.
  • Finally, in 2015 announcing the back end of the website’s ability to send information to the IRS was still not complete.
  • Rehiring CGI, the same Canadian company that built the disastrous, to fix the back end of the website. A company’s employee is a friend of Michelle Obama.
  • Discovering that 1.2 million enrollees were counted that should not have been because they got dental insurance instead of healthcare insurance bringing the number of enrollees down from a recalculated 8 million to 6.8 million enrollees for 2014.
  • Announcing that 11.5 million people have enrolled for 2015 (these numbers seemed shaking at the time of enrollment. It seemed to be closer to 9.5 million or less.)
  • Announcing that the group market Obamacare insurance enrollment is being delayed a year or two while the mandate penalty for employers was to start January 1,2015.

Along the way I got the feeling that none of the enrollment numbers could be trusted. HHS and CMS kept modifying and lowering them.

The Obama administration keeps telling American how great the enrollment is and that Obamacare is a success.

However, we are told only ten million enrollees had Obamacare insurance in 2016.

Eighty five percent of those on Obamacare are receiving subsidies so the premiums are affordable. These subsidized recipients still cannot afford the deductibles.

The remaining 15% enrollees have a pre-existing illness. They cannot find private insurance to buy.

What about the 330 million people who might have subpar healthcare insurance? How many employers might discontinue employee insurance?

After five years with all the new Obamacare taxes, I would not call Obamacare a successful healthcare reform program.

All of these enrollees are in the individual insurance market. These numbers do not include the group insurance market.

14 million people in the individual market lost their healthcare insurance pre Obamacare.

10 million gained insurance on the healthcare insurance exchanges in 2016. There is a net decrease of 4 million individuals that is not discussed by the Obama administration or the traditional mass media.

Many of the state healthcare insurance exchanges have failed.

Eighteen of the 22 state insurance co-ops have failed so far.

An unknown number of enrollees in 2014 did not re-enroll in 2015 because of the loss of the subsidy.

Other enrollees did not sign up again because they could not afford the high deductible.

At the end of 2015 enrollment the Obama administration announced that 11.5 million people were enrolled.

On March 16, 2015 the administration said about 16.4 million people have gained health insurance coverage since the Affordable Care Act became law nearly five years ago.

Please notice the tricky wording. The Obama administration is counting children under 26 that now can be included in their parents’ group insurance plans and the additional Medicaid recipients added by some states.

The count is not only the people who enrolled in Obamacare through the healthcare insurance exchanges.

The discussion should be about the success of the healthcare insurance exchanges not the increase in Medicaid coverage.

The 2014 enrollment figures as of March 18, 2015 were also inflated. It is noteworthy than the Medicaid/CHIP estimate was 14.1 M. It is down to 10 million in 2016.

Confirmed Exchange QHPs: 11,699,473 as of 3/18/15

Estimated: 11.95M (9.06M via HCgov) as of 3/18/15

Estimated ACA Policy Enrollment: 33.1M
(10.46M Exchange QHPs, 8.20M OFF-Exchange QHPs, 330K SHOP, 14.1M Medicaid/CHIP)

Written into the law is that only state healthcare exchanges can provide subsidies not the federal health exchanges.

President Obama has not asked congress to rewrite the law’s provision.

This was another example of executive overreach of power by President Obama.

It looks as if President Obama cannot help himself from trying to manipulate the American public.

Republicans have not pointed out all this manipulation to the voting public.

I believe the public has figured out the manipulation.

Hillary Clinton has promised she will expand Obamacare. Why expand a failed program?

Her unspoken goal is to institute a single party payer system. A single party payer system will also be unsustainable.

There is a better way!

It is a consumer driven healthcare system with my ideal medical saving account.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Bill Clinton Is Crazy As A Fox

Stanley Feld M.D.,FACP, MACE

 Many Republicans and Democrats thought Bill Clinton had lost his mind when he made his Obamacare statement earlier this week.

Most of the conservative traditional and alternative media also thought he lost his mind. They repeated Bill Clinton’s statement over and over again. The media’s goal on both sides of the aisle simply wanted to make sure it sunk into the head of the American people.

Notable & Quotable: Bill Clinton on ObamaCare

Former President Bill Clinton speaking about ObamaCare at a rally Monday in Flint, Mich.:”

 “The people that are getting killed in this deal (Obamacare) are small business people and individuals who make just a little too much to get any of these (Obamacare’s) subsidies.”

 “ Why? Because they’re not organized.”

 “ They don’t have any bargaining power with insurance companies. And they’re getting whacked.”

 “ So you’ve got this crazy (healthcare) system where all of a sudden 25 million more people have health care, and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half.

 It’s the craziest thing in the world.”




Bill Clinton knew exactly what he was doing. Hillary Clinton’s position on Obamacare has been clearly stated. She is for Obamacare and for the public option. She has stated that she is going to expand Obamacare.

Bill Clinton’s position sounds totally opposite his wife’s position.

Hillary Clinton’s website explains her position on healthcare clearly.

She wants to : Defend and expand the Affordable Care Act, which covers 20 million people.

Hillary Clinton stating that 20 million people were covered by Obamacare is untrue. In 2016 the health insurance exchanges only cover 10 million people. Obamacare has expanded Medicaid coverage by 10 million people. Medicaid coverage is less than ideal.

The comments in the WSJ about Bill Clinton’s comments are more entertaining than Bill’s comments about Obamacare.

One comment suggested that Bill Clinton is jealous of his wife.

“This is called a “Bill bomb”, designed to passive aggressively tank Hillary’s campaign so he doesn’t have to go back on the leash.”

“She was lagging in the polls, Bill had nothing, but she is surging again and Bill can’t have that.”

Some of the comments applaud Bill Clinton for finally speaking the truth.

       1.” You gotta love it when Bill sounds like a Republican.”

  1. It is so refreshing to hear a Democrat politician speak the truth. And oh, so rare. Perhaps Bill forgot to take his medication.”
  1. “Give the Democrats credit whenever they do something intelligent, and non-ideological, even if they do it for a confounding reason.”

      4. “Leave it to Bill to hit the nail on the head.  Pure genius.”

      5.”Perhaps there is one Clinton who tells the truth.”

This commentator forgot all of the lies Bill Clinton’s told us (the public) when he was president such as his most famous lie, “I did not have sex with that woman.”

      6.” I don’t know what’s more shocking: Bill slamming Obama’s signature law or a Clinton telling the truth.”

      7.” He must have been off his meds at the time he made the comment, the next day he was back on track. I guess Hillary had to break another lamp over his head.”

I believe Bill Clinton did a brilliant thing for his wife. Obamacare is going to fail. He and Hillary do not want to have anything to do with Obamacare’s failure.

Consumers have discovered that their premiums and deductibles for 2017 are rising to unaffordable level. These increases are because of Obamacare. The private sector has also experienced tremendous increases in premiums and deductible because of Obamacare.

Open enrollment for the health insurance exchanges are supposed to start November 1, 2016, seven days before the Presidential election. If Hillary Clinton does not separate herself from Obamacare it will sink her chances to be elected.

I think the Obama administration will delay open enrollment until after the Presidential election.

President Obama might be able to pull Obamacare’s failure out of the dirt if he is able to illegally obtain theJudgement Fund” money to pay the healthcare insurance industry the money he owes them.

The Republican establishment in congress should make a stink about the release of this money. The Republican establishment should not sell out to President Obama.

President Obama is pulling another illegal fast play on congress and the American taxpayer by getting this money.

President Clinton’s statement is his effort to distance his wife from the Obamacare impending failure.

His statement demonstrates the Clintons’ character. After President Obama and Michelle Obama went all out to endorse Hillary Clinton for President, Bill Clinton stabs President Obama’s legacy legislation in the back.

“Now that the Obamas have given Hillary their full-throated endorsement, Bill can take policy positions more in line with suffering middle class voters. In Clintonworld expedience supersedes truth.” 

Hillary Clinton’s goal is to usurp credit for healthcare reform from President Obama.

She wants to be able to say that healthcare insurance plans do not work.

America needs a single party payer system and it needs it now.

Bill Clinton’s assessment is correct on the issue of Obamacare. All Obamacare is doing is merely shifting costs from those who cannot pay to those who can pay.

It is truly a healthcare system that redistributes wealth as Dr. Don Berwick said a long time ago.

The Clintons want a single party payer system real fast so that they look like they are coming to the rescue of the American people.

Democrats running for congress have rapidly gotten on the Clinton bandwagon.

Clinton’s proposal is simply bait and switch.

The problem is a single party payer system detrimentally affects the middle class taxpayer the most as I have explained.

They are trying to make Obamacare’s failure into an election issue asset for Hillary Clinton who will come to the rescue with her single party payer system.

A single party payer system is unsustainable and has huge defects.

I also know the majority of the middle class does not trust Hillary or Bill Clinton.

The Clintons will not fooled the majority of the middle class again.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Defective Thinking About Single Party Payer Systems

Stanley Feld M.D.,FACP, MACE



In a government controlled single payer health care system the government provides the healthcare coverage for all. The government pays providers for various services at a cost determined by the government.

Advocates of a single party payer system in the United States have publicized that Canada, Britain and the European Countries have successful single party payer systems.

These declarations are untrue.

The definition of success is variable, problematical and questionable. It is successful in the fact that healthcare coverage is universal.

It is problematical in the sense that access to care is difficult. The rationing of medical care has inevitable because of the escalation of costs.

It is questionable as to whether these countries can afford to cover everyone. The National Healthcare System in Britain is falling apart rapidly. Hospitals are closing because of lack of funding. Patients’ waiting lines are increasing, access to care and rationing of care is increasing.

Britain has a robust private healthcare insurance industry for those who can afford to pay. The National Healthcare Systems costs are unsustainable.

In Britain the private healthcare insurance industry is thriving.

In Canada the healthcare system is absorbing 50% of Canada’s GDP.

Canada’s unsustainable healthcare system has resulted in government rationing of care as well as long waiting lines for patients to receive even rudimentary care much less hip or knee replacement.

The United States has three single party healthcare systems: the VA healthcare system, Medicaid and Medicare.

The VA Healthcare System is a treatment and financial disaster. It has evolved into a bureaucratic monster. Employees who do not perform cannot be fired according to government rules. Too many employees have been hired to try to get the job done. The infrastructure is administratively bloated.

The second reason for the VA Healthcare System’s problems is there is no intellectual or financial incentive to do a responsible and better job on the part of employees.

The culture of the VA System is that of a typical government bureaucracy. The federal government throwing more money at the VA System, to help our veterans receive better care, has not improved the system.

Patients are not satisfied with Medicaid because there is limited assess to care. Physicians do not accept Medicaid patients because reimbursement is too low. Medicaid provides an opportunity for the indigent to receive medical care. However the ability to get medical care is limited.

Seniors are satisfied with the care available through Medicare. However, as reimbursement is decreasing and the delivery of care is becoming more bureaucratic, physicians are leaving the Medicare system and demanding cash from seniors for medical care.

There is also an increase in concierge medicine for seniors.

Drugs are increasing in price. Seniors cannot afford their medication. Medicare Part D coverage (Drug Medicare) has become too expensive to afford.

The result is patients are becoming sicker because they cannot afford the prescribed medications. Then they end up in the hospital. The result is an increased cost to the Medicare System. Since deductibles and co-pay are increasing seniors are being bankrupt by the Medicare system.

The advocates of a single party system ignore basic inefficiencies inherent in government controlled bureaucratic systems.

These bureaucratic systems are inefficient and ineffective. They become unsustainable in all the single party payer systems in existence.

The deception sold to the public by progressive politicians is the advantage that medical care is free to all. The simple concept that nothing is free is ignored.

A system must replace these failed systems that provides incentives to consumers for consumers to drive the system.

Below are the claimed advantages to a single party payer system. I have noted the deception in each claim.

  1. Healthcare Coverage is Universal

Everyone has health care coverage to the full extent that his or her health needs require.

People with pre-existing illness cannot be refused medical treatment.”

This should be the goal of any healthcare system.

The problems with healthcare systems in which consumers are entitled almost always get abused. The healthcare system has to be developed where people are responsible for their health and healthcare dollars.

  1. Decrease Amount of Necessary Paperwork

That a single party payer system will “decrease the amount of necessary paperwork” is a fictitious advantage. It will increase the amount of paperwork as has been proven over and over again.

The goal of any government run healthcare system is to measure what the healthcare system is doing so that the government can determine the quality of care delivered on the basis of the information provided. The fact that the information provided could be fudged is immaterial to the documentation.

The delivery of medical care is complex. It is almost impossible to commoditize. In an effort to measure quality of care there are increased regulations and documentation requirements.

The more complex an illness is the more paperwork will be needed to enable evaluation of the quality of care.

The result will be there will be less time, not more time, for the medical staff to spend providing care for the patient.

The belief of single party payer advocates is “providers will have more time to spend with patients.”

Additionally because medical care is free the entitled inevitably overuse the healthcare system making it even less efficient.
“Advocates believe the costs of single payer health care systems will be lower.”

  1. Lower Costs

Progressives think the reasons for “the lower costs is there isn’t any competition, a not for profit structure, and a reduced number of administrative staff.”

“ The high salaries for administrators and sales people are eliminated in a single payer system.”

The costs of government run systems are never lower. The costs to patients are lower because it is free. The costs to the healthcare system are higher because there is no incentive to be competitive.

The government will have to outsource the administrative services to the healthcare industry. The healthcare industry will make the money even as they do now.

Obamacare’s administrative costs were supposed to be lower. The administration is in panic mode because of its high costs and impending failure.

A small part of the failure is the result of healthcare insurance companies non-participation in the health insurance exchanges and the failure of government set up Co-Op Insurance funds.

President Obama paid only 12% of what the healthcare insurance companies claim they are owed to cover their loses through the crazy reinsurance program the government promised the healthcare insurance industry.

President Obama, through the Justice Department is going to raid the Treasury’s Judgment Fund” to pay the insurance industry what they were promised in the reinsurance program.

It is essential for the survival of Obamacare that the healthcare insurance industries participate in Obamacare’s health insurance exchanges. Justice and the Treasury are ignoring the appropriation power of the congress.

This happens to be against the law.

In a 1998 letter the Government Accountability office pointed out that the Judgment Fund “is not a tool to circumvent congressional restrictions on appropriations.”

This is precisely what President Obama is doing.

The Administration will do anything to rescue its flailing Affordable Care Act, and nothing so meager as the law will interfere. This damage to the separation of powers, not a health-care bill, will be President Obama’s abiding legacy.”

The problem is congress will letter President Obama get away with doing this.

  1. No Insurance Companies Needed

The notion that the healthcare insurance industry is not needed for administrative services is a deception that progressive politicians continue to state falsely.

  1. Only One Buyer Required

“Only one buyer (the government) is required” is partially true and false. In the military the cost of drugs are cheaper than either the cost of drugs for government employees with Medicare Part C or seniors with Medicare Part D. The government is restricted from negotiating prices for drugs. The middlemen infrastructure for purchasing drug will remain.

I believe Americans are becoming more and more cynical about big government’s intentions and efficiencies. They want a change for good reason.

The following the ideas of progressives is not working. It is destroying the healthcare system.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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What Exactly Is A Public Option?

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Public Option: Another Catch 22

Stanley Feld M.D.,FACP,MACE

Obamacare is in crisis. The public does not realize it because the media is keeping the impending disaster out of the public’s view.

The Obama administration and media is also shielding the public from the past history of Obamacare and its failures at each step.

At this moment, the Obama administration, the traditional mass media and Hillary Clinton think the magic bullet to save Obamacare is a “Public Option.”

All progressives are obsessed with the idea that a single party payer system will magically convert Obamacare into an affordable healthcare system. They also think the Public Option is a direct route to a single party payer system.


It is unfortunate that the progressives’ base believes a single party payer system is the answer to our dysfunction healthcare system despite the failures experienced in Vermont, New Hampshire, Canada and England.

My wife and I were touring the Canadian Rockies a few weeks ago with a tour group.

I got into a discussion with a couple of lawyers on the tour about the healthcare system.

I told them Canada spends 50% of its GNP on healthcare. All of the provinces are experiencing massive deficits.

Canadians who are healthy and do not need to interact with the system are happy and feel secure that their healthcare needs will be serviced without cost. Nothing is free.

Canadians who need the healthcare system are unhappy. They experience long waits and poor service.

The lawyers’ immediate reaction was healthcare consuming 50% of Canada’s gross national product was impossible.

The United States consumes only 18.5% of our GDP on healthcare.

They checked their IPhones. Their iPhones said Canada only spends 11.4% of their GNP on healthcare. They clearly did not believe me.

I told them to read my blog and the Frazer Report.

The Washington Post published: in 2009, Canada spent 11.4 percent of its Gross Domestic Product on health care, which puts it on the slightly higher end of OECD countries:

This is not true according to the Fraser report.

 “Six of ten Canadian provinces are on track to spend half of their revenues on health care, according to the Frazer Institute. To be specific, 

By 2017, four more provinces — Saskatchewan, Alberta, British Columbia and New Brunswick — will spend half of their revenues on health care, according to the institute.”

I decided to reinvestigate the discrepancy between the two numbers when I got home.

Why would the Washington Post publish one number (11.4 percent of its Gross Domestic Product on healthcare) and the Fraser Report publish a 50% number?

In 2012, I figured the Washington Post just got it wrong. The reporter probably copied a number from some report that did not include all the funding for healthcare.

The Fraser Report added up all of contributions various Canadian agencies made to the government funding of the Canadian single party payer healthcare system.

The August 2016 Fraser Report made the discrepancy clear between the 11.4% and 50% number.

“Canadians often misunderstand the true cost of our public health care system.”

 “This occurs partly because Canadians do not incur direct expenses for their use of health care, and partly because Canadians cannot readily determine the value of their contribution to public health care insurance.”

The August 2016 Fraser Research Bulletin explains the discrepancy. It starts off by saying;

Health care in Canada is not “free.” While Canadians may not be billed directly when they use medical services, they pay a substantial amount of money for health care through the country’s tax system. Unfortunately, the size of these tax payments is hard to determine because there is no “dedicated” health insurance tax.

“As a result, individuals and families often cannot fully appreciate the true cost they pay towards the public health care system.”

The Canadian Government has figured out how to hide the true cost of healthcare from the press and the public.

The Obama administration is also hiding many costs from the American public as the insurance premiums are skyrocketing.

The purpose of this research bulletin is to help individuals Canadians and their families better understand how much healthcare actuallt dosts them personally so they can determine whether they are receiving good value for their tax dollars.”

 The problem is the Canadian public is only interested in what their individual healthcare coverage insurance costs.

Their coverage is “free” at the point of service. Free is good but nothing is free. Their complaint is the difficulty with access to care and the time it takes to get care.

Canadians are not thinking about the total healthcare costs to society. Canadians are not thinking about the source of revenue for that cost.

In Canada general revenue taxes are increased gradually.

Somehow these increases are not recognized.

Yet, people earning $48,456 a year have a tax rate of 43.1% and pay $11,439 dollars for healthcare coverage.

The healthcare coverage comes off the top of the tax bill similar to our social security payment pays for our Medicare Part B insurance.

Someone making $281,359 pays $158,255 in taxes or q tax rate of 56% of which $37,361 is paid for healthcare insurance coverage.

When people speak of “free” healthcare in Canada, they are entirely ignoring the substantial taxpayer-funded cost of the system.

The healthcare insurance premiums paid by Canadians only covers a fraction of the costs of the Canadian Healthcare System.

Some Canadians might assume that in those provinces that assess them, health care premiums cover the cost of health care.

 “However, the reality is that these premiums cover just a fraction of the cost of health care and are paid into general revenues from which health care is funded.”

 This is precisely what President Obama is doing with our healthcare system. The true cost is totally opaque.

In the U.S. it is impossible to figure out from which taxpayer fund President Obama take the revenue for the $2.5 billion dollar loans lost for the failed Co-Ops experiment, the $650 million dollar website fiasco, or the insurance subsides for 85% o the consumers who signed up for Obamacare.

 Congress is not helping us find out where the money is coming from either.

Indeed, Canadians cannot easily work out precisely what they pay to government each year for health care because there are many different sources of government revenues that may contribute to funding health care, including income taxes, Employment Insurance (EI) and Canada Pension

Plan (CPP) premiums, property taxes, profit taxes, sales taxes, taxes on the consumption of alcohol and tobacco, and import duties, among


 President Obama is not telling the American public the truth about the cost of Obamacare with its tiny participation.

If Americans knew where all the money is coming from they would demand immediate real of Obamacare.

There is a growing mistrust for our elected officials. The increase in public awareness is a result of the spread of social media and Internet communication.

It is difficult for the Obama administration and media to hide thing from the American people anymore. The catch is Americans have to more pay attention.

An excellent example is Hillary Clinton’s cancellation of a noon fund raising event is North Carolina. The cancellation was announced at 9 a.m. It went viral on the Internet at 10 a.m.

The cancellations aroused suspicion that Hillary was sick again, especially when her campaign announced that it had not comment.

Five hours later it announce that she had to cancel her events for the week to study for the debate.

With the many lies Americans have experienced from President Obama from Obamacare to the Iran Nuclear Treaty and Hillary from her emails and the Clinton Foundation, Americans are starting to become aware of their need to pay more attention to the day’s events and not rely on elected surrogates to look after us.

Healthcare, taxes, our economic growth and personal safety are important issues to most Americans. Many Americans are wondering if we can trust our surrogates.

Americans are starting to demand the truth.

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Donald Trump on Healthcare Reform

Stanley Feld M.D. FACP, MACE

Donald Trump’s healthcare proposals are totally different from Hillary Clinton’s. His proposals are a step in the right direction to Repair the Healthcare System.

His advisors tried to create a market based healthcare system. However, they have omitted the most important elements necessary to align all the stakeholders’ incentives.

Unfortunately, their approach is the usual healthcare policy wonks market based policy approach. They do not focus on the most important stakeholder in the healthcare system.

The consumer is the most important stakeholder in the healthcare system. The consumer should be the driver of the healthcare system.

A market based system should:

  1. Promote of consumer driven healthcare system.
  2. Promote consumers’ responsibility for their health and healthcare dollars.
  3. Promote the physician/patient relationships.
  4. Promote a respect for consumers’ intelligence. Consumers can judge what is best for their healthcare needs.
  5. Promotion of accurate education about a consumers’ disease and provide resources to help consumers make the best choices to treat their diseases and use their and healthcare dollars.

Donald Trump’s web site starts by pointing out the defects in Obamacare. The Obama administration and Hillary Clinton’s spin machine uses the traditional media to promote the erroneous concept that all that is needed to fix Obamacare’s small defects are small modifications and more money.

This is a wild fantasy. The real goal is to completely control the healthcare system.

Donald Trump’s web site starts by declaring that Obamacare must be repealed.

Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—(Obamacare.”

The average Americans are starting to understand Obamacare economic burden on the economy in general and them individually

“ The Affordable Care Act, (Obamacare), legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history must be repealed.”

President Obama and majorities in the House and Senate tightly controlled the debate in congress and the traditional media.

Nancy Pelosi said it all when she said “you will not know what is in Obamacare until it has passed.”

“Obamacare has tragically but predictably resulted in runaway costs.”

The runaway costs for the government and individuals were the result of:

“Websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices.”

Obamacare has raised the economic uncertainty of every single person residing in this country.”

This has resulted from the 10 hidden taxes, along the inhibiting effect on the economy and the uncertainty of the potential mandates, that resulted in and from job losses.

As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry.”

Donald Trump concludes that Obamacare cannot be fixed. It must be repealed.

“But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.”

Donald Trump recognizes that simply repealing Obamacare will not fix the healthcare system.

He also recognizes that he must work with Congress to have a series of reforms ready for implementation.

“We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country.”

It is refreshing to know that a potential president is willing to work with congress rather than issue executive orders and see if he can get away with them.

“By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.

Any reform effort must begin with Congress.”

Donald Trump says;

Several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.

This is the correct process according to the constitution.

It is imperative that Republicans maintain their majorities in the House and Senate in order for Donald Trump to lead legislation to repeal and replace Obamacare.

The following are the suggestions a Trump administration will offer the congress according to his website.

  1. Completely repeal Obamacare.                                                         
  2.  Our elected representatives must eliminate the individual mandate (tax according to the Supreme Court). No person should be required to buy insurance unless he or she wants to.
  3. Modify existing law that inhibits the sale of health insurance across state lines.

Donald Trump assumes eliminating state line restrictions will allow full competition in the healthcare insurance market place. He assumes insurance premium costs will go down and consumer satisfaction will go up. The healthcare insurance companies will try to keep the insurance premiums equally high in all states.

It can only work if consumers can buy insurance they believe they need. Costs of unnecessary insurance should not be piled into one insurance plan fits all. i.e. A post menopausal woman does not need to pay a birth control premium.

4. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system.

Individuals should be allowed to take the same tax deductions as group insurance plans are allowed.

     5. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.

This is where Donald Trump’s proposal weakens. The Medicaid program must be modified. Medicaid recipients should be incorporated into my ideal Medical Saving Account program. The government should act as the funding agent for the eligible poor.

This will put the poor on the same payment footing as everyone else.

The Medicaid eligible poor should be given financial incentives to take charge of their health and healthcare dollars.

Our healthcare system must be moved from a system that fixes you when you are sick or broken into a system that rewards people financially for remaining healthy and controlling their healthcare spending.

It is much cheaper to avoid the cost of emergency care than it is to get sick and have to go to the emergency room.

         6. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate.

Health Savings Accounts (HSAs) should be changed to Medical Savings Accounts (MSAs) to provide better financial incentives for people who choose this form of insurance. The Medical Savings Accounts can easily be customized so that consumers can choose the level of insurance they desire.

The contribution to the MSA can be flexible to provide adequate amounts of money to be put into the savings accounts to incentivize consumers to remain healthy.

Obesity is a huge program that must be consumer driven. Obesity must be cure by the patient and his family, not surgery.

Obese children are becoming diabetic and also hypertensive at a young age. This must be stopped because of the potential explosive effect of complications of both diabetes and hypertension on individual and overall costs of medical care.

      7. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals.

Price transparency is an essential provision for individuals, businesses and groups. It provides leverage for consumers to be responsible for their healthcare dollars. It is also necessary to require insurance companies to provide verifiable price transparency for their administrative costs and their direct patient care costs

Consumers must be empowered to be responsible and shop for the most value and best prices for procedures, exams or any other medical related procedure.

This is the way to decrease the cost of healthcare services and medical care services.

Social networking should be used as the backbone for the establishment of consumer empowerment.

The success of Angie’s list, Trip Advisor and Open Table are a result of social networking. Local communities have their individual social networks that empower people in their neighborhood to know which vendors provide the best value in their community.

This simple step can be used to decrease the cost of healthcare and medical care.

This could be a place where government can lead the way in establishing this accurate educational resources.

       8. Block-grant Medicaid to the states.

These block grants can be used by the states to fund MSAs without a threat of increasing state budget deficits or giving states rights to the control of the federal government.

Block grants for social networking should be used to provide incentives to help individuals to seek out and eliminate fraud, waste and abuse of some of its local providers. It would eliminate expensive big data collections that many times are inaccurate in decision making by central federal control.

       9. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products.

Federal and state governments should help its citizen choose safe, reliable and cheaper products for the treatment of their diseases.

It would help with compliance and adherence to recommended treatment and decrease the cost of care.

It would promote consumers taking responsibility for their own health and healthcare dollars.

     10.  Congressss will need the courage to step away from the special interests and do what is right for America.

One example is allowing consumers access to imported, safe and dependable drugs from overseas. It will provide more options to consumers. This is only one example of many that ways to decrease the cost of drugs in this country.

Donald Trump is proposing a lot of important changes.

However, he is missing the important element of consumer power, consumer initiative, and consumer incentives.

His healthcare changes must include a consumer driven system with an ideal medical saving account otherwise the healthcare system will remain an unmanageable, expensive and abused mess.

Donald Trump admits this is simply a start. His start is much more powerful than Hillary Clinton’s proposal to continue and build on Obamacare.

Obamacare has been a disaster that is unsustainable. It is weekly increasing the cost of care while rationing care and decreasing access to care.


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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Hillary Clinton On Healthcare Reform

Stanley Feld M.D.,FACP, MACE

The next two blogs will review the published position on healthcare of Hillary Clinton and Donald Trump.

Obamacare has not been a big issue in the presidential campaign yet. It will become a big issue in mid October when the new premium schedules will leak to the press and by the November 1 publication of premium date healthcare will be a full-blown campaign issue.

Obamacare is on the verge of failure. Democrats are starting to talk up a Public Option as the Obamacare salvation. The Public Option is not going to save Obamacare.

The healthcare Co-Ops were supposed to provide a competitive force for the healthcare insurance companies to keep down the premium costs. However, 17 out of 22 have failed. The other five will fail before the end of the year.

The Public Option is a federally controlled competitive force. However, because of healthcare insurance companies distrust for the Democrats and Obamacare few insurance companies will show up to compete.

The presidential campaign has been such a circus that our attention has been diverted from healthcare.

The failure will be noticed when the new premiums are published on November 1, 2016, five days before we go the polls.

This late date has been set deliberately by the Obama administration in order not to give Americans enough time to respond with anger toward Democrats and the potentially new Hillary Clinton administration and vote her down.

Hillary Clinton’s website’s first sentence in her preamble on healthcare says it all.

“As your president, I want to build on the progress we’ve made with Obamacare.

She will build on Obamacare. Obamacare is a failure by all measures once we see through President Obama, Paul Krugman, and Ezekeil Emanuel’s lies. Why would anyone want to build on that failure?

Hillary supports President Obama’s call for a near tripling of the size of the National Health Service Corps. It will also triple the cost with not evidence that it will be successful.

“ I’ll do more to bring down health care costs for families, ease burdens on small businesses, and make sure consumers have the choices they deserve.”

 It sounds like President Obama’s empty promise.

  1. If you like your doctor you can keep your doctor.
  2. If you like your insurance company you can keep your insurance company.
  3. If you make less than $250,000 dollars a year you will not pay one red cent more in taxes.

 “And frankly, it is finally time for us to deal with the skyrocketing out-of-pocket health costs, and particularly runaway prescription drug prices.”

This statement is important but is minor compared to what needs to be done.

The main body of Hillary Clinton’s position paper says the same thing. It does not give any details on how she will accomplish any of her promises.

Her campaign and the traditional media led by the New York Times have attacked every one of Donald Trump’s proposals because they claim he does not spell out how he would accomplish them.

Below are her website healthcare policies.

Defend and expand the Affordable Care Act, which covers 20 million people.

 In 2016, Obamacare’s Health Insurance Exchanges insure only ten million people.

Most of those 10 million have a pre-existing illness. These people could not buy healthcare insurance on the private market. Eighty-five percent of those people receive government supplements. There has been no increase in Obamacare enrollment since 2014. There has been a lot of lying about enrollment yearly.

It would be less expensive if a system of care were developed to provide these people with medical care without the bloated bureaucracy and falsely promised insurance benefits.

The expansion of Medicaid eligibility decreased the uninsured an additional 10 million. With Hillary Clinton’s plan to increase Syrian immigration to 500,000 a year and provide them with Medicaid the failure of Medicaid will be accelerated.

Medicaid is another failed government program. Medicaid patients have difficulty finding a physician and have decreased access for medical care.

Bring down out-of-pocket costs like copays and deductibles.

Hillary Clinton offers no plan on how she is going to accomplish this.

Reduce the cost of prescription drugs.

Again, there is no explanation for how she is going to reduce these high costs.

Protect consumers from unjustified prescription drug price increases from companies that market long-standing, life-saving treatments and face little or no competition.

Promises, promises, promises with no explanation of a plan. It sounds great but there is no plan explaining fulfillment.

Fight for health insurance for the lowest-income Americans in every state by incentivizing states to expand Medicaid—and make enrollment through Medicaid and the Affordable Care Act easier.

President Obama and his administration have told us over and over again that it is easy to enroll in Medicaid and Obamacare. The Obama administration even pays enrollment navigators $48 an hour.

Expand access to affordable health care to families regardless of immigration status.

Hillary Clinton clearly has no regard for cost. She also wants to expand the immigration of Syrians to 500,000 per year. When this happens the cost of Medicaid will explode.

The federal government will eventually try to dump those costs on the states. Most states have budget deficits that have to be cured now.

Taxpayers will be forced to endure both federal and state tax increases for a failed federal program.

President Obama’s original promise is that the Affordable Care Act (Obamacare) will be budget neutral.

Expand access to rural Americans, who often have difficulty finding quality, affordable health care.

Hillary Clinton pledges to explore cost-effective ways to make more health care providers eligible for telemedicine reimbursement under Medicare and other programs.

Please notice she is only exploring the possibility of telemedicine reimbursement. Americans have heard empty promises before.

Defend access to reproductive health care. 

Hillary will work to ensure that all women have access to preventive care, affordable contraception, and safe and legal abortion. This is not a promise. How she will accomplish this goal is not outlined.

Double funding for community health centers, and supports the healthcare workforce: 

This is an initiative that is part of Hillary Clinton’s comprehensive healthcare agenda.

She is going to double present funding for primary-care services at community health centers over the next decade.

This is another ideological plan whose effectiveness has not been proven.

The goal of community healthcare centers is to provide low-level care for illness. It does not promote a patient/physician relationship or patient responsibility. It does not provide patient choice.

It is another step to commoditize medical care.

There you have it. Hillary Clinton’s healthcare policy as described on her website.

It is an extension of President Obama’s failed healthcare policy of the last 7 years. There is no mention of patients or their responsibility for their health or healthcare.

None of these proposals will lower the price of healthcare or increase the quality of care.

Hillary Clinton’s proposals will increase spending on a failed program (Obamacare) that has increased America’s deficit.

Hillary Clinton believes: Together these steps will get us closer to the day when everyone in America has access to quality, affordable health care.”

I believe Hillary Clinton does not know what she is talking about. I know the American people are seeing what is happening to our healthcare system.

If you want more of Obamacare with its tremendous costs to individuals and the American people along with the lack of improvement in medical care vote for Hillary Clinton.

Hillary Clinton is a tax and spend progressive democrat who does not think about what consumers need. Her attitude is that consumers are not smart enough to choose.

She believes that the federal government knows best.

There is nothing in her healthcare plan to Repair the Healthcare System.

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

All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE


The Deception and Disinformation Continues

Stanley Feld M.D.,FACP,MACE

When Co-Op Health Insurers close, what happens to customers’ all ready paid in deductibles?

The new insurer will not credit the already paid deductibles in 2016. Consumers will have to start all over again with new deductibles. This is despite President Obama’s implied promise that consumers will get credit for the deductibles paid.  

President Obama’s goal was to make Obamacare as complicated as possible so no one could understand it.

I believe neither he nor his administration understand all the interwoven parts and the unintended consequences.

Obamacare was built to fail.

Obamacare was built so that whatever part of the component policy failed, that policy would ultimately default to a single party payer system. The original goal was to have complete government control of the healthcare system.

The federal government would control choice and restrict access to medical care.

Americans’ free choice would be disappear.

Obamacare’s healthcare exchanges have only been attractive to people who could not obtain healthcare insurance because they had pre-existing illnesses.

That was a good thing. However, premiums were too high for the healthy uninsured.

The healthy uninsured would pay for the consumers with preexisting illnesses and spread the risk. The thought was that it would lower the cost of insurance.

The Obama administration lent $2.5 billion dollars to only 22 states that opted to set up Co-Ops to compete with the healthcare care insurance companies offering insurance through the health insurance exchange in those states.

These Co-Ops were destined to fail. The Obama administration’s plan was to low ball the insurance premiums and force the healthcare insurance companies to compete and lower their premiums.

President Obama’s reinsurance program to subsidize and protect insurers from loss fell apart because of budget restraints that he signed into law.

High-risk people with pre-existing illnesses flocked to sign up for the Co-Op’s healthcare insurance. The Co-Op insurance plans were poorly advertised and constructed. Few healthy people bought the plans.

We are constantly told how many people lost their insurance and their deductible.

In reality the Co-Ops was the “public option” without the approval of congress.

So far, seventeen of the twenty-two have declared bankruptcy so far. The remaining five Co-Ops are on the way. The federal government will never get paid back for the $2.5 billion dollars in loans.

Illinois’ Co-Op “ Land of Lincoln” declared bankruptcy and closed out over 49,000 patrons. The have to get new insurance to cover them for October, November and December.

A large insurer (Blue Cross and Blue Shield of Illinois) on the Illinois’ Obamacare exchange has decided not to credit former Land of Lincoln members for money they’ve already paid toward their deductibles despite a request from the state to consider doing so.”

“They will likely have to start from zero again on their deductibles and out-of-pocket max payments — in some cases costing them thousands of additional dollars.”

The other large insurers have not commented yet. President Obama has not come through with his promise to cover these deductibles.

President Obama and his press secretary deny Obamacare is in trouble. The casual observer who reads are Paul Krugman’s articles in the New York Times and believes he personally has adequate healthcare insurance would also believe the lie.

Paul Krugman is President Obama and Hillary Clinton’s hatchet man. When something goes wrong in any area of the economy Mr. Krugman blames it on the Republicans without evidence or data.

The New York Times and his readers believe him without critically evaluating his statements.

Paul Krugman: “Most of the news about health reform has been good, defying the dire predictions of right-wing doomsayers.”

 This is lie. He has no positive evidence for this statement except that Obamacare has added 10 million people to the Medicaid program.

This could have been accomplished without Obamacare by simply raising the definition of poverty from its obsolete 1955 level.

Paul Krugman :“But this week has brought some genuine bad news: The giant insurer Aetna announced that it would be pulling out of many of the “exchanges,” the special insurance markets the law established.”

 Others have pulled out in addition to Aetna.

UnitedHealth, Cigna, Blue Cross and Blue Shield and other smaller insurance companies such as Baylor/ Scott and White have pulled out because they have lost huge amounts of money. Their losses are unsustainable for their business.

Seventeen of the 22 federally funded Co-Ops have gone bankrupt and closed down. They were supposed to create competition like the public option to keep premium prices and deductibles down.

Paul Krugman says: “This doesn’t mean that the reform is about to collapse.”

What does it mean? He does not say.

Then he goes on to attack the Republican Party and Donald Trump.

“They’re problems that would be relatively easy to fix in a normal political system, one in which parties can compromise to make government work.

Maybe the Republicans cannot compromise because Obamacare was so poorly conceived and constructed.

Obamacare has been a waste of government money and taxpayers’ money. It is destroying the delivery of medical care. I would call this a failure.

Maybe the Republicans are correct in opposing a law that is increasing the federal deficit while claiming is that it is budget neutral.

It is unbelievable that Hillary Clinton wants to expand Obamacare. Isn’t it because Obamacare is failing and unsustainable?

Then Mr. Krugman goes on to take an inappropriate swing at Donald Trump.

“But they (the problems) won’t get resolved if we elect a clueless president (although he’d turn to terrific people, the best people, for advice, believe me. Not.).”

Paul Krugman then goes on to tell lie after lie about the success of Obamacare and how unfairly Republicans view Obamacare.

“Paul Krugman says:” The economy of race prevents Medicare and Obamacare expansion.”

“White voters “don’t like the idea of helping neighbors who don’t look like them”

“New York Times columnist Paul Krugman argued Monday that the opposition of red states like Texas to accepting federal money to fund Medicaid expansion isn’t based, as claimed, on a commitment to smaller government and the superiority of the free market so much as it is the politics of race, and who would receive those funds.

Medicaid expansion, Krugman noted, disproportionately benefits nonwhite Americas, and voters in red states — particular the white ones — “don’t like the idea of helping neighbors who don’t look like them.

Paul Krugman is an economics professor. Can’t he figure out that the system has failed economically? American needs a better system with responsible consumers driving the system.

Who is stimulating race wars without facts or evidence?

Paul Krugman is stimulating race wars with unfounded statement like this in order to defend Obamacare and President Obama’s legislation. Legislation that has failed.

Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law.”

Higher than expected costs have led UnitedHealth, Aetna, Humana and many smaller companies such as Baylor/Scott and White to pull out of Obamacare’s federal health insurance plan.

With the demise of the state Co-Ops the competition is even slimmer.

“The Kaiser Family Foundation, in a study commissioned by the Wall Street Journal, estimates that 19% of Obamacare enrollees seeking coverage in 2017 will be in a market with just one insurer, up from just 2% in 2016. Another 19% will have access to just two carriers, up from 12%.

Forty percent of 10 million people is 4 million people who are going to be affected by a decrease in competition. The total enrollment in Obamacare has been stagnant the last 3 years.”

We must repeal this debacle called Obamacare and start a new system that could work. A consumer driven healthcare system for all as described in my article “My Ideal Medical Saving Account is Democratic.”

It includes everyone. It provides financial incentives to everyone to be responsible for their own health and healthcare dollars.

“What do we have to lose?”

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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