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Jerry The Diabetic Teddy Bear

Stanley Feld M.D.,FACP, MACE

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Last week two young entrepreneurs showed me a fascinating way to teach children age 3 to 8 with Type 1 Diabetes Mellitus how to take care of their disease.

The onset of Type 1 Diabetes Mellitus in young children is devastating for their parents. Many parents blame themselves for the child’s disease. The child is usually frightened and angry about having to take shots. They are also angry about the food restrictions and the fact that they are different from their friends. Often they become rebellious and try to avoid the shots or do not comply with the rules of food intake.   

Everyone has seen a 5 year old mesmerized by Leapster, an educational computer game. Children feel compelled to master Leapster. It keeps their attention for hours.  

Two recent college graduates Aaron Horowitz and Hannah Chung designed and are now marketing Jerry The Bear.

 

 

http://youtu.be/GptPWHLhiZo

They participated in a wonderful program called Design for America program at Northwestern University while in college.

"Without believing in our ability to develop and implement innovative solutions that can address the world’s challenges, we will not even act.

We can’t innovate if we don’t believe that we can. We must work together with those from all different backgrounds and perspectives, we must work with our community, and we must support each other in our efforts improve the world around us.

Design for America’s vision is a world where people believe in their ability to innovate and tackle the most ill-structured challenges of our time.  

Design for America teaches human centered design to young adults and collaborating community partners through extra-curricular, university based, student led design studios to look locally, create fervently and act fearlessly. DFA currently tackles national challenges in Education, Health, Economy and Environment."

 

http://youtu.be/tYppYU6XV5o

Aaron and Hannah produced Jerry the Diabetic Teddy Bear. After graduating college this year they applied and were accepted to a TechStars affiliated accelerator program in Rhode Island Beta Springs to further develop Jerry.

Jerry the Diabetic Teddy Bear is a fantastic teaching tool for young children. Young kids love their Teddy Bears. Jerry helps kids with Type 1 Diabetes adjust to their new lifestyle. By playing with Jerry children will learn to master their medical procedures.

Diabetic children will transfer the anger they feel at the onset of Type 1 Diabetes into an intense responsibility for taking care of their Jerry the Diabetic Bear.

The child with Type 1 Diabetes learns how to vary insulin doses and food intake through a computer chip algorithm game. The game teaches how to determine insulin dosage and food intake in order to keep Jerry the Diabetic Bear’s blood sugar as close to normal as possible.

In turn the child learns how to take care of his own Diabetes.  The child learns to be responsible for Jerry’s care and in turn his/her own care in order to remain healthy. Education must be made entertaining and purposeful. Jerry the Diabetic Teddy Bear is an effective educational vehicle that is simple and purposeful.

There is no reason that innovative teaching applications like Jerry the Diabetic Teddy Bear could not be produced for children with other chronic diseases such as asthma.

Design for America promotes the innovative thinking in young college students. It expands imaginative thinking in order to create new and effective products.

Rather than whine about the obesity epidemic in America we should be teaching children through entertaining and purposeful innovative educational ways to learn about food values, exercise and obesity.

This type of education should be universal if we are going to educate our population about the prevention and care of chronic disease.

This is a powerful way to reduce healthcare costs.

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

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Social Networks, Patient Education And The Healthcare System

Stanley Feld M.D., FACP, MACE

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WATCHING THE YOU TUBES ARE IMPORTANT TO YOUR UNDERSTANDING THE POINT OF THIS BLOG.

The value of social networking has been partially understood by society. To me social networking’s potential for improving the quality of medical care has been poorly understood. Social networking can be a valuable educational tool in medical care.

I have always believed that if patients have a better understanding of their disease, they can better understand the reasons for their treatment. The result will be a better treatment outcome. This understanding will increase adherence to treatment. Adherence to recommended treatment nationally is about 50% for most chronic diseases. 

One of the spokes in the business model wheel for the ideal future healthcare system state emphasizes development of social networks within medical practices.

Social networks can act as physician extenders to increase physicians’ ability to teach patients to be a “Professor of Their Disease.” Physicians can increase the quality of care they deliver by creating social networks within their practice. Patients can create a nickname so as to be anonymous to the social network. The physicians would be aware of the nickname.

Slide21

Social networking is another name for participating in a community. Most people participate in multiple communities. Some join communities for social reasons, others for educational reasons, and still others for economic reasons.

Human are social beings. They enjoy interrelating with others.  

There are hundreds of communities on-line. These communities encompass many of the subcultures in our society.

For example, I have joined the on-line TED, Sermo, and Medscape communities to name a few to satisfy my need for continuing life long learning.

Some patients go on-line to find out about their disease. They either did not hear or did not understand their physician’s explanation of their disease.

Some explanations are very complicated. Some are not in agreement with the physician’s explanation. Some physicians do not explain diseases well.

The lack of understanding about their disease could have been because patients were too anxious about their disease to hear or understand the explanation for a particular treatment. A patient could believe the explanation was gibberish.

A great illustration of gibberish is the following explanation of the Turbo Encabulator. Try to understand the following explanation of the Turbo Encabulator.

  

http://youtu.be/MXW0bx_Ooq4

This is pure gibberish. A person can understand all the words if he concentrated but the string of words has no meaning.   Patients need to be able to hear explanations that answer their specific questions over and over again. Disease processes and the effects of treatment can be complicated.

All complicated issues can be explained simply. Complexity is the result of combining multiple simple effects.  The complicated issues can be explained by dissecting these effects to their core.

The trick is to develop the right teaching materials. The following is an example of what I mean by developing the right teaching material.

The main stream media and many people have interpreted Paul Ryan’s claim that President Obama has double counted the $500 billion dollar saving by which the President claims he is reducing the deficit with his healthcare reform act.

Everyone has heard the Carl Sandberg’s statement, “If you tell a lie enough times it becomes the truth.”

If Representative Ryan demonstrated the double counting in plain English as the following animated cartoon does, 100% of people would understand why Paul Ryan is correct in making that claim. It is arithmetic explained simply.

  

 

http://youtu.be/q8x20P4RpgQ

A more complicated subject can be made simple as the following animation, “Changing Education Paradigms” shows

The animation technique is entertaining. It holds the viewer’s attention. It is a powerful teaching tool. This tool can be developed for all chronic and acute diseases. It could be used as a teaching tool in social networks within a physician’s practice. It would be available 24/7.

  

http://youtu.be/zDZFcDGpL4U

 It the government wanted to create an efficient healthcare system it should help physicians set up social networks and develop animated cartoons for chronic disease management.

Physicians could choose web sites of their choice to educate their patients. These social networks could be set up so patients could interact with other patients in their physicians’ practices.

Patients could learn from each other about their treatment successes and failures. The social networks could be broken into subgroups such as diabetes, asthma, heart disease and others.

The social network could be an effective extension of the physician’s care with interactions supervised by the patient’s own physician. A modest reimbursement for the physician’s time should be provided.

Physicians should set up social networks with other physicians in their community to discuss interesting cases. This was the original purpose of hospital grand rounds and other teaching rounds.  This community activity is disappearing as physicians are seeing more patients and cannot break away to get to the conferences. The national online communities are good but a local online community is better.

All medicine is local and medical education should be local to have its greatest impact.

Social networking in medicine is all about educating patients in the care of their disease. Patients are the only ones who can control the course of their disease and its outcome. Physicians have to provide patients with the learning platform and supervise the treatment.

 

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

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    Canada’s Medicare system is a universal single-payer system that covers about 70% of the country’s health care expenses. The Canada Health Act requires that all insured are fully insured for hospitalization and basic health care. About 91% of hospital costs and 99% of physician services are financed by the public sector.

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America Is An Innovative And Exciting Nation

Stanley Feld M.D.,FACP,MACE

I had several wonderful intellectual experiences last weekend. These experiences served to confirm my thinking that intelligent Americans are less interested in politics, rhetoric and empty promises and more interested in innovative solutions to all the ills that our bureaucratic political processes have brought upon us.

Todd Siler, Phd

My first stop was a visit with Todd Siler, Phd. Todd is a famous American multimedia artist, author, educator, and inventor. He is equally well known for his art and for his work in creativity research.

Todd’s analytic skills and creativity are uncanny.

The following quote is from one of his web sites,

 In 1890, the psychologist and philosopher, William James, described “Cerebralists” as “those who combine the sensual and spiritual, the physical and intellectual” in their creations. “

Clearly, we’ve lost sight of the broader meaning and reality of this practice. 

Cerebralism encompasses all forms and expressions of art. Through art, we can connect and transform everything (information, knowledge, ideas, experiences), to create new meanings and purposes for everything. Art makes life meaningful. It inspires wonder, while challenging the limits of our vision and imagination."

Please click on to Todd’s imaginative art. http://www.toddsilerart.com/index.html

In our rapidly changing world, where it seems, to many, confusing and scary Todd’s message is brilliant and enlightening. His course “Think Like A Genius” is enabling. It enables people to think expansively through art and science to develop strategies and actions that are innovative. He promotes mutual respect, trust and love.

One of Todd’s trademark symbols is;

  Todd siler png

It would serve everyone well to “Think Like a Genius” rather than think selfishly and try to take advantage of others.

http://www.thinklikeagenius.com/

 

My wife and I met Todd three years ago through an introduction from my son Brad (both MIT graduates). Since then Todd and I have been in constant communication via Skype. Last week was special.

Thanks, Todd.

Nextera Healthcare

My next visit was to Nextera Healthcare. Nextera Healthcare is a new model for delivering healthcare. It follows many of the principles embodied in my ideal medical savings account model.  It delivers compassionate care at an affordable cost.

Nextera Healthcare combines the compassionate practice of medicine with advanced information technology. My impression is that the founders have fire in their belly for delivering the best medical care for their patients.

I will explain more about Nextera Healthcare in the near future.  

The reason I am so high on Nextera Healthcare is that it closely fits a model of healthcare delivery that I believe will work. It will increase the quality of medical care and decrease the cost of healthcare. 

Nextera Healthcare has the potential to permit the patient to be responsible for managing their health and their healthcare dollars.

Nextera Healthcare has the potential to reduce healthcare cost to individuals, employer sponsored self insured plans, associations and even the government while permitting consumers to make their own healthcare decisions.

http://www.nexterahealthcare.com/

TechStars

Next I stopped in at the TechStars fancy new dungeon. TechStars was co-founded by my son Brad Feld and David Cohen in Boulder, Colorado in 2007. It has been a very successful start up accelerator.

TechStars has expanded to Boston, New York, Seattle, and San Antonio. TechStars also has a number of affiliates in many cities in the U.S. and throughout the world.

Bloomberg TV has a special about TechStars concepts in 2011. TechStars business model is compelling to me.

I show up at TechStars Boulder’s office every year with permission from Brad and David. The goal is see if the 10 selected companies can explain their company’s business model to me is a way that I can understand.

It is a fascinating experience for me to see how these start-up companies hone their product and their story for Demo Day. Each company is mentored for three months to develop their model and hone their presentation.

On Demo Day Brad and David invite venture capitalist from all over the country to listen to these technology start-ups’ story and have the opportunity to invest in them.

The success rate for investment has been very high each year and at every site.

Last Thursday was the second day of the new session in Boulder. It was the first Demo Day practice session.

The first practice sessions blew my mind. I think the kids are getting smarter, more articulate and more creative each year.  Someone told me it was harder to get into TechStars than it was to get into Harvard Business School.

 

http://youtu.be/pLIVBTmg3Gg

 

GoldLab’s 3rd Annual Symposium “Time: Tempus Fugit”  

The purpose of the trip was to attended GoldLab’s 3rd Annual Symposium “Time: Tempus Fugit” at the Colorado University as an invited guest.

Dr. Larry Gold is a legendary Biotechnology guru. His mission for these Symposia is to synthesize the confluence of science and humanity. His goal is to stimulate the thinking of bench scientists, practicing physicians and social scientists to understand progress and thinking in each discipline.

Once the participants are stimulated they are encouraged to focus on actionable solutions to the complex problems society faces through each discipline’s lens.

“This was a symposium that truly, truly, truly engaged all four organs of the participants — the head, the heart, the gut and the hoo-ha organ (ah-ha) organ. Larry Gold’s  Symposium  “Time: Tempus Fugit” did so it in grand style.’

It was certainly an invigorating weekend for me. The levels of intellect and the abilities to “Think Like a Genius” are very high.

I am certain the younger generation is not going to let President Obama get away with his “Obamacare” and other government controlling baloney he is pushing.

The challenge is going to be how to get their attention now and not later when the disintermediating task will be much harder.

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

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    I constantly spent my half an hour to read this blog’s posts everyday along with a mug of coffee.

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It Not About Ideology: It’s About What Could Work

Stanley Feld M.D.,FACP,MACE

Jonathan Hiadt has become a very popular author during these difficult times of “class warfare.” In “Righteous Minds” he posits that both the Right and the Left think they are correct about political, social and economic issues. Since the opinions of each are usually opposite disputes occur.

His point is that the Right and the Left need to understand reasons for each groups’ thinking. It might result in tolerance and respect by each side for each other.

I sense a definite leaning toward the Left in his presentation with his condescending attitude toward the Right.

In this political season I have a problem with siding with either the Right or the Left in their political arguments. My impression is both sides are wrong with the Left being more wrong than the Right.

Both sides are trying to condition our minds to side with them. This should indicate how powerful the people really are.

George W. Bush and Ronald Reagan are dirty words to most of the Left.

The Left has demonized George W. Bush and Ronal Reagan because their thinking is not compatible with the thinking of the Left.

The Right loves Ronald Reagan and seems to be a little embarrassed by the mention of George W. Bush.

No one should be embarrassed about George W. He claimed to be a Compassionate Conservative. This phrase drove the Left crazy. George W. co-opted the Left’s claim to fame with the word compassionate.

The Left leaning media was frenzied about it for 8 years.  George W’s problem was he let some vested interests get too strong to the detriment of all Americans.

What is President Obama doing? He promised to “Transform America.” He is driving the Right leaning media crazy. Many Americans sense President Obama’s transformation. Americans do not like President Obama’s interpretation of transformation.

President Obama is increasing government control and decreasing our freedoms. Americans sense that our living standards are worse, our way of life is becoming difficult, the way we think about ourselves as a nation has become unpleasant and economy has gotten worse.

President Obama is also bending the rules to serve his ideological thinking. There is a growing mistrust of him because of his methodology and his ideology. The traditional media appears to be on the President’s side. The traditional media is terrified. They are losing their audience and in turn their ability to make a profit.

To me is all about media manipulation. The media’s agenda is to reach as large an audience as possible. Once this is achieved it can sell advertising space and make as much profit as possible.

The media wants to make a horserace out of every piece of “news” and a scandal out of every piece of non-news. The media on both the Right and the Left omit “news” that doesn’t fit its ideological agenda.

Think about it. This is the reason all political campaign are so expensive. If there were significant campaign finance reform the media would go bankrupt.

Politicians have to become media actors to win the hearts and souls of Americans. This was never more noticeable between and extremely articulate Barack Obama and a relatively inarticulate John McCain and a politically unschooled Sarah Palin.  Politicians have to appear to know something and stay on script.

Folks, we nave been brain washed. 

The most important asset we have as humans is our health. Systems have developed over the past 60 years in medicine that have improved our health and longevity. 

These same systems have launched vast industries and sub-industries that suck the money out of the system.

Where does the money go? Only 10% of the healthcare dollars spent go to physicians. The rest of the healthcare dollars goes to the secondary stakeholders (the middlemen) that add little value to the treatment of disease.

It is up to the people to become engaged in the political system and say we want a healthcare system that works and does not waste money.

We want a consumer driven healthcare system between consumers and physicians.

We want public service announcements that teach us how to drive the system and achieve the advantage of scale.

We do not want the government to make decisions for us.

We want to have the ability to make our own decisions.

We want to have control over our own destiny.

We want to have control over our healthcare dollar.

We want to have economic incentives to make our own medical choices.

We want to have pride in our nation,

We wanted to have trust in our government.

Todd Siler’s three guiding principles says it all:

Todd siler png

Consumers must take responsibility for their medical care and their healthcare dollars. My Medical Savings Account will go a long way to bring this about.

Consumers are the only ones that can make elected officials run our government in a way that supports these guiding principles.

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

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My Wife Is Wonderful!

Stanley Feld M.D.,FACP, MACE

IF YOU DO NOT GET THE IMAGES IN YOUR EMAIL FEED PLEASE DOUBLE-CLICK ON THE TITLE. THANK YOU

My wife of 49 years is the greatest person I ever met. We have had a wonderful life together. It has been a great trip.

S and C to abbott 20111 best image007

I have always told my boys, Brad and Daniel, “If you’re not on the edge you are taking up too much space.”

I married a woman who has not been frightened to take that journey with me.

Just imagine, when we were in the Air Force in 1965, I had a one-month vacation in the summer of 1966.

Neither one of us had ever camped out in a tent. A pediatrician drove to the Air Force Base with his young family in an Air-Stream trailer after camping out for 3 weeks before arriving to Blytheville Arkansas.

I said to Cecelia, “If Rosen could do it we can do it. It might even be fun.” Bravely, she took up the challenge even though Brad was less than 6 months old and still on formula.

I ordered and got confirmation for a Pop Up Trailer Tent from the Air Force Base’s recreation services. Four days before the trip I went to pick the trailer up. The previous user trashed the Trailer Tent. The Sergeant was a patient of mine. He fixed us up with a brand new pink four-man survival tent. He taught me how to put it. The tent was 6ft by 4 ft. with a crawl tunnel door.

Cecelia was not pleased with the accomadations but accepted it as an adventure. After studying the Boy Scout manual, we headed off for a 1-month tour through the Grand Canyon, Bryce, Zion and the Canyon Lands.

These rookie campers did a great job and had a wonderful time.

Next we decided to leave New England, Massachusetts, Mass General Hospital and the many offers I had to be a Clinical Endocrinologist in the Boston area and the New York City area for Dallas Texas.

We hated the grey sky, bitter cold and snow in the northeast.

The year was 1969. We knew two people in Dallas.

Cecelia researched demographic in the states and concluded that Dallas, Texas needed a Clinical Endocrinologist.

Dallas was not what it is today but it was great. I built a wonderful practice of Clinical Endocrinology when most people didn’t know what a Clinical Endocrinologist did.

Cecelia was behind me all the way.

After I became involved in medical politics as President of the American Association of Clinical Endocrinologists, I decided I could Repair the Healthcare System. I decided to leave my practice and give it a try.

It has been harder than I expected.

However, Cecelia has backed my mission all the way. What a woman.

As many of you know Cecelia Feld is an accomplished Texas artist. She does printmaking, collages, monotypes and photography. 

 Cecelia_Feld_01

She has done a wonderful art photography series on the new Calatrava Bridge in Dallas. Her exhibit of these photographs has been displayed at the Dallas Architectural Forum. Several people have expressed interest in buying these photographs. 

DSC_5991tn bridge

In my opinion, these photographs are spectacular.

Last Saturday night she had a show of her new Collages at the Mary Tomas gallery in Dallas Texas.

  1st show picture

The pieces in the show are incredible. Imbed in the collages are samples of photographs taken all over the world of images that are formed by streets that can be seen underfoot when walking through cities, towns and villages.

2nd Untitled
Cecelia is a master of color and its juxtapositions. http://www.studio7310.com/ArtEveryday/2012/05/unwrapped/#comments

She maintains a web site www.studio7310.com

and a blog  http://www.studio7310.com/ArtEveryday/

 

Please click on the links to get a feel for Cecelia’s work. Thank you.

She is an excellent writer and educator.

Two weeks ago she came up with a brilliant idea. Lots of people contribute to charity. She presented an offer to her followers to contribute $100 to a charity of their choice. She will then send then a 5×7 collage on her big birthday in September as her birthday present to you for your contribution. Below are the rules in Cecelia’s words.

“Summer is almost here (in Texas, anyway), which means my birthday is not far behind. September 25. No, you may not ask how old I’ll be (please don’t ask my kids). It’s a big number. 

To celebrate the occasion I have decided to work on a project this summer which will enable you to add an original work of art by me to your collection.

Here’s the deal:

1. You donate at least $100.00 to your favorite charity. (Really small amount, isn’t it)?

2. You tell me the name of the charity and that you have made the donation. Send me your address.

3. I will send you a 4×6 collage on 5×7 paper. One collage per total donation.

4. You must make your donation and let me know by June 20.  

5. I will send the collage by the end of September.

What a win-win deal!  A worthy charity benefits and you get a Cecelia Feld original work of art.

I get the pleasure of giving back to everyone who has supported me in so many ways along my life’s artistic journey. What a great birthday present for me! 

Let’s do it!

Here are 2 examples of my small collages from the “Spectrum 1-10 series.”

1221-Spectrum-8-collage-6x4-2009-copy

#1221 Spectrum 8, collage, 6×4", 2009

1222-Spectrum-9-collage-6x4-2009-copy

#1222 Spectrum 9, collage 6×4", 2009

 www.studio7310.com

 Last Saturday went to her opening in two cars because she had to be there early. We left the show in both cars to go to dinner. The highway entrance was closed for reconstruction.

 I thought I knew where we were and how to find the highway. I volunteered to lead us to the highway. I promptly got us lost in the depths of the back of downtown Dallas.

It felt like Tom Wolfe’s being stuck on Buckner Blvd in Bonfires of the Vanities to both of us as I tried desperately to recover and get on any major highway.

 

This has been the spirit of our life together. We are both willing to take chances by utilizing educated guesses.

 

I am convinced that the key to our successful marriage is the profound mutual respect we have for each other.  

 

Can anyone ask for a better, more adventurous, more innovative and more talented wife.

 

I am very proud of her.

 

 I am a very lucky guy.

 

 I love you, Cecelia.

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Ignoring The Rules

 

Stanley Feld M.D., FACP,MACE

 President Obama and his healthcare agencies do not follow the rules required for agencies to write new regulations.

If President Obama does not follow the rules and regulations how can he expect agencies in the government as well as private businesses to follow the rules and regulations?

The President is supposed to set an example for others.

The Congress has relinquished its watchdog power over the executive branch of government. Even the head of CMS, the agency writing the regulations, was an appointee not approved by congress.

Government is supposed to be elected by the people for the people. President Obama has side stepped this obligation. He feels he knows what the people need.

“In a series of papers for the Mercatus Center at George Mason University, Christopher Conover and Jerry Ellig provide evidence to suggest that “the involvement of both White House and high-ranking agency staff” suggests that “the administration likely got the [ObamaCare] rules it wanted written.”

This series of papers were published in January 2012. I missed them. The traditional media ignored their findings. The Mercatus Center’s papers were not picked up by the alternative media either.   

I have noted, in the past, that President Obama and his staff have consistently “cooked the books” on budget estimates of the costs of his Healthcare Reform Plan.

 His numbers did not add up. His assumptions are usually incorrect. The data presented to the CBO has been inaccurate.

 

 

 

 

 

In summary, these Mercatus Center papers demonstrate how President Obama overrode the normal checks and balances used to ensure that federal regulations impose the smallest possible burden on the private sector.

He bypassed the required regulations used in evaluating the regulatory impact for interim rules.

"Rather than posting required regulatory impact analyses (RIAs) with interim rules and allowing time for analysis and comment, the White House and its agency heads dictated the rules that would be written, curbed the Office of Management and Budget (OMB) review function, and then simply declared that the interim rules were final."

Dr. Jerry Ellig is the study's co-author.  He said;

 "In this study, we looked at the federal government’s analysis for the 8 major “interim final” regulations issued in 2010 to implement key components of the Patient Protection and Affordable Care Act (ACA)."

"The intent of regulatory analysis is to inform decisions by identifying the problem the regulation is supposed to solve, and assessing the pros and cons of alternative solutions. But we found these key ACA analyses to be rushed, seriously incomplete, and rarely used to inform decisions.'

 In 2008, the average regulation received 56 days of OMB review. In 2009, the average regulation received 27 days of review. 

 In 2010, the average ObamaCare regulation received 5 days of review.

The review was brief because it was not done according to the rules and regulations.

President Obama cannot possibly understand the economic impact of the resulting regulations. Their economic impact is poorly defined and therefore not understood.

The authors suggested that Congress should consider establishing an independent review agency that would do a regulatory impact analysis of the proposed regulation using widely accepted standards before the regulations are final. 

“The RIAs accompanying the regulations were “seriously incomplete, and they fell far short of federal agencies’ normal practice.”

The Mercatus Center’s Regulatory Report Card criteria, the best analysis of the 8 regulations studied received just 25 out of 60 possible points—the equivalent of an ‘F’.

“President Obama’s regulatory impact analyses also regularly under-estimated costs, over-estimated benefits, and ignored alternatives that would have had lower costs or greater benefits.”  

The defects in the regulations are too numerous to list and too aggravating to contemplate.

Health care economists have estimated that these defects will result in between a 10 and 41 percent cost overrun in health care spending

My major point is not the defects in the final interim regulations.

My point is the regulatory process using rules of the regulatory impact analysis have been ignored.

The rules of the process have been ignored in order to reflect President Obama’s ideology.

The issue is a process issue.  President Obama’s administration circumvented processes that were constructed to protect the American people from government abuse.

He has disrespected the will of the people and the checks and balance system, has marginalized congress, tried to intimidate the judiciary system and ignored the constitution.

How can President Obama expect the American people to respect or trust him? Americans are smart but only if their sources of information are not bias or controlled.

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

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My Ideal Medical Savings Account Is Democratic!

Stanley Feld M.D.,FACP,MACE

A reader sent this comment; “My Ideal Medical Savings Account (MSA) “was not democratic and leads to restriction of medical care for the less fortunate.'

This comment is totally incorrect. I suspect the comment came from a person who has “an entitlements are good mentality.”

I believe that incentives are good. They lead to innovation. Innovation leads to better ideas.

Healthcare entitlement leads to ever increasing costs, stagnation, restrictions on freedom of choice and a decrease in access to care.

I have written extensively about the virtues of My Ideal Medical Savings Accounts (MSAs). They are different than Health Savings Accounts (HSAs).

HSAs put money not spent in a trust for future healthcare expenses. MSAs take the money out of play for healthcare expenses. MSAs provide a trust fund for the consumer’s retirement.

MSAs provide added incentives over HSAs to obtain and maintain good health.  Obesity is a major factor in the onset of chronic diseases. Consumers must be motivated to avoid obesity to maintain good health. MSAs can provide that incentive.

The MSA’s can replace every form of health insurance at a reduced cost. It limits the risk to the healthcare insurance industry while providing consumers with choice.

This would result in competition among healthcare providers. Competition would bring down the cost of healthcare.

Some people might not like MSA’s because they are liberating. They provide consumers of healthcare with freedom of choice. They also give consumers the opportunity to be responsible for their healthcare dollars while providing them with incentives to take care of their health.

MSAs could be used for private insurance purchasers, group insurance plans, employer self insurance plans, State Funded self-insurance plans and Medicare and Medicaid.

In each case the funding source is different. The cost of the high deductible insurance is low because the risk is low. 

If it were a $6,000 deductible MSA, the first $6,000 would be placed in a trust for the consumer. Whatever they did not spend would go into a retirement trust.  If they spent over $6,000 they would have first dollar healthcare insurance coverage. Their trust would obviously receive no money that year.

The incentive would be for consumers to take care of their health so they do not get sick and end up in an expensive emergency room.

If a person had a chronic illness such as asthma, Diabetes, or health disease with a tendency to congestive heart failure and ended up in the emergency room they would use up their $6,000.

If they took care of themselves by spending $3,000 of their $6,000 trust their funding source could afford to give their trust a $1500 reward. The benefit to the funding source is it saved money by the consumer not being admitted to the hospital. The patient stayed healthy and was more productive.

President Obama does not want to try this out. He wants consumers and businesses to be dependent of the central government for everything.

MSAs would lead to consumer independence from central government control of our healthcare. MSAs would put all consumers at whatever socioeconomic level in charge of their own destiny.

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

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Can President Obama Intimidate The Supreme Court?

Stanley Feld M.D.,FACP,MACE

It is unlikely that President Obama can intimidate the Supreme Court.

The Supreme Court is going to judge “Obamacare” on the basis of its constitutionally.

Two weeks ago President Obama tried to intimidate the Supreme Court.

With a rhetorical back of the hand, President Obama seemingly attempted to browbeat Supreme Court justices into rescuing his increasingly imperiled signature legislative accomplishment – Obamacare. The president proclaimed that it would be "unprecedented" and "extraordinary" for the Supreme Court to overturn "a law that was passed by a strong majority of a democratically elected Congress." To add insult to self-inflicted injury, the president suggested that "judicial activism" would be an appropriate label if the Supreme Court were to "somehow overturn a duly constituted and passed law."

The president is wrong on the facts and wrong on the law. As we all know, the law was not passed by "a strong majority" of Congress. It won House passage by a razor-thin seven votes and even more narrowly escaped filibuster in the Senate. Even that close margin was sullied by vote-buying allegations such as the Cornhusker Kickback. The law turns out to be even more unpopular with the American people.”

I was horrified at President Obama’s attempt at intimidation. The public backlash he received compelled him to backpedal. He tried to explain what he meant the next day. He was unsuccessful.

He should understand “as a constitutional lawyer” the Supreme Court’s job is to decide if a law is constitutional. 

On May 3,2012 President Obama tried another route to influence the Supreme Court’s potential decision on his healthcare reform act. 

“In papers filed with the Supreme Court, administration lawyers have warned of “extraordinary disruption” if Medicare is forced to unwind countless transactions that are based on payment changes required by more than 20 separate sections of the Affordable Care Act.”

The administration counters that even if the Supreme Court strikes down the insurance mandate, the court should preserve most of the rest of the legislation. That would leave in place the administration’s changes to Medicare as well as a major expansion of Medicaid coverage.

“Justice Department lawyers said reversing the Medicare payment changes “would impose staggering administrative burdens” on the government and “could cause major delays and errors” in claims payment.”

President Obama rolled out Dr. Donald Berwick, former non-congressional confirmed head of CMS, to inform the public of the devastating affects repealing the law would have on seniors.

“Tossing out President Barack Obama’s health care law would have major unintended consequences for Medicare’s payment systems.

“Medicare cannot turn on a dime,” said former administrator Don Berwick, Obama’s first Medicare chief. “I would not be surprised if there are delays and problems with payment flow. Medicare has dealt with sudden changes in payment before, but it is not easy.”

AARP is also helping President Obama with his dirty work. It should not be forgotten that AARP took $4 billion dollars from UnitedHealthcare to be it exclusive vendor for Medicare Part D and Medicare Advantage.

 AARP says it’s concerned. If doctors became embroiled in a legal battle over payments, then “a general concern would be that physicians would cease to take on new Medicare patients, as well as potentially have issues seeing their current patients,” said Ariel Gonzalez, top health care lobbyist for the organization.

President Obama was smart enough not to personally frighten seniors. If the Supreme Court’s decision goes against him and hardships are created for seniors because of the disruptions to Medicare he can point to the Supreme Court as being a political activist court. He can say the Supreme Court has thwarted his agenda and has harmed seniors.

He can claim he is the defender of seniors. His hope is this maneuver will help in his reelection campaign.

The Supreme Court is the interpreter of the Constitution. It is not the defender of President Obama’s ideology. The Supreme Court’s integrity should not be attacked before or after a decision is made.

If the Supreme Court deems President Obama’s Healthcare Reform mandate unconstitutional, it is unconstitutional.

President Obama’s politics are a dirty business. Manipulating the traditional media and American public’s thinking rather than presenting the truth seems to be President Obama’s goal.

The traditional media has omitted the fact that President Obama is going to make major disruptive changes to Medicare on his own. He is going to decrease Medicare funding by $500 billion dollars.

In fact, the decrease funding was to take effect before the election.

He conveniently delayed the scheduled reduction until after the election in order to not upset seniors and lose the senior vote.

Former Medicare/Medicaid administrators disagree on the potential for major disruptions in Medicare.

“There is an independent legal basis to pay providers if the Supreme Court strikes down the entire law,” said Thomas Barker, a former Health and Human Services general counsel in the George W. Bush administration.

Tom Scully was CMS Director Medicare during former President George W. Bush’s first term.

He said,

He does not foresee major problems, although he acknowledges it would be a “nightmare” for agency bureaucrats.

Scully dismissed the notion that private Medicare plans would be jeopardized if the Supreme Court throws out the law.

“The idea that Medicare Advantage plans would shut down and patients would be thrown into the street is just people making up arguments to stir the pot,”

 President Obama has been planning to get rid of Medicare Advantage with his Medicare funding reductions. Seniors will then be in an uproar.

“Even if the law were completely overturned, the government would still have authority under previous legislation to pay hospitals, doctors, insurance plans, nursing homes and other providers.”

My interpretation is that this is another “trick play” by President Obama intended to put pressure on the Supreme Court to not overturn the law.

It will not work. President Obama’s disinformation and manipulations of the traditional media are wearing thin on everyone.

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

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In Response To “A Real Marketplace For Healthcare.”

 A reader wrote in response to  "A Real Marketplace For Healthcare." , 

"Or said simply, “find me one large government run entity that is both high quality and low cost”?  There are zero of them."

I believe many people are thinking the same thing as Obamacare marches to its potential victory lap.

On the way to the full implimentation Obamacare has cost the American taxpayers many (unpublished) billions of dollars.

Everything tried by Obamacare has failed. These failures should not be lost in the flurry of President Obama's demogagory and distractions.

I fear the only thing that Obamacare will accomplish is creating government imposition of its bureaucratic will over Americans' freedom to choose. Obamacare will also destroy America's spirit of innovation.

A famous patient of mind told me many years ago,

"Americans' get what they deserve because they do not pay close attention to the facts." 

It is difficult to obtain the facts. I believe Americans have been trained by the media to hear sound bites and not facts. Americans have no time to discover the facts.

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

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