Stanley Feld M.D.,FACP,MACE

It’s clear. President Obama
has used the same techniques to neutralize the scandals and mishaps during his
administration.

In has been the same for Benghazi,
NSA, IRS, and Fast and Furious scandals.

President Obama makes his
characteristic statement, “This is unacceptable
and we will get to the bottom of this.”

After this statement there is
never any follow-up. What has been done? Has President Obama gotten to the
bottom of it?

The public never learns who
was responsible for the debacle. No one ever gets fired and the traditional
media carries on. The public soon forgets about a non-resolved scandal.   

President Obama always leads the
public to believe he had nothing to do with the scandals or the decision-making
leading to the scandals.

He is the President. He should
know. If congress investigates the scandal it gets stonewalled by the administration. The investigationg committee then is accused
of muckraking.

Somehow the traditional media
buys this story and sells it to the public. It is the journalist’s obligation to
dig into a scandal and find out the real story. It is not done.

Nothing this administration
does has been transparent. The traditional media ignores the scandals and so
does the public.

The devil is always in the
details.  

The real story is the attack on individual
freedoms and choices. They are being impinged upon by the bureaucratic regulations of
big government. The traditional media should make this clear.

America does have a freedom
of information act and constitutional rights that have to be protected and not
ignored.

All the participants in the
various scandals finger point to others being responsible for the actions that
would not be approved by the people.

No one ever questions whether President Obama is
responsible for the scandals.  

The same method of operation
is being put in place to explain the colossal disaster of www.healthcare.gov’s rollout.

The Obamacare web site has
many problems. It is not a simple fix as the President and his administration
has declared it to be.

President Obama claims he did
not know anything about the problems before the launch. He has promised to get
to the bottom of this.

He is finger pointing to
everyone except himself and his administration. 

If the Obama administration
did not know about the impending failure it is either stupid, or irresponsible
or both.

President Obama is not stupid. He is cunning.

These are President Obama’s remarks in the
Rose Garden of the White House last week.

 “Shortly
before the president’s appearance, White House officials let it be known that the “president will directly address the technical
problems with HealthCare.gov – troubles he and his team find unacceptable.” But
in that Rose Garden appearance, the president did not explain what the
technical problems with HealthCare.gov were, though he did acknowledge their existence and stated “there is no excuse” for them.

He then promised he would recruit the best
information technology talent in the country to come to the rescue and fix the
problems.

President Obama happened to hire one of Michelle
Obama classmates at Princeton in a no-bid contract to build the web site. The
administration paid $634 million taxpayer dollars to Michelle Obama’s friend’s
company and got a disaster.

"Toni
Townes-Whitley, Princeton class of ’85, is senior vice president
at CGI Federal, which earned the no-bid contract to
build the $678 million Obamacare enrollment website at Healthcare.gov. CGI
Federal is the U.S. arm of a Canadian company.

"Townes-Whitley
and her Princeton classmate Michelle Obama are both members of the Association of Black Princeton Alumni."

The Obama administration also awarded CGI
another no-bid contract for 2 billion dollars to clean up from the Sandy
Hurricane.

 Mr.
Nelson chair
of Housing Trust Fund Corporation presented that the State
received a $1.7 billion allocation in CDBG Disaster Recovery aid from HUD to
aid impacted businesses and residences.

 The
corporation requires immediate access to consultant services to assist in policy and
procedure development, training, surge capacity, and call center assistance,
and stated that CGI Federal Inc. could provide such services.

The
resolution was passed and scheduled to “take effect immediately.”

Nearly a
year after the devastating storm, a majority of the 24,000 families that have
requested monetary assistance have yet to receive a penny from the federal aid
package.”

Does anyone think something funny going on at
taxpayers’ expense?

Shouldn’t President Obama have hired the best
minds in the country to build the web site to begin with?

Do you
remember this famous statement?

http://nyti.ms/18ThbbJ

Ezra Pound
is a big fan of President Obama and Obamacare. What happened? Did he change his
mind?

http://www.youtube.com/watch?v=AQxYY2dyChY&feature=player_detailpage

 Uwe Reinhardt is an economics professor
Princeton. He gave
President Obama an F on his mid-term grade on Obamacare.

A key discussion being avoided in the
mainstream media is whether President knew about the impending disaster. I suspect
he did.

It was one of the reasons he gave the group
healthcare insurance holders a one-year waiver. Parenthetically, he is not
seeking the advice or consent of the congress. This is probably
unconstitutional.

The group healthcare insurance market represents
the largest percentage of people insured. The individual insurance market represents
a relatively small percentage of the total insured population. The number of
people affected cannot make a big enough stink to be noticed by the traditional
media.

If the group insurance market were included in
the rollout, the community uproar would be too great for the Obama administration
to ignore or pivot from.

The public is already hearing the pivot from
President Obama and Kathleen Sibelius. They claim the past is the past. We must
ignore the past and go forward to fix the problem.

It sounds like the same story Hillary Clinton
told congress about Benghazi when she scolded a congressman during her Benghazi
testimony about Ambassador Stevens death. “He
is dead. Let us go on and deal with the problem.”

This method of operation is going to back fire
on President Obama for two reasons.

1. Americans are finally recognizing the Obama
administration’s methods of operation. It is to deflect with half-truths,
deceive and pivot. The public is getting angry.

2. There are an increasing number of people
who have lost their job, their healthcare insurance and the doctors. In the last
week 650,000 people lost healthcare insurance coverage they liked.

This is because of the exclusive regulatory
control the Democrats gave Kathleen Sibelius in passing Obamacare.

Not one single Republican voted for the
Affordable Care Act (Obamacare). 

The preparations for the implementation of
Obamacare for the group healthcare insurance market through health insurance
exchanges and www.healthcare.gov have unleashed gigantic outcries from both the
young and the middle-aged middle class.

The outrage is not over yet.

President Obama said he did not anticipate
that so many corporations would reduce insuring so many of their workers.

President Obama has discovered an obviously
scapegoat.

The “glitch” is not
Obamacare fault. It is the big bad corporations that are trying to make a
profit.

Wait a minute! Isn’t that the American way?
You build a business to try to make a profit within the rules.

The 40,000 new Kathleen Sibelius healthcare
regulations are preventing them from making a profit while providing healthcare
insurance. They want to provide affordable healthcare coverage.

The only way corporations can make a profit is
by dropping healthcare insurance of their employees.

Maybe driving people into the health insurance
exchange was President Obama’s goal in the first place. Remember Barney Frank
and John Kerry’s dismay about passing a bill without a public option. President
Obama response was don’t worry.

Well, we have an expensive public option that
doesn’t work. Who is going to pay for it?

 The
middle class is going to pay for it with increased healthcare insurance
payments and increased taxes. 

 The
cost of insurance on the health insurance exchange is high unless one qualifies
for a government subsidy. I have previously explained the dynamics involved in the
cost of healthcare insurance when a person receives a government subsidy.

Young healthy people will not buy insurance.
With the present computer programs the government will not know who qualifies
for a subsidy or be able to identify people will should be penalized.

A key to a business’ survival is to adjust to
adverse circumstance as long as the business has the freedom to adjust.

Watch out for the freedom to adjust to
anything.

Watch out seniors. Medicare is next.

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

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Stanley Feld M.D., FACP, MACE

I ended my last blog with,

“President Obama’s goal is to create more chaos
and dysfunction in the healthcare system. “

“Only then can the government really step in and
say let me help you.”

It is the only
reason President Obama told the then Senator Kerry and Congressman Frank not to
worry if the final bill does not have a public option.

Kerry and Frank said
Obamacare would not work without a public option. The only thing that would
work is a single party payer system.

With limited benefit
plan, employers would avoid the broader $2,000 per-worker penalty.

It is not
clear is whether employers could face a $3,000 penalty per individual for any
employee who opts out of the limited benefit plan.

Four
problems are being discovered with the health insurance exchanges.

1.
If the employee is a low wage employee that refused employer provided insurance
he is not eligible for a government subsidy.

2.
If the federal government runs the health insurance exchange, the federal
government by law is not permitted to provide a subsidy. Only state run
healthcare insurance plans can provide subsidies.

Over
50% of the states have refused to run health insurance plans. Therefore people
who need subsidies are not eligible in over 50% of the states.

3.
The law calls for tax credits and not subsidies. All of a sudden the words “tax
credits” have been dropped in discussion. Only taxpayers who earn over $38,000
per year pay taxes. The only way a person can utilize a tax credit is by
deducting the tax credit from taxable income.

The
government has gotten around this problem by giving the healthcare insurance companies a tax credit in advance and calling it a subsidy for qualified
persons.

Those
workers who opt out of the employer provider plan for a health insurance
exchange plan would not be eligible for a government subsidy. 

A full-time worker earning $9 an hour would
have to pay as much as $70 a month for a mid level exchange plan from a health
insurance exchange, even with the subsidies, according to the Kaiser Foundation.

At $12 an
hour, the workers' share of the premium would rise to as much as $140 a month.

 A $12 an hour worker cannot afford to pay $1680
a year for healthcare insurance.

Mid
level coverage is limited coverage. A patient might need a higher-level plan that costs $200
a month or $2400 per year. This plan is out of reach for most patients making $40,000/year.

 "There are going to be many people who will
be ill and need a more robust plan,” a health benefit
advisor proclaimed.

Currently, only one-quarter of workers eligible
for the mini-med plan take it. Ms. Newman said, "We
really feel like the people who are not taking it now will not take it
then."

There
is a huge glitch in the health insurance exchanges’ individual healthcare
market. This glitch will make the health insurance exchanges more costly and
less attractive to all stakeholders. It will decrease the number of people
insured and increase the federal deficit.

The
majority of the individual market is comprised of low wage earners with
irregular work histories.

These people may be
self-employed or seasonal workers with surges of income. They could be
part-time workers with several part time jobs. 

Obamacare does not permit cancellation of the health insurance exchange
policy because it will mean that people will be in violation of the federal mandate
if they do not have insurance. 

The Obamacare bureaucrats realize that people receiving subsidies might
have a hard time paying the premiums even if they receive a subsidy.

These people live from month to month. Some have surges in income. Some
collect commissions one month and nothing the next month. Most have old cars.
They might suddenly need new brakes or new tires. Some might get the flu and have
to stay home without pay for a week. There are many reasons low wage earners
suddenly have a hard time paying healthcare premiums even if they are subsidized.

Many do not have bank accounts or credit cards. There is no such thing
as auto pay in their world.

The Obamacare bureaucrats writing the health insurance exchange
regulations are people with nice bureaucratic jobs with steady paychecks. They
have no idea how difficult it is to make ends meet for these people each month.

The healthcare insurance industry
does not care about these problems. It may provide for a grace period of a week or two. If a healthcare
policyholder fails to pay their healthcare policy premium the policy is
cancelled in the real world.

In the bureaucratic world of Obamacare the healthcare insurer cannot
cancel the insurance in the usual way.

HHS has created through multiple regulations a whole new and very
restrictive method of discontinuing healthcare policies that must be followed
to a “T” by the healthcare insurance industry.

This method will lead to even more dysfunction in the healthcare system.

HSS has instituted a 90-day grace period for paying premiums only for those
receiving federal subsidies from the health insurance exchanges.  

At the end of the 90-day grace period the policyholders must pay the
entire three months due. If they could not pay the premium monthly how are
they going to pay the three month fee?

Aetna was not so dumb in dropping out of the health insurance exchange
system after all.

During the three-month grace period if a policyholder get sick and
needs care they will be entitled to care.

Who will bear the financial responsibility for the care? Not the
patient.

HHS has decided to split the financial responsibility between the
insurance companies and the providers. The insurance company will cover the
first month and the hospitals and physicians will cover the next two months.

After three months the insurance company can cancel the insurance.  However people can re-enroll again during the
next signup period without penalty.

If one is clever enough a patient can receive 12 months of care and
coverage for nine months of premiums without penalty.  

“Along with paying for services during the first month of
the delinquency, the insurer must:

1) notify HHS of the non-payment;

2) notify
providers of the possibility of denied claims during the second and third
months;

3) notify the insured that he/she is delinquent;

4) continue to collect
the advanced tax credit on behalf of the policyholder;

5) return the tax credit
for the second and third month to the Treasury;

6) issue a termination notice
to the insured at the end of the grace period.”

This procedure is a
very large administrative burden and potential financial loss because of the
federal government's decreases in funding. Most providers and insurance companies will quit
participating in the health insurance exchange program.

Rather than increasing affordability and access to care it will decrease
access to care and affordability of care. It will create a more dysfunctional
healthcare system.

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

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