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All items for July, 2017

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They Are Getting There

Stanley Feld M.D.,FACP, MACE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

hfo/world-population/us-population/ 

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

The current enrollment is obviously post Obamacare.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Something needs to be done about this madness now.

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

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

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The Republican Establishment’s Failure

Stanley Feld M.D.,FACP, MACE

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

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

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

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

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

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

A reader wrote:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

My Ideal Medical Saving Account is a much better idea.

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

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

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

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

Socialism does not work!

Socialsim for blog

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

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

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

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

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

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

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

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How Can I Be So Misinterpreted?

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