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The Republican Health Care Con By THE NYTimes EDITORIAL BOARD JAN. 21, 2017

Stanley Feld M.D., FACP, MACE

The New York Times editorial “The Republican Healthcare Con” should really be entitled “The New York Times Con of The Republican Health Care Con”

In my opinion The New York Times has become a biased newspaper. Instead of publishing “all the news fit to print”, it is printing articles and editorials that are biased opinions with incomplete facts.

The Republicans have not introduced their replacement of Obamacare yet this editorial is critiquing the replacements effect on the healthcare system..

Everyone is entitled to his or her own opinion. No one is entitled to his or her made up facts.

Republicans say the Affordable Care Act provides health insurance that manages to be both lousy and expensive.”

This is true. Most of the population seems to agree with this statement.

The only people buying insurance from the health insurance exchanges are people with pre-existing illnesses. These people have no other insurance available.

“Whatever the flaws of these policies (Obamacare), the new Trump administration is trying to pull off a con by offering Americans coverage that is likely to be so much worse that it would barely deserve the name insurance.

It would also leave many millions without the medical care they need.”

How does the New York Times editorial board know this when the Trump administration’s healthcare plan has not been introduced?

The liberal media keeps saying the Republicans have no plan. If Republicans do not have a plan how can the NYT criticize it?

How can a non-existent healthcare plan leave many millions without the medical care they need”?

There is no evidence for the statement above.

This reality became increasingly clear when President Trump’s choice to run the Department of Health and Human Services, Tom Price, testified before a Senate committee last week.

He looked pained as he described the terrible predicament of people who earned around $30,000 to $50,000 a year and had to deny “themselves the kind of care that they need” because they had Obamacare policies with deductibles of $6,000 to $12,000.

Tom Price M.D. is correct in saying the Obamacare deductibles are $6,000-$12,000. The NYT left out that the Obamacare networks available are restrictive and the access to proper healthcare is difficult.

The NYT editorial board also left out the fact that 85% of people buying healthcare insurance from the health insurance exchanges are subsidized by the government and have a pre-existing illness.

“ Yet, earlier in the same hearing, Mr. Price extolled the virtues of policies that would be woefully inadequate — policies that cover medical treatment only in catastrophic cases.”

This is a misrepresentation of Dr. Price’s testimony.

Perhaps the NYT editorial Board does not understand Health Savings Accounts?

If you want to understand a potential Trump administration proposal read my blog “Medical Savings Accounts Are Democratic.”

Dr. Price was talking about the virtues of health saving accounts without being specific.

The goal of health savings accounts are to put consumers in control of their medical care and healthcare dollars while providing them with financial incentives to save retirement dollars and not waste medical care dollars.

Consumers could have control of what they spend for their own healthcare.

The employer or government would pay for the deductible and the reinsurance above the deductible.

The money would be put in a healthcare trust. The money in the trust would pay for medical care.

If consumers did not spend the money on medical care that year, it would go into a personal saving trust for those consumers retirement.

“ Such policies often have deductibles of around $14,000 for family coverage.”

FALSE! One can get excellent coverage with a $6,000 deductible and first dollar coverage after spending $6,000 at a reasonable price.

Health Savings Accounts are the fastest growing healthcare insurance vehicle.

The government has put so many restrictions on health savings account that employees are hesitant to offer it. The government must remove these restrictions. www.unitedheath.com

“ This is simple hypocrisy. Condemn the policy you don’t like, propose something far worse as a replacement and claim that it is much better”

This paragraph is written to condemn Dr. Price and rile up the anti-Trump forces with false information.

The editorial completely disregards the fact that a proposal has not yet been announced by the Trump administration.

There were 2000 plus pages published about President Obama’s Obamacare proposal. There were glaring defects in he proposal.

The NYT did not comment on these defects at the time. Others did. I turned out that the defects were the source of Obamacare’s failure.

In reality the NYT has no idea of what the Trump administration’s proposal will be.

The NYT editorial also ignores the fact that Obamacare is unsustainable, unaffordable and is restricting access to care while rationing care for the very citizens that need the care.

“Mr. Price and Mr. Trump have recently said that their goal is to offer health care to many more people than are covered by the current health care law, which has driven the uninsured rate to historic lows.”

I believe historic lows are a counting error just as the unemployment rate and the inflation rate are counting errors in order to provide the Obama administration acceptable numbers.

Average people know exactly what is happening.

Mr. Price’s testimony and the legislation he introduced in the House (a few years ago), where until recently he was the Budget Committee chairman, show that the new administration will make decent health care less affordable and less accessible for most people.

The underlined portion is a NYT editorial opinion. It is an opinion without facts or evidence. It could also be a lack of understanding of the bill Dr. Price’s introduced.

The Trump administration’s upcoming proposal might be completely different.

How would the NYT know the Trump administration’s healthcare plan would make decent health care less affordable and less accessible for most people?

This is an unsubstantiated bias that would qualify as fake news.

“Those Health Savings Accounts would not help families earning the median household income of $56,000 a year because these families would never be able to sock away enough money.”

The NYT editorial either missed the concept of Health Savings Account totally or is reporting the concept to fit its bias.

The best description of what Mr. Price stands for can be found in a bill he introduced in 2015, the Empowering Patients First Act. It would “empower” Americans by eliminating the health care law’s expansion of Medicaid that has helped more than 10.7 million newly eligible people enroll in that government-run insurance program.

Many of these Medicaid patients cannot find a physician or hospital that accepts Medicaid.

Therefore they have very limited access to care.

A potential proposal could expand Medicaid patients’ access to care using health savings accounts.

It would also drastically cut subsidies that have helped 11.5 million people purchase private insurance on federal and state health exchanges.

There is no evidence for this wild statement.

Under his bill, people buying insurance for themselves would get between $1,200 and $3,000 a year in subsidies, down from an average of $4,600 that people get now on HealthCare.gov.

The amount of tax benefits or tax credits for Health Savings Accounts have been restricted by Obamacare in order to discourage its use.

The Obama administration wanted to control medical care and eliminate consumer choice and power.

President Obama wanted healthcare decisions to be in the hands of the central government.

The Trump administration plans to modify these restrictions. President Trump has stated he wants to put healthcare decision making back into consumers’ hands and not the government’s hands.

The bill would even get rid of the requirement that allows young people to stay on their parents’ insurance policy until age 26, a provision that is widely popular.

This is totally false and once again fake news.

And it would hurt people who get insurance through their employers by setting a cap on how much of that expense businesses can claim as a deduction on their taxes. Experts say that over time this would encourage companies to stop offering health benefits to workers.

The independent insurance market has not had tax deduction. It should be on a level playing field with group insurance. There is no evidence that the group market will lose its tax deduction.

“When it comes to health care, Mr. Price and other Republicans say their goal is to give people more choices. It is hard to argue against choice. But in the ideological world inhabited by Mr. Price, House Speaker Paul Ryan and many other Republicans, choice is often a euphemism for scrapping sensible regulations that protect people.”

This claim also has no basis in fact. It is pure opinion by the NYT editorial board.

“Some Americans might well be tempted by this far-right approach. They would have to pay less up front for these skeletal policies than they do now for comprehensive coverage.”

Has Obamacare provided comprehensive care? It is unaffordable and inaccessible to all.

But over time, when people need health care to recover from accidents, treat diabetes, have a baby or battle addiction, they will be hit by overwhelming bills.

Where did this come from? It came from a negative bias toward Donald Trump and his administration without facts or evidence.

The Trump administration seems perfectly willing to sell those people down the river with false promises.

People are not stupid. They do not need government to rule their life and make healthcare decisions for them.

People need incentive to control their health and healthcare dollars.

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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Come On Guys, Give Them A Chance!

Stanley Feld M.D.,FACP, MACE

It is clear that Donald Trump won the presidential election.

The U.S. economy is in bad shape despite what President Obama has been telling us. Economic growth has been stagnant with growth at less than 2%.

People are feeling the loss of jobs as factories are closing.

Corporations are moving factories overseas for cheaper labor.

The many unemployed gave up looking of jobs. Full time jobs have been switched to part-time jobs so corporations can avoid the Obamacare mandate. People need to have at least two jobs to make ends meet.

Price inflation continues but is not measured because food and fuel are left out of the inflation calculation.

Inner city unemployment is worse despite President Obama’s saying it is getting better. Neighborhood security has declined. National security is threatened. People do not feel safe.

Obamacare, which was supposed to provide universal healthcare that was affordable to all, was a outright failure both in terms of affordability for individuals and to the national economy.

Yet, the Obama administration, through the mainstream media, keeps telling the people everything is going as planned.

The people could easily see that the administration was tell them a lie. The unemployment rate was reported as being less than 5%.

Americans realized that much of the money for food stamps was being abused. It was discovered that many people were not using the money for food.

Hard working Americans found out that one could collect at least $49,000 non-taxed dollars from the government for not working.

Our foreign policy was in a shambles.

Americans were being told by President Obama that we winning the war. Yet we were losing territory to ISSI and experiencing terrorism both at home and abroad.

Ordinary hard working people were beginning to realize that the tax and spend Democratic Party were ripping them off even if the details of these rip offs were unclear.

Many state governorships and state legislatures were lost to Republicans. Many seats in the U.S. Senate and house were lost to Republicans.

It was clear that the people wanted a change even though they felt the Republican establishment had deceived them previously.

They understood that government was too large. The government bureaucracy consisted of people who could not be fired. These people can obstruct change.

As government grows it employs more people and it becomes more stagnant and less functional.

Along comes Hillary Clinton.

Hillary Clinton was a non-charismatic presidential candidate who received millions of dollars from rich people to buy uninspiring advertising on television.

Her message was that she was going to continue President Obama’s legacy. She missed the point completely.

Donald J. Trump comes along and tells the people they are being ripped off by our own government and by other governments. Our trade deals stink. Other countries are living off our tax dollars because of our government’s stupidity. He promises to fix it.

He says America has to be run like a business. He will bring back jobs, decrease waste, increase the status of our military all around the world and uncover the great energy and potential of America, especially in the decaying inner cities.

It is a great message. Few know how he is going to do it. He is not telling anyone. He says he is going to hire great people to help him. He is going to hire successful people to help him.

He is going to create opportunities for everyone using a free market based economy.

America as been sliding toward a central government controlled economy for many years.

It should be clear to everyone that Keynesan based central controlled economy does not work.

Fredrick Hayek taught us that in 1937. However, few listened.

I think it is because the central government fears a loss of control over the economy and the people. It fears that very smart people can take advantage of an economy if they have the ability initiative and become innovative without government restraints. The government does not want to believe that the free market works.

Steve Jobs believed it. Jeff Bezos believed it. All the start-ups believe it.

At the Consumer Electronic Show I saw many companies tying to succeed without government interference.

Why? People want to have the freedom to be innovative and creative.

Maybe the American people believe that Donald Trump is going to give them that opportunity without as many government restraints.

The establishment’s fear is warranted.

My view is the government’s job is to legislate the rules that put everyone on a level playing field. The government should step aside and make sure everyone plays by the rules.

This brings me back to my title, “Come On Guys. Give Them A Chance!”

Donald Trump might just know how to navigate through the swamp of the dysfunctional government bureaucracy.

He doesn’t have to tell us how he is going to do it yet. He just has to do it. He might know how to navigate around America’s bad trade deals.

He might just know how to pick a Secretary of Health and Human Services in the name of Tom Price M.D.. Tom Price M.D. might be the person who can navigate across the failed Obamacare healthcare system.

Tom Price M.D. is a smart and decent man. The Democrats and the media might want to indulge in his character assassination out of fear that he might have a workable plan to repair the healthcare system.

The American people are wise to the Democrats’ tactics.

These tactics will hurt them and not Tom Price M.D..

Maybe he knows how to create a system where if you like your doctor you can keep your doctor. If you like your insurance you can keep your insurance. If you like your freedom to choose you can keep that also.

The Democrats, the main stream media and the government bureaucrats should not criticize Donald Trump when the Democrats have failed so miserably. They do not know what the Republicans will propose.

We know what doesn’t work. That is Obamacare!!

Give the new guys a chance!

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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Pre-Election Obama Administration Lies

Stanley Feld M.D.,FACP,MACE

The Obama administration is out in force telling pre-election lies so that the Democrat’s base that loves entitlements stays calm.

New data from Joint Commission on Taxation led the TPC to cut the number of people paying federal income taxes by 3.9 million. In total, 77.5 million individuals and married couples — or tax units. as they are defined by the TPC — won’t pay income tax this year out of a total of 171.3 million. The previous estimate was for 66.2 million out of 163.8 million tax units not paying income tax in 2015.

In 2015, this represented 45.2% of the taxpayer units.  In 2013, 40.4% of taxpayer units paid no taxes. With the influx of illegal immigrants paying no taxes the percentage of non taxpaying units will increase.

The illegal immigrants will receive Medicaid and other entitlements.

Hillary Clinton has pledged to increase illegal immigration with open borders and increase Medicaid enrollment.

Taxes will have to be increased. The middle class will be crushed. Hillary Clinton will hide some of these taxes as President Obama has done for Obamacare..

President Obama is trying desperately to save Obamacare from self-destruction.

I have recently reviewed the phony enrollment figures for 2014, 2015 and 2016 published by the Obama administration. There has not been a significant increase in enrollment in the last three years.

The claim that there are 20 million enrollees as a result of Obamacare is not even a half-truth. There are only 10 million enrollees from the Health Insurance Exchanges.

The failed Medicaid entitlement program has an added 10 million enrollees and insufficient physician coverage.

The first pre-election day lie was HHS Secretary Sylvia Burwell telling a group that the 2017 Open Enrollment period was going to sign up an additional 1 million enrollees. She said the Federal Health Insurance Exchange marketplace was strong.

The Marketplace is strong – and will continue to be strong – because it is offering a product people want and need.

This year, we know the Marketplace is strong, but we think it will grow even more.”

“As we look to this next open enrollment period, we project that the Marketplace will grow by another million people. By the end of open enrollment for 2017, we expect 13.8 million people to have selected a plan.”

Obamacare enrollment through the Health Insurance Exchanges was supposed to grow to 21 million last year according to the CBO estimate. At best, 11 million people are enrolled not 12.8 as claimed. Eighty-five percent of the enrollees receive subsidies.

President Obama’s goal is to have a single party payer in control, namely the government.

Secretary Burwell goes on to conclude;

“In closing, as the President said during the debate over the law, “we did not come to fear the future. We came here to shape it.”

It looks like President Obama is shaping the future in a way Americans did not anticipate or want.

The next big pre-election lie was President Obama’s lie admitting that Health Insurance Exchange premiums will go up 22% in 2017. He also said that the government would cover the premium increases for those receiving subsidies.

He did not discuss the government’s position on the increases in deductibles. Is President Obama also covering the deductible increases?

Where is President Obama getting the money? I think the money for the increased subsidies was built into the budget by telling the CBO that there were supposed to be 21 million enrollees in the Federal Health Insurance Exchanges. Only 10 million enrollees showed up.

The reason for these continuing lies is to calm the public. President Obama and Hillary Clinton want us to believe that Obamacare is good and is working well.

The obvious message of these lies is that the public should vote for Hillary Clinton to continue this good work.

 

https://youtu.be/ziVfvWO8oUE

This You Tube is an excellent summary of all the lies President Obama and the Obama administration have told the America public since the Affordable Care Act (Obamacare) was passed.

It is worth ten minutes of your time to review this deception.

This week he tried to dodge the responsibility for the Health Insurance Exchanges demise and also claimed he should not be blamed for the rise in premiums in the private group insurance market.

Of these major cities, the places with the largest increases in the unsubsidized second-lowest silver plan were Phoenix, AZ (up 145% from $207 to $507 per month for a 40-year-old non-smoker),

Three hundred dollars a month or $3,600 dollars a year is a lot of money for a person making between $40,000 and $50,000 per year.

 The premium increases in Birmingham, AL (up 71% from $288 to $492) and Oklahoma City, OK (up 67% from $295 to $493).

 “ Meanwhile, unsubsidized premiums for the second-lowest silver premiums will decrease in Indianapolis, IN (down -4% from $298 to $286 for a 40-year-old non-smoker), Cleveland, OH (down -2% from $234 to $229), and Providence, RI (down -1% from $263 to $261) and increase just 1% in Little Rock, AR (from $310 to $314).”

 In many states there isn’t any competition in healthcare insurance for consumers business.

“Marketplace insurer participation in states using Healthcare.gov in 2017 ranges from 1 company in Alabama, Alaska, Oklahoma, South Carolina, and Wyoming, to 15 companies in Wisconsin.”

Hillary Clinton bragged that healthcare reform was called Hillarycare long before it was called Obamacare.

I would not be very proud of that statement, if I were her.

I do not believe the American public is not going to be fooled again by progressive rhetoric and lies.

Obamacare is a disaster. I have described the disaster and its potential consequences for since its passage in 2010.

It has caused both the public and private healthcare markets to escalate insurance premiums to unaffordable levels for all Americans. The cost to the federal government is unsustainable.

The present awareness of the Obamacare disaster is the straw that is going to break the back of Hillary Clinton’s campaign.

All Americans deserve a better healthcare system than Obamacare.

My ideal medical saving account is the solution to the healthcare problem.

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.”

Clinton

 


https://youtu.be/ETVcsPRTSHM

 

Trump

https://youtu.be/jziTLD0Gc7Y

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

Sowell

 

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.

https://youtu.be/f3BS4C9el98

 

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

others.”

 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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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

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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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