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Disinformation and the healthcare system

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It Is All About Trust

Stanley
Feld M.D.,FACP,MACE

I
voted for President Obama in 2008 because he promised us hope and change. I
knew little of his past or present ideology. He was an attractive candidate and
promised hope.  The New York Times never
went into depth about his past, past interests or past performances.

Americans
trusted him and voted for him. He looked like and acted like the candidate of
hope. I trusted him to lead America on the right path.

President
Obama has done so many things wrong in the last 4 years that it is amazing to
me that anyone trusts him today.

Yet
he even said in one of his stump speeches “you
know me and you know you can trust me.”

Immediately
after his inauguration America was confronted with an $800 billion dollar
stimulus package that promised to produce millions of shovel ready jobs. 

There
weren’t many shovel ready jobs. He baled out some companies and not others. All
the bale outs were at taxpayer expense.

This
stimulus package provided lots of money to increase the size of government. In
fact, President Obama used a sizable about of this money to build a government
bureaucracy for a healthcare bill that was yet to be written.

A
few things developed that made me suspicious of President Obama’s ideology.  President Obama is dedicated to big
government and big spending even though it is inefficient and not directed
toward its original goal.

I
have not been a fan of John Maynard Keynes since I read Fredrick Hayek ‘s “Road to
Serfdom.” 

FDR
did not spend his way out of the depression. World War II got us out of the
depression.

Keynesian
economic has not worked. President Obama was clearly putting us on a “Road to
Serfdom” with his out of control spending and increased national debt by over
$4 trillion dollars.

President
Obama has made many annoying moves in the last four years to fake out the
American public
.

Common
denominators have been a lack of transparency, a disregard for the legislative
branch of government and an overuse of executive orders.

Recent
lack of transparency is illustrated by Fast and Furious and the tragic Benghazi
tragedy
.

The
mainstream media’s coverage has been disgraceful.  http://query.nytimes.com/search/sitesearch/#/Bengasi%2C+Libya+consulate/

Other
annoying actions have been the transfer of power from the congress to the
executive branch and the intimidation of the Supreme Court.

It
seems that he either ignores the constitution or gets around its meaning in
some way. The notion that the constitution is an antiquated document is
offensive and appalling.

The
media as been manipulated by the way events and facts are presented.  November 2nd unemployment results are an
outstanding example.

Americans
have been conditioned over the years to get their news from sound bites and not
detailed facts. Whichever sound bite is present the most times becomes the
fact.

The
economy is not doing well. It is growing at a very slow pace. Job growth is
slow. The presentation of the monthly data is confusing.

The November 2 unemployment
headline was; “Latest Jobs Report Shows Persistent Economic
Growth.”

 The first sentence was there were 171,000 new
jobs in October
. The economy needs 500,000 new jobs per month for a normal recovery.

Consumers
still cannot get jobs, credit or loans from banks.

The
last sentence in the press release stated that unemployment rate rose from 7.8%
to 7.9%
. No one remembers the last sentence

Since
the media is the message and 171,000 new jobs sounds like a big number that is
better than expected. It gives the illusion that the economy is improving on
President Obama’s watch.

Americans are not
stupid. The New York Times is trying much too hard to get President Obama re-elected.

President
Obama has generated mistrust by Americans for the promises he made about Medicare
and Obamacare. The amount of money spent, so far, by the President Obama on
Obamacare is not available to the public.

The
analysis of the increase in middle class taxes already in place as a result of
Obamacare are not discussed by the main stream media nor by President Obama.  

There
are 10 hidden taxes on citizens making less than $250,000 a year i.e. the
Medicare payroll tax. This tax is going up from 2.9 percent to 3.8 percent. There is an additional 3.8
percent Medicare tax added to investment income. Together, this will cost
taxpayers $318 billion from 2013 to 2022. These taxes were not obvious to the
great majority.

The
impact of future Obamacare taxes on the middle class is going to be
overwhelming. The new taxes were written into Obamacare but not presented to
the public. This serves to increase the mistrust for President Obama and his
promise for transparency.

The
one thing I learned from Hayek is that you cannot manipulate the economy by
edict or force without limiting freedom. In a “free” society “ the unintended
consequences and costs are certain to get out of control.

Costs
can be controlled in a level playing field competitive free market. The
consumer driven market is non-existent. Consumers must start to understand
their power in society.

Government
should make rules that level the paying field for all and then get out of the
way. No spinning the facts and no non-transparent activities. No favoritism to
lobbyists, associations or unions.

Rules
should be made for the benefit of the people in a competitive environment.

Medicare
premiums and deductible expenses for senior will raise not decrease as promised
by President Obama. Out of pocket expenses will rise.

Seniors’ standard Medicare
Part B monthly premiums will jump
from $99.90 to $128.20 at the low end of the
means testing while their Part B deductibles will rise from $140 to $180. Seniors’ Medicare hospital deductible on admission will
increase from $1,156 to $1,336, while their daily hospital
coinsurance will climb from $289 to $334 in out of pocket expenses.

I
have pointed out that Obama care’s main feature, ACO’s, will be impossible to
execute and will subsequently fail. This will lead to greater distortions of
the healthcare system.

The
result will be a decrease in choice, a decrease in the freedom to choose your
physicians or recommended care, a decrease in access to care and rationing of
care once the government has total control.

This
does not included increases in costs to seniors and the middle class that has
been scheduled by Obamacare.   

All
the stakeholders have taken advantage of the healthcare system in its present
form. The stakeholders are the healthcare insurance industry, the hospital
systems, the government, the patients and the physicians.

The
healthcare system needs a new business model in order to survive. President
Obama’s business model is not the one. The public does not trust it.

The
actions of the stakeholders are natural as these stakeholders try to survive.

 It is government’s job to make the rules so
these dysfunctional survival methods cannot flourish.  

President
Obama cannot be an effective leader in the future. The public does not trust
him any more.

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

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Twisting the Facts About Health Care

Stanley Feld M.D.,FACP,MACE

I have been a New York Times reader since 7th grade. At
that time I delivered the New York Times to all the classrooms in my Junior
High School.

The New York Times has become pretty shabby in recent
years. It has stopped printing unbiased news. It does not print,  “All
The News Fit To Print.”

It has been publishing biased news, news leaks as well as
opinions that have contained innuendo and not based on facts.

A glaring example is the healthcare editorial on Sunday October
21,2012.

The New York Times is trying very hard to help defeat
Mitt Romney and push President Obama over the finish line.

I hope intelligent readers can see through the Times’
smokescreen of no facts and evaluate the candidates objectively.

The editorial’s first sentence is absolutely correct.

“The outcome of the presidential election will determine which of
two opposing paths the nation will follow on health care for all Americans.”

One
path represented by Obamacare is a path of government takeover of healthcare.
It will convert the healthcare system totally to an entitlement system.  The government will make the rules and create regulations.
Many will be difficult to follow and impossible to enforce.

This
path leads to restriction of freedom of choice, rationing and a decrease in
access to healthcare.

Americans
did not expect this option when they elected President Obama.

It
is easy to remember the sound-bite, “ If you like your present
insurance you can keep it. If you like your physicians you can keep them.”

His
campaign principles were vague. His promises were broad brushstrokes of
policies and not a specific outline of policies. At the end of these vague
promises was the appealing promise of affordable healthcare insurance coverage
for all.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/09/is-medicare-an-effective-bureaucracy-part-1.html

It
turns out that after four years healthcare insurance coverage has become more
expensive. There is no relief in sight. All Americans are subjected to 10
hidden taxes that in effect increases the cost of healthcare insurance
coverage.

America
has passed a 2400 page bill that few read and fewer understand. The bill has
generated over 44,000 new regulations so far and massive new government
bureaucracies.

The
bill was supposed to decrease the cost of healthcare by over $125 billion
dollars during the next ten years.

It
is now estimated to cost taxpayers an additional $1 trillion dollars over ten
years.

The
New York Times editorial goes on to say:

“If voters re-elect President Obama, he will
protect the health care reforms that are his signature domestic achievement.”

It
sounds like the New York Times believes this is a good thing. My guess is the
Times is not a very good judge of sound business practices because it is itself
on the verge of bankruptcy.  Obamacare is
unsustainable and destined to drive America into bankruptcy.

So
far President Obama has done nothing to decrease the number of uninsured and
nothing to decrease the cost of care. In fact the cost of care has escalated as
patient deductibles have increased, premiums have increased and the quality of
employer coverage has decreased. Employer sponsored healthcare insurance
coverage is expected to decrease further in the next two years.

The
New York Times editorial goes on to state:

“If they elect Mitt
Romney, they will be choosing a man who has pledged to repeal the reform law
and replace it with — who knows what?”

The biggest defects in today’s healthcare system are ;

1. It does not encourage individuals to be responsible for the
maintenance for their own health

2, it does not give consumers control of their healthcare dollars
or incentives to preserve those dollars.

3. It does not discourage the practice of defensive medicine with
effective tort reform.

4. It does not create a competitive healthcare market that must
become consumer driven in order to control costs.

The New York Times invites us to visit Mitt Romney’s web site
after this biased preamble:

“The competing visions are often difficult to evaluate because the
Republican candidates — Mr. Romney and his running mate, Paul Ryan — have
become so artful about obfuscating their plans for Medicare, Medicaid and what
they will do to reform the whole system.”

I went to the web site to see what Mitt Romney’s plan is. He has
very specific proposals in his healthcare plan. The proposals could Repair the
Healthcare System if implemented correctly.

I imagine the New York Times did not pay attention to any of the
words in the plan because they are drinking President Obama/Mr. David Axelrod’s
"Kool Aid."

The Times tells us in the very next sentence;

“Almost nothing the Republican candidates say on these or other
health care issues can be taken at face value.”

I would say this is not objective reporting.

What is Mitt Romney’s healthcare plan? I would like readers to
read it carefully and judge for themselves.

He first explains the Obamacare failures. The failures are
important to keep in mind because Obamacare has been shoved down the mouth of
Americans.

OBAMA'S FAILURE

Unfortunately,
the transformation in American health care set in motion by Obamacare will take
us in precisely the wrong direction. The bill, itself more than 2,400 pages
long, relies on a dense web of regulations, fees, subsidies, excise taxes,
exchanges, and rule-setting boards to give the federal government extraordinary
control over every corner of the health care system. The costs are
commensurate: Obamacare added a trillion dollars in new health care spending.
To pay for it, the law raised taxes by $500 billion on everyone from
middle-class families to innovative medical device makers, and then slashed
$500 billion from Medicare.

Obamacare
was unpopular when passed, and remains unpopular today, because the American
people recognize that a government takeover is the wrong approach. While
Obamacare may create a new health insurance entitlement, it will only worsen
the system’s existing problems. When was the last time a massive government
program lowered cost, improved efficiency, or raised the consistency of
service? Obamacare will violate that crucial first principle of medicine: “do
no harm.” It will make America a less attractive place to practice medicine,
discourage innovators from investing in life-saving technology, and restrict
consumer choice.

In short,
President Obama’s trillion dollar federal takeover of the U.S. health care
system is a disaster for the federal budget, a disaster for the constitutional
principles of federalism, and a disaster for the American people.

MITT'S PLAN

On his
first day in office, Mitt Romney will issue an executive order that paves the
way for the federal government to issue Obamacare waivers to all fifty states.
He will then work with Congress to repeal the full legislation as quickly as
possible.

In place
of Obamacare, Mitt will pursue policies that give each state the power to craft
a health care reform plan that is best for its own citizens. The federal
government’s role will be to help markets work by creating a level playing
field for competition. 

Restore
State Leadership and Flexibility

Mitt will
begin by returning states to their proper place in charge of regulating local
insurance markets and caring for the poor, uninsured, and chronically ill.
States will have both the incentive and the flexibility to experiment, learn
from one another, and craft the approaches best suited to their own citizens.

  • Block grant Medicaid and other payments to
    states
  • Limit federal standards and requirements on
    both private insurance and Medicaid coverage
  • Ensure flexibility to help the uninsured,
    including public-private partnerships, exchanges, and subsidies
  • Ensure flexibility to help the chronically
    ill, including high-risk pools, reinsurance, and risk adjustment
  • Offer innovation grants to explore
    non-litigation alternatives to dispute resolution

Promote
Free Markets and Fair Competition

Competition
drives improvements in efficiency and effectiveness, offering consumers’ higher
quality goods and services at lower cost.  It can have the same effect in
the health care system, if given the chance to work.

  • Cap non-economic damages in medical
    malpractice lawsuits
  • Empower individuals and small businesses to
    form purchasing pools
  • Prevent discrimination against individuals
    with pre-existing conditions who maintain continuous coverage
  • Facilitate IT interoperability

Empower
Consumer Choice

For
markets to work, consumers must have the information and the power to make
decisions about their own care.  Placing the patient at the center of the
process will drive quality up and cost down while ensuring that services are
designed to provide what Americans actually want.

  • End tax discrimination against the individual
    purchase of insurance
  • Allow consumers to purchase insurance across
    state lines
  • Unshackle HSAs by allowing funds to be used
    for insurance premiums
  • Promote "co-insurance" products
  • Promote alternatives to "fee for
    service"
  • Encourage "Consumer Reports"-type
    ratings of alternative insurance plans

 

Mitt Romney’s plan is an outline of his healthcare plan that
corrects all of the defects in our healthcare system. Obamacare has amplified
the healthcare system’s defects.

By giving states the opportunity to select a waiver from Obamacare,
Governor Romney is eradicating all the new taxes, regulations, bureaucracy, and
impingement on individual choice, individual freedoms and access to care
issues. He is also opening the door for subsidized healthcare coverage for
those in need.

It is much more specific than the plan President Obama presented before
his election in 2008. I have reviewed my articles on his proposals. President
Obama disguised his real intentions. He made it sound much better than he
intended. If one reads between the lines it is clear President Obama wanted the
federal government to control the healthcare system.

The blog post from 2008 make interest reading. Please click on
them.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-1.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-2.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-3.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-4.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-5.html

President Obama is the pot calling the kettle black.

Government Romney puts the consumer first, not the government. His
plan also strengthens states rights which have been severely discounted during
his term in office. The states can be a little more efficient that the central
government.

President Obama has presented nothing about his healthcare plan
during his reelection cycle,

Many of the regulations have not been written yet. President Obama
is waiting until after the election when “he
will have more flexibility. ”

Please remember I voted for him in 2008. President Obama has been a
tremendous disappointment to me. He does not understand the American psyche and
is ignoring Americans’ wishes.

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

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Medical Costs Outrun President Obama’s Projections

Stanley Feld M.D.,FACP,MACE

No one should be surprised that the cost of
healthcare and medical prices are overrunning projections by the Obama
administration. It was self-evident with the passage of Obamacare. Now it is
official.

President Obama has done all the wrong things to
lower costs and all the right things to raise costs.

The
Health Care Cost Institute analyzes claims data from UnitedHealth Group Inc.,
Aetna Inc. and Humana Inc.
The Institute said the cost for consumers with
employer-sponsored healthcare insurance plans increased 4.6 percent in 2011.
The government estimated a 3.9% increase for 2011.

A recently published study
by the U.S. Centers for Disease Control and Prevention found the number of
people without insurance climbed 1.7 percent in the first quarter of 2012.

Both numbers are the
opposite of the numbers President Obama promised in 2009 when he was forcing
congress to pass Obamacare.

The
CDC reported that 47.3 million people lacked insurance, and the health
institute said hospitals and doctors raised prices at a clip that outstripped
demand.

Why is President Obama not bending the cost
curve as he promised? I would say he either doesn’t know what he is doing or he
knows precisely what he is doing.

My guess is he is trying to force consumers into
a "Public Option" that will be created by the health insurance exchanges. He is
also trying to stick the cost of this “Public Option” onto state governments.
The state governments are required to balance their budget.

Even before states institute the health
insurance exchanges most states are suffering from large budget deficits when
they are supposed to have a balanced budget.

The health insurance exchanges will make it
worse.  The federal government will have
to bail states out as the payer of last resort. This will increase the federal
deficit even further. The federal government will have to print more money.

Printing more money will devalue savings,
salaries and purchasing power. The result will be further inflation. Somewhere someone like a China will not continue to buy the United State's depth and it will default on payment.

America is currently suffering from inflation.
It is being disguised because the government has eliminated fuel costs and food
costs from inflation calculation.

I believe Americans understand this. Governor
Romney must emphasize this in no uncertain terms.

Affordable Care Act, which
promises to expand coverage to 30 million Americans starting in 2014 and trim
health costs.

 

 “If you don’t bend the cost curve, ultimately
insurance gets more expensive,” said Douglas Holtz-Eakin, the president of the
American Action Forum, a Washington-based advocacy group that opposes the health
law. “It’s a big problem for the Affordable Care Act.”
 

Obamacare tries to limit insurers’
administrative expenses and profits. The Healthcare insurance industry is
supposed to pay at least 80% of premiums for direct patient care. (Medical Loss
Ratio of 80
%).

However, President Obama
has permitted the healthcare insurance industry to continue to count expenses
for administrative services into the direct medical services column. The result
is a decrease in the amount of money available for direct patient care.

The Health Care Cost
Institute published the direct cost per person under employer- sponsored plans
increased from $4,349.00 in 2010 to $4,547.00 per person in 2011. United, Cigna
and Humana cover 40 million people.

I have previously published
that the cost per Medicare senior is $6,600 a year.

The obvious question is why
should an employer pay $15,000 to $20,000 dollars a person a year when the cost
is $4,547?

Why should I be paying a
premium of over $15,000 a year in after tax dollars for my Medicare premium and
supplements for my wife and me when it costs $6,600 per person? The $6,600 per
year average includes the sickest seniors. 

Each year the government
increases the Medicare premiums on a means tested basis because it spends money
above my premium cost. 

Keep in mind I have been
paying into the Medicare Trust since 1965. Now I am paying an additional
$15,000 a year for direct services that cost $6,600 per year per person.

Any salary earned by a
senior results in them paying into the Medicare trust.

Someone is ripping off the
system. The likely candidates are the healthcare insurance industry and the ever-increasing
government bureaucracy.

The
institute created last year to analyze claims data from major insurers, found
that charges for hospital emergency rooms rose 9.1 percent in 2011, after
adjusting for a reduction in the intensity of care they delivered.”

This statistic is a
distraction from the real issue. The real issue is to explain the difference in
direct cost compared to premium costs. 

President Obama believes
that hospitals owning and managing physicians practices will result in best
practices using evidence- based medicine.

I believe a system can be
built to teach independent physicians best practices combined with their use of
clinical judgment.

Holtz-Eakin, former CBO
head, believes that Obamacare encourages consolidation among hospitals and
doctors. The consolidation of hospitals and physicians is leading to greater
pricing power by the hospital system.

The problem with the
consolidation of hospital systems and physician practices, is that physicians
are not receiving an increase in reimbursement for their intellectual property
or technical skills.

The hospital system owns physicians’
intellectual property and technical skills. Its staff does the collecting and
financials. The hospital system enjoys the increase in revenues. The salaries
for its administrators have skyrocketed into an average of 1 million to 5
million dollars a year.

It is clear that the price
of adding 30 million people to the healthcare insurance rolls will increase
costs. The increasing price spiral will not be to the advantage of patients and
physicians.

The costs will become
unsustainable and the government controlled healthcare system will collapse.

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

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The Healthcare System in Switzerland Works

Stanley Feld
M.D.,FACP,MACE

Paul
Krugman is starting to drive me crazy with all his fact free declarations about
the healthcare system.

He recently declared that consumer driven healthcare has
been a bust everywhere it has been tried. Paul Krugman as an “expert” has once
again made a declaration that contradicts the facts. He is clearly not
interested in being confused by facts.

Paul Krugman is against putting consumers in
control of the healthcare system. He feels,
as President Obama feels, that a central committee (IPAB) should be in charge
of deciding what to do with limited health care resources. 

He has said,

 "Consumer-based" medicine has been a
bust everywhere it has been tried.
Medicare Advantage was supposed to save
money; it ended up costing substantially more than traditional Medicare.

Medicare Advantage costs the government more
money because the government gave the private insurance companies a $3,000 bonus
per senior to get Medicare out of the government’s hands.

This is one of the principle reasons I am not a fan of
Medicare Advantage.

In reality Medicare Advantage provides more
services at lower premiums and deductibles for seniors. Seniors with Medicare Advantage use
fewer services resulting in a lower cost of total services and more profit for the
healthcare insurance industry.

“America has the most "consumer-driven" health care
system in the advanced world. It also has by far the highest costs yet provides
a quality of care no better than far cheaper systems in other countries.”

Paul
Krugman is wrong.  Switzerland has the
most consumer driven healthcare system in the world and the Swiss government
pays far less than most countries while the Swiss get a high quality of care.

His ideology
blinds his mind. The healthcare system in Switzerland is a consumer driven
healthcare system that works for the Swiss. The Swiss government makes the
rules and then gets out of the way.

The
Swiss healthcare system can be used to start a constructive conversation about
healthcare reform in America that can satisfy both conservatives and liberals
and save the U.S. from bankruptcy resulting from expanding entitlements.

The
healthcare system in Switzerland is a consumer driven healthcare system in
which consumers have choice. It has resulted in a low income tax rate,
universal healthcare, and satisfied stakeholders

The
Swiss system could not be totally transformed into an American system because
of America’s embedded ideology and prejudices as well as stakeholder vested interests.
However it outlines the government’s role in a healthcare system and highlights
the power of a consumer driven system.

America’s
healthcare system must undergo significant changes. Most of these significant
changes have been ignored by President Obama in Obamacare. It empowers
government and not the consumer.

Paul Krugman has stated flatly, "Patients
are not consumers"

“Patients get illness that others (government) should decide on
whether it is cost effective to treat
.”

This
attitude toward patients points out the disrespect for the intelligence and
judgment of consumers.

The elements
critical to meaningful reform of America’s healthcare system must include the
following changes.

1.
There must be significant and meaningful Tort Reform to decrease the practice
of defensive medicine.

2.
There must be significant reform of the healthcare insurance industry’s
financial rules to stop the industry from listing non-direct care expenses as
direct patient care.

3.
There must be regulations to cause the healthcare industry to be competitive
for consumers’ business. Government should not be the consumer of healthcare.

4.
There must be legislation to change the healthcare insurance industry’s incentives
for profitability in order to create innovative healthcare insurance products
that will reduce healthcare costs.

5.
There must be significant financial incentives for consumers to be motivated to
save healthcare dollars.

6.
Consumer must responsible for their health and healthcare dollars. The
entitlement mentality must be eliminated.

7.
Hospital systems should be competing for patients’ healthcare dollars and not
government healthcare dollars.

8.
Physicians must be responsible to consumers and not hospital systems or the
government.

9.
Insurance costs must be community rated.

The
healthcare system must be a consumer driven system just as purchasing
groceries, automobiles, computers and televisions are. If the product is poor
the company will go out of business.

America’s goals should be universal healthcare
coverage with freedom of choice, and reduction of healthcare costs.

It is worth understanding the Swiss healthcare
system as a starting point to meaningful reform of the American healthcare
system. 

These are the major features
of the Swiss Healthcare System:

1.Swiss citizens
buy insurance for themselves.

2.There are no
employer-sponsored or government-run insurance programs.

3.Insurance
prices are transparent to the beneficiary and community rated.

4. The
government defines the minimum insurance benefit packages that must be offered.
 Everyone must have the minimum
healthcare insurance coverage.

5. All
packages require beneficiaries to pick up a portion of the costs of their care
(deductibles and coinsurance) in order to incentivize citizens to be
responsible for their health and the control of healthcare dollars spent.

6. My ideal
medical savings account would provide a positive incentive by rewarding
citizens who did not spend the first $6,000 dollar to keep that money in a
retirement account.

7. Patient
incentive is a critical element in healthcare reform because incentives provide
consumers with a reason to take care of their health and healthcare
dollars 

8.The Swiss government
subsidizes health care for the poor on a graduated basis, with the goal of
preventing individuals from spending more than 10 percent of their income on healthcare
insurance.

9. Citizens
can be responsible for a significant component of healthcare costs in Switzerland.

10. Consumers
often opt for the cheaper healthcare insurance packages. They have freedom of
choice.  Many Swiss consumers choice chose
minimal insurance plans combined with high-deductible insurance plans.

11. Citizens
are free to choose comprehensive insurance coverage or some form of
supplemental coverage. It is not a one size fits all system.

12. Ninety-nine
percent (99.5%) of Swiss citizens have health insurance.

13.There are
about 100 different private insurance companies in Switzerland with multiple
healthcare insurance plans.

14. It is clear
that the government has made the rules and then has gotten out of the way. The
rules have set up a market driven competitive healthcare system.

15. The result
has been that healthcare insurers are competing for consumers’ business on
price and service. Consumers gravitate to the best price and service that fits
their needs.

16. The Swiss
healthcare system not only helps to curb health care inflation but most
beneficiaries have complete freedom to choose their doctor.

17. The setup
of the system has resulted is low waiting times for physician and hospital
services with a minimum of bureaucratic slow downs. 

18. The Swiss healthcare
system aligns all the stakeholder incentives by empowering the consumer while
helping less fortunate consumers.

19. Government
spending on health care in Switzerland is only 2.7 percent of GDP, by far the
lowest in the developed world.

U.S.
government spending on health care was 7.4 percent of GDP in 2008 and will
exponentially grow under Obamacare.

 “ If the U.S. could move its state health spending to Swiss
levels, it would save more than $700 billion a year.”

Dr. Regina Hertzlinger has an excellent description of the
Swiss healthcare system in the following You Tube.


 

http://youtu.be/E5bsz_oewDA

Switzerland’s
healthcare system cannot be superimposed on the U.S. healthcare system. It can
be used as a starting point to empower consumers to drive the healthcare system
and be part of the solution. 

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

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Permalink:

Does It Work For The Canadian Government?

Stanley Feld M.D.,FACP,MACE

In the last blog post I have discussed how a former Canadian
physician (now a U.S. physician) felt about the Canadian system.

The next question is does the Canadian Healthcare System work for the
Canadian government? 

The answer is No!

The Canadian deficit resulting from the Canadian healthcare system is mounting at a unsustainable rate in a country that is already overtaxed. The problem is
the government is not admitting it and the U.S. government and media are
ignoring it.  

I have discussed how patients I interviewed in Canada feel about
their healthcare system. Some of Canadians are bitter about Canadian physicians
immigrating to the U.S. because the practice conditions are better in the U.S. than
in Canada.

The Canadians complained that physicians coming to Canada from
India and China are not being licensed to practice medicine despite the severe
physician shortage. Most of these physicians are driving taxicabs.  

 I included a You Tube of Canada patients raving about the Canada
Healthcare system.

 The people interviewed looked healthy and probably did little
interacting with the healthcare system.

Is the Canadian healthcare system good or a least better than the
U.S. healthcare system?

There have been two recent articles in American newspapers that
applaud the Canadian system.

  1. Debunking Canadian health care myths
    – The Denver Post
                                                                                                                             http://www.denverpost.com/opinion/ci_12523427#ixzz25y9kuiVG

 2. Everything you ever wanted to know about Canadian
health care in one post. Washington Post

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/01/everything-you-ever-wanted-to-know-about-canadian-health-care-in-one-post/

Both articles are opinion articles and lack concrete evidence. The
articles contain both misinformation and disinformation.  

 It reminded me of a Justice Scalia’s recent comment on 60 minutes.

“You should not believe what you read about the
court in the newspapers,” Scalia said. “Because the information has either been
made up or given to the newspapers by somebody who is violating a confidence,
which means that person is not reliable.”

Scalia

The Fraser Institute is a well-respected Canadian think tank. Its
research is accurate with a libertarian slant.

Its 2011 report contradicts the statistics in these articles
concerning the Canadian government healthcare costs.

 Article 1. “Ten percent of Canada's GDP is
spent on health care for 100 percent of the population. The U.S. spends 17
percent of its GDP but 15 percent of its population has no coverage whatsoever
and millions of others have inadequate coverage. In essence, the U.S. system is
considerably more expensive than Canada's.”

Article
2.
 “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 institute. To be
specific, in 2011, health care spending consumed 50 percent of revenues in
Canada’s two largest provinces, Ontario and Quebec.

According to the
institute,

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

These two articles are
either copying other inaccurate articles or copying each other. It could be
they are just reporting provincial (states) spending and not total costs.
Healthcare costs in Canada are rising faster than the GDP.

“Total
federal, provincial and territorial government health spending has grown by 8.1
percent annually, while the national GDP in Canada rose by only 6.7 percent
during the same period.”

Article 1 states that
the decision making for treatment and tests needed are made exclusively by the
patients’ physicians. We know this is not true because of the rationing of care
and the long wait times to see a physician.

“In Canada, the government has absolutely no say in who gets care or how
they get it. Medical decisions are left entirely up to doctors, as they should
be.”

There are no requirements for pre-authorization whatsoever. If your
family doctor says you need an MRI, you get one.”

Article 2. states the opposite.  “The Canadian health care system was
built around the principle that all citizens will receive all “
medically
necessary and hospital physician services
.” To that end, each of Canada’s 10
provinces and three territories finance and run a statewide health insurance
program with federal aid. There is no cost-sharing for the health care services
guaranteed under federal law.”

The Fraser report
describes the actions the provincial governments have taken in response to the
rapidly rising costs.

The provincial
governments have raised taxes and rationed care, increasing patient wait times.
This agrees with the reactions of the people I interviewed

“Provincial
drug plans have also more often refused to pay for most of the drugs that are
certified as “safe and effective” by Health Canada.”

“Unsustainable
rates of growth in health care spending crowd out the resources available for
other purposes including education, public safety, and economic
growth-enhancing tax relief,”

Despite Canada’s
increase in federal funding and rationing of care the cost of care increases.
The federal government has encouraged the individual provinces to make the
necessary reforms to increase their efficiency and decrease bureaucratic waste.
The low overhead figures quoted by the two U.S. newspaper articles are wrong.

We conclude
that Canada’s health system produces rates of growth in health spending that
are not sustainable solely through redistributive public financing,” the report
concluded.

“In 2011,
health care spending consumed 50 percent of revenues in Canada’s two largest
provinces, Ontario and Quebec.

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.”

“Federal
funding is not a solution: the federal government has already transferred
billions more in health funding to the provinces than the amounts needed to
keep up with general price inflation or population growth.  

The study added that none of the government’s rationing efforts
have made the growth of government spending on health care sustainable.

“The Fraser Institute concluded that Canada’s
health care system is spending at an unsustainable rate. Six of ten Canadian
provinces are on track to spend half of their revenues on health care
,
according to the institute.”

We conclude that Canada’s health system
produces rates of growth in health spending that are not sustainable solely
through redistributive public financing.”

The media is the message. The message sent controls behavior.

All Canadians want a comfortable entitlement for healthcare. I do
not blame them.

The problem is entitlements are too expensive for the government.  They don’t work because governments cannot
legislate behavior by directives. Individuals must be responsible for their
health and healthcare dollars. Using incentive programs government can help
people be responsible to and for them.

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

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Permalink:

Health Insurance Exchanges And The Federal Government

 Stanley Feld M.D., FACP,
MACE

Health
Insurance Exchanges
are supposed to be state-regulated
and standardized health care plans in the United
States
, from which individuals may purchase health insurance
coverage eligible for federal subsidies.

All exchanges must be fully certified and
operational by January 1, 2014 under federal law.[1]

The health insurance
exchanges in all states are not going to be operational on time.

However, Americans of
all income brackets are experiencing the increases in 20 hidden taxes in
Obamacare right now. The increase in taxes is supposed to amount to $1.2
trillion dollars.

The health insurance
exchanges, are supposedly one of the centerpieces of President Obama’s health care law,

Their formation is failing
despite President Obama’s publicity.

If they are created President
Obama will have a clear path to the Democratic Party’s cherished Public Option.

This will be a giant
step to achieving a single party payer healthcare system.

Unfortunately, the
single party payer system will in turn fail because it will be unaffordable for
America.

Individual states and
the healthcare insurance industry will do everything they can to undermine the
success of health insurance exchanges.

Federal officials never
thought they would end up running the Health Insurance Exchanges. President
Obama’s plan was to dump this formidable and complex task on the states. Half
the states have refused to participate.

Obama
administration officials are getting ready to set up
and operate new 
health insurance markets
in about half the states, where local officials appear unwilling or unable to
do so.”
 

“So far, Governors of 13 states with nearly
one-third of the United States population have sent letters to the Obama administration
saying they intend to set up exchanges. Complete applications are due on Nov.
16, 2013.”

In other words, 37 states have not signed up
ye
t. Once those 13 states that have signed up and start calculating their costs
for setting up and running the health insurance exchanges I suspect they will
also withdraw.

The Secretary of Health and
Human Services, Kathleen Sibelius
’ plan was to complete the regulations for the
states to start the health insurance exchanges by January 1,2014. 

The Secretary of Health and
Human Service has emphasized that states must meet her standards of transparency
and accountability.

The federal government requires
state exchanges to develop budgets and project operating costs, revenues and
expenditures to the central government’s satisfaction.

States must explain how the
revenue will be generated and how the exchange will address any financial
deficits.

The federal government wants to
set up the rules and require the states to execute these rules at the states
expense. President Obama promised to “fund” the exchanges for the states for
two years. After that they are on their own.

The health exchange programs
will be delayed because the government pledged to set up the health exchanges
in the states that opted out of the program. It has not started to set up these
exchanges.

Creation
of Health Insurance Exchanges is a complex and expensive task. States are
required to operate under a balanced budget. States cannot balance their
budgets with health insurance exchanges unless they further increase taxes.

 “Federal and state officials and health policy experts expect that
the federal government
will run the exchanges in about half of the 50 states.”

 My
guess is it will be closer to 35 states. Federal officials are preparing to do
the job. It will be poorly executed and difficult politically.

President Obama knows the
public fears a federal takeover of the healthcare system. He realizes the
public understands the health Insurance exchanges are one more step toward a
federal takeover of the healthcare system.

The Obama administration
does not want to encourage that fear by taking over the Health Insurance
Exchanges.

Neither does the Obama
administration want to alienate state officials whose help they need to execute
the federally run healthcare exchanges.

The federal government
does not have the manpower to run all these exchanges. It is outsourcing the
work to private contractors.

We have seen the
disastrous abuse to physicians by outsourcing fraud and abuse investigations to
private contractors.

“The Obama
administration has invited advertising agencies to devise an elaborate
“outreach and education campaign” to publicize the federal exchanges and their
potential benefits for consumers.”

The Federal officials
are hiring private contractors to provide “in-person assistance” to consumers
and to operate call centers.

President Obama’s
administration has attacked Mitt Romney and Bain Capital for outsourcing of
jobs.

President Obama is now outsourcing
these jobs to a foreign company, while America desperately needs jobs here.
This is duplicity to its highest degree.

He better keep it out of
the mainstream media or Mitt Romney out to get it in the mainstream media
somehow.

Federal officials
have turned to the American subsidiary of a Canadian company,
the CGI Group, to
provide information technology services to the federal exchanges under a
contract that could be worth $93.7 million over five years.

Kathleen Sibelius has demanded total transparency
of state health insurance exchanges yet planning for the federal exchanges has been done
almost entirely behind closed doors.

“We have gotten
little bits of information here and there about how the federal exchange might
operate,” said Linda J. Sheppard, a senior official at the Kansas Insurance
Department.

“I was on a panel at
Rockhurst University here, and I was asked, ‘Where is the Web site for the
federal exchange?’ I chuckled. There really isn’t any federal exchange Web
site.”

In New Hampshire, Thomas
M. Harte, the president of Landmark Benefits, which arranges health insurance
for 300 employers of all sizes, said:

“Nobody has any idea
what the federal exchange will look like. There has not been much communication
between officials drafting plans for the federal exchange and the people who
will use it: consumers, employers, brokers and insurers.”

Administration officials
have not set forth a budget for the federal exchanges.

“They said they
intended to charge “user fees” to the participating health insurance plans.

It is unclear whether
the fees are subject to approval by Congress or whether insurers could pass the
costs on to consumers.”

The Federal Government
is not telling us what they are going to do. It is not following its call for transparent
regulations.

It is pretty clear to me
this will be one of many steps toward the destruction of the healthcare system.
The healthcare system will self implode. At that point everyone will be begging
the government to take over.

It will be impossible
for President Obama to take over a business the government cannot afford.

A key to Repairing the
Healthcare System is to decrease the outsourcing and bureaucratic complexity.

It is to let Americans
be independent, own their healthcare dollars and their health and not be
dependent on government complexity, inefficiency and rationing of care.

Entitlements do not save
money!

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

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Here Come The Fibs, Distortions and Lies

Stanley Feld M.D.,FACP,MACE

As we approach November 6th (election day)
we will be subjected to more fibs, distortions and lies from President Obama
and his administration.

He has had a miserable record during his first term in
office. The only tactic he has left is to make villains out of Mitt Romney and
Paul Ryan while he makes promises he cannot keep. He has not kept most of the
promises he made before he took office.

As soon as Paul Ryan finished his speech at the
Republic convention he was accused of telling lies.

Carl Sandburg said in The Prairie Years “If you tell a lies enough times it becomes
the truth. The problem is a liar must have a good memory.”

Mr. Sandburg left out the fact that your audience has
to have a good memory to recall your first lie. One of the lies President Obama
told was the lies of Jonathan Gruber in 2009.

At the height of the Obamacare debate, Mr. Gruber’s
lie was all over the op-ed pages throughout the nation. Mr. Gruber, an MIT
economist and architect of Obamacare, stated that Obamacare would reduce the
cost of healthcare insurance for everyone.

“What
we know
 for sure “is
that [the bill] will lower the cost of buying non-group health insurance.” 

The law
permits children under 26 years old to stay on their parents’ healthcare
insurance plan.

Immediately, the parents’ healthcare insurance premiums rose
significantly.

 

           Jonathan Gruber
is now telling state governments that the law will significantly increase the
cost of insurance for everyon
e.

 The result is the opposite of the promise.

President Obama brags about this achievement. In
reality he gave the healthcare insurance industry an excuse to raise premiums.

 Jonathan Gruber asserted that in 2016, young people would save 13 percent, and older
people 31 percent, on their insurance premiums
.

 “President Obama, too, touted the
bill’s ability to “bend the cost curve,”
 repeatedly
promising
 that the law would “bring down premiums by
$2,500 for the typical family.”

Jonathan Gruber now: “Obamacare will increase premiums by 19-30 percent.”

President Obama now figures he can call Paul
Ryan a liar.

He has a sympathetic audience in the traditional
media. However, President Obama with Obamacare is throwing Grandma over the
cliff. In fact it looks like he is pulling a Thelma and Louise with the United
Sates of America.

 

 http://youtu.be/4z88U915uq8

President Obama still seems like a nice guy. Everyone
would love to believe in him but they just can’t trust him.

 During
his speech Paul Ryan said,

 

And the biggest, coldest power play of all in Obamacare came at
the expense of the elderly
.

You see, even with all the hidden taxes to pay
for the health care takeover, even with new taxes on nearly a million small
businesses, the planners in Washington still didn’t have enough money. 
They needed more.  They needed hundreds of billions more.”

 “So, they just took it all away from
Medicare
.  Seven hundred and sixteen billion dollars,
funneled out of Medicare by President Obama
.  An obligation we
have to our parents and grandparents is being sacrificed, all to pay for a new entitlement we didn’t even ask for
The greatest threat to Medicare is Obamacare.”

Paul Ryan’s statement is correct.  President Obama accused Paul Ryan of leaving
the $716 billion dollars in Medicare. He did but he does not use it for
Obamacare. Mitt Romney will repeal Obamacare his first day in office.  

The
$716 billion left in Medicare by Paul Ryan will shore up the solvency of the
Medicare program itself.

Below
is what President Obama was using the $716 billion dollars in Medicare cuts for.
Notice the $1.2 trillion dollars in new taxes and the $716 billion dollars in
Medicare cuts are being used to pay $644 billion dollars for Medicaid expansion
and $1.19 trillion dollars for subsided exchanges. The a deficit would be $141
billion dollars.

 
Untitled.png obams 716

Does
anyone believe the deficit would be that low? I doubt it.

President Obama was going to cut $542 billion from
Medicare in the original CBO scoring.

It
turns out that President Obama is the liar. Someone ought to tell President
Obama, “The public is getting tired of
his lies once they understand them.”

Paul
Ryan also said,

 “President Obama created a bipartisan
debt commission. They came back with an urgent report.  He thanked them,
sent them on their way, and then did exactly nothing
.”

Paul Ryan is
absolutely correct. Simpson and Bowles are still steaming about their
commission’s treatment by the President. Paul Ryan then went on to say,

“Republicans stepped up with good-faith reforms and solutions
equal to the problems.  How did the president respond?  By doing
nothing – nothing except to dodge and demagogue the issue.”

This is what Erskine Bowles,
President Clinton’s former chief of staff and the leader of President Obama’s
deficit commission, had to say about Paul Ryan in September of 2011;

I’m
telling you, this guy is amazing.
I always thought I was okay with arithmetic.
This guy can run circles around me. He is honest, he is
straightforward, he is sincere
. And the budget he came forward with
is just like Paul Ryan. It is a sensible,
straightforward, honest, serious budget and it cut the budget deficit just like
we did by four trillion dollars
.”

President
Obama attacked Paul Ryan by saying Ryan voted against the Simpson-Bowles
commission.

The
traditional mainstream media has supported President Obama’s attack without
fact checking. The media was satisfied that President Obama’s message
neutralized Mr. Ryan’s attack on the President.

The
mainstream media never bothered to find out why Paul Ryan voted against the
Simpson-Bowles recommendations.

The
media figured it, the media, is the message. President Obama figured the
media’s message would take care of Mr. Ryan. Mr. Ryan was clearly a hypocrite
to the mainstream media.

 It’s
true that Paul Ryan voted against the Simpson-Bowles recommendations because Simpson-Bowles
raised taxes while doing little
to nothing about health-care spending
, the biggest driver of
growing deficits.

By
rejecting Simpson-Bowles, Ryan decided to put forward his own plan for deficit
reduction the Path
to Prosperity
.

On
the other hand this is what Erskine Bowles had to say about President Obama’s
budget:

“President Obama, as you remember, came out with a budget.
And I don’t think anybody took that budget very seriously. The
Senate voted against it 97 to nothing.

He therefore, after a lot of pressure from folks like me, he came
out with a new budget framework. And in that budget framework, he cuts the
budget by four trillion dollars over twelve years. And, to be candid, this four trillion dollars cut was very heavily back-end loaded.
So, that if you looked at it on a ten-year basis and compared apples to apples,
it really was about a two and a half trillion dollar cut.”

More tricks to deceive the public. I could go on and on. Americans
have been fibbed and lied to by its purveyor of hope (President Obama).

However, I think President Obama has lost his tall with the
public. He is now calling for sympathy. He wants the public to let him finish
the difficult work he started.

I hope the public does not give him that chance.

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

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Medicaid Patients And Physicians

Stanley Feld M.D.,FACP, MACE

Obamacare becomes
more complicated and expensive by the week. President Obama has intentionally
made the real costs of Medicaid more difficult to follow.

He originally fudged
the information to the CBO in order to obtain favorable scoring
. The first
scoring created a deficit decrease of 108 billion dollars over 10 years. He
used this CBO scoring to convince the Democrats in both the House and the
Senate to vote for the bill.

Then the states that paid
most of the Medicaid bill complained.  They
had budget deficits that would increase. 
States are obligated by law to balance their budgets. The people could
not afford a raise in taxes.

President Obama said
he would pay 90% of the Medicaid bill for two years.

This would increase
federal expenditures for Medicaid. The increase was not calculated into the
original CBO scoring.

Now a study shows
that 33% of physicians will not accept Medicaid patients because the
reimbursement is too low.

This study is probably
not accurate. There will be less than 66% of physicians accepting Medicaid
patient. Physicians’ reimbursement has fallen below physicians’ operating
expenses. In 2014 Medicaid enrollment will explode. Under Obamacare an additional
16 million people will be eligible for Medicaid. 

I wonder what is to
become of the other 16 million uninsured when the promise was to insure 32
million people?

Avik Roy pointed out that states with Democratic governors tend to have lower physician
reimbursement rates for Medicaid. Those Democratic governors have the highest
budget deficits.

It is easier to cut
physicians’ reimbursement rates than reduce the already minimal services. Entitled
patients have been more vocal than physicians.

A higher percentage
of physicians will quit Medicaid. They cannot pay their office expenses with
the present level of reimbursement.

They will say, “I
quit.”

If this happens and enough
physicians quit, these states will tell their licensed physicians that they
will not be able to renew their license to practice medicine unless they accept
Medicaid patients.

I predict they will
quit anyway.

This could
prove true in a state like California
, where 1.8 million residents are expected
to gain coverage – but fewer than 60 percent of providers presently accept new
patients in the program.”

 President Obama anticipated
this in the Obamacare bill. The law increases Medicaid reimbursements for
primary care doctors to match those of Medicare providers.

The goal is to entice primary care physicians to participate in
the program.

There are several things wrong with this thinking,

  1. The increases are short term. The
    Federal government will only increase payment for two years. Clearly if the
    increase in reimbursement is successful it will have to be extended to maintain
    the increase in participation. Some interest groups already have their eyes on an extension.
  2. The increases do not include specialists
    so few specialists will participate at the onset, paralyzing the Medicaid system.
    If President Obama increases payment to specialists the Obamacare deficit will
    increase even further. 
  3. Medicare reimbursement is decreasing and may end up being lower
    than present Medicaid reimbursement. Therefore this entire exercise is another
    Obama trick play.
  4.  “As long as
    a doctor or hospital isn't losing money
    , they will probably accept new
    patients.”
     

 The key then, is Medicaid reimbursement. Federal dollars
will only last two years. It means states will have
an additional hundreds of thousands of Medicaid recipients for which they will be
on the hook for either keeping the
higher level of reimbursement once the money from Washington dries up, or cut reimbursement rates and watch
doctors bail out.

It is obvious the “fix”
is in, but without specialists included it will not work. Obamacare will have to subsidize the increase. This will increase
the federal deficit even more. In fact it will bankrupt the country.

This was
apparently the plan all along
. The two year funding was put in to reduce the initial
10 year costs and fool the public into thinking Obamacare costs less than it
actually will”.
 

This is only one of the trick plays that President Obama
included in Obamacare to deceive Congress and the people. Remember Nancy
Pelosi’s famous statement, “We will not
know what is in the bill until after we pass it.”

Obamacare contains hundreds of deficit increasing tricks
claimed to be deficit reducing. 

He spent money without attention to consequences.

The only sane thing to do is to repeal it and start over
again unless the goal is to bankrupt the country.

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

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“Here You Go Again”

 

Stanley Feld M.D.,FACP,MACE

In
recent days President Obama and his team have ramped up a coordinated effort to
depict Paul Ryan as a candidate that will destroy Medicare with vouchers. His
team is doing this to scare seniors into voting for President Obama.

President
Obama has been disingenuous throughout this campaign. He has had little success
in fixing the economy despite his promise to do so.

American
are less better off in 2012 than they were is 2008. I believe President Obama
has weakened institutions that have strengthened American democracy and the freedoms
its citizens enjoy.

With
executive orders and the bully pulpit he has weakened the balance of power
between the executive branch, the legislative branch and the judicial branch. He
has ignored many of the principle tenets of the U.S. Constitution.

He has trampled States Rights in favor of his
notion of central government control. In turn, Americans are feeling the freedoms
they have enjoyed are being taken away by central government executive orders.  

President
Obama does not have a record of achievement to sell to the American people. The
only option he has is to destroy the character and credibility of  his opponents. He character assassination
tactics have been disingenuous and irrelevant.

The
traditional media have been our surrogates in the past for news and
information. However the traditional media have been biased and have supported
President Obama’s tactics. The traditional media have ignore the real issues of
the day. 

What
could Governor Romney’s perfect reaction be to President Obama’s now hollow
promises for America’s future?

The
perfect response could be Governor Reagan’s reaction to President Jimmy Carter
during the 1980 Presidential Debate.

President
Carter’s unsuccessful policies were not congruent with America’s desires for economic
prosperity and freedom. During the debate Reagan’s response to a Carter
soliloquy on what he wanted to achieve was simple.    

  

 

  http://youtu.be/px7aRIhUkHY

One big issue is the escalating deficit. A
principle cause of the increasing deficits is President Obama’s excessive
spending on failed entitlement programs. Medicare is a failing program.
Obamacare is adding 30 million more people to a failing program and increasing
its complexity. This new entitlement program is increasing the deficits and will
bankrupt the U.S. quicker.

None of the “improvements” have been proven or
shown to be executable. This certainly will lead to increased central
government control of the distribution of medical care.

Former vice
presidential candidate Sen. Joe Lieberman said last year
, "We can't save
Medicare as we know it. We can only save Medicare if we change it."

President
Obama isn’t taking the deficit crisis seriously. He has caused in excess of 1
trillion dollars in deficits yearly for a total of 4 trillion dollars during he
term as President.

He
has no regard for fiscal responsibility. He has ignored the recommendations of
his own Bowles Simpson commission on deficit reduction.

Through a disingenuous marketing campaign he ridicules Paul Ryan’s  comprehensive alternative.

Erskine Bowles, President Clinton's former chief of staff
and the co-chairman of the Bowles-Simpson commission, described the Ryan budget
that passed the House in March as "sensible, straightforward, honest,
[and] serious."

About President's Obama's budget, which failed in the
Senate in May by a vote of 97 to zero, Mr. Bowles said, "I don't think
anybody (
including
President Obama)  took that budget very seriously."

Since President Obama doesn’t take the deficit
crisis seriously, the traditional media has not taken the deficit crisis
seriously. The traditional media are President Obama fans.

How can we expect the public to understand the
seriousness of the deficit crisis?

It is hard to imagine the meaning of a 16
trillion dollar deficit much less the significance of an increase of 1 trillion
dollars a year. It is difficult to understand the deficit reduction compromise
the congress has come to with respect to the deficit as these numbers are
thrown around.

It is difficult to visualize the breadth of the
deficit when speaking in trillions of dollars.

Last week a reader sent me an easy to
understand explanation.  Everyone needs
to understand the scope of the deficit. President Obama should not take us to
be fools. 

It is easy to become agitated by these numbers.

 U.S. 2011 Financial Statement

 

U.S. Revenue                
$ 2,170,000,000,000   or       
$2.17 trillion dollars

 

Federal Money Spent     $
3.820,000,000,000   or        
$3.82 trillion dollars

 

New Debt                       
$ 1,650,000,000,000   or       
$1.65 trillion dollars

 

National Debt                   
$14,271,000,000,000          $
14.271 trillion dollars

 


Recent Budget cuts            
$  35,500,000,000           $ 35.5 billion dollars

 

Congress and President Obama have agreed to
$35.5 billion dollars of recent budget cuts. It sounds like a lot of money. There
has been a lot of tradition media babble and coverage on this insignificant reduction.

It makes us think the President and congress
are doing something significant to reduce the deficit. Everyone understands the
waste inherent in government spending on government programs.

If we pretend these financial figures are a
family budget, we can see that the budget cuts are ludicrous. 

Let us remove all the zero’s from the trillion
dollar numbers to arrive at understandable amounts. Then let us pretend it represents
a family financial statement.

Family 2011 Financial Statement 

Annual Family Income is  $ 21,700 dollars in the year.

 

The family spends $ 38,200 dollars that year.

 

New credit card interest bearing debt increases
by $16,500.

 

Outstanding Balance on the credit card
increases to $142,710 dollars.

The reaction of most people is this is crazy.
He will never repay the family debt.       
 

The head of the family promises the credit card
company he is going to decrease

spending.

He cuts family spending by $35.50 a year after
he promises the credit card company he would decrease his debt by 50% in 4
years.

The head of the family has three choices. He
can increase revenue somehow but his boss does not want to raise his salary. He
can raise the debt ceiling. His lender does not want to raise his debt ceiling
because he is a bad risk. Raising the debt ceiling means he has to manufacture
more money with credit card borrowing. The lender said enough is a enough.

His last choice is to decrease his family’s
unnecessary spending.

President Obama’s decrease in spending is a
joke and an insult to a lender.  

President Obama is not serious about lowing the
deficit. Paul Ryan is. He has presented a sensible way to save Medicare.

Whom do you think the creditors of the United
States would trust more?

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

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