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View Of A Young Doctor: Dr. Starner Jones

January 21, 2015
inMedicaid, Medicare, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System
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Stanley Feld M.D.,FACP,MACE

 A reader sent this note to me with a request to pass it on. The note hits the nail on the head.

 Dr. Starner Jones is an intern in a large community hospital.

 As a young physician he understands the folly of America’s entitlement society.

His short two-paragraph letter to President Obama accurately puts the blame for America’s dysfunctional healthcare system and its accelerated unsustainability on our  "Culture Crisis." Our country has a "Health Care Crisis" as a result of its "Cultural Crisis".

He presents the crisis, its diagnosis, prognosis and cure in just three (3) short paragraphs.

If you doubt any part of what Dr. Jones says, go visit your local hospital emergency room as an observer for an hour or so some Friday or Saturday night. Then see how many responsible people you can send his solution to for them to send it on. 

 “Dear Mr. President:

During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ring tone.

While glancing over her patient chart, I happened to notice that her payer status was listed as "Medicaid"! (A Completely Free Healthcare Program provided by our Government) During my examination of her, the patient informed me that she smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and beer.

And you and our Congress expect me to pay for this woman's health care?

 I contend that our nation's "health care crisis" is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a "crisis of culture", a culture in which it is perfectly acceptable to spend money on luxuries and vices while refusing to take care of one's self or, heaven forbid, purchase health insurance. It is a culture based on the irresponsible credo that "I can do whatever I want to because someone else will always take care of me."

Once you fix this "culture crisis" that rewards irresponsibility and dependency, you'll be amazed at how quickly our nation's health care difficulties will disappear.

Respectfully, 
STARNER JONES, MD"

 If you agree…pass it on to responsible friends. 

There are additional reasons for America’s “healthcare crisis.” However, as long as we elect local, state and federal politicians who believe that all of society must be responsible for the welfare of the irresponsible members of society, America’s unsustainable economic situation will become worse.

Someone told me America is the greatest economic machine in the world “only because we print more money and suck less.”

 The more people receiving the benefits of the inefficient redistribution of wealth through entitlement programs the harder it will become to reinvigorate the American dream.

America is working its way toward a totally socialist society where the government supports us and tells us what to do and where and when to do it.

We will wake up one day and ask what happened to the freedoms guaranteed by the Constitution and Bill of Rights.

The answer is we gave them away to power hungry politicians who want to control us.

France just dropped its 75% tax rate because its society was economically unsustainable no matter how high its tax rate and the economy is collapsing.

France has had a "Culture Crisis "that is causing its social and economic collapse. The country finally realizes the people must have incentives to be creative. Progress does not happen as a result of entitlement and the redistribution of wealth.

The British National Health Service is in grave financial difficulty. 

 The NHS is in danger of being shut down.

"It’s a period of unprecedented pressure, of undue pressure. the NHS is facing very difficult times, yes. The word "crisis" implies that you can’t deal with it."

"A Department of Health spokesman said: "In common with healthcare systems around the world, the NHS is facing unprecedented demand, but undermining the principle of services being free at the point of use is not the answer."

I think rather than repeating the same mistakes over and over again, someone would learn something about fixing the “Culture Crisis”.

 As other countries are trying to fix their “Culture Crisis”, President Obama is going in the other direction and accelerating the road to economic failure.

Jack P, Athens wrote the following comment in MailOnline.com,  

“Socialism always brings a good laugh when it collapses as the politicians raise taxes to cover their mistakes.”

President Obama is destroying the healthcare system with Obamacare.

I would try to fix America’s “Culture (entitlement) Crisis” by helping people become responsible and act independently. I would not increase policies that promote individual dependency on the government.

Somehow Americans have to wake up as a people and try to stop the government from following this path.

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

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Things Happen When No One is Looking

January 4, 2015
inMedicaid, Medicare, Medicine: Healthcare System, Patients Problems, Physician's Problems, Stakeholder Mistrust
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Stanley Feld M.D.,FACP,MACE

I wish you all a Happy and Healthy New Yew Year.

I have not written blogs during the holiday season because I figured no one would pay attention to what is happing in healthcare.

President Obama figured the same and snuck in a few things to continue to destroy the healthcare system.

Obamacare “innovative programs” seem to be going nowhere. The Obama administration continues to insist that all is going well.

The money spent is being wasted. The taxes for the funding of Obamacare’s 6.7 million enrollees is increasing as it attempts to increase enrollment to 9 million down from the original enrollment goal of 12 million.

I received a note from a reader who said Obamacare is here to stay. It is what it is. We should try to repair Obamacare rather than repeal it and replace it.

In my view Obamacare cannot be repaired. It was created to destroy the healthcare system. President Obama’s goal is to replace Obamacare with a government controlled single party payer system.

 The result will be to control and restrict access to care and ration care. It is a step on the way to restrict citizens’ freedoms.

Every week indications of Obamacare’s failures appear but are kept under the public’s radar.  The Obama administration spins the facts and the mainstream media’s regurgitates that spin.

 The Obamacare signup figures as complied by http://acasignups.net as of 12/30 2014 are very different that the administration’s spin to the media that the open enrollment period is going great.

Obamacare’s enrollment is still 1 million below estimate at this point

Confirmed 2015 QHPs: 7,403,558 as of 12/29/14
Estimated 2015 QHPs (Cumulative):
11/21: 610K (462K HCgov) • 11/28: 1.02M (765K HCgov) • 12/05: 1.80M (1.35M HCgov)
12/12: 3.26M (2.46M HCgov) • 12/15: 4.70M (3.52M HCgov) • 12/19: 8.52M (6.40M HCgov)
12/23: 8.65M (6.50M HCgov) • 12/30: 8.84M (6.54M HCgov)
state-level projections

 HHS finally announced that approximately 87% of Americans who selected 2015 health insurance plans through HealthCare.gov in the first month of open enrollment are receiving financial assistance to lower their monthly premiums. This percentage of subsidy awards is higher than in the same period last year.

The number is significant because, should the U.S. Supreme Court decide against the Obama administration in the King v. Burwell case it is scheduled to hear in March, consumers living in the 37 states relying on the subsidies from HealthCare.gov could lose their premium subsidies.

Another problem is even with the subsidy the people who received them cannot afford the insurance deductible. They do not seek medical care.

HHS has yet to disclose if it has a contingency plan should a ruling come down that only those who buy Obamacare insurance through state exchanges are eligible for coverage subsidies.

The CMS Innovation Center was established by section 3021 of the Affordable Care Act (Obamacare) for the purpose of testing “innovative payment” and service delivery models to reduce healthcare expenditures while preserving or enhancing the quality of care” for those individuals who receive Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) benefits.

To date the CMS Innovation Center has awarded $2.6 billion through September 2014 to hospitals, doctors and others through nearly two dozen programs that tested new ways to deliver healthcare and pay for it.

“Results of those programs some underway since 2011including more than 60,000 providers and 2.5 million patients in Medicare, Medicaid and the Children's Health Insurance Program, are largely not yet available, the Innovation Center said in its second report to Congress.”

The ICD-10 diagnostic and procedure codes were to be implemented two years ago. It appears to be going nowhere because it is too complicated. President Obama will probably delay it again.

The change toICD-10 from ICD-9 has been pushed forward at least three times. It is too complicated. It is designed to commoditized medical treatment and eliminate physician judgment. Codes have been increase from 18,000 (complicated enough) to 68,000. Neither physicians nor their unsophisticated computer systems can comply correctly.

The Obama administration is still pushing for its execution and wasting money yearly. Physicians cannot and will not comply with this government regulation.

 It is destined to fail at a tremendous waste of taxpayers’ dollars.

“President Obama promised the AMA he would fix the defective Medicare Sustainable Growth Rate formula( GRF) for calculating Medicare reimbursement to physicians. As a result of that promise the AMA supported President Obama’s healthcare reform bill.” 

The GRF is not fixed yet. Congress delays the reductions in reimbursement due to this defective bureaucratic formula  each year and adds the percentage reduction in physician reimbursement to next year’s reimbursement reduction.

This year physicians can expect another 4% reduction for a total of 32% since 2002.  We will see if congress fixes this defective formula this year.  

On January 1, 2015 physicians are going to experience a series of pay cuts from CMS.  If functional electronic medical records are not implemented physicians will experience additional reimbursement reductions from Medicare and Medicaid.

http://www.forbes.com/sites/brucejapsen/2015/01/01/multiple-pay-cuts-hit-doctors-in-2015/#comment_reply

Physicians are struggling to deal with new measurements to improve quality and deal with a myriad of new changes in Medicare and Medicaid rules and regulations.

Two years ago in order to attract more physicians to accept Medicaid to care for the growing number of enrollees in Medicaid, Obamacare increased Medicaid reimbursement by 40%. The increase in reimbursement was to last only until January1, 2015 and then revert to the 2012 reimbursement schedule.

Those pediatricians, family practitioners and internists were faked out once more by Obamacare and President Obama’s promises.

The biggest pay surprise to physicians will come when the old reimbursement returns. Poor Americans on Medicaid will suffer when they cannot find a physician.  

“No other segment of the health care industry faces penalties as steep as these and no other segment faces such challenging implementation logistics,” Dr. James Madara, the AMA’s CEO wrote to the Obama administration.  “The tsunami of rules and policies surrounding the penalties are in a constant state of flux due to scheduled phase-ins and annual changes in regulatory requirements.”

 The cascade of rules and regulations will affect every specialty of medicine. The only thing left is for physicians to quit participating in government programs.

Then government can force medical license renewal to be tied to participation in government healthcare programs.

Where is physicians’ choice and freedom? There is currently a physician shortage. If physicians quit medicine and surgery what will happen to patient care?

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

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The Significance Of The Jonathan Gruber Controversy

November 16, 2014
inDisinformation and the healthcare system, Medicaid, Medicare, Medicine: Healthcare System, Patients Problems, Physician's Problems, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System
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Stanley Feld M.D.,FACP,MACE

Jonathan Gruber, a professor of Economics at MIT and one of the authors of Obamacare, made comments in 2013 about the trick plays the Obama administration used to pass the Affordable Care Act.

Jonathan Gruber’s comments serve to help Americans understand the mechanics of the passage of Obamacare. Hopefully it will serve as a wakeup call for the entire electorate.

Jonathon Gruber’s comments reflect the attitude of President Obama and his entire administration toward the electorate.  

  

http://youtu.be/G790p0LcgbI

The cover-up always makes it worse.

 

http://youtu.be/zhavicDc0Ts

Mr. Gruber admits what many of us have understood throughout President Obama’s years in office. President Obama’s attitude is reflected in all the trick plays he has pulled on congress and the American people during the passage and implementation of Obamacare.

Please look at all the articles covering President Obama’s trick plays since 2008 by clicking here.

The mainstream media has done President Obama’s bidding. It has not covered the meaning of Jonathan Gruber’s comments and the disrespect he and others have for the intelligence of the American public.

A reader sent me this comment before Jonathan Gruber’s comments were discovered.

“Dr. Feld,

There is some science behind the Progressive methodology that non-progressives need to learn.  The Progressive movement talks directly to the limbic portion of the brain while non-progressives tend to sort through facts in the neocortex.

Decisions are made in the emotional limbic portion of the brain, hence the reason and way marketers appeal to emotions versus your facts. 

The bottom line is this, non-progressives need to turn their facts into stories that are emotional or conservatives will always be out sold by those who’s arguments are devoid of facts (or outright lies) but full of emotion.

Have an awesome day.”

The Gruber controversy has given Americans a story that stimulates an emotional response. Americans are offended by being called stupid.

Jonathan Gruber did not make these statements in a void. It had to reflect the thinking of Obama administration. Even John Kerry gave him some help.

 

 

Published on Nov 12, 2014

Gruber explains how Senator John Kerry helped him fool stupid voters into accepting a tax hike.

   

 

http://youtu.be/iUOyqw5HhRI

 Mr. Gruber could not have made the decisions on his own to take the policy actions he described.

He never should have described the actions of those involved in public.

 The Obama administration also provided the Congressional Budget Office (CBO) with wrong information. The information led to wrong CBO’s conclusions regarding Obamacare’s real costs. The CBO crunches numbers fed to it by the Obama administration.

 The Obama administration used CBO’s false scoring to sell the CBO’s economic conclusions to the public through the mainstream media.  

It is clear that President Obama and his administration believe they are smarter than the American people. President Obama believes that his administration knows what is best for Americans.

The only reason the American people have not connected the dots is because they believe the president is an honorable man. The president is not expected to lie to the public.  

The progressive press is trying to divert attention from Jonathan Gruber’s comments. It is trying to get the public to ignore Mr. Gruber.

An initial diversion came from Paul Krugman in his Victory Lap article about Obamacare.

Paul Krugman said the health economist Jonathan Gruber, one of the principal architects of health reform  recently summed it up:

“The Medicaid-rejection states “are willing to sacrifice billions of dollars of injections into their economy in order to punish poor people. It really is just almost awesome in its evilness.”

Paul Krugman did not provide any facts just an appeal to emotion.

 MSNBC used this emotional stimulation to get its followers to ignore Jonathan Gruber’s comments.

“Part of the problem with the Jonathan Gruber “stupid” story is that it’s a shiny object for the political world to stare at for a while. It offers more heat than light. It’s a bouncing ball for political insiders to chase after, despite its relative insignificance.”

“But since it’s likely to soon be the subject of congressional hearings, and since your crazy uncle who watches Fox News all day will be talking about nothing else at Thanksgiving, let’s grudgingly tackle this week’s Most Important Story Of All Time As Agreed Upon By Republicans And The Beltway Media.”
 

Please note the inference that Republicans and Fox News are stupid for making an issue out of Jon Gruber’s statements. The implication is MSNBC is smart.

Progressives need public support in order to maintain power.

The problem is the public is tired of progressives’ emotional appeals devoid of facts.

The progressive press including MSNBC and The New York Times need examine their premises. They are daily losing listeners and readers .

Nancy Pelosi is incredible.

She said,

“Let’s put Jonathan Gruber aside.”

 “House Minority Leader Nancy Pelosi responds to Jonathan Gruber’s comments on the Affordable Care Act, saying, “I don’t know who he is. He didn’t help write our bill. So with all due respect to your question, you had a person who wasn’t writing our bill commenting on what was going on when we were writing the bill who has withdrew some of the statements that he made. So let’s put him aside.”

It is almost as bad as "we will not know what is in the bill until we pass it."

President Obama and his administration are trying to prevent public understanding of his current tricks plays. He continues to try to divert American from the truth about Obamacare.

President Obama needs to explain the truth to regain his credibility with the American people.

He must address these unanswered issues if he wants to maintain his promise of transparency.

  1. Why the healthcare.gov open enrollment period was delayed until November 15th.
  2. What is the actual number of valid enrollees in Obamacare in 2014? Is it 8 million, 7 million, 5.6 million or 3 million? I thought Obamacare and its mandate would be in effect for small businesses and corporations in 2015.
  3. Why has the estimate of total enrollment for 2015 been reduced from 13 million to 9 million? I thought 2015 Obamacare would be fully implemented and many more people would sign up as they lost employer sponsored insurance.
  4. How many people who received government subsidies last year lied on their application?
  5. Why weren’t the rules for subsidies enforce?
  6. How many people lost their subsidy?
  7. How are you going to collect the subsidy from people that lied?
  8. How many people have claimed they are not going to re-enroll in Obamacare this year and why are they not going to enroll?
  9. How does a person receive a tax credit when he has no taxable income to apply that tax credit to?  

     10. Explain the status of the open enrollment and the mandate for small businesses and large corporations.

      11. What is the status of waivers that companies and unions received from Obamacare for 2015?

      12. Why does the state of Massachusetts have a failed State Health Insurance Exchange that     required  $400 million dollars in federal  supplements each year if Romneycare is so successful?

      13. Why would the government subsidize healthcare insurance companies to participate in Obamacare?

     14. Why is the public being told that healthcare exchanges premiums are going down when in reality they are going up?

     15. What is happening with the Minimed Insurance policies that were supposed to expire in 2015?

     16. What does Obamacare cost the federal government? Is it budget neutral?

     17. What is the exact amount of increased taxes used to fund Obamacare?

     18. What percentage of the increased taxes are collected from each income group?

These are just a few of the questions President Obama and his administration have not provided the answer to.

 The answers to these questions would permit the public to understand Obamacare’s sustainability.

 The Jonathan Gruber incident has made it clear how President Obama and his administration operates as well as its lack of respect for the intelligence of the American public.

 Americans are not dumb. They want to believe their leaders. Their leaders have lied to them. Americans recognize that. President Obama and his administration have little credibility with the American public. President Obama promised a transparent government. There is not any transparency.

The midterm elections proved Americans are aware. It is a good first step.  Now we have to see what the Republicans will do with this leadership opportunity. 

 

 

An explanation of Obamacare.

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

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A CMS Mistake!!

August 13, 2014
inConsumer Driven Health Care, Disinformation and the healthcare system, Medicaid, Medicare, Medicine: Healthcare System, Patients Problems, Physician's Problems, Stakeholder Mistrust
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Stanley Feld M.D.,FACP,MACE

For years practicing physicians knew that hospital outpatient clinics charges were 30-60 percent higher that physicians’ free standing clinics.

CMS didn’t know it or didn’t want to know it.

CMS administers Medicare and Medicaid. CMS was restricting payment for outpatient procedures and tests done in freestanding practicing physicians’ offices while paying higher fees for the exact same outpatient hospital procedures and tests.

As rules and regulations and the complexity of the business of practicing medicine in private freestanding outpatient clinics increased physicians sold their practices to hospital systems.

The government and the healthcare industry encouraged these sales by increasing the complexity of running a private practice.

The probable logic was they would only have to deal with one entity (the Hospital System) rather than 600 individual doctors or clinics using that hospital system.

The government’s excuse for cutting out freestanding individual practices and clinics was efficiency and patient safety.

The hospitals were overjoyed to be able to buy physician practices.

“As the Affordable Care Act attempts to steer people away from pricey hospital inpatient admissions, hospitals have begun buying up doctors’ offices in hopes of increasing their revenue and market share.”

The hospital systems’ then discovered they were losing money by buying physicians’ free standing practices.

 In essence they were trying to buy physicians’ intellectual property and surgical skills because the traditional brick and mortar hospital building was becoming less profitable. Many surgical procedures were being done as outpatient procedures.

Physicians were less productive as hospital employees than they were when they owned their own practices. They were guarantied a salary.

Hospitals did not bother to calculate the money they made from doing the entire outpatient testing and procedures when presenting the loss to the government.

Hospital systems have been selective, first buying Primary Care Physicians’ freestanding office practices. Next they started trying to buy oncology practices.

“The number of oncology practices owned by hospitals increased by 24 percent from 2011 to 2012. By turning what used to be independent medical offices into so-called hospital outpatient centers, hospitals are creating networks that, critics say, give them the power to set prices and ultimately raise costs for private insurers and government programs such as Medicare.”

To further encourage physician owned clinics to migrate to hospital system owned practices the government and the healthcare insurance industry provided separate revenue codes to allow hospital systems to collect more for the same tests and procedures done in physicians’ free standing offices.

Finally,

“The Medicare Payment Advisory Commission, which advises Congress, are sounding the alarm. In May, MedPAC Executive Director Mark Miller testified before a House panel that these price differences “need immediate attention.”

 Medicare should align rates “to limit the incentive to shift cases to higher cost settings,”

The hospital systems’ excuse for the higher charges is it has higher operating costs than freestanding clinics such as running an emergency room.

Hospital systems receive higher reimbursement than private freestanding clinics doing the same procedure or delivering the same treatment.

The hospital system’s retail price is much higher than what it receives from CMS and the healthcare insurance industry. The discount price is somewhere around 50%

Even with the discount the hospital systems’ prices are 30-50% higher than the freestanding clinics’ prices.

The glossary of charges and discounts should be available to all consumers of healthcare. None of the prices are transparent. Patients’ have to fight hard to get the prices.

The focus or reports of prices has been on the outrageous prices for cancer drugs.

“A treatment of Herceptin, a breast cancer drug from Genentech, cost private insurers $2,740 when used in an independent clinic and $5,350 in a hospital outpatient setting, according to an analysis of 2012 claims by PricewaterhouseCoopers’ Health Research Institute.”

“The price of Avastin, another Genentech cancer drug, increased from $6,620 to $14,100, the Health Research Institute says.”

Echocardiograms in a hospital facility are reimbursed at twice the price as the reimbursement in a private physician owned facility. 

Dr. Keith Smith with the Oklahoma Surgical Center charges less than some patients’ deductible for some surgical procedures without accepting Medicare or private insurance.

If Medicare paid the lower office rate for 66 outpatient services even when they’re performed in hospital-owned facilities, the government would save $1 billion a year and lower Medicare patients’ bills by $200 million, MedPAC Executive Director Mark Miller said before the House panel. Medicare insured 49 million Americans at a cost of $573 billion in 2012.

This is an analysis of only 66 outpatient procedures. There are hundreds of outpatient procedures. Imagine the savings if all the procedures were captured.

“Hospital outpatient visits for echocardiograms jumped 33 percent from 2010 to 2012, MedPAC found, while visits to independent offices declined. Echocardiograms cost more than double in hospital-owned locations.”

As hospital system merge the price will go up even further. The hospital systems are now negotiating from a position of strength. Hospital systems are making the money as private physicians’ reimbursement shrinks.

The government and the healthcare insurance industry are finding their scheme to destroy private practice was a big mistake.

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

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Obamacare’s Disasters Are Unfolding

November 24, 2013
inDisinformation and the healthcare system, Medicaid, Medicare, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
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Stanley Feld M.D.,FACP,MACE

Along with the web site’s disastrous failures, other impending Obamacare disasters are unfolding.

Things look so bad for Obamacare that President Obama sent out a directive to change its name from Obamacare to the Affordable Care Act.

I believe Americans are well aware of the fact that Obamacare is neither affordable nor accountable to consumers. A name change will not help. Obamacare will not bend the cost curve nor save each family $2500 a year for healthcare insurance.

I have pointed out the problems with Obamacare since before its inception.

The list includes;

 Loss of your current insurance policy.

  1. Loss of your present doctor.
  2. Loss of participating doctors in your network.
  3. Loss of your present insurance coverage.
  4. Failure of the development of Accountable Care Organizations.
  5. Failure of Pay4Performance measures to reimburse physicians and hospitals.
  6. The lack of incentive for consumers to take care of their health or healthcare dollars.
  7. The lack of dealing with the issue of tort reform. Tort reform would lower the cost of care dramatically.
  8. It does not decrease healthcare insurance industry abuse of the Medical Loss Ratio.
  9. It has not increased the ease of data transfer among providers.
  10. The loss of freedom of choice for consumers and physicians.  

 Consumers are becoming outraged at the inefficiency of implementation as all these are beginning to affect them personally.

 Where is the physicians’ outrage?

Premiums and deductibles are rising. Medical care is starting to be rationed. The intensity of the outrage will rise as access to care decreases.

A physician friend of mind who is over 65 years old on Medicare said Medicare has been good to him and his wife.

Medicare has also been good to his practice of internal medicine. He believes America should have Medicare for all with a single party payer.

I just listened and smiled. The old Medicare system is unsustainable. Wait until he sees the new Medicare premiums for seniors and the reimbursement schedule for physicians in 2014.

Forget the regulations he is going to have to deal with. Forget the restrictions of access to care he will have to deal with. Forget the rationing of care he will have to deal with.

It will not be pleasant.

Consumers are realizing they are the victims of higher prices and lower levels of care. Hospitals, insurance companies and doctors are also going to be the victims of enslavement by regulations.

 Government bureaucracy, inefficency and waste will flourish.

I hope everyone realizes that the individual market was the first market to be attacked by Obamacare because it is the smallest market. The individual market only affects 5 million people.

The next market in line to be destroyed is seniors and Medicare. It is starting already with the destruction of Medicare Advantage.

The employer sponsored healthcare insurance market will start being destroyed in 2014.

President Obama just delayed the implementation of the private market mandate from October 15th until after the November 2014 elections.

The delay will not take the spotlight off the failure of Obamacare and protect Democrats from the outrage of Americans toward Democrats during to 2014 election campaigns.

I believe the American people are on to President Obama’s tactics of attacking his enemies personally.

Consumer outrage about Obamacare will dominate the media despite President Obama’s attempt to manipulate the liberal traditional media.

 He seems desperate to create a distraction. His Iranian deal will create a temporary distraction.

President Obama brought several selected progressive “influential  commentators” to the White House for a little policy briefing last week.

They all said the meeting was confidential. I say the meeting was an attempt at media manipulation. Hopefully the media is realizing reality.

Obamacare was supposed to be built by the best minds in the healthcare policy business. It appears the problem was these best minds knew little about the healthcare insurance business, the hospital system business or the practice of medicine.

Obamacare has not aligned any of the vested interests of the primary and secondary stakeholders. In fact, misalignment of vested interests has increased since passage of the law.

I cannot figure out what the President Obama was thinking. All signs point to the fact that President Obama wants to destroy the present healthcare system and replace it with a single party payer system.

I have pointed out multiple examples in this thinking including President Obama’s declaration as far back as 2003 and since that he prefers a single party payer system.

He has also emphasized that the universal care system he will put into place (Obamacare) is a transitional system. It is a system that will collapse and be replaced with a single party payer.

  

http://youtu.be/BKkTRMEyAhs

This You Tube is compelling. It demonstrates President Obama’s ideological goal not practical goals. 

President Obama admits that Obamacare is a transition system. He wants to eliminate employer sponsored healthcare coverage and the destruction of the healthcare insurance industry.

President Obama simply ignores the fact that the administrative services are provided by the healthcare insurance industry to administer Medicare and Medicaid.

The government could not do it without the healthcare insurance industry. The cost of the administrative services is a non-transparent 40% of every Medicare and Medicaid dollar.

Medicare and Medicaid are single party payer systems. The healthcare insurance industry presumably bids for each states contract. Indirectly the healthcare insurance company rips off the consumers by ripping off the government for the administrative service for Medicare and Medicaid.

All we have to do is remember the $2,000 toilet seats in a government cargo plane to understand the efficiency of a government run program that outsources the fulfillment of a mission.

It is hard for most people to believe that President Obama’s purpose all along was to destroy Obamacare (his namesake) and replace it with a single party payer system.

Everyone must notice that he is now been calling Obamacare the Affordable Care Act.

 

I am sure he wanted the hysteria that is going on right now over dropped insurance coverage, dropped physicians and changed insurance plans to subside.

However he did not expect the mistrust the public has for him. The genie is out of the bottle. The country doesn’t trust this nice guy anymore.

He did not expect the outrage to be directed at him. This is the reason he is blaming the failure on the Republican Party one day, the healthcare insurance companies the next and doctors and hospital systems the next.

He has also giving special favors to his political base. These favors has made the middle class public very angry at him.

A more glaring favor is exempting all of congress from participating in Obamacare.

The fast food companies’ exemption has angered small business owners.

Exempting unions from Obamacare has been totally disgraceful.  

The destruction of Medicare Advantage for seniors is on the way.  Senior outrage will be seen in the next few months.

President Obama is going to try to blame the healthcare insurance industry, hospital systems and physicians for this disaster.

Very few Americans are going to believe him.

Americans understand that he is forcing premium prices and out of pocket expenses up with unnecessary bureaucracy and regulations.

He is restricting care to the elderly and access to care in hospitals and doctors’ offices.

He has created greater dysfunction in the healthcare system.

The dysfunction is going to get worse.

He will achieve his goal to force the healthcare system to collapse.

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

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A Review Of The Deception In Obamacare

August 14, 2013
inDisinformation and the healthcare system, Medicaid, Medicare, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
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Stanley
Feld M.D.,FACP, MACE

The goal to provide
affordable healthcare and access to care for all Americans is an admirable
goal.

Obamacare is making
Americans dependent on the government for their healthcare access and health
decisions. This is bad.  

President Obama is doing
this slowly but surely. The goal is to first destroy the present healthcare
system. The more he destroys, the more the stakeholders, healthcare insurance
industry, hospital systems, physicians, drug companies and patients game the
system

Americans are known to
be individualists. They cherish their freedoms. However, over the last 50 years
many entitlements have been introduced at the price of forfeiting many
freedoms.

Some entitlements have
been for consumer protection. Others have not.

Obamacare is about
government control and takeover of the healthcare system. President Obama
understands that he cannot force people to do what they do not want to do.

However they will do
anything when they have no choice. He is creating a no choice environment
slowly but surely. He is doing it with a bad law, lots of lies and
disinformation, and a golden tongue,

He changes and ignores
parts of the law he wrote to fit he needs by executive order, disrespects the
will of the people and congress and folds to pressures of lobbying from his
base. He marginalizes his enemies.

His changing the law
without the consent of congress is probably unconstitutional. However no
Republican has questioned his tactics.

He stays on the
offensive and keeps Republicans on the defensive. Republicans must have someone
who could parry his offenses and put him on the defense even though he has the
unequivocal support of the traditional media.

On Friday August 9th
was a perfect example of this offensive.

 The idea that you
would shut down the government unless you prevent 30 million people from
getting healthcare is a bad idea...

I'm assuming they will not take that path…I have
confidence that common sense, in the end, will prevail.

He explained his delay
of the employer mandate by saying going through congress would be the
"normal thing" to do "but
we're not in a normal atmosphere around here when it comes to
'Obamacare.'"

The president called efforts to defund and repeal Obamacare the
Republicans' "holy grail" and an "ideological fixation."

You have got to give it
to him. No one would ever think Obamacare is having so much trouble because it
is a lousy law, that is impossible to build out its structure, Impossible to
implement, impossible to execute and impossible to enforce.

The majority of the
country and majority of the stakeholders are against the bill. President Obama
just goes right ahead despite the will of the people.

Obamacare did not get
one single Republican vote. President Obama’s twist and turns have kept
Republicans in a reactive and defensive mode.

Every time Republicans
go on the offense they are blamed for the bad law’s (Obamacare’s) failure. They
do not answer back.

I believe the majority
of the people know what President Obama is about. They do not trust him. The
lack of trust renders him ineffective.

Someone needs to turn
the tables on him.

I also believe President
Obama is about to turn the tables on himself. His says he is all ears for a
good idea but Republicans have not presented him with one.

This is not true. The
problem is President Obama doesn’t listen.

The list of lies and
misrepresentations are enormous. These lies and misrepresentations have
resulted in the lack of trust.

 Below are some of the things promised that so
we should not forget.

 1. Imposing President Obama’s idea of
transformation by social engineering in which the majority of the population
does not agree with.   

 2. Imposing 21 hidden taxes that few knew
about before the bills passage. Few knew the effect of these taxes on small
business until after passage of Obamacare. These tax increases amount to
the biggest tax increase in our history.

This occurred after
President Obama pledged no new taxes for anyone making less than $250,000
dollars. All of these taxes are passed on to consumers.

3. The medical device
tax alone is a job-killing and innovation-stifling medical device tax.  33 Democrat senators are now opposed to this tax. He does not have the support of his
party on this tax.

4. Independent Payment
Advisory Board (the IPAB) is going to ration healthcare. Sarah Palin called it aka death
panels. Howard Dean, recently termed it a "health care rationing body" that
Congress should be "getting rid of." The Obama administration insists
there is not going to be rationing of care.

5. The original CBO
cost estimate was a reduction in healthcare costs in 10 years. The
CBO used six years of costs and ten years of taxes. The next estimate using
rigged numbers given to the CBO by the Obama administration was less than $1
trillion.

The ten-year CBO cost
estimate has now reached $2.6 trillion. We have not heard from the Obama
administration about this new estimate.

6. Health
insurance premiums are soaring despite President Obama’s recent statements that
healthcare premiums are falling. All employer and employees will say President
Obama is wrong.

Four years ago President
Obama promised the public that, “Obamacare
would reduce a "typical family's premium by up
to $2,500 a year."

 7. We will all recall these famous lines, “If you like your doctor, you
will be able to keep your doctor. Period.”

  If you like your healthcares plan, you will be able to
keep your health care plan. Period.

  “No one will take it
away. No matter what.”

No statement is more
dramatic but false.

8. Obamacare is making an already serious shortage of doctors worse. Many physicians are opting out of Obamacare, Medicare and Medicaid.

To make thing worse
patients will have to pay physicians directly. The Obama administration
published a new rule for seniors. CMS will not reimburse patients the 70% of
their out of pocket expenses for physicians that do not accept Medicare or
Medicaid.

The result will be an
increased out of pocket burden for all patients, rich and poor.

9. Many employers
are likely to drop health coverage. There has been widespread reduction of work hours to avoid paying an Obamacare
mandated penalty to provide employee health insurance.

 Obamacare has created a burden on economic
growth. It has resulted in the creation of "seven times more part-time jobs"
than full-time jobs. It has decreased the living wage for millions of Americans
and created millions more uninsured patients.

These part time workers
will be forced to buy insurance through the health insurance exchanges. This
will balloon the federal deficit even further.

10. The states have been
given the option to participate in health insurance exchanges and expanding
Medicare and Medicaid. Thirty three states have refused to participate. They
know they cannot afford to increase their states’ budget deficit.

11. The healthcare
insurance industry thought it would make a killing by insuring people through
the health insurance exchanges. In Medicare and Medicaid they bill the
government for doing the administrative services. President Obama has changed
the promised health insurance rules. Several insurers are leaving all of the states. More are to follow.

12. Recent surveys show that 63 percent of voters think the law
needs to be changed, and a 57-percent majority feeling that implementation is
"a joke."

This is happening despite
the traditional media helping President Obama’s political campaign to promote
Obamacare.

These are just a few of
the reasons for the mistrust of the administration.

Next will be a summary
of President Obama’s probable unconstitutional delays in the law without
congressional permission.

Max Baucus was
corrected. Obamacare is an expensive train wreck.

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

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Physicians Opting Out Of Medicare And Obamacare

August 4, 2013
inHealthcare Insurance Industry, Medicaid, Medicare, Medicine: Healthcare System
• Leave a comment

Stanley Feld M.D.,FACP,MACE

I have discussed the disillusionment of Obamacare by several
major stakeholders, hospital systems, insurance companies, union leaders and
large corporations in my last three blog posts.

As Obamacare gets more complicated physicians are opting out of Medicare and will
not participate in Obamacare.

All most physicians want is to practice the best medicine they can
using their intellectual property or surgical skills.

Physicians are people who want to help people. They are not street
crooks.

Obamacare is trying to commoditize medical care, decrease physician
value and reimbursement.

Commoditization of medical care will decrease physicians’ freedom to
exercise their medical judgment. Medical decision-making will be in the hands
of distant involved bureaucrats. Access to care will be determined by
bureaucratic rules and not the patients and their physicians.

 Physicians are opting out of Medicare, Medicaid and
Obamacare.  They have become totally frustrated
with Medicare and Medicaid reimbursement rates and the mounting rules and
regulations.

Marilyn B. Tavenner R.N., the
administrator of the Centers for Medicare and Medicaid Services told congress
that an insignificant number of physicians have dropped out of Medicare and
Medicaid. This is clearly not true.

A
CMS report said 9,539 physicians who had accepted Medicare in the past opted
out of the program in 2012, up from 3,700 in 2009. That compares with 685,000
doctors who were enrolled as participating physicians in Medicare last year,
according to CMS, which has never released annual opt-out figures before.


The number of physicians opting out of Medicare last year
nearly tripled from three years earlier, according to the Centers for Medicare
and Medicaid Services.

This is not an insignificant number of physicians when
America is experiencing a shortage of primary care physicians.

“A study in the
journal Health Affairs this month found that 33% of primary-care physicians
didn't accept new Medicaid patients in 2010-2011,” even though they continue to participate
in Medicare.

Some physicians are limiting the number of Medicare patients
they treat even if they don't formally opt out of the system.

The reason is Medicare reimbursement is so low and getting
lower. It some cases reimbursement is lower that the cost to deliver the care.

 A study found that 4%
of family physicians are now in cash-only or concierge practices.

 The Obama administration issued an
executive order this year where Medicare would not reimburse anything to
patients paying cash to non-participating physicians.

This is putting an increased burden on Medicare patients.

“All told, health experts say the number of doctors going
"off-grid" isn't enough to undermine the Affordable Care Act.”

The Obama administration’s bureaucrats are not facing
reality. Today, before the expansion of Medicaid it is difficult for Medicare
and Medicaid patients to find a physician.

Joe Baker,
president of the Medicare Rights Center, said his patient-advocacy group has
had an increase in calls from seniors who can't find doctors willing to treat
them.

Many physicians will not accept Medicaid patients. CMS
administrators want the public to believe this is not true. They say the number
of physicians not taking Medicaid is insignificant.

Medicaid physicians have to see as many as 200 patients or
more a day to make a living.  There are
not enough minutes in a day to see that many patients and have a quality care visit.
These physicians have employees who are seeing patients for them. These
physicians then sign off as seeing the patient.

This volume then triggers a probe on their practices and
accusations of fraud. As Medicaid gets expanded through Obamacare to cover the
uninsured, there will be even fewer and fewer Medicaid physicians and a greater
physician shortage.

Medicaid physicians are not interested nor can they take the
government abuse.

Employers are cutting back on hiring full time employees and
hiring part time employees to avoid the rising insurance costs.

Marilyn B. Tavenner, the administrator of the
Centers for Medicare and Medicaid Services, told Congress that she
had heard of only “isolated incidents” in which employers tried to cut back
hours. Representative Steve Scalise, Republican of Louisiana, told her that she
must be “living in some cocoon” because he heard of such actions almost every
day.

Every large corporation is converting as many
full time workers to part-time workers as possible because of Obamacare in
order to avoid the Obamacare mandate. Part-time workers have felt the
disastrous impact on wealth production and economic activity.

These are the revised statistics from the Bureau
of Labor Statistics for May and June.

The establishment
survey showed a gain of 162,000 jobs.

The previous two months were revised
lower. The employment change for May revised down by 19,000 (from +195,000 to
+176,000), and the employment change for June revised down by 7,000 (from
+195,000 to +188,000).

The unemployment rate dropped 0.2 to 7.4%. 

Explaining
the Unemployment Rate Drop


  • Employment
    rose by 227,000 of which 103,000 were part-time jobs. 
  • The Civilian Labor
    Force Declined by 37,000 even though population rose by 204,000.
  • Those "Not in
    Labor Force" rose by 240,000.
  • Participation Rate
    fell 0.1 to 63.4%, a mere 0.1 higher than the low of 63.3% dating back to 1979.

July BLS Jobs
Statistics at a Glance

 

  • Payrolls
    +162,000 – Establishment Survey
  • US Employment +227,000
    – Household Survey
  • US Unemployment
    -263,000 – Household Survey
  • Involuntary Part-Time Work +19,000 –
    Household Survey
  • Voluntary Part-Time Work +84,000 –
    Household Survey
  • Baseline Unemployment
    Rate -0.2 – Household Survey
  • U-6 unemployment -0.3
    to 14.0% – Household Survey
  • Civilian Labor Force
    -37,000 – Household Survey
  • Not in Labor Force
    -240,000 – Household Survey
  • Participation Rate
    -0.1 at 63.4 – Household Survey

Read more at http://globaleconomicanalysis.blogspot.com/2013/08/establishment-survey-162k-jobs-may-and.html#llfksKs7fC6lhCcU.99

 Marilyn B. Tavenner making the above statement to congress
makes her a liar or a person not in touch with reality. Have can the American
people entrust our healthcare decisions to these bureaucrats?

The Obama administration needs both the primary and
secondary stakeholders’ cooperation if Obamacare has the slightest chance of
succeeding.

I do not think Obamacare can survive. It will sink under its
own weight as it tries to control all of the stakeholders through oppressive
regulations without regard for their vested interests.

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

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Permalink:

Hospital Systems Are Finally Realizing There Are Problems With Obamacare

July 24, 2013
inDisinformation and the healthcare system, Medicaid, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP, MACE

Hospital systems loved the prospect
of Obamacare. Physicians would be forced into full time salaried hospital
system positions. Hospital systems would own physicians’ intellectual property
and surgical skills.

Physicians would be the hospital
systems’ cash cow. Its brick and mortar model was failing. Surgery and recovery
from surgery was improving. Length of hospital stays was decreasing.

The problem hospital systems were
discovering was that physicians were not as productive when salaried as they
were when they owned their own practices.

Surgery was being performed as
outpatient surgery in freestanding surgery centers. Physicians own most of
these surgery centers independent of hospital systems.

The advantage of these outpatient
surgery centers to patients is they are cheaper, price transparent and have
comparable outcomes.


The healthcare insurance industry has
even encouraged their use. The Obama administration doesn’t like them because they
encourage patient choice and independence. This is the opposite of Obamacare's goal of government dependence and control of patient choice.

Hospital systems thought Obamacare
would provide millions of newly insured patients. This would translate to
higher profits for the hospital systems.

Obamacare’s supposed
goal was
improving access to care for low-income families and individuals. Hospital systems were led to believe that they would treat more
patients with health insurance through expanded Medicaid eligibility.

With the
introduction of health insurance exchanges, low-income individuals would be
able to purchase healthcare insurance coverage at a subsidized rate.

The subsidy would
come in the form of a tax credit. Hospital systems did not realize that low-income
families do not pay taxes so they would not pay any tax to apply a tax credit.
These families making up to $38,000 dollars a year could not afford the lowest
insurance of $12,000 dollars a year. They would opt to not buy the health
insurance exchange offerings.

The health
insurance exchanges would not reduce the amount of uncompensated care provided
by the nation's hospitals.

Suddenly hospital
systems realized that their hospital consultants were wrong.  While it sounded good on paper, many hospital
finance administrators are terrified that Obamacare will result in a hospital
system taking great losses as a result of decreased reimbursement and a
decrease in the promised insured population.

“Tim
Nguyen, corporate controller at Palomar Health, a San Diego–based system with
690 licensed acute care hospital beds and $2.5 billion in gross annual revenue,
says there is a catch-22 built into the healthcare legislation that will
ultimately hurt hospital systems.”

 There is another catch to Obamacare. I cannot
tell if this was an unintended consequence or purposeful deception by the Obama
administration.  The exchanges will have
different tiers with different deductibles and copays.

“California's
health exchanges will have four tiers when the program goes live in January
2014, Nguyen explains: platinum (where the patient pays 10% of total healthcare
expenses); gold (20%); silver (30%); and bronze (40%).”

"These
patients will still be responsible to pay, and they probably don't make that
much money and are likely to choose the silver or bronze tier to keep the
premiums low. … That will increase our bad debt even though they have
insurance."

The low- income
families will believe they have good insurance coverage. If they get sick they
will be responsible for the high deductibles and co-pays.

If they choose to buy
the insurance they will use the hospital facilities without realizing that the
insurance does not cover everything.

 After hospitalization
they will be hit with a bill they cannot afford. The hospital system will
pursue payment but will not be able to collect. The hospital will have to write
it off.

 There is total
uncertainty about the rules. However, before a hospital system should accept
the program they should know the rules. Their participation can ruin them financially.

Marlene Zurack is senior vice president of
finance and chief financial officer for New York City Health and Hospitals
Corporation (HCC). HCC is a municipal integrated healthcare delivery system
with $7.1 billion in total operating revenue when combined with HHC's MetroPlus
health plan.

HCC cares for indigent and low-income
patients. It is subsidized by the Medicaid's Disproportionate Share Hospital
program.


She is doubtful that the insurance exchanges
will result in a net benefit to her organization. She insures 1.4 million
people. The systems treat 475,000 uninsured patients. She has two problems with
the health insurance exchanges.

She does not know how many of the uninsured
will get insurance, what level of insurance will they buy and how much of a
difference the insurance payment is from the Medicaid's Disproportionate Share
Hospital program.

“HHC
is likely to lose revenue in the end, Zurack says, due to cuts being made to
Medicaid's Disproportionate Share Hospital program, which distributes payments
to qualifying hospitals that serve a large number of uninsured individuals.”

In
reality, Zurack says, the cuts will be extremely damaging to hospitals that
serve this population.

New York City Health and Hospital Corporation
is scheduled to lose $17.1 billion dollars between 2014 and 2020 due to federal
cuts In the Medicaid Disproportionate Share Hospital program.

Obamacare is becoming a reality. Hospital
systems such as HCC are realizing the financial impact of Obamacare.

Accountable
Care Organizations are Obamacare’s signature tool to improve access to care and
decrease the cost of care.

The promise to hospital
systems’ is that by increasing efficiency ACOs could increase hospital systems’ profit.

Incorporated into the ACO scheme
is profit sharing with the government if there are reduced costs. Included is
reduction in payment if costs exceed benchmark costs.

Only 10% of hospital systems
have signed up in the last two years. The Obama administration has done a lot
of bragging about enrollment.

Originally there were thirty-two “Pioneer”
hospital systems. The Mayo Clinic and the Cleveland Clinic rejected being
Pioneer participants. The goal of ACOs is to develop integrated care delivery
systems.

Last week 9 of the original 32
Pioneer ACOs withdrew from the original program. CMS gave no explanation for
them leaving.

I believe they realized they
couldn’t integrate their delivery system the way the government wants.

They cannot make any money
participating in the Medicare Shared Savings Program.

Seven of the nine are applying to transition
to the Medicare Shared Savings Program, while two are abandoning the program
completely. CMS declined to identify which ACOs are leaving the Pioneer program
and which are simply shifting to the MSSP.

 The nine departing
ACOs are:

  • Prime Care Medical Network Inc., an IPA-based ACO serving San
    Bernadino and Riverside counties in California.
  • University of Michigan Health System in Ann Arbor.
  • Physician Health Partners LLC, a medical management company in
    Denver.
  • Seton Health Alliance, a network of providers comprised in the
    11-county Austin area.
  • "Plus ACO," a partership between North Texas Specialty
    Physicians and Texas Health Resources
  • Healthcare Partners Nevada ACO LLC, a multispecialty medical
    group and IPA serving Clark and Nye counties in Nevada
  • Healthcare Partners California ACO LLC, a multispecialty medical
    group and IPA serving Los Angeles and Orange counties in California.
  • JSA Care Partners LLC, a primary medical group and IPA serving
    the Orlando, Tampa and South Florida area.
  • Presbyterian Healthcare Services, an integrated delivery system
    serving the Albuquerque area.

 “Plus
ACO”, a partnership between Texas Health Resources and North Texas Specialty
Physicians, has plans to leave the Pioneer ACO program by mid-August, but the
two organizations say they are open to "remaining in the Pioneer ACO
program if we can find an economically viable way to do so."

 ACO’s are doomed. Obamacare is falling apart.

President Obama immediately went on the campaign
trail telling the country how great Obamacare is already.  

 
 

http://youtu.be/Kyv8ZRkXnfU?t=58s

He continues to ignore problems with Obamacare’s implementation
and costs. He has no regard for America’s financial stability.

Americans’ are starting to understand his attitude.

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

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Permalink:

Games On!

June 23, 2013
inDisinformation and the healthcare system, Medicaid, Medicare, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld
M.D.,FACP,MACE

Articles
about the virtues of Obamacare are appearing almost daily. It is pretty clear that
the information is being fed to the media by the Obama administration.

The
problem is the sound bites are not truthful. The best sound bites are in the
Obama administration has to offer are in play. All the virtues expressed about
Obamacare are expensive and un-executable by the Obama administration.

On June 16th
Timothy Egan was called on to spin the Obamacare tale in the New York Times.

He lauded
the virtues of Obamacare while executing the blame game once again. He starts
by describing an under 26 year old with Hodgkin’s lymphoma who was treated to
remission using his parents’ employer provided healthcare insurance.

The parents’
employer’s healthcare insurance premiums increased the past few years since it
is the law under Obamacare to cover children until they are 26 years old. The
coverage pre Obamacare covered only up to 18 years old.

Here is
the blame game.

“But he’s (the under 26 year old) still a pariah in the eyes
of the insurance industry, which means they can deny him a policy that might
save his life.

Not for long. In six months’ time, the heartless practice of
refusing to let sick people buy affordable health insurance — private-sector
death panels, the most odious kind of American exceptionalism — will be illegal
from shore to shore.”

Timothy Eagan’s example is true. However,
Obamacare’s most disturbing
feature is the Independent Payment Advisory Board. The IPAB, sometimes called a
"death panel," threatens to nullify Mr. Eagan’s euphoria for
Obamacare.

Maybe this person will not get approved for retreatment if
the determination for retreatment is not cost effective according to the IPAB

A vivid example of government’s control over an individual’s
personal life and death decisions is the rules that bared access by 10-year old
Sarah Murnaghan to the adult lung-transplant list.

Health and Human Services Secretary Kathleen Sibelius refused
to waive rules made by bureaucrats to permit this 10 year old a lung
transplant. 

Who knows what can happen when the power to make rules and
enforce them is in the hands of a bureaucracy? Bureaucracies have a tendency to
create rules in which no one has to take responsibility for decisions that affect
others’ lives and personal freedoms.

It is obvious that the grip of the bureaucracy will clamp
down much harder once the Independent Payment Advisory Board gets going in the
next two years. There will be no going back.

The Obamacare’s IPAB is not answerable to any one.

Cost will be an issue in the bureaucratic IPAB’s decision-making process
and not the patient’s vested interests.

Timothy Eagan goes on to say,

“The early indications are that most Americans will be
pleasantly surprised. Millions of people, shopping and comparing prices on the
exchanges set up by the states, are likely to get far better coverage for the
same — or less — money than they pay now.

There is no data for this statement except the
misinformation and number fudging done by California Covered. The costs in
California will be outrageous.

The state of Washington also published disinformation
about the cost of care under their health insurance exchange.

 The law, as honest
conservatives predicted, before they orphaned their own idea, is injecting
competition into a market dominated by a few big names.

Washington only has one insurance company signed up.

The real number prediction for Washington's health insurance exchange is that even in over-regulated
Washington State, Obamacare will increase individual health insurance premiums
by 34-80%

What will happen if, in the end, Obamacare really works?”

The early indications from the State of California and Paul
Krugman are misleading and dead wrong. I have pointed out that in an earlier
article. Obamacare is going to be a train wreck both financially and medical
care wise.

In additional, the Obama administration has to build 34 of
its own health insurance exchanges. It couldn’t suck 34 states into the Obamacare
overspending mud hole.

Auditors at the Government Accountability Office released
the results of two investigations. It optimistically concluded that it
"cannot yet be determined" if Obamacare will be ready for enrollment
a mere four months from now.

The health insurance exchanges are supposed to open October
1. The administration insists that it will.

The GAO's
detailed portrait of blown deadlines, regulatory improvisation and general
chaos explains why HHS has been anti-transparent.  

HHS will run 34
federal versions in whole or part as Governors continue their Obamacare
resistance.

Some of the health insurance exchange preparations have
barely begun. The Obama administration has already blamed it on conservatives
and Republicans.

The GAO attempted to track "key activities"
necessary to set up exchanges and identified "more than 100." But the
auditors can't give a precise number because "the nature of the activities
that [HHS] and the states will conduct has not been finalized and may continue
to evolve."

Mr. Eagan then criticizes
Republicans.

“They
have good reason to fear it: if Obamacare works, the game will be over for
those who oppose the most significant change in American life in a generation’s
time.”

The chance that Obamacare
will work is minimal. In either case it will be the most significant change in
American life in a generation’s time.

Ben Carson M.D.  has a very
practical comment about the health insurance exchanges.

Obamacare will be a disastrous
change and the Democrats will try to blame its failure on Republicans. It has
nothing to do with Republicans. It is simply a law that is destined to be a
train wreck.

Obamacare cannot be executed
and America cannot afford the cost of Obamacare.

Young people will not buy
individual insurance from the health insurance exchanges.

The young individuals who
do not receive healthcare coverage from their employer are not stupid. It makes little financial
sense for them to subsidize the medical care of others given the choice.

The traditional media is
getting nervous as they see President Obama using them to promote Obamacare and
convince young healthy people to join with a campaign of disinformation.

The media have lately
emphasized the real challenge of enticing healthy young adults to sign up for
Obamacare. Obamacare needs these young people to sign up and buy the insurance.

The states that have signed
on to the health insurance exchanges and the federal government are counting on
young people who are healthy to make Obamacare work.

Obamacare will not work even if they sign up. President Obama will
have to impose more and more taxes as hiddden taxes and means tested taxes as
there are more and more shortfalls.

This has been the destiny of all entitlement states and countries. These
higher taxes will have a devastating effect on the economy and economic growth.

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

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The problem is that as the Obama administration and
its media surrogates tell lies they start believing these lies until the devastation
hits.

Devastation of the healthcare system, the economy and
the financial structure is closer than they think.

 

  • Eugene Charter Service • October 14, 2013

    Everything is very open with a clear clarification of the challenges. It was definitely informative. Your site is very helpful. Many thanks for sharing!

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