Stanley Feld M.D.,FACP,MACE
Charles Gabe’s graph of enrollment as of 12/9/2017 was published with only six days of open enrollment left.
There are only 5,894,342 confirmed enrollees. There is no indication of how many enrollees paid the first month’s premium. The low-ball estimate was 7.2 million.
Of those enrolled only 3,604,44 were enrolled in President Obama’s Health Insurance Exchanges to buy healthcare insurance.
2,289,902 were enrolled in Medicaid. The number of illegal immigrants in that number is unknown.
December 15th is the deadline for enrollment in 42 states. Eight states have already extended the deadline.
This is an extremely disappointing outcome for Democrats who refuse to believe Obamacare has failed. Last year the Democrats and President Obama were bragging that Obamacare provided healthcare insurance for 20 million people.
The problem was that 13 million of those 20 million were enrolled in Medicaid and of the 9 million who bought insurance through the health insurance exchange many did not complete their premium payment for the whole year.
The government subsidized eighty-five percent of those people who bought healthcare insurance through the health insurance exchanges.
Organized medicine has not provided leadership for the medical and surgical community or its patients.
In turn medical professional feel powerless. I believe the profession is about to give up on trying to influence positive change in the healthcare system for its benefit and its patients benefit.
A reader, D.F. M.D., responded to my last blog writing;
“That nothing much is happening in Washington re: healthcare reform may be one of the largest blessings our country has seen this year.”
It might be a blessing because the politicians do not have a clue as to what can be done to repair the healthcare system.
Politicians are not interested in listening to physicians or patients. The people that stand to lose the most in this dilemma are patients.
D.F., M.D. goes on,
“ We are agreed that our congress hasn’t done much, but there are other activities afoot that will almost certainly be game changers and they are largely un-noticed when it comes to their impact on healthcare services.”
his is very true. When President Trump was running for president he kept declaring that the “government” made the worse deals for the American people with NAFTA, Iran nuclear deal, and the pacific trade deal. He essentially called President Obama and congress stupid.
Now congress is asking big business to help them out of the healthcare mess. The pending take over of medicine by big business is going to destroy medical care in America while they are claiming to save the healthcare system.
D.F. MD writes
“The CVS/Aetna merger, and today’s announcement that United Healthcare is buying DaVita, a healthcare group with over 300 sites of service to add to it’s Optum, segment, with 1,100 care sites of various sorts, not to mention US Oncology, owned by McKesson, that sees about 14-15% of patients with cancer in the US.”
The corporate take over of medical care is growing daily. Without physicians and patients there would not be a need for a healthcare system. Physicians have voluntarily given up their intellectual property and freedom to use their own clinical judgment to the will of corporations.
America is in the early stages of this phenomenon. Medical care is becoming a commodity. Physicians and patients have given up the thought of a personal relationship embodied in the physician patient relationship. Good medical care (in my opinion) is predicated on the patient physician relationship because much morbidity and negative emotional responses to treatment can vanish with an effective patient physician relationship.
Truly, corporate medicine, once outlawed in many states, (for good reason) is on track to become the biggest player in healthcare. Add to that the report that 60% of physicians are now employed by hospitals, which is in some ways creating a body of spokespersons for healthcare that has not been seen before.”
The result is massive Medicare and Medicaid cost overruns that are not approved by congress. The Democrats are trying hard to blame the costs overruns and Obamacare’s failure on President Trump without good reason.
However, the media is the message and the media is on President Obama and the Democrats side.
D.F., MD continues,
“I have always believed that the medical profession though organized medicine has been remiss by maintaining a low profile where change is concerned, either in the development of programs or the creation and passing of legislation.”
Edward Annis M.D. a former president of the AMA was organized medicine leaders who lead the fight to outlaw corporate take over of the healthcare system and the takeover of medical practice. Dr. Annis wrote an excellent book called Code Blue in 1993.
A reviewer, Frank J. Primich M.D. in 1994 wrote;
“Code Blue takes its name from the most common term used by hospital public address systems to signify cardiac arrest.
The announcement sends an assortment of specially trained personnel scurrying to the designated site. Modern techniques and technology, when given the timely opportunity, have been highly successful in restoring life.”
“The protagonist in Dr. Annis’s book is the private practice of medicine, which has been declared dead by some of its adversaries. Resuscitation requires an understanding of what has gone wrong, and what can be done about it.”
Dr. Annis was right on target. No one involved in organized medicine has taken this stand presently.
The reviewer goes on;
“In every field, there is an internal rating system. Ed Annis is the acknowledged superstar of those of us who have pleaded the cause of fee-for-service medical practice and maintenance of the traditional doctor-patient relationship.”
All of the healthcare policy wonks and congress people ignore the importance of the physician patient relationship. When they get sick and do not have a patient physician relationship they yearn for one.
“The same time span has seen a steady encroachment into the process from a variety of third parties, particularly government.”
“The concept of socialized medicine, discredited elsewhere in the world, has been introduced, through gradualism, to the point where we are now, in effect, semi- socialized. The current proposals for national health care threaten to push us beyond the point of no return.”
These quotes were taken from the article written in 1994 at the peak of the Hillary-care debate. Wilbur Mills started the socialized medicine debate in America in 1935.
D.F. MD note goes on to say,
“Now they are increasingly tied to large business entities one sort or another.”
Soon, advocates for patients with no financial axe to grind may end up being only us old retired docs, some of whom have retired because of “improvements” like the electronic medical records which have managed to make their developers rich while not doing all that much to enhance patient care. Unfortunately the old docs lack organization, money, and voice.”
Organized medicine has not provided leadership to help patients understand that when large corporations take over the infrastructure of medicine medical care will be totally commoditized and the important physician patient relationship will be lost forever.
“Then there are the CBO projections https://www.cbo.gov/publication/53090 which are sometimes wide of the mark, but which the liberal media trumpet as the gospel in projecting the effect on patient care is certain healthcare reforms are enacted and implemented.”
“The result of all that is that almost anything that is proffered as change is shouted down by one interest group or another, often by people who don’t have much of a clue re: what they are protesting about.”
DF, MD
The only thing that can turn this trend around is patients and a consumer driven healthcare system along with some organized medicine leadership.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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