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Obamacare Tax Hikes That Are Forgotten

Stanley Feld M.D.,FACP,MACE

Americans have forgotten the increase in taxes written into President Obama’s Healthcare Reform Act. There are 20 hidden taxes in the law that effect citizens earning less than $250,000 dollars a year.

According to Grover Norquist there will be ½ trillion dollars ($500 billion) in new taxes collected from the group of people making less than $250,000 a year.

These new taxes contradict President Obama’s promise that “anyone making under $250,000 a year will not pay a dime in new taxes.” Many of these taxes on businesses have been passed on to consumers in the form of higher prices.

  

 

https://youtu.be/eHlRY3kHhBk

 

 

 

I am not talking about the increase in taxes on capital gains and dividends that seniors rely on to survive. I am talking about all the other taxes that affect purchasing power.

In 2012, Grover Norquist wrote an excellent summary of those new taxes for the public to review. President Obama’s hypocrisy toward the American people is obvious.

The traditional media have ignored these new taxes and Mr. Norquist’s summary.   No one is talking about how these taxes are hurting seniors and the middle class economically.  

Since the recent Supreme Court decision has managed to keep Obamacare alive, it is vital that voters in all income brackets understand the new taxes imbedded in the law.

President Obama was not telling the truth when he said people earning under $250,000 would not pay one single dime more in taxes.

I suggest everyone watch President Obama’s lying and defending of his lies. After the first You Tube let it keep playing to hear subsequent You Tubes.

  

http://youtu.be/56c1fSdTAWI

Grover Norquist is president of Americans for Tax Reform, a coalition of taxpayer groups, individuals, and businesses opposed to higher taxes at the federal, state, and local levels. The coalition organized the Taxpayer Protection Pledge, which asks all candidates for federal and state office to commit themselves in writing to oppose all tax increases.

In my blog “ The Supreme Court And Obamacare” I said Obamacare is the largest tax increase in American history. As things go sour for Obamacare the government is going to have to raise taxes even further.

Taxpayers earning under $250,000 will experience the burden of the $500 billion dollar increase in their taxes.

Mr. Norquist’s article appeared in 2012.

“Obamacare contains 20 new or higher taxes on American families and small businesses. 

Arranged by their respective effective dates, below is the total list of all $500 billion-plus in tax hikes (over the next ten years) in Obamacare, where to find them in the bill, and how much your taxes are scheduled to go up as of today:

Taxes that took effect in 2010:

1. Excise Tax on Charitable Hospitals (Min$/immediate): $50,000 per hospital if they fail to meet new "community health assessment needs," "financial assistance," and "billing and collection" rules set by HHS. Bill: PPACA; Page: 1,961-1,971.

2. Codification of the “economic substance doctrine” (Tax hike of $4.5 billion). This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed. Bill: Reconciliation Act; Page: 108-113.

3. “Black liquor” tax hike (Tax hike of $23.6 billion). This is a tax increase on a type of bio-fuel. Bill: Reconciliation Act; Page: 105.

4. Tax on Innovator Drug Companies ($22.2 bil/Jan 2010): $2.3 billion annual tax on the industry imposed relative to share of sales made that year. Bill: PPACA; Page: 1,971-1,980.

5. Blue Cross/Blue Shield Tax Hike ($0.4 bil/Jan 2010): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services. Bill: PPACA; Page: 2,004.

6. Tax on Indoor Tanning Services ($2.7 billion/July 1, 2010): New 10 percent excise tax on Americans using indoor tanning salons. Bill: PPACA; Page: 2,397-2,399.

Taxes that took effect in 2011:

7. Medicine Cabinet Tax ($5 bil/Jan 2011): Americans no longer able to use health savings account (HSA), flexible spending account (FSA), or health reimbursement (HRA) pre-tax dollars to purchase non-prescription, over-the-counter medicines (except insulin). Bill: PPACA; Page: 1,957-1,959.

8. HSA Withdrawal Tax Hike ($1.4 bil/Jan 2011): Increases additional tax on non-medical early withdrawals from an HSA from 10 to 20 percent, disadvantaging them relative to IRAs and other tax-advantaged accounts, which remain at 10 percent. Bill: PPACA; Page: 1,959.

Taxes that took effect in 2012:

9. Employer Reporting of Insurance on W-2 (Min$/Jan 2012): Preamble to taxing health benefits on individual tax returns. Bill: PPACA; Page: 1,957.

Taxes that take effect in 2013:

10. Surtax on Investment Income ($123 billion/Jan. 2013): Creation of a new, 3.8 percent surtax on investment income earned in households making at least $250,000 ($200,000 single). This would result in the following top tax rates on investment income: Bill: Reconciliation Act; Page: 87-93.

 

Capital Gains

Dividends

Other*

2012

15%

15%

35%

2013+

23.8%

43.4%

43.4%


*Other unearned income includes (for surtax purposes) gross income from interest, annuities, royalties, net rents, and passive income in partnerships and Subchapter-S corporations. It does not include municipal bond interest or life insurance proceeds, since those do not add to gross income. It does not include active trade or business income, fair market value sales of ownership in pass-through entities, or distributions from retirement plans. The 3.8% surtax does not apply to non-resident aliens.

11. Hike in Medicare Payroll Tax ($86.8 bil/Jan 2013): Current law and changes:

 

First $200,000
($250,000 Married)
Employer/Employee

All Remaining Wages
Employer/Employee

Current Law

1.45%/1.45%
2.9% self-employed

1.45%/1.45%
2.9% self-employed

Obamacare Tax Hike

1.45%/1.45%
2.9% self-employed

1.45%/2.35%
3.8% self-employed

Bill: PPACA, Reconciliation Act; Page: 2000-2003; 87-93

12. Tax on Medical Device Manufacturers ($20 bil/Jan 2013): Medical device manufacturers employ 360,000 people in 6000 plants across the country. This law imposes a new 2.3% excise tax. Exempts items retailing for <$100. Bill: PPACA; Page: 1,980-1,986

13. Raise "Haircut" for Medical Itemized Deduction from 7.5% to 10% of AGI($15.2 bil/Jan 2013): Currently, those facing high medical expenses are allowed a deduction for medical expenses to the extent that those expenses exceed 7.5 percent of adjusted gross income (AGI). The new provision imposes a threshold of 10 percent of AGI. Waived for 65+ taxpayers in 2013-2016 only. Bill: PPACA; Page: 1,994-1,995

14. Flexible Spending Account Cap – aka “Special Needs Kids Tax” ($13 bil/Jan 2013): Imposes cap on FSAs of $2500 (now unlimited). Indexed to inflation after 2013. There is one group of FSA owners for whom this new cap will be particularly cruel and onerous: parents of special needs children. There are thousands of families with special needs children in the United States, and many of them use FSAs to pay for special needs education. Tuition rates at one leading school that teaches special needs children in Washington, D.C. (National Child Research Center) can easily exceed $14,000 per year. Under tax rules, FSA dollars can be used to pay for this type of special needs education. Bill: PPACA; Page: 2,388-2,389

15. Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D ($4.5 bil/Jan 2013) Bill: PPACA; Page: 1,994

16. $500,000 Annual Executive Compensation Limit for Health Insurance Executives ($0.6 bil/Jan 2013). Bill: PPACA; Page: 1,995-2,000

Taxes that took effect in 2014:

17. Individual Mandate Excise Tax (Jan 2014): Starting in 2014, anyone not buying “qualifying” health insurance must pay an income surtax according to the higher of the following

 

1 Adult

2 Adults

3+ Adults

2014

1% AGI/$95

1% AGI/$190

1% AGI/$285

2015

2% AGI/$325

2% AGI/$650

2% AGI/$975

2016 +

2.5% AGI/$695

2.5% AGI/$1390

2.5% AGI/$2085


Exemptions for religious objectors, undocumented immigrants, prisoners, those earning less than the poverty line, members of Indian tribes, and hardship cases (determined by HHS).Bill: PPACA; Page: 317-337

18. Employer Mandate Tax (Jan 2014): If an employer does not offer health coverage, and at least one employee qualifies for a health tax credit, the employer must pay an additional non-deductible tax of $2000 for all full-time employees. Applies to all employers with 50 or more employees. If any employee actually receives coverage through the exchange, the penalty on the employer for that employee rises to $3000. If the employer requires a waiting period to enroll in coverage of 30-60 days, there is a $400 tax per employee ($600 if the period is 60 days or longer).Bill: PPACA; Page: 345-346

Combined score of individual and employer mandate tax penalty: $65 billion/10 years

19. Tax on Health Insurers ($60.1 bil/Jan 2014): Annual tax on the industry imposed relative to health insurance premiums collected that year. Phases in gradually until 2018. Fully-imposed on firms with $50 million in profits. Bill: PPACA; Page: 1,986-1,993

Taxes that take effect in 2018:

20. Excise Tax on Comprehensive Health Insurance Plans ($32 bil/Jan 2018): Starting in 2018, new 40 percent excise tax on “Cadillac” health insurance plans ($10,200 single/$27,500 family). Higher threshold ($11,500 single/$29,450 family) for early retirees and high-risk professions. CPI +1 percentage point indexed. Bill: PPACA; Page: 1,941-1,956

© 2012 Newsmax. All rights reserved.

Mr. Norquist left out the worst tax of all. The “tax” is under everyone’s radar. It has not been mentioned in the traditional mainstream media. It is the tax on Seniors who are on Medicare.

"The per person Medicare Insurance Premium will increase from the present
Monthly Fee of $96.40, rising to:

$104.20 in 2012

$120.20 in 2013

And

$247.00 in 2014."

 

All seniors are means tested. This means the greater your income from any source including work income, pension income, capital gains and interest or dividend income the higher the baseline premiums become.

 

This “tax” had been decided by a Democratic controlled congress that had not read the bill or understood all of its consequences.  

These are provisions incorporated in the Obamacare legislation, purposely
delayed so as not to anger seniors during President Obama’s 2012 Re-Election Campaign.

 

Please send this blog to all the seniors you know and their children. It is important for them to know that President Obama is throwing seniors under the bus.  Obamacare must be repealed.

Everyone must stay focused. President Obama is going to try to change the conversation.

Some of these taxes have already gone into effect. If the Republicans win the House and the Senate as well as the Presidency, Obamacare could be repealed.   

Everyone interested in America’s economic future must tell a friend. President Obama has deceived Americans.  

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

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The Facts

Stanley Feld M.D.,FACP,MACE

The fact that the Obama administration believes that Americans are stupid as expressed by Jonathan Gruber is an insult on its own. The fact that the Obama administration persists in treating us as if we are stupid simply compounds the insult.

In the run up to the February 15th ending of the 2015 www.healthcare.gov enrollment period and the new Republican congress’ upcoming vote to repeal Obamacare, the Obama administration is trying to convince Americans that Obamacare is working and is good for all Americans.

The public knows better by now. The middle class is feeling the economic pain Obamacare has created. They sense President Obama telling another lie.

 Recent headlines have been

Obamacare Will Cost 20% Less

Affordable Care Act will Cost 20% Less Than Initial Projections, CBO Says

Right-Wing Media Won't Tell You That The CBO's New Obamacare Cost Estimates Are Lower Than Expected

President Obama’s deception implies Obamacare is cost effective. All the CBO is saying is the numbers given to it, this time, by the Obama administration show the cost of Obamacare will be 20% lower than the CBO original estimate in 2011.

The additional new taxes for Obamacare were initiated in 2011 based on those CBO estimates.

One important reason for the 20% decrease in cost from the original estimate in 2010 is that fewer people have chosen to enroll in www.healthcare.gov in 2014.

Since fewer people enrolled there is a $51 billion of savings in federal subsidies for fewer enrollees in health insurance exchanges.

This represents a failure of Obamacare not a success as claimed by the Obama Administration.

The government estimates a total 10.7 million will enroll by February 15,2015. On February 2,2015 there were 7.53 million qualified enrollees. The original estimate in 2010 was 17.5 million. The first 2015 estimate enrollment in 2014 was reduced 3 months ago to 13 million. The enrollment figure was modified.

The taxes the middle class have been forced to pay for Obamacare were not modified.

The real numbers are totally confusing because the government documentation is very difficult to follow. CMS modifies the numbers constantly with corrections. The modifications serve to keep Americans stupid and confused.

The Obama administration is now spinning the significance of the CBO report to its political advantage.

The online Daily Mail of Britain published this online story. The headline does not exactly reflect potential consequences of the Facts.

"Obamacare program costs $50,000 in taxpayer money for every American who gets health insurance, says bombshell budget report."

  • ·       Government will spend $1.993 TRILLION over a decade and take in $643 BILLION in new taxes, penalties and fees related to Obamacare
  • ·       The $1.35 trillion net cost will result in 'between 24 million and 27 million' fewer Americans being uninsured – a $50,000 price tag per person at best
  • ·       The law will still leave 'between 29 million and 31 million' nonelderly Americans without medical insurance
  • Numbers assume Obamacare insurance exchange enrollment will double between now and 2025 "

  Buried in a 15-page section of the nonpartisan organization's new ten-year budget outlook were numbers to calculate the cost of Obamacare legislation to add patients to the insurance role. “The $1.35 trillion net cost will result in 'between 24 million and 27 million' fewer Americans being uninsured – a $50,000 price tag per person at best.”

It is impossible to judge whether these estimated figures are correct because estimates are mostly wrong.

What we do know is Obamacare is not doing well from everyone’s except President Obama’s point of view. The spin is keeping all Americans who are seeking the truth confused. Americans want a solution to the deterioration of the healthcare system.

Another reason for the reduction in Obamacare healthcare spending could come from the reduction in reimbursement to physicians.

Insurance companies have not suffered the same reimbursement insult because the government has subsidized the healthcare insurance industry and provides a guaranteed profit that is not included in the CBO estimate.

A third reason for the reduction in spending could be explained in part by the growth of consumer-driven health plans and the Great Recession.

A fourth reason for the 20% reduction could be that the insurance products on the health insurance exchanges have high deductibles. It takes a while before the patients reach their deductibles and the government starts spending money on reimbursement. Patients can also be staying away from receiving appropriate medical care because they cannot afford the deductible.

The CBO report projects that 75 percent of enrollees will receive subsidies in 2015. However, 87 percent received subsidies in 2014. This is wishful thinking on the part of those who provided the data for the CBO to evaluate to believe the subsidy percentage will decrease.  The CBO projected a further decrease in subsidy to 71% in 2025.

The health insurance exchange experience so far suggests there is adverse patient selection. It can be assumed that there will be an increase in healthcare risk and an increase subsidy percentage in the future.

CBO projects the average exchange subsidy per covered enrollee in 2015 will be $4,330 and increase to $7,710 by 2025. These costs represent a 78 percent increase in costs.

However, I do not think anyone can draw any conclusions from the CBO’s report.

I do believe that Obamacare is President Obama's  push to a single party payer healthcare system because of the structure of its market driven elements are destined to fail.

Government will then take over telling us what medical care we can or cannot have.

”We are fast approaching the stage of ultimate inversion: the stage where the government is free to do anything it pleases, while the citizens may act only by permission.” - Ayn Rand

The CBO report of a 20% reduction is spending as a result of Obamacare is meaningless. It is being used by President Obama to confuse the public for political reasons.

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

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Are You Kidding?

Stanley Feld M.D.,FACP,MACE

The New York Times continues to have Ezekiel Emanuel M.D., Provost of the University of Pennsylvania write a medical opinionator column.

It is no wonder the Times circulation has fallen to only 2 million readers. It is no longer the newspaper that prints “all the news that is fit to print.’

Malcolm Gladewell, in a critique of Steven Brill’s “Bitter Pill”, describes Ezekiel Emanuel as follows,

Emanuel was the “brashest” and most “academically credentialed of the trio of brilliant Emanuel brothers,” took “edgy” positions, and had an “MD and a PhD (in political philosophy) from Harvard, a master’s from Oxford, and a position teaching oncology at the Dana-Farber Cancer Institute in Boston.”

 He had “brains, cunning and [a] biting persona,” and was “ready, willing and able to layer it with the self-righteousness of a guy who treated cancer patients.”  

He also does not give a straight answer when challenged.

In my opinion he des not understand either the healthcare system or the medical care system. He does not understand patients’ problems or needs.

Yet President Obama has used him as his medical care advisor for Obamacare. Two recent articles that he has written emphasize the above. 

The first is “Why I Hope to Die at 75” An argument by Ezekiel Emanuel that society and families—and himself—will be better off if nature takes its course swiftly and promptly.

http://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/

It must be read to be believed. No amount of commentary can describe this unbelievable argument. It left me speechless. It is a set up for government to ration medical care.

It also made me wonder how the President of the United States can permit Dr. Emanuel to be the spokesman for medical care in America. President Obama can only permit it if he agrees that government should control our freedom of choice.

Dr. Ezekiel Emanuel, last heard from claiming that he wants to die at 75 in order to avoid becoming a burden on society, writes in the New York Times that “screening healthy people who have no complaints is a pretty ineffective way to improve people’s health.”

He believes that government should control patients’ freedoms.

In an article he wrote that appeared in Lancet he stated;  We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favoring the worst-off, maximizing total benefits, and promoting and rewarding social usefulness. 

Dr. Emanuel is all about rationing care for individuals. He is all about the government telling individuals what care they are entitled to depending on their age and usefulness to society.

The second article that solidified my concept of this man was his article Skip Your Annual Physical.

http://www.nytimes.com/2015/01/09/opinion/skip-your-annual-physical.html?_r=0

It should be read to understand his mission.

President Obama had built into Obamacare preventive services requirements. This resulted in at least 5 million people in the individual healthcare market losing their insurance and their doctors.

Obamacare mandates that Americans pay via new taxes and inflated health insurance premiums for services they do not need or they do not want. One ridiculous service would be birth control for the elderly.

Additionally the National Commission on Prevention Priorities found that by increasing just five preventive services, clinicians could save more than 100,000 lives per year. These services include breast cancer screening in women 40 and older, flu immunizations in adults 50 and over, colorectal cancer screening in adults 50 and over, smoking cessation counseling, and a daily aspirin in high risk cardiovascular patients.

Ezekiel Emanuel now contradicts this previously adopted notion. Now he wants it out. President Obama can probably take it out by executive order.

One can get a deeper an understanding of this man’s temperament when listening to these two interviews.

  

http://youtu.be/7XD7650Rl04

 

http://youtu.be/QgHTzbZ4crU

Obamacare’s architects are setting up Americans to be resolved to accept what the government will decide and provide. Americans will have no option to decide what medical care they can have and what physicians they can see. Non-elected bureaucrats will decide for us.

I implore Americans, congress, all of organized medicine and all physicians to say enough is enough. Obamacare should be repealed.

  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

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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Notice The Enrollment Spin

Stanley Feld M.D.,FACP,MACE

The disinformation coming from the Obama administration is unrelenting.

CMS has released Obamacare’s open enrollment numbers through 12/15/14.

 On December 15,2014 all of last years enrollees who did not change their health plan or did not discontinued their plan were automatically re-enrolled for 2015.

 

Confirmed 2015 QHPs: 3,039,524 as of 12/15/14”

“Estimated 2015 QHPs (Cumulative):


11/21: 610K (462K HCgov) • 11/28: 1.02M (765K HCgov) • 12/05: 1.80M (1.35M HCgov) Thru 12/15: 4.70M (3.52M HCgov

http://acasignups.net

Enrollment by state can be studied in the following link.

The Obama Administration bragged with the following statement.

The number of people enrolling or re-enrolling last week was considerably higher than in previous weeks. Week one saw 500,000 enrollees, week two had 300,000 and week three saw 600,000 sign up through HealthCare.gov.

Week four saw 850,000 people enrolling or re-enrolling.

The cumulative estimate of people needed to sign up was 4.7 million through 12/15/14. The sign up number included people who were automatically re- enrolled with the same insurance policy they bought last year. This year’s premiums and deductibles will be higher that last year’s premiums in most cases.

The Obama administration picked up 1 million enrollees for the week as a result of the automatic re-enrollment. These enrollees have been warned that they will be paying a higher premium than if they searched for a different plan by a different insurance carrier.

Only 3.4 million sign ups were confirmed to receive healthcare coverage by January 1,2015.

This is only seventy percent (70%) of the expected enrollment through 12/15/14. The enrollment had been extended previously to February 15, 2015.

http://acasignups.net/spreadsheet

CMS told us that last year 8 million were enrolled. The number was modified to 7.2 million and then changed to 6.7 million as 400,000 were not enrolled in healthcare but bought dental care insurance.

We were never told that 65% of the enrollees received federal subsidies in the traditional media. How many of those people who received subsidies subsequently lost their subsidy because the IRS could not confirm their reported income?

The next critical question is how many of the people who lost their subsidy dropped their insurance because they could not afford the premiums and deductibles.

How many people that enrolled have preexisting illnesses? How many of the people who enrolled can pay the high deductibles and copays?

How many people in the individual market can afford to pay the insurance premiums with pre-tax dollars?

Whatever the premium is in the individual market the enrollee has to have twice as much disposable income to pay the premium because the premium is not tax deductible.

Healthcare insurance premiums are tax deductible to employers in the employer group markets.

How many taxpayers know that the Obama administration is subsidizing the healthcare insurance industry so the industry cannot loss money if the healthcare insurance is bought through Obamacare?

The original goal for enrollment for 2015 was 13.5 million. It was lowered to 12 million and now 9 million by the time the enrollment started. If 6.7 million were originally enrolled the increase in new enrollment will only be 2.3 million.

What happened to all the millions of people who lost insurance through their employer because they were shifted to part-time work?

It seems that Obamacare is unattractive or unaffordable to those who need it most. If taxpayers knew the waste in Obamacare’s administration and guarantees to the healthcare industry, taxpayers would not be very happy.

It goes back to Jonathan Gruber’s statement that the people are stupid and the lack of transparency is very powerful political tool.

Meanwhile, the enrollment rate is low but the Obama administration is feeding the traditional media the spin that enrollment is surging. This game is not going to promote Obamacare’s credibility.

More than a million people signed up for health insurance plans onHealthCare.gov in the past week, bringing the overall total of signups for the first four weeks of the current open-enrollment period to nearly 2.5 million, the CMS announced Tuesday.

Dec. 15 was the HealthCare.gov deadline to enroll for coverage to go into effect Jan. 1.” 

“More than half of the people who enrolled between Dec. 6-12 were renewing their coverage.

Many of the State Health Exchanges are already extending the deadline for coverage to begin January 1,2015, California, Maryland and Minnesota, Idaho, Massachusetts, New York, Rhode Island and Washington already have extended their deadlines for signing up.

If enrollment was going as well as the Obama administration claims, there would not be so many 2 week extensions.

 “Our community wants to do everything we can to make sure consumers have greater peace of mind about their healthcare coverage and to support them throughout the open-enrollment process,” Karen Ignagni, CEO of America's Health Insurance Plans, said in a statement Monday.ė

Why wouldn’t the healthcare insurance companies want more enrollees? They are selling insurance policies for the Obamacare at no financial risk.
 
Federal plans are underway for a special outreach campaign to the roughly 250,000 individuals whose existing plans are no longer being offered on the federal exchange for 2015. HHS plans to point these people in the direction of a plan that is substantially similar to the ones they've lost but they won't be auto-enrolled.”

The Obamacare’s enrollment period is desperate for more enrollees

HHS is rolling out online partnerships with three online firms to further promote HealthCare.gov during the current open-enrollment period,which ends Feb. 15.
The partnerships are with Monster.com, Peers.org, and Higi, a provider of interactive health stations tracking weight, BMI and other vital signs to supermarkets such as Kroger and Meijer. The company will post messages informing users of the open-enrollment period. 

The partnerships are innovative but have a low probability of success.

President Obama and his administration continue its information  spin. The real truth is the Obama administration is not transparent at all. It takes hard work to figure out what is the truth.

The public is beginning to figure out that they are not getting the truth.  Consumers are directly affected by the manipulation of the truth personally. Consumers are not showing up to participate.

Presently, Obamacare is only covering consumers in the individual marketplace.

Just wait until Obamacare affects the small group and large group employers that are going to have to pay a penalty for providing  unqualified Obamacare healthcare coverage. 

One outstanding example is the worthless Mini-med plans of McDonald and Burger King that President Obama gave a waiver to until 2017.

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

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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Why Republicans Need A Viable Healthcare Plan NOW

Stanley Feld M.D.,FACP,MACE

I have been asked by many of my conservative friends why so many of my liberal friends believe Obamacare is great.

My liberal friends think conservatives are are illogical, callous, spiteful, partisan and soulless. Some even believe conservatives are ignorant.

 Obamacare provides coverage for people who cannot get coverage or afford healthcare coverage in the pre Obamacare era. Insurance options and county healthcare system were inadequate for servicing these people.

It turns out that people who need to buy healthcare insurance coverage through Obamacare cannot afford the coverage either.

Even with the illegal subsidies they cannot afford the deductibles.

Obamacare is not the solution to our healthcare system problems. Obamacare is an inefficient bureaucracy that was pasted onto a pre-existing dysfunction and unsustainable healthcare system.

The costs overall are increasing despite the Obama administration and progressives telling us the costs are decreasing. Healthcare taxes have increased the overall federal tax rate to 50%.

Americans have not been provided with the real tax rate increases or unemployed or partially employed statistics since 2009. Yet progressive quote the figures the administration provides as absolute facts.

Americans know something funny is going on because they have less money to spend.

Progressives do not want to understand these consequences. The acceleration of unintended consequences of Obamacare will lead to the economic collapse of the healthcare system as well as the economic collapse of the country.

Progressives want to ignore the effects Obamacare is having on the economy even though only 15 of the 350 million of us are in the individual market and less that 7 million are insured under Obamacare.

Progressives ignore the facts and revert to name calling aimed at conservatives.

Conservatives do not know how to respond. Progressives continue to call conservatives tax adverse, callus, ignorant and for the vested interest of big business.

I try reading and listening both the progressive and conservative media. Progressives play the same theme continuously.

Progressives continuously use emotionally charged examples that anyone would be sympathetic to. At the same time they belittle their “conservative opponents.”

A New York Magazine article by Jonathan Chait entitled, “Yes, the Republican Obamacare Strategy Will Kill People”  illustrates my point.

“There is a famous thought experiment called the trolley problem, and it goes like this: A runaway trolley is headed toward five people bound on the tracks. You are standing before the switch that could divert it onto another track, where it would kill only one person. Do you pull the switch?

The problem is a way of grappling with the moral responsibility of actively killing a person for some larger end, a problem that lurks behind much of the role of the state, from policing to Harry Truman dropping the atomic bomb on Japan.”

The reader should not be confused by where this story is going. It is a distraction from the real problems of Obamacare’s healthcare policy and implementation.

“The trolley problem is the most flattering possible way to think about the conservative movement’s fanatical commitment to repealing Obamacare.”

“ That is, if you ignore the obvious elements of partisan spite, callousness, and self-deception, one can posit a commitment to abstract moral principles about the role of the state.”

This sentence serves as an invective against the conservative enemy.

Conservatives’ abstract principles, like most people, can come attached to specific costs. If they pull the switch and repeal Obamacare, or if they persuade five Republican Supreme Court justices to cripple it, they will spare America from the evils of mandates, taxes, regulation, and what they imagine being European socialist horrors. They will also kill what are now identifiable human beings”.

This sums up progressives’ attack against conservatives. The reader will be convinced that the conservatives are evil, use corrupt tactics and act immorally.

Mr. Chiat ignores the unworkable healthcare policy and economically unsustainable facts.

It is all about character assassination of an opponent. It is a typical Saul Alinsky tactic.

Mr. Chiat then goes on to describe a Washington Post report of a patient (Mr. Tedrow) who without the benefit of Obamacare’s health insurance exchange coverage plus subsidy could not have had a liver transplant. Obamacare saved the patient’s life.

There have been many stories like this published in the traditional progressive media in defense of Obamacare.

The article states that all the Republican Party wants to do is repeal Obamacare and go back the pre-Obamacare dysfunctional healthcare system.

Republican health-care plan is no better than the pre-reform status quo. Conservatives are within their rights to prefer freedom from taxes and regulation even at the cost of David Tedrow’s well being.”

The New York Magazine article presupposes that a Republican Healthcare Plan will ignore patients like David Tedrow.

But any morally serious position has to account for the brutal realities embedded in this trade-off. Truman’s war strategy involved killing a lot of Japanese civilians.”

The Republican health-care strategy is to flip a switch whose immediate effect will be to impoverish and kill a lot of people. Is there a single conservative who will admit this?”

The article also presupposes that Republicans will just flip the switch on the people that need help and kill them.

Republicans must immediately present an understandable healthcare plan to the public that is sustainable and will preserve our freedoms to make our own our healthcare decisions rather than the government choosing for us.

Republican cannot propose tweaks around the edges of Obamacare such as repealing the medical device tax. This proposal will have little effect on repairing the healthcare system.

 A reader responding to by last post wrote that describe the writing of a sustainable plan,

 “I think you could more simply say this to rally America:

 “We must change our healthcare system because its current costs are unsustainable.  The only two choices we have is to freely change it by taking more responsibility for ourselves (The American Way) or be forced to do what the Government tells us to do (The Obamacare way).” 

“After that, everything else is tactics.  Obamacare must be seen for what is it, Government force.  It is not healthcare.”

I think the majority of voting Americans, who take the time to think about these things, are aware of the limitations on our freedom to choose and the financial unsustainability of Obamacare.

Americans are aware of the fact that they have been lied to by the Obama administration over and over again. Americans do not trust the Obama administration to make serious healthcare decisions for them.

They do not understand what they can do about it. The President and the congress are supposed to work for us. It is imperative to express your opinion to them.

They understand the progressive spin masters whose only tool is to discredit conservative integrity, thought and intentions.

 Republicans must immediately develop and publicize a logical plan will provide  universal healthcare for all Americans while maintaining their freedoms.

Americans must be in control of their health and their healthcare dollars even if the government has to supply the needy with healthcare dollars.

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

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Election Time! Obamacare Is Not Working

Stanley Feld M.D.,FACP,MACE

Despite the proclamations of President Obama and Paul Krugman Obamacare is not working.

However, if you tell a lie enough times it becomes the truth. This is especially true if you have enough traditional media coverage of the lie.

The reality is consumers cannot keep their own doctor, access to care is decreasing, and you cannot keep your healthcare insurance plan if you liked your  plan because of Obamacare’s imposed rules and regulations.

Healthcare insurance premiums are increasing despite President Obama’s proclamation that healthcare insurance premiums are affordable. Consumers’ out of pocket costs are increasing despite President Obama’s claims.

The narrow and ultra-narrow new networks on the federal health insurance exchanges are decreasing consumer choice of physicians. The access to quality healthcare at a reasonable price is vanishing.

Consumers are feeling these negative affects on their quality of life already. They will not forget it at the polls on Tuesday despite the efforts of the Democrats to keep Obamacare a non-issue.

President Obama wishing that Obamacare is working does not make it so. He cannot simply decree lower prices. He cannot simply say I want better quality. Neither happens out of thin air. Obamacare’s rules and regulations are disastrous.

The reality is government cannot do a thing about the negative affects Obamacare is having on consumers except repeal it.

Neither federal nor state government can tweak Obamacare and fix the negative affects. These affects are here already. Federal and state government cannot hide the avalanche of negative affects that are coming.

Consumers don’t believe President Obama or the government’s spin anymore.   

The mid-term elections are two days away and the progressives Democrats are trying to make Obamacare better with propositions on the mid-term ballot.

They are trying to improve Obamacare in their states and disguise its goal of increasing government control of healthcare. Increasing the rules and regulations in order to control the healthcare system does not work.  

In the process, progressive in various states are contradicting each other. The bottom line is none of the propositions will work.

Progressives have become prisoners of Obamacare as well as prisoners of their own thinking.

California liberals (progressives) are always the leaders in progressive propositions that make no sense. On Tuesday November 4th California’s propositions 45 and 46 stand out.

Prop. 45 would give the healthcare insurance commissioner the power to reject rates he deems “unreasonable,” with no reference to actuarial or solvency standards.

Anthem Blue Cross is raising small healthcare insurance group premiums 9.8% in 2015.  This is happening even though Obamacare guarantees the healthcare insurance industry an adequate profit through the federal government’s reinsurance plan for healthcare insurance carriers.

 Who is paying for this guarantee and this rate increase? Consumers are through higher taxes. The California commissioner is going to try to reduce the increase to 2.1% through added power given to him by Prop. 45. 

What is the commissioner going to do about it?  Nothing! If he does not permit the raise the exchange will not have healthcare insurance companies providing administrative services for its healthcare coverage. The government cannot provide administrative services.  Any attempt at price control has not worked in the past and will not work in the future.

The healthcare insurance industry’s alternative is to have narrower networks and less coverage. The consumer will have to cover the cost of better coverage.

Proposition 45 also gives trial lawyers the right to challenge rates in court. It is a good deal for trial lawyers on both sides of the price control issue. It is a terrible   deal for taxpayers on both sides of the issue. It will increase the cost of healthcare resulting in higher taxes.

A logical proposition would be to develop a competitive system for consumers and insurance companies so that insurance companies fight for consumers’ business rather than impose the bureaucratic practice of selective contracting. The bureaucracy provides a list of demands and then picks a few compliant winners. The losers are excluded from the federally subsidized exchange.

Government would dictate what products consumers are allowed to buy and use its clairvoyance to decide what businesses can charge.”

Why wouldn’t you let consumers decide what they want rather than bureaucrats telling consumers what healthcare policy they can have?

Proposition 46 is another disastrous proposition.

In 1975 the then Governor Jerry Brown limited medical malpractice awards to $250,000 for non-economic injury. It decreased the medical malpractice business for lawyers in California.  Lawyers would not take cases that did not make them enough money.

Proposition 46 is proposing to lift the $250,000 restrictions for non-economic damages on medical malpractice awards to $1.1 million dollars. The affect will be more medical malpractice lawsuits because lawyers once again can make some serious money from frivolous malpractice suits with minimal effort.

Physicians’ malpractice premiums will rise once again, and once again doctors will be forced to raise their fees or leave the state. The availability of physicians will decrease. Consumers will suffer again suffer from a proposition that was not thought out.

It does not make sense. I hope the citizens of California are paying attention to the implications of these two propositions.

The common denominator is the propositions are great for trial lawyers and terrible for consumers. The propositions will not be effective in making Obamacare better for consumers.

The goal should be to lower the cost of healthcare for consumers not increase it.  

South Dakota has a proposition (Prop IM-17) which, rather than limiting networks expands networks.

Prop IM-17 is trying to regulate back into existence the access to medical providers that ObamaCare destroyed.

Patients expecting to keep the doctor they liked continue to discover that the narrow networks offered on the exchanges resemble the standard of care in Medicaid.

“Measure-17 would force insurers to accept “any willing provider.” All doctors and hospitals licensed by the state that met certain de minimis conditions must be covered by all plans, regardless of cost or quality.

“IM-17’s cure is worse than the Obamacare disease.”

Healthcare prices will increase. Healthcare insurance premiums will increase. The conflicts among providers will intensify. Consumers’ access to care will be diminished.

The California and South Dakota referenda reflect liberal health-care confusion.”

America is supposed to be a government by the people for the people. The government should not be a government dictating what can have.

Progressives are prisoners of their ideology.

I hope the American people understand this on November 4,2014 and vote to stop progressives“stinkin thinkin.”  

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

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The Practice Of Medicine Is Becoming Less Enjoyable

Stanley Feld M.D.,FACP,MACE

I think everyone got Dr. Mark Sklar’s message in "Doctoring in the Age of ObamaCare" If anyone did not get his message I suggest you read his article again.

The practice of medicine is becoming more difficult for all the reasons Dr. Sklar outlined. It has become difficult because of Obamacare’s new rules and regulations.    

Nine of ten practicing physicians discourage their children and others from going into medicine.

Increasing numbers of practicing physicians are depressed. Three to four hundred physicians will commit suicide this year. Many physicians are retiring early.       

“Simply put, being a doctor has become a miserable and humiliating undertaking. Indeed, many doctors feel that America has declared war on physicians—and both physicians and patients are the losers.”

The medical profession has lost status in the eyes of the public in the last 50 years.

Physicians were the pillars of any community. If you were smart and sincere and ambitious, at the top of your class, there was nothing nobler or more rewarding that you could aspire to become.

Medicine has become just another profession. Physicians have become insecure, discontented and anxious about the future of medicine. Obamacare has intensified that insecurity.

In surveys and articles that appear in many newspapers and online blogs the majority of physicians express diminished enthusiasm for medicine.  

“American doctors are suffering from a collective malaise. We strove, made sacrifices—and for what? For many of us, the job has become only that—a job.”

Many physicians young and old are looking for an exit strategy. Many medical students go into higher-paying specialties such as radiology and anesthesiology so they can retire as quickly as possible.

  • “Non-primary care doctors earn on average 65% more, or $116,000 more each year, than do primary care doctors (pediatricians, family medicine doctors and internal medicine doctors).”
  • Physician MBA programs permit physicians to leave their practice and go into management. These physician executive programs are flourishing.

         The Drop-Out-Club, which hooks doctors up with jobs at hedge funds and venture capital firms are also growing.

Patients need contented physicians. They do not need discontented or depressed physicians. They do not need physicians who are compelled to practice defensive medicine in order to avoid malpractice suits.

They do not need a government that relies on healthcare policy advisors with no experience in the practice of medicine to create policies. The healthcare policy advisors try to shift control from individual consumers to the government and the healthcare insurance industry.

These physicians’ feelings are stated thousands of times by physicians in the pits. No one is interested in listening because the media is the message.

Politicians and the healthcare industry have employed a methodical campaign to devalue physicians and physicians’ medical care in order to control the healthcare system.

The traditional mainstream media keeps on reporting that physicians are money grubbing crooks who do not care for patients. The traditional mainstream media believes that information technology is the key to straightening out our dysfunctional healthcare system.

The government and the traditional mainstream media are feeding consumers nonsense. 

Has anyone ever experienced an efficiently run government agency?

The government is inefficient. It is being taken advantage by the healthcare insurance industry and hospital systems at taxpayers’ expenses while adding little value to the medical care system. 

 Consider what one doctor had to say on Sermo, the online community of more than 270,000 physicians:

"I wouldn't do it again, and it has nothing to do with the money.

I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients.

Working up patients in the ER these days involves shotguning multiple unnecessary tests (everybody gets a CT!) despite the fact that we know they don't need them, and being aware of the wastefulness of it all really sucks the love out of what you do.

I could have made my living and been more fulfilled.

The sad part is we chose medicine because we thought it was worthwhile and noble, but from what I have seen in my short career, it is a charade."

Consumer recognition of this physician’s discontent is new. Physicians have been pointing it out for years.

 The medical profession has not had an effective voice to make this discontent clear.

Consumers of healthcare are starting to listen because it is affecting them directly and they do not like it.

Maybe a consumer driven protest will occur in order to get legislation passed to restore the patient physician relationship.

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



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