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Politicians,Healthcare and Vested Interests

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Significance Of IBM Retiree Decision

September 18, 2013
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System
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Stanley
Feld M.D.,FACP,MACE

 IBM’s dropping of retirees’ healthcare plans will be the cause of a
continuing avalanche of companies dropping healthcare insurance for its non-retired
employees.  These companies are doing it
in two ways. They are decreasing work hours from 40 to 30 hours per week. They
are hiring part time employees. The are also outsourcing work to avoid paying
an “Obamacare penalty.”

Companies are contracting with “Private Health Exchanges” to service the
rest of their employees. The companies provide a stipend for healthcare
coverage and send employees to the “Private Health Exchange” to buy coverage.
If employees cannot afford the coverage, employees would be able to buy
insurance from the government health insurance exchange.

 

In February 2011 I wrote about the McKinsey study that estimated the
percent of employers that would stop providing healthcare insurance for their
employees in 2014.

None of the Obamacare fans wanted to believe this study.

Senator John Kerry and Representative Barney Frank said a public option was
essential in order for Obamacare to work.

President Obama told them not to worry. Obamacare will work without a
public option.

I called Obamacare’s health insurance exchanges essentially Obamacare’s Public
Option. Consumers will be forced into the health insurance exchanges in 2014.

The Congressional Budget Office provides congress estimates of the effects
of legislation. The CBO is not required to think.

 The CBO crunches numbers provided
to it by the administration. The administration has been less than candid with
everyone including the American public

“The
Congressional Budget Office estimated that only 7 percent of employees
currently covered by employer-sponsored insurance (ESI) will have to switch to
government subsidized-exchange policies (Public Option) in 2014.”

The McKinsey study concluded; Feb 2011

 

  • Overall, 30 percent of employers will definitely
    or probably stop offering ESI in the years after 2014.
  • Many
    Human Resources officers and CFOs do not know the implications of Obama care.
  • Among employers having a high understanding of
    President Obama’s Healthcare Reform Act more than 50% will stop offering
    employee healthcare benefit and more than 60% will make some kind of change.
  • At least 30 percent of employers feel they would
    gain economically from dropping coverage and paying the penalty. They would
    even gain if they increase their employees’ salary or other benefits.
  •  The
    insurance coverage is in excess of $15,000 per year per employee. The
    government penalty is $2,000 per employee.
  • The
    difference in cost will force employers to drop ESI and force employees into
    the Public Option.  This was President Obama’s plan all along.
  • The survey also showed that more than 85 percent
    of employees would remain at their jobs even if their employer stopped offering
    ESI.
  • Sixty (60) percent of employees would expect an
    increase in compensation from their employers    . 
  • Who
    are these rules in favor of? They are not in favor of the employee.”

 

“Health care reform fundamentally alters the
social contract inherent in employer-sponsored medical benefits and how
employees value health insurance as a form of compensation.”

 “Obamacare” guarantees the right to health
insurance regardless of an individual’s medical status or ability to pay. In
doing so, it minimizes the moral obligation employers may feel to cover the
sickest employees, who would otherwise be denied coverage in today’s individual
health insurance market.

The logical result is healthcare insurance
premiums would increase for the individual and benefits would decrease to keep
the premium cost down.

In 2014, people who are not offered affordable
health insurance coverage by their employers will receive income-indexed
premium and out-of-pocket cost-sharing subsidies from the government through public
health insurance exchanges.

The highest subsidies will be offered to the
lowest-income workers. It enables these low paid workers to obtain coverage
they could not afford in today’s individual healthcare insurance market.

It will force people into the dysfunctional
individual insurance market under public supervision of public health insurance
exchange.

The government will pay the subsidies for the resulting
increased premiums that will result from expanded coverage in this “Public
Option.” The government would then pass the increased premium cost on to the
taxpayer on a means tested basis and with higher taxes.

This is what Don Berwick and President Obama meant by
redistributing wealth. 

The next step is government’s complete control of
a single party healthcare system. 

Employers will no longer be able to offer better
healthcare insurance benefits to their highly compensated executives either.
Companies will be forced to discontinue employee healthcare coverage. We see
that happening in the Fall of 2013.

The penalty is set low to further encourage
companies to discontinue coverage. President Obama’s goal is to have most people
in the “Public Option.”


This will lead to government control of the
healthcare system and all the inefficiencies that will result. These
inefficiencies will increase the cost of care and result in a decrease in
access to care as well as rationing of care.

 State insurance exchanges will be paid for
by the states with a federal subsidy. These exchanges will offer individual and
family policies of set benefit levels (bronze, silver, gold, and platinum) from
a variety of insurance companies.

The effect on the federal deficit will be much
greater than the original CBO’s estimated. The number of people who will loss
their company insurance was estimated by the CBO at 10 million, or about 7
percent of employees, currently covered by ESI.

Seventy (70) million people was McKinsey’s estimate in 2011.

“ A July study by Craig Garthwaite of Northwestern
University’s Kellogg School of Management predicts as many as 940,000. That
number is an estimate of how many adults without children are working because
of what the researchers call “employment lock.”

This
increased number of participants will add to the federal deficit. The increased
federal deficit will result in higher taxes for everyone, including the middle
class.

“The taxpayers are going to get
hammered,” says Douglas Holtz-Eakin, a former Congressional Budget Office
director who is now president of American Action Forum, a Washington-based
advocacy group that opposes the health law. “It’s going to be extraordinarily
expensive.”

President Obama wins his ideological goal.
Consumers will have less control over their own healthcare decisions and
choices. 

The healthcare insurance industry will gain more
control over pricing. This will increase profits because they will administer
government health insurance exchange services. President Obama will continue to
outsource the administrative services to the healthcare insurance industry.

 The losers will be consumers and
physicians.

The impending results are all totally
predictable. Obamacare fans refuse to listen.

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

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President Obama Should Listen To Physicians

August 28, 2013
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Mistrust
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Stanley Feld M.D.,FACP,MACE

President
Obama keeps saying over and over that Republicans do
not have any good health care reform solutions.

“Republican
don’t have an agenda to provide health insurance to people at affordable
rates.”

It all depends
on the definition of a good idea. Is it one that will work or one that will
fail? A good idea is it one that agrees with President Obama’s agenda. If it
doesn’t agree with his agenda it is a bad idea.

By President
Obama and Harry Reid own admission they believe Obamacare is a good step toward
a single party payer. They believe Obamacare will fail.

Any idea that
interferes with President Obama’s is defined as a bad idea.

The Republicans
and thoughtful people with actual healthcare experience have plenty of good
ideas. They do not agree with President Obama’s agenda.

 

http://youtu.be/4-lnzEwt3HM

This program containing Republican ideas three years ago had only 807 views on You Tube.

Congress voted for the
law (only Democrats voted for the law). They have now exempted themselves from
the law because they realize it is a bad law. It looks as if Obamacare will be
a train wreck.

Image1
Image1

Perhaps that is where
President Obama wants it to end.

 

 As each day
passes Obamacare looks like it will be a very expensive train wreck.

 Physicians are tired of being blamed for the rising
healthcare costs. They are starting to realize that they have to take action to
preserve their professional integrity.

In fact, in a recent study by the Physicians Foundation, six
out of ten physicians said they would quit medicine.

Most physicians love practicing medicine but cannot
understand the unbelievably wrong direction President Obama is taking to reform
the healthcare system.

 Many physicians
are looking for viable exit strategies to avoid quitting.

The
Physicians Foundation commissioned an extensive survey of
nearly 13,575 physicians. Meritt Hawkins, the physician search and consulting
firm, conducted the survey.

 
“The survey found
that 60% of physicians would
retire today, if given the
opportunity—an increase from 45% in 2008. And it's not just disgruntled and
tired Baby Boomers who want to abandon their healing work. At least 47% of
physicians under 40 also said they would retire today, if given the
opportunity.”

The
survey pointed out many major problem areas.

Two specific issues consistently agreed on by physicians
were malpractice concerns and the need for tort reform as well as the lack of
cohesive leadership among all physician groups to represent the vested
interests of physicians and their patients.

This survey is an excellent and detailed survey that has
heightened the awareness of physicians’ practice problems.

The Massachusetts Medical Society survey pointed out the
scope of defensive medicine. I extrapolated findings of the society’s survey to
the nation.

My conclusion was that $500 billion to $700 billion
dollars a year is spent on defensive medicine testing. Tort reform would
decrease the cost incurred by defensive medicine over testing.

The Mass Medical Society survey demonstrated that
physicians are frightened by the multidimensional stress of malpractice suits.
Physicians will do as much testing as necessary to avoid a malpractice suit for
missing a diagnosis. Most physicians do not experience financial gain in over
testing. The hospital system does.

President Obama and his advisors have ignored tort reform
and defensive medicine as an insignificant cost. Ezekiel Emanuel M.D. one of
President Obama’s advisors thinks defensive medicine only raises the cost of
the healthcare system between $2 to $3 billion dollars a year. This is a
misguided bias.

The Physician Foundation survey notes that many policy
makers, academics, and others identify fee-for-service reimbursement as a key
driver of health care costs. Physicians believe that "defensive
medicine is a far more important cost driver."
 
Forty
percent (40%) of the physicians surveyed said "liability/defensive
medicine pressures" was the least satisfying aspect of medical practice.

 Sixty nine percent
(69%) of physicians said defensive medicine is the "number one ranked
factor" driving up healthcare costs. The survey described the ordering of
tests, prescribing of drugs, and conducting of procedures done "partly or
solely to drive a wedge against potential malpractice lawsuits."  

"Medical
malpractice lawsuits are common, adding an additional layer of paperwork,
expense, and stress in virtually every physician's work day," the report
adds.

The government ought to be listening to physicians practicing medicine every
day rather than ivory tower professors who have never practiced medicine a day
in their lives.

"Physicians
understand to some degree that's the cost of doing business, but the defensive
medicine goes deeper than that, in the ordering of extra tests, doing the extra
procedures, and extra scans to protect [oneself] against a malpractice suit.”

Medical malpractice is at the heart of overspending in
American healthcare. President Obama and Obamacare have ignored it. Some states
have addressed it and the cost of care has been decreasing slowly. I believe it
will take time in those states.  If
anyone is sincere about bending the healthcare cost curve they have to take
defensive medicine seriously. 

According to the survey physicians
felt that there is a lack of a forceful cohesive voice representing them.

"There
is a systematic, endemic series of problems," Ray says. "Everywhere there
is defensive medicine, regulation issues, reimbursement issues. We are all in
the same boat. But physician representation is balkanized. There is not a
national organization that represents a majority of physicians."

When the survey asked which best describes
their feelings about the current state of the medical profession, only 3.9
percent of physicians used the words “very positive,” while 23.4 percent of
physicians indicated their feelings are “very negative.”

The majority of physicians – 68.2 percent —
described their feelings as either somewhat negative” or “very negative,” while
only 31.8 percent of physicians’, described their feelings as “somewhat positive”
or “very positive”.

A "least satisfying" aspect of
practicing medicine included dealing with Medicare/Medicaid/government
regulations (27.4%) and reimbursement issues (27.3%).

The American Medical Association (AMA)
represents only 15% of physicians, according to the Physician Foundation report. One of the reasons for the low enrollment is that physicians feel the
AMA does not represent their vested interests.

 Sermo is another physician organization. It is an Internet social
network. In less than 2 years Sermo had as many members as the AMA.

Sermo originally concentrated on
socioeconomic issues. It also discussed difficult clinical cases. 

The socioeconomic activity has recently
faded. Sermo’s power was using the social network to do instant surveys of physicians’
opinions on healthcare policy and patient care hassles.

These surveys were quickly disseminated to
the public as media stories of physicians’ opinions. It was done through public
service announcements and daily press releases.

Physicians were able to let the public know
how they felt about an issue instantly. It was very attractive. Somehow the
initial vigor stalled. Physicians are now left without a vehicle or organization
to express their feelings.

Government, the healthcare insurance industry
and the hospital systems have little desire to listen to the concerns of
practicing physicians. It is more important for these stakeholders to control
physicians. It will not work long term.

The Physicians Foundation Biennial Survey is
valid and accurate. However it is not dynamic or evolving. Neither the PFB
survey of the Sermo survey have gotten the attention they deserve.

Both are must reads along with the
Massachusetts Medical Society survey for those interested in physician concerns
and behavior.

Patients’ problems with the healthcare system
get less attention. The government and insurance companies tell patients what
they can and cannot do.

Repair of the healthcare system will only
happen when the American healthcare system evolves to a consumer driven
healthcare system with individual responsibility and patient control of their
healthcare dollars.

The reality is that health care should be as decentralized and regulated as close
to the people as possible, not run by Washington mandates.

This concept
opposes President Obama’s agenda.  

President
Obama has the power of the pulpit and has the gift of misdirection.

The
healthcare system is going to fail unless the public wakes up to the facts.

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

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Are The Unintended Consequence’s Of Obamacare Unintended?

August 25, 2013
inHealthcare Insurance Industry, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Mistrust
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Stanley Feld M.D.,FACP,MACE
 

It is hard to tell whether the unintended
consequences were really intended consequences on the way to destroying the
healthcare system.

Harry Reid and the President have already
admitted that Obamacare is a good first step on the way to a government
controlled single party payer system.

There are several problems with a single
party payer system,

  1. The
    government cannot afford it.
  2. The
    government cannot run it. It will have to hire the healthcare insurance
    industry to administer it. It costs the government 40% of the healthcare
    dollars to have the healthcare insurance industry provide administrative
    services for Medicare and Medicaid presently.
  3. Providers
    will not have incentive to produce. Reimbursement will be low and salaries will
    be low.

Normally if one works for a company, the
company provides healthcare insurance to the family. When Obamacare raised the
mandate limit forcing employers to provide healthcare insurance for employees’
children living at home to 26 years old, companies have been trying to figure
out how to avoid paying the increased premium cost of healthcare insurance.

Most companies have reduced or are reducing
employment to less than 30 hours to avoid the penalty for not providing
healthcare insurance.

Many companies have applied for wavers.
These companies will get waivers if they are the Obama administration’s
friends. Congress got a waiver.

U.P.S. announced it would discontinue
Health Benefits for spouses of some workers. U.P.S. joins the list of other
companies doing the same thing. These include large employers like Xerox and Teva Pharmaceuticals. They
have chosen to impose surcharges on employees for spousal coverage.

Cities like Terre Haute,
Ind., are adopting a spousal carve-out so that working spouses would not be
covered under its health plans even if the healthcare insurance plan of the
spouse’s company is worse than Terra Haute’s healthcare insurance plan.

The University of Virginia
has just announced a similar spousal carve out. It is rumored that the state of
Virginia is next.

“UVA said
this is only one of many “major changes” coming to their health plans as a
result of ObamaCare. The university says the changes are necessary because the
law is projected to add $7.3 million to the cost of the university’s health
plan in 2014 alone.”

Isn’t Obamacare called the
Affordable Care Act? In truth it is not. It will drive these spouses into a
health insurance exchange.

 “U.P.S. said, “Limiting plan eligibility is
one way to manage ongoing health care costs, now and into the future, so that
we can continue to provide affordable coverage for our employees.”

 — U.P.S. told employees, “Since the Affordable
Care Act requires employers to provide affordable coverage, we believe your
spouse should be covered by their own employer — just as U.P.S. has a
responsibility to offer coverage to you, our employee.”

Delta Airlines announced
that someone
leaked a letter from Delta Air Lines to the Obama administration.

The
letter stated that the “cost of providing health care to our employees will
increase by nearly $100,000,000 next year.” The letter also states that much of
the increase is due to Obamacare.

It means the airline tickets are going to increase in
price. This will become a burden on businesses who depend on flying to do
business. In turn, products these companies produce will increase in price.  

The ordinary consumer will also be affected by rising
airline ticket prices.

U.P.S. said, “Limiting plan
eligibility is one way to manage ongoing health care costs, now and into the
future, so that we can continue to provide affordable coverage for our
employees.”

U.P.S. estimates they cover
33,000 spouses. Fifteen thousand (15,000) spouses can get coverage through
their own employers. It should be added that they can get insurance until the companies
of these15,000 spouses drop their own healthcare coverage.

 If U.P.S
cannot lower insurance costs, they will raise shipping prices. Once again the middle
class is the victim. Another option is to drop healthcare insurance for all
employees and let them participate in the health insurance exchanges.

 Companies providing executive insurance
of $27,500 or more for employee family coverage or $10,200 for individual
coverage (Cadillac plans) will have to pay an additional 40% Obamacare tax in
2018.

This Cadillac plan tax is
something many companies are thinking about and making plans to discontinue in
the future.

The whole thing stinks.

It might not be an
unintended consequence. It might be an intended consequence.

 It might be exactly what President Obama wants
to drive as many people as possible into his health insurance exchanges.

His excuse for the increased
costs is that the American people cannot refuse to pay for something they have
obligated themselves to pay. In reality they have been deceived. They have been
tricked, forced and deceived into this obligation.

The Obama
administration is building a detective squad to target and penalize consumers and
companies that don't follow Obamacare's rules.

 The
Department of Health and Human Services has hired 1,814 criminal investigators.
On the day President Obama signed the Affordable Care Act into law in 2010, HHS received authority
to hire 1,814 investigators to
sleuth out violations of the law.

Congressmen who supported Obamacare find this new police force
confusing.

“HHS received authority from the Office of Personnel Management
(OPM) to make as many as 1,814 new hires under an emergency 'Direct Hiring
Authority' order.”

 The Obama administration ordered that employment expansion despite
a government-wide hiring freeze that is in place.

Why doesn’t President Obama
listen to the will of the people?

Everyone is against it. Everyone
has to be more vocal. Everyone has to vote these people out of power.

Otherwise we are on the Road
to Serfdom.

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

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Some More Obamacare Deceptions

August 18, 2013
inDisinformation and the healthcare system, Healthcare Insurance Industry, Politicians,Healthcare and Vested Interests, Stakeholder Mistrust
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Stanley Feld M.D.,FACP, MACE

 Does anyone remember the CLASS Act as part of
the Obamacare promise for affordable healthcare coverage? I do. It sounded
great but I knew it couldn’t be done without tremendous cost to the federal
government.

It would drive deficit spending through
the roof.

The CLASS Act (Community Living
Assistance Services and Support) was shut down 19 months after passage of
Obamacare.

 There was little discussion
of the CLASS Act until Kathleen Sibelius’ announcement to discontinue
CLASS.  

 She said,

 “The administration was shutting down CLASS. After 19 months of research and consultation, “we have not
identified a way to make Class work at this time.

The thing that bothers
me the most about Obamacare is the sneaky machinations the Obama administration
uses to hide the bad news about Obamacare from the American public. When the American
public finds out they are disappointed and feel deceived.

However, it also feels
so complicated that they tend to ignore it.

 When the Obama administrated delayed the
employer mandate for a year employers were relieved. None of the traditional
media made a big deal about delaying the employer mandate which meant that Obamacare was
in trouble.

 Some conservatives and conservative outlets
cried, “Why not delay the individual
mandate as well?”

The reason is obvious.
The Obama administration wants the entitlement to start whether it is ready or
not so it cannot be repealed or discontinued. People do not like to relinquish
a freebie.

As soon as that
discussion was over the government announced that the verification process for
subsidies might not be ready until October 1, 2013.

If the tests find security
problems in the verification systems, the information officer could delay the
marketplace opening or decide to open the insurance exchanges with
less-than-optimal assurances that users’ personal information is adequately
protected.

The Obama administration
then announced it would provide premium subsidies on an “honor system” so as
not to delay the onset of the individual mandate.

“The administration promises no one will lie
because once they get the verification process started they will be able to
find out who lied about the subsidies.”

The Obama administration’s
navigators program is a program to train and pay people to go into the
community and sign up people to enroll in the Obamacare health insurance
exchange.  

“More than 100 groups
will split $67 million to help people “navigate” the new Obamacare health insurance
exchanges.”

These “navigators” will have to undergo mandatory federal
training and become certified.

“The 67 million dollars is more money than the
administration initially said would be available but short of what advocates
say will be needed to help people sign up”.


It sounds like another cash for clunkers program.


When are Republicans or
Conservatives going to say something to make the public aware of what is going on?

To add insult to injury
congress exempted itself from Obamacare because of economic hardships leaving
ordinary people to be subject to penalties if they do not join the health
insurance exchanges.

 The Obama administration has given over 2,000 group
waivers.

The Obama administration
and Harry Reid and Nancy Pelosi are working on the Unions’ problems with
Obamacare. One could bet that it will be fair to the Unions as the rest of us
are ignored.

 With all of the IRS’s problems of late it is
frightening to think of the IRS monitoring abuses of Obamacare.

The IRS employees union
is presently seeking a way to get a waiver from Obamacare.

“And speaking of haunting, does anyone in this
country look forward to being scrutinized by the IRS on every aspect of his or
her personal health care decisions, especially after we learn of the
politicizing and privacy abuses by that agency?”

 Does anyone remember the 60 lawsuits the
Catholic Church initiated challenging President Obama’s contraception mandates?
The church claims the mandate to provide contraceptives represents an attack on
religious freedom and the first amendment.

Despite all this the
traditional media and President Obama keep saying Obamacare is right on
schedule.

We have heard nothing
about the extra costs Obamacare is generating for start-up and implementation. 

Last weekend Harry Reid let the cat out of the bag. President Obama real goal is to have Obamacare fail and replace it with a single party payer system.

  

Harry Ried and a single party payer

 http://youtu.be/SXgSKwYMnWo

The biggest political maneuver by President
Obama of all is the maneuver to delay the law’s caps on out of pocket expenses for consumers
such as for deductibles and co-pays.

This is perhaps the most
attractive benefit of Obamacare after guaranteed insurability.  

"Section 2707(b) of the Public Health Service Act, as added by Obamacare, requires that “a group
health plan and a health insurance issuer offering group or individual health
insurance coverage may not establish lifetime limits on the dollar value of
benefits for the any participant or beneficiary.”

Annual limits on cost-sharing are
specified by Section 1302(c) of the Affordable Care Act; in addition, starting
in 2014, deductibles are limited to $2,000 per year for individual plans, and
$4,000 per year for family plans.

This is a wonderful
benefit. If someone gets sick he is only liable for $2,000 if single and $4,000
if he has a family.

The problem arises when the
healthcare insurance industry calculates the premium with this benefit included.
The insurance premiums skyrocket. Premiums are scheduled to dramatically
increase in 2014.

President Obama’s
problem is that 2014 is a congressional election year. Skyrocketing premiums in
2014 may make Obama fans and the Democratic base angry with President Obama and
the Democrats running for congress.  

President Obama having
gotten away with all his other delays in implementation simply delayed this
part of the law until after the election.

The American public
doesn’t realize that he has delayed perhaps the best benefit in the law from
the public’s viewpoint. His hope is the public will not notice the delay with
the help of the traditional media’s lack of coverage.

In 2015 he will sock the
increased premiums to the public. He will then blame it on the
Republicans. 

There are two basic
issues. The first is the need for the public to realize all these deceptions in
Obamacare.

The second one is the
public is beginning to realize that it cannot trust President Obama or congress
to represent its welfare.

It is time for
Republicans to stand up and put an end to this charade. I hope someone has the guts
to do it.

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

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Another Friday Afternoon 3 P.M. Press Release

August 11, 2013
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System
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Stanley Feld M.D.,FACP, MACE

It seems
that all official Obama administration reports that portend bad news for the
administration’s policy are released late Friday afternoon when everyone is
heading home for the weekend.

It is a
time when the news of the reports and press releases are least noticed.

The late
Friday afternoon report on August 2, 2013 was released the afternoon congress
was going on summer recess for the month of August.

The HHS Inspector General announced that Obamacare’s privacy protections program
is way behind schedule. It will not be ready by October 1st when
policies will be available to the public. It opens the door for rampant
violations of the law.  

'Based on OIG’s analysis, Obamacare’s exchanges
may end up illegally exposing Americans’ private records to hackers and
criminals."

The Privacy Act of 1974
mandates that each agency of the federal government utilize administrative and
physical security systems to prevent the unauthorized release of personal
records.

The Federal Information
Security Management Act of 2002 requires the executive branch to ensure that
Americans’ private records are protected from misuse and security breaches.

The Obama administration is
ignoring these laws. On his road show this week he said the health insurance
exchanges will start selling insurance on October 1,2013 to go into effect
January 1, 2014.

“In the
case of the Obamacare hub, any serious security breach could result in
identity theft.”

The Obamacare “Hub”
computer system cost the government $267 million so far.  It is
supposed to provide the government with the means to see which applicants
qualify for what programs.

On another Friday afternoon during the July 4th weekend,” Sarah Kliff and Sandhya Somashekhar of
the Washington Post discovered that the Obama administration had
buried in the Federal Register the
announcement that the government won’t be able to verify whether or not
applicants for Obamacare’s insurance exchange subsidies are actually qualified
for the aid, in the 16 states that are setting up their own exchanges."

 "Instead,
until at least 2015, these states will be able to “accept the applicant’s
attestation [regarding eligibility] without further verification.” 

This appeared in the Federal
Register two days after the July 3rd announcement that the federal
government would postpone for one year a requirement that employers with 50 or
more full-time workers provide health coverage.

I think these announcements
warrant the term ”Weekend Surprises”
or DBA “I hope no one notices.”

“The Obamacare health insurance exchanges
mandate the creation of a “data hub” through which exchanges can access
personal records from seven different agencies—the Internal Revenue Service,
the Social Security Administration, the Department of Homeland Security, the
Veterans Health Administration, the Department of Defense, the Office of
Personnel Management, and the Peace Corps—in order to determine eligibility for
exchange subsidies and mandate penalties.”

Under FISMA, the Obama administration must
adhere to the guidelines of the National Institute of Standards and Technology
in achieving these safeguards, before the Obamacare exchanges can legally
operate.

 It seems it is much more convenient to ignore the law
written by the Obama administration and Democrats. Unfortunately, Republicans
have not pointed this out to the people.

It gets worse. This policy
not only ignores the law of the land it encourages fraud and abuse.

 According to the law, a person or family is
not eligible for Obamacare’s subsidies if your employer has offered you what
the government considers “affordable” coverage.

Employers are not going
to have to report whether or not they’ve offered “affordable” coverage. How can
the government verify whether or not workers are eligible for subsidies? 

 The Centers for Medicare
and Medicaid Services said. “The exchange may accept the applicant’s
attestation regarding enrollment in an eligible employer-sponsored plan…without
further verification, instead of following the procedure in
§155.320(d)(3)(iii).”

The Obama administration
will also allow people to gain means-tested subsidized coverage on the
exchanges without having to have the IRS do means testing on their income.

According to CMS,

 “For income verification, for the first year of operations, we are
providing Exchanges with temporarily expanded discretion to accept an
attestation of projected annual household income without further verification.”

 Another President Obama
trick. If enough people enroll in the new entitlement it will be politically
impossible for Republicans to repeal Obamacare in the future.

These ad-lib rules
deliberately encourage tens of billions of dollars of waste, fraud, and abuse.  

Who is going to suffer
in the long run? Hard-working taxpayers. These taxpayers will not receive
subsidies. Many of them do not support Obamacare.

Where is the Republican
outrage?

President Obama
anticipated the Republican outrage this week on his political road show.

President Obama blamed Republicans for doing
everything in their power to torpedo Obamacare implementation
during a Friday afternoon “press conference” before going on his $7.6 million
dollar a week vacation on Martha’s Vineyard.

 “The “one unifying principle” for Republicans
was keeping 30 million people from getting healthcare, hurting the elderly,
removing care for the ill.

“There’s not a
pretense how they’re going to replace it with something better,” Obama said. He
accused Republicans of an “ideological fixation.” He then compared the
Obamacare rollout glitches to glitches in Apple rolling out a new iPad. “I make
no apologies” for such glitches, he stated.

Then he said it
would be foolish for Republicans to “shut down the government to prevent 30
million people from getting healthcare.”

Notice President Obama's use of words.

Pure unadulterated well crafted demagoguery.

When are the Republicans’ going to respond? When are the
people going to recognize President Obama’s game.

Hopefully not before it is too late.

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

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Maybe Obamacare Is Not Such A Good Idea

August 7, 2013
inHealthcare Insurance Industry, Medicine: Healthcare System, Patients Problems, Physician's Problems, Politicians,Healthcare and Vested Interests, Stakeholder Mistrust
• Leave a comment

Stanley
Feld M.D.,FACP ,MACE

Dear
President Obama;

Maybe Obamacare
is not such a good idea.

I suspect
you will not read this nor have you read my letters to you when you were first
elected.

The letters
were about how our healthcare system became so dysfunctional and what solutions, that will work,
are needed to repair the healthcare system.

Dear President Obama Part 1

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/11/dear-president-elect-obama.html

Dear President Obama Part 2

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/11/dear-president-elect-obama-part-2.html

Dear President Obama Part 3

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/11/dear-president-elect-obama-part-3.html

Dear President Obama Part 4

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/12/dear-president-elect-obama-part-4.html

Dear President Obama Part 5

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/12/dear-president–elect-barack-obama-part-5.html

Dear President Obama Part 6

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/12/dear-president-elect-obama-part-6-why-dont-you-listen-to-practicing-physicians.html

Respectfully,

Stanley Feld M.D., FACP, MACE

President Obama did not listen to me at all. It looks like his
agenda was not to "Repair the Healthcare System." It was to destroy it and
replace it with a government control single party payer system.

I continually think about the statement President Obama made to
Barney Frank and John Kerry when passing the law. They said the law must have a
public option and a single party payer to work.

President Obama told them not to worry about the public option.

Now Obamacare is experiencing objections from the interest
groups whose support is needed.

The unions, government workers in congress, the IRS, the healthcare
insurance industry, small businesses, large corporations, large fast food
businesses, privately insured Americans, Medicare insured seniors, physicians, hospital
systems all have objections to the law now.


Many states realized they would get stuck with the bill for the
health insurance exchange. Thirty-three states did not want to participate.
Many did not want to increase their budget deficits.   

All these stakeholders are realizing that President Obama has thrown
them under the bus despite his initial promises.

Obamacare does not serve the vested interests of any of these
stakeholders. 

Some of the stakeholders are going to get special treatment with
waivers.

For Obamacare to work, everyone must participate. The mandate was
included in the law to force everyone to participate.

The Supreme Court called it a tax to allow the Obamacare law to be
constitutional.

A basic insurance principle is that everyone must participate to spread
the risk for the insurance industry.

The present system and Obamacare exempts the insurance companies from incurring risk.
It also exempts patients from being responsible for their own health and
healthcare dollars. When Americans spend their own money the free market works as
we have seen in many industries. They support the best product within their
means.

The government could support the underprivileged by providing them with
their healthcare dollars and teaching them how to use them.

The biggest villains in the healthcare system are the healthcare
insurance companies. They take 40% of every healthcare dollar spent by private
and public insurers off the top.

The healthcare insurance industry is the administrative service
provider for all public employees, public healthcare entitilments and private health insurance plans. The 40% overhead is charged
to all. The charge is not transparent.

Obamacare sets the conditions for continued abuse by the healthcare
insurance industry.

The Obama Administration estimates that
of the projected 7 million exchange enrollees next year, 2.7 million need to be young adults (with a low
risk of being sick) to make the premiums work.

 If young people don’t show up for Obamacare,
premiums for everyone else in the exchanges will skyrocket—which, of course,
dramatically increases the cost for taxpayers.

Congress
and congressional government workers wanted to be exempt from Obamacare because

 “The 2010 law
generally requires lawmakers and aides who work in their personal offices to
get coverage through the exchanges.”


That implies that they would no longer receive
coverage through the Federal Employees Health Benefits Program…

It does not clearly
authorize the government to pay premiums for federal employees who obtain
insurance through the exchanges.


Nor does it
authorize the government to reimburse federal employees who buy health
insurance on their own.”

Congress and their aides have
the best insurance coverage in the nation. Taxpayers subsidize their healthcare
insurance.

Through the years this
subsidy has been discussed.  Many have objected
to the cost of this Congressional benefit.

Congress has
objected to Obamacare changing the healthcare insurance they have enjoyed. Congress wants to be exempt from Obamacare.

“President
Barack Obama privately told Democratic senators he is now personally involved
in resolving a heated dispute over how Obamacare treats Capitol Hill aides and
lawmakers, according to senators in the meeting.”

Few on Capital Hill objected to President Obama changing the
rules of the law himself to protect their benefit.

A question should be asked, “Why should Congress and
congressional aides be treated differently than the general population?”

“At issue is whether
Obama’s health care law allows the federal government to continue to pay part
of the health insurance premiums for members of Congress and thousands of Hill
aides when they are nudged onto health exchanges.”


Currently, the government
pays nearly 75 percent of these premiums.

 The government’s contributions are in jeopardy
due to a controversial Republican amendment to Obamacare, which
says that by 2014, lawmakers and their staff must be covered by plans “created”
by the law or “offered through an exchange.”

President Obama declared,
“I'm on it” to clear up Capital Hill’s objections to Obamacare’s effect on
Capital Hill’s healthcare insurance.

The IRS employees also want to be exempt from Obamacare.

IRS
chief Danny Werfel, the head of the agency charged with administering Obamacare
said that he would rather keep his own insurance than get coverage under the
system created by President Barack Obama's single domestic policy
achievement. 

Danny Werfel made this statement before the
House Ways and Means Committee,

"I would prefer to stay with the current policy that I'm
pleased with rather than go through a change if I don't need to go through that
change."

Like
most
other federal workers, IRS employees currently get their health insurance
through the Federal Employees Health Benefits Program, which also covers
members of Congress.

House Ways and Means Committee Chairman Dave Camp said he has long
believed, “every American ought to be exempt from
the law, which is why he supports full repeal,”

IRS employees have the
responsibility to enforce much of the health insurance law,
especially in terms of collecting the taxes and distributing subsidies that finance
the whole system.

IRS agents, in addition to
collecting taxes will also collect data and apply penalties for those who fail
to comply with many of Obamacare’s requirements.

The special favors are coming
next. The Obama administration will only create more dysfunction in the
healthcare system. President Obama’s published goals are good. However, the law
is bad and its execution is worse.

Maybe he ought to consider
my Ideal Medical Savings Accounts as a free market solution to our healthcare
system’s problems.

If you do
not like what is going on, please write your senator, congressman and the
President and tell them that,

“Maybe Obamacare Is Not Such A Good
Idea.”

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

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Obamacare’s Games For Stakeholders And The Unintended Consequences

July 21, 2013
inConsumer Driven Health Care, Medicine: Healthcare System, Patients Problems, Politicians,Healthcare and Vested Interests, Stakeholder Mistrust
• Leave a comment

Stanley
Feld M.D.,FACP,MACP

I can’t help remembering
Nancy Pelosi’s famous statement, “We have to pass the bill to find out what is
in it.”


  

http://youtu.be/lAt54NKsRRk

The public didn’t like
Obamacare to begin with.

Each day “we are finding out what is in it.”

Each day it gets worse
despite the fact the President Obama keeps saying Obamacare is great and will save us
money. Americans do not believe him.

If you are a big
government control advocate, the ideology of Obamacare could be applauded.

Practically, Obamacare is
naïve and an impending “train wreck.”
Unintended consequences keep appearing because of defects in the theory and poor
design.

Patients, the healthcare
care insurance industry, physicians, hospital systems, and drug companies could
have predicated these unintended consequence if they knew what was it the bill
at its passage. Those who did understand the Accountable Care Act (Obamacare)
hated the act at its passage.

Many of my progressive
friends blame the problems Obamacare is having on Republicans.

I think they are getting
that idea because the New York Times and its editorial op-ed writers that are making
that claim. However, the New York Times offers no concrete proof.

Obamacare is failing on it
own. Its implementation gets harder and more expensive each day.

The unions were President
Obama biggest ally. All of a sudden Obamacare’s unintended consequences has
angered the unions. The unions realize what Obamacare is doing to them.


On July 12, James Hoffa of the Teamsters (1.4
million members), Joseph Hansen of the Food and Commercial Workers (1.3 million
members) and D. Taylor of UNITE-HERE (200,000 members, mostly culinary and
hotel workers) wrote to complain about the president's Affordable Care Act.

Obamacare is destroying
the 40-hour workweek unions worked many years to achieve.  Employers are hiring part time employees to replace full
time employees that had been laid off because of the recession.

Employers are doing this
to avoid a $2,000 penalty for not providing healthcare insurance for each employee.
 

The majority of the job
growth figure of 195,000 for June consisted of part time job growth.

Union
leaders are correct. Obamacare "creates
an incentive to keep employees’ work hours below 30
hours a week."

After
all, employers can avoid a $2,000-per-worker penalty if they don't provide mandated insurance as long as employees
work fewer than 30 hours a week.

" Union leaders have realized—too late—that
ObamaCare will affect the livelihood of millions of workers who wait tables,
wash dishes, clean hotels, man registers, stock shelves and perform other tasks
that can be limited to shifts of less than 30 hours a week."

White
house Press Secretary Jay Carney said it "is
belied by the facts."

Once
again he was lying. He used 2010 Bureau of Labor Statistics numbers to answer
the complaint.

“So far
this year, as ObamaCare is being implemented, full-time employment has grown at
an average monthly rate of 21,700 while part-time employment has increased an average
of 93,000 a month.”


These
are terrible numbers that belie Jay Carney’s “facts.”

 Three big unions
worry that the health law will hurt their members' benefits and paychecks.

The letter to Nancy
Pelosi and Harry Reid was unusually harsh.

The letter was not from
Mr. Obama's GOP adversaries but from the president’s allies, the big three most
powerful unions. A fourth union joined the group a few days later.

The unions finally
realized that Obamacare was going to cut unions out of some government
subsidies. Obamacare makes a unionized workforce more expensive for employers.  It makes it less attractive for workers to
join unions.

"Millions of union workers, the
letter notes, are covered by nonprofit health plans jointly administered by
employers and unions, and won't qualify for ObamaCare's generous taxpayer
subsidies."

This will drive union
members out of their unions.

Further, the unions
nonprofit insurance plans are subject to "Obamacare’s new 2-3% tax on each
insurance policy they place."

The union wants their members
exempt from this tax because the union will be forced to pass it on to their
members. Members will be forced to use the health insurance exchanges to buy
their healthcare insurance.

Unions are starting to
realize the goal of Obamacare is to force everyone into his “Public Option”
that will default to a single party payer. The result will be complete
government control of the healthcare system.

There are three insurance
options in the health insurance exchanges. Citizens will buy the cheapest
“affordable option.”  The deductibles
will be high. Citizens will have to pay deductibles out of pocket decreasing
their purchasing power.

Republicans are enjoying
this meltdown. They want Obamacare
repealed.

“House Republicans say their goal is to repeal President Obama's
health care law, not to present an alternative plan.”


This is a big mistake on
the part of the Republicans. Republicans do not have a viable substitute to
repair the dysfunctional healthcare system.

"Every voter knows what Republicans are against. They don't
know what they're for" on health care, said Rep. Steve Israel of New York,
who heads House Democrats' campaign committee.”


 “He said the strategy would haunt Republicans next year among
moderate and independent voters who want changes, not outright repeal.”

Republicans need an
innovative alternative to Obamacare that will work and excite the public.  They need a plan that will put consumers in
charge of their health and healthcare dollar. Consumers do not want a healthcare
system that puts the government in charge of their health.

Consumer driven
healthcare with my democratic ideal medical savings account should be adopted
by the Republican Party to replace Obamacare.

Republicans must take a
stand and help Americans avoid Obamacare’s impending disaster to our economy,
job growth and financial viability. 

Republicans must show Americans
that they care about them and have a viable solution to our healthcare systems problems.

Otherwise as President
Obama said this week, “he will blow right
through it” as he
has done in the past.

 Now that Americans are waking up it is time
for the Republican leadership to start waking up and fight back effectively.

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

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The Lack Of Price Transparency

July 14, 2013
inConsumer Driven Health Care, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests
• Leave a comment

Stanley Feld M.D., FACP, MACE.

I believe the New York Times is doing a great disservice to the American
public in its biased promotion of the virtues of Obamacare. The intellectuals
of our society read the Times and never question this bias. In fact the Times
publishes letters from these intellectuals that confirm its biased statements.  The more letters that come in the more they
are published. Before anyone knows it the bias becomes the truth.

On July 8 2013 the NYT published an article entitled “What Does Birth Cost? Hard to Tell”

The article's opening
paragraph reveals its bias.

“We’re
continually told that when it comes to health care, we need to be savvy and
shop around for the best prices. To that end, policy experts and politicians
promote health care savings accounts, saying they make “health care consumers”
(a k a patients) more conscious of prices, bringing down the cost of medical
care.”

It goes through this woeful story of how an uninsured
pregnant woman tries to find a best price for her delivery from hospitals in
her community.

“Here is what happened to my daughter, Therese Allison, when she
tried to be just the sort of shrewd and informed patient that politicians
should love.”

At this point I realized the article was another New York
Times propaganda article implying the potential virtues of Obamacare. President
Obama and the Democrats have mandated that patients like this buy healthcare
insurance from health insurance exchanges. They want patients to be dependent
on the government and not give patients the choice to make their own independent
choices.

The healthcare system’s dice are loaded against this woman’s
independent free choice.

“ Pregnancy is a pre-existing
condition, so she can’t get health insurance at any price. And
now that the birth of her baby is imminent, she wants to find out what a
delivery will cost, maybe even negotiate a price for this expensive procedure.”

Therese’s  midwife offered to call the two hospitals the midwife
uses. She wanted pricing for an uncomplicated normal vaginal delivery without
an epidural. Therese’s plan was to leave the hospital the next day.

One hospital gave her a conditional price estimate. The other
didn’t. The second told her to apply for Medicaid. She thought there should be
a law making hospital systems reveal their prices.

 Uwe Reinhardt, a
Princeton health care economist who is a frequent contributor to The New York
Times said hospitals do not have to their reveal prices.

“He said. Hospitals do not have to tell you their prices, and
often they keep them secret until they send the bill.”

“When I was chair of the New Jersey commission on hospitals two
years ago, my wife, at my behest, tried to get a price for a normal delivery
from the Princeton Medical Center,” Dr. Reinhardt said. “She pretended to be an
uninsured entrepreneur earning $80,000 a year. She got nowhere. I then called
to try out a colonoscopy. I got nowhere too.”

Dr. Reinhardt is a big fan of Obamacare. His implication is the
Obama administration is going to fix the non-transparency barrier.

Dr. Reinhardt said, “The situation is all so
pathetic.”

The problem is he does not
offer a solution to fix the problem.

The Obama administration has tried to break the price
transparency barrier by publishing Medicare and Medicaid prices. The effort is
confusing, insufficient and incomplete.

Medicare and Medicaid reimbursements have been published in some
states in the past. Private insurance reimbursements to hospital systems have
been published for some diseases but it has been incomplete and
incomprehensible. 

These reimbursement figures have been difficult to find on the
Internet. Additionally the prices have nothing to do with private healthcare insurance
contract prices of private insurance co-pay.

The Obama administration just had Medicare publish a giant spreadsheet with its payments for
the 100 most popular hospital procedures and treatments in 3,000 hospitals
across the country using claims data.

The moment the ICM-10 coding system is mandatory the number of diagnostic
codes will increase from 18,000 to 68,000. ICM-10 coding will decrease consumers’
ability to understand reimbursement and co-pays.

Pregnancy is not on the Medicare spreadsheet list along with
many other common procedures. The claims data is not connected to private
insurance payments and co-pays. As I have pointed out in the past, claims data
is notoriously inaccurate.

What is needed is a smartphone app listing prices for consumers
by zip code similar to Travelocity and Kayak for airline tickets and hotels. Consumers’
pricing would be instantly transparent.

There is no indication that the Obama administration is working
on this.

It is up to consumers to force the issue of price transparency.
It will lead to price competition and decrease the cost of healthcare..

Physicians in some parts of the country have taken the
initiative to encourage real price transparency and price competition.

I do not think we can rely on the government.

The Obama administration’s goal is to not have a healthcare system
with free market competition. He wants a government controlled healthcare
system.

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Holy Cow, He Does It Again!

July 7, 2013
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP,MACE

The Obama
administration has not been forthright with Congress and the American people in
explaining Fast and Furious, the Benghazi incident, the IRS scandal, the NSA
scandal, and his unilateral decision not to enforce immigration laws with
respect to young immigrants.

I understand most people know little of the
details of these scandals,unconstitutional maneuvers and bypassing of
congress because the traditional media have ignored the details

The lack of honesty, changing stories and delays in providing explanations
about these scandals has made the administration’s credibility even worse.

There are many who suggest that the authority President Obama has assumed
in bypassing congress through executive orders and regulations has been
unconstitutional.

The constitutionality of the Obama administration’s most recent action
has been to delay the implementation of the provisions in Obamacare’s mandates requiring
everyone to buy insurance or face a penalty.

I do believe it is unconstitutional to ignore the provisions in a law
without the consent of congress, which passed the law.

“A constitutional law professor
at George Washington University Jonathan Turley said that Obama “has been far
more aggressive in circumventing Congress and far more successful in creating
an imperial presidency” than Bush.”

“President
Barack Obama’s latest legal end run around Congress — delaying enforcement of
the employer health mandate — has sparked more questions about whether he’s
abusing his executive discretion under the Constitution.”

Many congressmen have complained, including some Democrats up for
reelection in 2014.

Rep. Steve King, R-Iowa, said,
“If President Obama wants to make changes to Obamacare, he must come to
Congress. … We are a nation governed by laws written by Congress, not memos
and blog posts written by bureaucrats.”

“President Obama will get his way,” said Michael Tanner.

Michael Tanner, a senior fellow at the Cato Institute, said
Obama appeared to be stretching his authority to the limit.

“It’s less of a frontal assault than it is a flanking maneuver,”
he said. “He may be violating the spirit of the law but not necessarily the
letter.

The legality is up in the air.”

When President Obama
has run into opposition to his political ideology he has gone around congress.
He is a master of “gotcha politics.”

Timothy Jost, a longtime supporter of the health care law and a
law professor at Washington and Lee University, defended the mandate decision.

“This is really a question of enforcement and when the
administration runs into practical difficulty, it delays enforcement,” he said.

"He predicted the administration would get its way in the end."

“I don’t see the courts intervening here. I’m sure Congress will
hold hearings but there really isn’t anything they can do.”

 Unfortunately, Obamacare is the law of the land.

Obamacare is a stupid law. President Obama’s delaying implementation is
demonstrating that Obamacare is not going to work.

 Obamacare will destroy the already
dysfunctional healthcare system for the reasons I have outlined.

This delay is
one of many Obamacare delays we are going to see in the coming months.

Others might include.

  1. Implementation of the mandate for individuals.
  2. Implementation of health insurance exchanges.
  3. Implementation of ACO’s.
  4. Implementation of Electronic Medical Records.
  5. IRS policing implementation of Obamacare.

There will be protests against the many waivers and exemptions from the
law that President Obama has given various groups including labor unions,
congressional members and government workers. These exemptions and desired
exemptions have not been reported in detail in the traditional media. I suspect
the exemptions will just happen without awareness by the public.

The Obama administration made a big mistake by spying on the Associated
Press reporters. The press has been his biggest ally in helping him get away
with all the stretching of his executive powers by not informing the public. Now
the press is angry and I suspect might not be as accommodating to him.

The law's implementation is turning into a fiasco for the ages,
and this week's version is the White House decision to delay the law's
insurance mandate for businesses, though not for individuals.

The employer mandate is central to Obamacare's
claim of providing universal coverage. Companies with 50 or more "employee
equivalents" must pay a $2,000 penalty per full-time employee if they
don't provide government-approved health insurance.

Mark Mazur, the deputy assistant Treasury
secretary for tax policy, published a blog Tuesday night July 2, the night
before the July 4 weekend holiday break canceling the insurance reporting rules
and tax enforcement until 2015.

This is a typical Obama administration tactic
hoping the cancellation would be forgotten after the weekend. It didn’t work.
People are still talking about a bureaucrat changing the rules of the law
because it cannot be executed.

“White House
fixer Valerie Jarrett tried to contain the fallout with a separate blog post
promising that ObamaCare is otherwise "staying the course." That's
true only if she's referring to the carelessness and improvisation that have
defined the law so far.”

The Treasury Department does not have the
computing ability to figure out who is complying with the law. The IRS does not
have the ability or manpower to police the law.

The law does not say the Obama administration
can impose the mandate whenever it feels it is politically convenient. The
individual mandate is next to go.

The damage from Obamacare has already occurred.
Healthcare insurance premiums have risen on average 20% this year.

Small and large companies are only hiring part
time people to avoid the penalty. (Under 30 hours per week). This week’s
unemployment figure was 195,000 only because of part time hiring. There was a
major decrease in full time workers.

There is an increase in non-insured as the
businesses are dropping healthcare insurance for employees.

Obamacare
has become a rolling "train wreck," in Senator Max Baucus's memorable
phrase, and it gets worse the more of it the public sees.

The employer mandate is terrible policy, as I
pointed out before it was passed. The Obama administration has now admitted that it
can't implement Obamacare properly or on time after Americans have been paying the 10
hidden taxes for the past two years.

Please wake up America.

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

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