Stakeholder Abuse of the Healthcare System

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I Gave You A Better Plan In 2008

December 8, 2013

inMedicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D., FACP, MACE

“The hardest thing to explain is the glaringly evident, which everybody has decided not to see.”

Any Rand, The Fountainhead

December 7,2013

Dear President Obama;

Last week you said no one has showed you a better plan for healthcare than Obamacare.

You were the dysfunctional healthcare system’s great hope in 2008. Your problem is you listened to the wrong people when you wanted to repair the healthcare system.

Unfortunately, these people believe as you believe. Their ideology believes in central government control and the redistribution of wealth. This ideology has only led to the failure of national economies in the past.

There are better plans than Obamacare.

In fact, I sent you six letters right after you were elected President explaining how the healthcare system had gotten into the mess it was in and what must be done to repair the mess.

You ignored me completely. I understand why. Your ideology is to increase central government control and redistribute wealth.

I believe in giving individuals the ability to control their own destiny, make free choices, and have incentives to improve and become innovative.

Increasing incentives promotes innovation. You believe in decisions by committee. I have never seen that work in business.

There are several key elements needed to Repair the Healthcare System.

The first is consumers must be responsible for their own healthcare dollars and their own health. Government should not be responsible for consumers’ healthcare dollars.

Consumers must be given positive financial incentives and education to use their healthcare dollars wisely and take care of their health.

A system of financial incentives can be set up so that people who are sick with a chronic disease such as diabetes, heart disease or lung disease can be rewarded if they keep themselves from getting a complication of their chronic disease.

Eighty percent of the healthcare dollars are spent on the complications of chronic diseases. Clinical research studies have shown that appropriate medical care and appropriate self-management can decrease the complications of chronic disease by at least 50%.

People are not dumb. If they had control of their money and freedom to choose they would choose to keep themselves healthy.

Past government attempts at redistributing wealth have never worked. Redistribution of wealth by increasing taxes on “the wealthy” has never historically increased efficiency or productivity.

What makes you think total government control and the redistribution of wealth will work now?

I appreciate your desire to have all Americans covered with healthcare insurance.

What makes you think healthcare coverage will make Americans healthy?

If you would provide incentives to American consumers to practice healthy habits and save money you would better serve us.

The healthcare insurance industry takes at least 40% of the healthcare dollars off the top of both private and public insurance.

You have done nothing with Obamacare to decrease the insurance industry’s incentives except try to penalize them. Obamacare has been unsuccessful.

The reason is clear. Obamacare is totally dependent on the administrative services of the insurance industry.

If fact, because of your disastrous web site you have asked the insurance industry to tell you how much the government owes them. This is the fox in the hen house.

What have you done about Tort Reform?

You have done nothing. Why?

Your healthcare policy advisors know little about medical care and the problems in the practice of medicine. They believe that the practice of defensive medicine has a minor effect on the cost of medical care.

An estimate is that defensive medicine costs the medical care system $300 billion to $750 billion dollars a year in unnecessary testing.

Obamacare’s solution is to pay less money for those tests, not to eliminate the need to do those tests.

At the same time Obamacare lets secondary stakeholders take advantage of the system. It costs the government $1700 dollars for a fifteen minute ambulance drive to a hospital. Why? What are the basic costs and a reasonable profit to the ambulance company?

Physicians who treat those Medicaid patients brought in by the ambulance receive $24 dollars in reimbursement for his care. Does that make any sense to you?

Your government bureaucrats say we need to save money somewhere.

Hospital systems also receive special deals from the government.

Every hospital has a least two sets of books. One set for the government to see how much the hospital system is losing and the other set to show the hospital administration and board of trustees how much they are making.

Why are hospital administrator salaries increasing as physician salaries are decreasing?

Physicians are smart people. They will figure out how to get around the distortions being created by Obamacare. The result will be a more costly healthcare system and a further increase in the redistribution of wealth.

Who approved of the $640 million dollars contract to CGI for www.healthcare.gov only to receive a system that doesn’t function and is probably about half built using an antiquated software program that should not be used?

Is it cronyism or stupidity? I know you are not stupid.

We have seen many examples of cronyism. In healthcare the multiple waivers from Obamacare are egregious. Two of the most agregious waivers were the waivers to congress and the unions.

What should the role of government be in healthcare? Government should work to align everyone’s vested interests. It should set conditions to give all stakeholders real incentives to improve the healthcare system efficiently.

Consumers should be given the most incentive. Consumers are the only one that will be able to lower the costs. Consumers and physicians generate those costs. You do not impose restrictions by penalty. You increase incentives to get consumers to save money.

Try my ideal medical savings accounts.

Below are the links to the letters I had written to you when you were President-elect in case someone in your administration misplaced them.

In those letters is the course you should have followed to have a legacy to be proud of.

I have also provided a host of summary blogs that have explained repairs in detail.

Dear President-elect Obama Part 1

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

Dear President Obama-elect Part 2

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

Dear President Obama-elect Part 3

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

Dear President Obama-elect Part 4

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

Dear President Obama-elect Part 5

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

Dear President Obama-elect 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

Summary Blogs

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/summary-blogs/

You are the one who asked to “show me a better plan.”

I hope you pay attention to my letters this time.

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

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Is This A Lie?

December 4, 2013

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D., FACP,MACE

In the last ten days before the November 30 deadline to fix healthcare.gov President Obama dialed down his definition of fixing www.healtcare.gov.

http://youtu.be/mr_bHZbqqhU

President Obama knew at that time that the back end of www.healthcare.gov was not completed. He knew a security was not built into the system. Yet he is telling the people it would not work perfectly.

At the same time he made this promise he was fighting the reality. It looked like the traditional media was finally presenting reality and not President Obama campaign hype.

Obamacare is directly affecting them. Over 5 million people, in the individual market have lost a healthcare insurance policy. They could not get on healthcare.gov to buy insurance from the health insurance exchange.

I would expect at least 5 million more to lose their individual insurance. It is predicted that at least 80 million more will lose their group policy under Obamacare.

The premiums for new policies are skyrocketing because of the required Obamacare coverage mandate.

On Sunday, as a Nov. 30 deadline set by the administration for improvements to the web site had passed.

CMS issued a report concluding: "We believe we have met the goal of having a system that will work smoothly for the vast majority of users."

On October 5, we were told that healthcare.gov would be completely operational by November 30^th. Would that statement be considered a lie given the result?

Federal officials have acknowledged they had only begun to make headway on the biggest underlying problems: the system's ability to verify users' identities and accurately transmit enrollment data to insurers.

Insurers have complained they have not gotten accurate data to do their due diligence. There is no mechanism for payment of premiums or subsidies. The insurance companies have not issued insurance policies.

Many people think they have signed up for insurance. They do not have an insurance policy that covers their healthcare.

They have not been issued insurance policies because of the lack of the health insurance exchange transfer of accurate verified data nor have they paid the premium.

Once a person applies for insurance, income must be verified, subsidy calculated and a premium must be paid before insurance is in effect.

Much of this data collection and transfer has not been built into the healthcare.gov system.

Many software programmers claim the software used by CGI makes the integration impossible to do effectively.

Insurers do not want to take the risk without verification of the criteria for qualifications or premium collection.

Insurers and some states are continuing to look for ways to bypass the balky technology underpinning the health-care law despite the Obama administration's claim Sunday that it had made "dramatic progress" in fixing the federal insurance website.

The Obama administration has not released the number of people who have applied, been approved and have paid their premiums.

Only 26,000 people signed up and think they “got” insurance coverage by November 2 according to data released November 15^th.

The November 30^th numbers have not been officially released.

I do not blame the healthcare insurance industry for doing business in a business like way.

Obamacare is facing these and other giant issues.

Another big issue is the security of personal information issue an applicant enters on the web site. The security of information has not been addressed. In fact, hidden code in the web sites code releases www.healthcare.gov from responsibility for maintaining privacy.

The application process is still complex. This is a glimpse of the steps necessary to complete the application. Double click on the image to enlarge the image.

http://online.wsj.com/news/articles/SB10001424052702304355104579231870862102710

As far as President Obama is concerned he has delivered on his promise to make www.healthcare.gov functional by November 30 even if he modified his promise along the way.

The traditional media is cheering for him on his delivery of his promise.

Can anyone believe this?

After spending two months of defending www.healthcare.gov and his ill advised promises about “keeping your healthcare insurance and doctor period”, President Obama figured it is time to change the subject and go on the offensive since he has delivered as promised on the web site.

President Obama, starting Tuesday, will hold an event a day that will emphasize a different benefit of the law and try to remind Americans why Democrats pushed the law through Congress in the first place, according a White House official.

The plan is to have an event-a-day push to extoll the virtues of Obamacare. It will continue through much of the holiday season until the Dec. 23 enrollment deadline for January coverage.

The Obama administration coordinated the promotional blitz with Democratic allies on Capitol Hill and the party's campaign committees, all of which will be involved in pitching the daily message through press events and social media.

The idea of this campaign is to refocus the media and citizens away from the upcoming problems with www.healthcare.gov and emphasize the core principles of Obamacare.

President Obama has used the same strategy many times with healthcare, and his other scandals as he pursues his transformational agenda. It is called a diversion.

He plans to make clear the direct benefits Obamacare has provided to millions of Americans already.

Americans are starting realize Obamacare has meant more taxes,( to everyone including the poor, middleclass and wealthy), tremendous increases in healthcare insurance premiums, less full time jobs, less access to care and glimpses of the upcoming torrent of rationing of medical care.

Democrats and consumers are realizing the sham of this promotional campaign.

Many congressmen are running for the exits because they are up for reelection in 2014. They are trying to avoid the folly of President Obama’s promotional blitz.

The public relations ploy will further decrease President Obama’s credibility.

How can we trust the government with our healthcare decisions when it is having so much difficulty constructing a web site?

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

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The Meaning Of Trust

November 27, 2013

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

Trust is a big five letter word.

a : assured reliance on the character, ability, strength, integrity or truth of someone or something

b : one in which confidence is placed

2 a : dependence on something future or contingent : hope

Thanksgiving is a time of giving thanks for all we have to be grateful for.

This Thanksgiving the majority of Americans do not trust President Obama.

Suddenly there is an awareness that most of us were mislead on many of his policies.

The biggest mistrust resulted from his signature legislation, Obamacare.

Americans have also been programed by television and their digital devices to have a short attention span.

We become easily distracted.

Overloading us with incongruous facts that have nothing to do with our livelihood causes us to forget these details quickly.

On this Thanksgiving we should be grateful that we have the freedom to put the facts together to give them coherent meaning.

In short, our President and our government officials have lied to us for the last 5 years. The goal was a government take over of our lives.

Americans are finally paying attention as their livelihoods and healthcare coverage are being threatened.

President Obama has lost the trust of the American people.

The details of this erosion of President Obama’s trustworthiness is demonstrated by the following You Tubes.

1. The lack of privacy and avoidance of HIPA Compliance is pointed out in this congressional hearing. The traditional media has not covered this important confession. The testimony emphasizes his disregard of a promise of privacy by President Obama.

http://youtu.be/uOk0vOup4yA

2. This video puts every promise and lie into historical perspective. It is worthwhile viewing to the entire video

http://youtu.be/LGeWMPFlGlY

3. The following video is a navigator explaining credit risks and the insurance companies deciding to admit people to Obamacare after they have applied.

Please start at 9 minutes and 55 seconds into the You Tube.

http://youtu.be/Aywn34RcAIo?t=9m55s

4. The last video is called “Obamacare Is The Biggest Swindle Ever.” This is nothing people do not know.

However it is a good memory stimulator. Everyone remembers the quote “You can fool me once, you can fool me twice, etc.”

http://youtu.be/sMFLbRilj3M

On this Thanksgiving we should be thankful for our freedoms. We should be thankful for our freedom to think and our freedom to express ourselves.

Even though the first amendment has taken a beating in the last 5 years it is surviving.

We must be thankful we live in a country that is run by government of the people, by the people and for the people.

We must appreciate our power as individuals.

We must recognize which government officials have done the people wrong.

At this time we must exercise the power of our vote to get rid of them and elect surrogates who will run the government for the people and not surrogate who want to control the people.

President Obama has relinquished our faith in bestowing our trust in him as our surrogate.

His attempts at talking his way out of the mistrust is only making the mistrust worse.

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

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Obamacare’s Disasters Are Unfolding

November 24, 2013

inDisinformation and the healthcare system, Medicaid, Medicare, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

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

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

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

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

The list includes;

Loss of your current insurance policy.

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

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

Where is the physicians’ outrage?

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

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

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

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

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

It will not be pleasant.

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

Government bureaucracy, inefficency and waste will flourish.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

http://youtu.be/BKkTRMEyAhs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Exempting unions from Obamacare has been totally disgraceful.

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

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

Very few Americans are going to believe him.

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

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

He has created greater dysfunction in the healthcare system.

The dysfunction is going to get worse.

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

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

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What Is Going On With Obamacare?

November 17, 2013

inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

President Obama’s implementation of Obamacare is right on course to destroy the healthcare system and replace it with the federal government being the single party payer.

He is out to prove that the free market system does not work.

President Obama uses the strategies of Cloward and Pivan as well as Saul Alinsky to overwhelm the healthcare system. The goal is to create chaos in the system.

At the same time he attacks his enemies personally.

Cloward and Pivan said full enrollment of those eligible for welfare (entitlement/Obamacare) “would produce bureaucratic disruption in welfare agencies and fiscal disruption in local and state governments” that would “deepen existing divisions among elements in the big-city political parties and party coalitions.

The remaining white middle class, the working-class ethnic groups and the growing minority poor would be polarized. This would further weaken democratic institutions and existing political parties.

"In order to avoid the continuation of the chaos the federal government would step in and be obligated to advance a federal solution to poverty that would override local welfare failures, local class and racial conflicts and local revenue dilemmas.”[3]

Doesn’t this sound familiar? This week President Obama presented a non-fix to fix the problem of over five million people losing their insurance coverage. His move will only accelerate the chaos in the healthcare system he has already created.

Saul Alinsky said “do not let the enemy attack with a constructive solution. The enemy must be neutralized before its solution takes hold.”

The way to neutralize the enemy is by focusing on an individual you are going to attack. “Do not attack the constructive solution or the institution.”

Freeze the criticism on the individual; personalize the individual criticism and then polarize the populous against the individual and the constructive solution that individual represents.

This is exactly what President Obama and the Democrats did to Mitt Romney and Paul Ryan. President Obama ignores the opposition’s constructive solutions.

An unidentified source sent me this comment. I am in total agreement

“Obamacare was designed to fail so that the unwashed masses, at the mercy of a cumbersome and unworkable system would look to Obama and the Feds for salvation in the form of single-payer medical care”.

The only "incompetent and unknowledgeable" aspect of the situation is that Obama never, ever considered that the sycophantic Mainstream Media would ever call him out on this.

President Obama has never considered the wisdom of the American people.

In reality, government interference with the free market and its bureaucratic structure, inefficiencies and ill informed advisors have been the major cause of all the chaos.

Barney Frank and John Kerry told President Obama that the only way Obamacare would work is with a strong public option and a single party payer system. President Obama’s response was don’t worry just pass the Affordable Care Act.

The creation of chaos in the healthcare system is the first step. Obamacare has succeed is creating chaos for people having their healthcare insurance coverage cancelled.

President Obama promised them that they could keep their insurance if they like their insurance. They could also keep their doctor if they liked their doctor.

He knew that this was not true in 2010. Nevertheless he promised it 23 more times since.

The New York Times reported,” A Contrite Obama Unveils a Health Fix

President Obama announced a fix to his signature health care law that will allow existing customers to keep their insurance plans.”

President Obama was far from contrite in my view. His non-fix fix will serve to accelerate the chaos in the marketplace.

His pronouncement is unconstitutional.

The insurance industry is not inclined to do things obviously against the “law of the land”. The main reason is the insurance industry has already purged the old insurance policies from their systems.

It will be impossible to reactivate them again in four weeks.

Increasing chaos is an important step in accelerating President Obama’s endgame to collapse the entire healthcare system.

Let us look at what he said during his “contrite” press conference.

"His announced fix is aimed at remedying the mass cancellation of individually purchased insurance plans by letting insurance companies re-offer non-compliant policies."

President Obama let slip that this is one big blame-shifting exercise. He announced that no one would be able to say Obamacare caused him or her to lose insurance.

This is a Saul Alinsky tactic. The insurance industry has no inclination or ability to change its policies this late in the game. The industry can only lose money doing this.

President Obama has thus set up the healthcare insurance industry to take the blame for the before and after crisis in the healthcare system.

The fix undermines the essential premise of Obamacare. The young healthy people need to be forced into buying insurance through the health insurance exchanges. Insurance they do not want or need.

The President’s new fix will explicitly encourage many people to stay out of the exchange. The signal is clear that no one should sign up now because the entire program is in flux. Young people do not trust President Obama anymore.

There were a series of incredible statements and lies made at the fix press conference. Those paying close attention could hear them.

“We fumbled the rollout on this health-care law.”

No kidding. Where is the lie about the promise you made after you knew this would happen with both the web site and the ability to keep your insurance.

“I completely get how upsetting this can be for a lot of Americans.”

Thank you Mr. President.

“It is a complex process.”

Therefore, no one in the administration is to be blamed for anything that went wrong because it is a complex process.

“I was not informed directly [How about indirectly?], that the Web site would not be working. . . .

I don’t think I’m stupid enough to go around saying this is going to be like shopping on Amazon or Travelocity, a week before the Web site opens, if I thought that it wasn’t going to work.”

This is either an intentional lie or he did not listen to people who were telling him the web site was not ready.

People were telling him for months that the web site was not ready, not secure and not tested.

It is time for President Obama take some personal responsibility.

“With respect to the pledge I made that if you like your plan you can keep it. . . that there is no doubt that the way I put that forward unequivocally ended up not being accurate.”

President Obama didn’t lie. He was just inaccurate. Hah!

“The Affordable Care Act is not going to be the reason why insurers have to cancel your plans.”

President Obama must be kidding. His administration’s regulations made the old insurance policies against the law of the land.

“The federal government does a lot of things really well. One of those things it does not do well is information technology procurement.”

Is it the federal government’s fault when President Obama awarded the non-bid contract to build the web site to Michelle Obama’s girlfriend?

“In terms of what happens on Nov. 30th or Dec. 1st, I think it’s fair to say that the improvement will be marked and noticeable.”

I thought we were promised that the web site would be fixed by November 30.

“What we are also discovering is insurance is complicated to buy.”

Why make it more complicated with Obamacare? The process could and should be simplified.

“There is no doubt that our failure to roll out the ACA smoothly has put a burden on Democrats, whether they’re running or not.”

The burden is on the Democrats. They were fools to pass this un-executable law without reading it or understanding it.

Didn’t Nancy Pelosi tell fellow Democrats that they have to pass the bill in order to see what is in it?

Democrats were the only ones that voted yes for the bill. They are responsible for what is in it.

They all deserve to be kicked out of office in 2014.

“There have been times where I thought we were … slapped around a little bit unjustly. This one’s deserved, all right?”

Again Saul Alinsky comes up. In the last few days I have once again seen the race card come up in the traditional media and among celebrities. Alinsky said attack your enemy personally.

There is beginning to be outrage and fear among the people of all socioeconomic groups. Everyone is now getting President Obama number. No one trusts him anymore.

Obamacare must be repealed. America must start all over again to reform the healthcare system.

A good place to start is with My Ideal Medical Savings Accounts and Tort Reform.

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

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.^[3]

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The American Awakening

November 6, 2013

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld
M.D.,FACP,MACE

Many of my good liberal
friends have been upset with me since Obamacare was passed into law.

I read the 2000 plus
page bill. I was distressed by the many changes to Americans’ freedom to
choose, increased hidden taxes, and the obvious road to the destruction of the
healthcare system.

I immediately regretted
my vote in 2008 for President Obama even though I liked the guy’s style.

I felt he knew little
about how the healthcare system worked. I soon learned he was not interested in
listening to practicing physicians.

I have tried to follow
the 20,000 new regulations that have served to increase the mess that has been
created. I have reported on some of them.

Unfortunately the
traditional media has remained enamored by President Obama’s charm. The
traditional media had continued to dismiss reality until the recent web site
disaster.

The Obamacare disaster
is much worse than the web site disaster by itself. I sense the traditional
media is buying the explanation.

The reality is this web
site disaster represents the worst example of cronyism. It is even worse than
the Solyndra scandal. The Solyndra scandal on cost $535 million in federal guarantees .

The administration
issued a non- bid contract of $634 million dollars to a company in which an
executive is a good friend of Michelle Obama. CGI’s web site looks fantastic.
The reality is they have had health insurance exchange software programs that
have failed in three provinces in Canada.

President Obama has been
lying his way through the web site disaster. The bizarre thing is he thinks he
will get away with it.

http://videos.nymag.com/video/If-You-Like-Your-Plan-Supercut

The public is becoming aware of the fact that Americans are
losing their healthcare coverage by political design.

President Obama is rapidly losing the trust Americans had in
him as reflected in the polls. They fear they might lose their own healthcare
coverage next.

“The
law is systematically dismantling the individual insurance market, as its
architects intended from the start.”

I have been saying this since 2008. The aim of
Obamacare is for Americans to not to have a choice remaining. It will be a
single party payer system by default.

The traditional media is waking up. The first
wave is the 14 million people in the individual insurance market. Those 14
million Americans are being trapped into Obamacare. The 14 million are making a
big stink. President Obama is caught in an outright lie.

“Until
this month, consumers who weren't insured through their jobs were allowed to
buy insurance that provides the best value based on their own needs. One of
every 10 private policies is sold through the individual market, covering about
7% of the U.S. population under age 65.”

President Obama did a clever thing. He gave a
waiver to the group insurance market until 2015. The traditional wisdom is that
the waivers were given because Obamacare was not ready to service the group
market.

The real reason for the waiver was to avoid
the uproar from 160 million people who have group insurance.

The 160 million Americans who will lose their
group insurance coverage next year will find out they have been deceived by
President Obama.

“The millions of Americans who are receiving
termination notices because their current coverage does not conform to Health
and Human Services Department rules may not realize this is by design.”

The administration is rolling out its media
spin. President Obama is trying to blame everyone in sight except himself. He
is blaming the healthcare insurance industry and Fox News for his debacle.

President
Obama has blamed Fox News for inciting people to be against Obamacare. A reader
sent me this You Tube of Neil Cavuto's reply to President Obama. Mr. Cavuto
hits the nail on its head.

“Cavuto: Mr. President, we at Fox News are not
the problem.”

http://youtu.be/DDdmtJCEWPA

President
Obama felt that free choice is a threat to Obamacare. If too many
people could keep the insurance policies they liked instead of joining the
government exchanges Obamacare could fail.

It has
been now been shown that his goal in 2010 was to destroy the private healthcare
coverage market.

“Liberals
believe they must destroy the market in order to save it.”

The healthcare plans
the President promised people could keep have been intentionally outlawed by
regulations written by Kathleen Sibelius in the Federal Register as far back as
2010.

“The
goal is to force individuals earning more than $46,000 or a family of four
above $94,000, who don't qualify for subsidies, into the overpriced health
insurance exchange.”

“If these middle-class ObamaCare
losers can be forced into the exchanges, they become financiers of the new
pay-as-you-go entitlement.”

They
will pay $10,000 a year for a healthcare plan that people earning under that
amount will pay less than $1,000 per year. The government subsidy will finance
the difference.

If
enough people earning more than $46,000 and $94,000 a year do not sign up for
Obamacare, the federal government will have to make up the difference to the
insurance company that is providing the administrative services for that
healthcare coverage.

I hope
people remember another of President Obama’s promises. He said families making
under $250,000 a year would not pay one
dime extra in taxes. The traditional media has ignored this lie.

http://youtu.be/cJ5fOsyj-bk

The operative
word that exposes the lie is “Not a
penny more in taxes on nothing because the last thing we want to do is to put a
burden on the middle class.”

http://youtu.be/7uoE_NicaMY

What
about all the hidden taxes? What about all the tax increases passed on to the
middle class in the form of increased prices?

One
can say President Obama is a genius as well as a liar. His goal is to destroy
the healthcare system and the middle class.

He is
on course to succeed unless the American people stop him.

I am
pleased that Americans are starting to wake up to his goals and are starting to
rebel.

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

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Don’t Confuse Me With Facts

October 9, 2013

inDisinformation and the healthcare system, Healthcare Insurance Industry, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley
Feld M.D.,FACP,MACE

Sometimes,
in order to believe a certain ideology, some smart people take the position of
not wanting to be to be confused by facts.

Countries
with socialized medicine have said their citizens are happy with their care.
Therefore, this is the evidence that the U.S. should have a socialized medicine
system.

Less
than 20% of a nation’s population experiences the healthcare system at a moment
in time. The 80% who are not sick are happy because they feel secure. If they
got sick they believe they would receive free medical care. The result is the
majority of the population under a socialized medical system likes the system.

This
Is A FACT (TIAF)

Dr.
Donald Berwick former acting head of CMS and author of Obamacare wrote, in a
personal letter to “Senior Government Officials and Senior Executives of the National
Health Service in England after doing a review of the NHS.”

“You are stewards of a
globally important treasure: the NHS. In its form and mission, guided by the
unwavering charter of universal care, accessible to all, and free at the point
of service, the NHS is a unique example for all to learn from and emulate.”

Dr.
Donald Berwick added, “redistribution of
wealth is the very essence of a compassionate healthcare system for all.”

I
disagreed with Dr. Berwick in an earlier blog. I said citizens responsible for
their own health, healthcare and healthcare dollars are essential ingredients
for a cost efficient healthcare system.

Patients
are the primary stakeholders. Patients must be actively responsible for their
health. They must have a moral and intellectual responsibility for their own
health as well as a financial incentive to be responsible for themselves.

They
must have own their healthcare dollars, have the freedom to make their own
healthcare choices and have access to care.

The
government must create educational vehicles to help patients make the correct
choices.

The government must provide financial
incentives for people to make those choices.

Medical
care and medical decisions made for patients by a bureaucracy has historically
failed to control costs or provide efficient and compassionate medical care.

Socialized
medicine run by bureaucrats has failed in England. Medical care consumes more
than 50% of England’s GDP.

This
Is A Fact (TIAF)

Medicare
is wonderful for people over 65 years old. Seniors could not buy healthcare
insurance from a healthcare insurance company. The healthcare industry had not
figured out how to make money from these people so they disqualified them.

If
the government got rid of the $250 billion dollars in administrative waste and
inefficiencies each year, Medicare and Medicaid would become sustainable.

This
Is A Fact (TIAF)

Medicare
and Medicaid provide no incentives for patients to take care of their health.

Chronic
diseases are ineffectively managed. The complications of chronic diseases
consume 80% of Medicare’s healthcare dollars. If chronic diseases were managed
properly the complication rate from chronic diseases could be decreased by at
least 50%.

This
Is A Fact (TIAF)

Many
patients do not have the incentive to take care of themselves. They leave it up
to the system to take care of them.

Unfortunately,
it has be demonstrated that a government controlled system creates ever
increasing bureaucracies and cost inflation.

This
Is Fact. (TIAF)

Most
all of the nation’s attempts to control healthcare costs in the past 50 years
have failed. (Price control of the 70’s, HMO’s, Managed Care, PPOs.)

These
systems had to be abandoned. Nevertheless, healthcare policy wonks continue to
give the same advice and make the same mistakes. The policy wonks’ advice is to
institute greater government controls over medical care.

This
Is A Fact (TIAF)

A recent report about England’s hospital
conditions in Mid Staffordshire has emphasized the defects in England’s 60 year
socialized medicine experiment.

The
report only covers hospital inpatient defects. It does not cover the many
defects in outpatient services.

The report is “Report of the Mid Staffordshire NHS Foundation Trust
Public Inquiry

5
February 2013 to the Secretary of State.”

The
report stated that;

1. For
many patients the most basic elements of care were neglected.

2. Calls
for help to use the bathroom were ignored and patients were left lying in
soiled sheeting and sitting on commodes for hours.

3.
Patients felt afraid and disenfranchised.

4. Patients
were left unwashed, at times for up to a month.

5.
Food and drinks were left out of the reach of patients and many were forced to
rely on family members for help with feeding.

6. Staff
failed to make basic observations and pain relief was provided late or in some
cases not at all.

7. Patients
were too often discharged before it was appropriate, only to have to be
re-admitted shortly afterwards.

8.
The standards of hygiene were at times awful, with families forced to remove
used bandages and dressings from public areas and clean toilets themselves for
fear of spreading infections.

9. These
healthcare conditions caused the deaths of an unknown number of patients.

Robert Francis QC Inquiry Chairman who wrote
the report covered a wide range of system failures. I will only highlight the
key failures contained in the 500-page report. This report was mandated by the House of Commons.

These defect are occurring throughout the
entire NHS system. The NHS is not as glorious as the Obama administration or
Dr. Berwick’s has idealization the NHS to be.

"The
story the report tells is first and foremost of appalling suffering of many
patients. This was primarily caused by a serious failure on the part of a
provider Trust Board. (Bureaucracy)"

"The trust board did not listen
sufficiently to its patients and staff or ensure the correction of deficiencies
brought to the Trust’s attention."

The NHS bureaucracy did not put patients
first. It put the various levels of bureaucracy in charge. Bureaucracies deaden
incentives and lose focus on who is the main stakeholder in the healthcare system.

"The
trust failed to tackle an insidious negative culture involving a tolerance of
poor standards and a disengagement from managerial and leadership
responsibilities".

"This
failure was in part the consequence of
allowing a focus on reaching national access targets; achieving financial
balance and seeking foundation trust status to be at the cost of delivering
acceptable standards of care."

Appropriate
statistical reports and collection of reports are more important that
appropriate patient care.

Robert
Francis goes on to outline how the bureaucracy puts measurements first, not
patients.

None
of the bureaucrats want to take responsibility for what is going wrong. Finger
pointing and blame shifting is an occupation in the British healthcare system.

"The
NHS system includes many checks and balances. These checks and balances should
have prevented serious systemic failure of this sort."

"There
were and are a plethora of agencies, scrutiny groups, commissioners, regulators
and professional bodies, all of whom might have been expected by patients and
the public to detect and do something effective to remedy non-compliance with
acceptable standards of care.

For
years that did not occur."

Watch out America!

We are falling into the same trap with Obamacare.
It might sound good to some. It will not work judging by the experience of
others.

Unfortunately,
the Obamacare’s model is the British healthcare system. I do not think the
traditional media should praise it. The traditional media should publish the
facts of history.

The
traditional media should call for the repeal of Obamacare.

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

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http://kosenok.softintergroup.ru • October 26, 2013

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Swenzy online promotion • January 20, 2014

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Is There A Solution?

October 1, 2013

inMedicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

• Leave a comment

Stanley Feld M.D.,FACP
MACE

A study of the organization chart presented in my last blog shows
that Obamacare will be an unworkable mess.

The health insurance exchanges look like they
are going to make healthcare more expensive because of 20,000 new
regulations. Employers are looking for
ways to avoid Obamacare and get out of the healthcare coverage business.

Employers
are realizing they can avoid certain penalties under Obamacare by offering very
limited plans that lack key benefits which satisfy the true definition of
healthcare insurance.

Benefits
advisers and insurance brokers are increasing their commissions by offering low
benefit plans that cover minimum benefits such as preventive services. The
healthcare plans provide just enough minimum benefit requirements to avoid Obamacare’s
penalty. If an employee wants real coverage he is on his own.

Obamacare’s
promise was that healthcare insurance coverage would broadly enrich at lower
affordable costs.

“Federal
officials say these limited benefits plans, in concept, would appear to qualify
as acceptable minimum coverage under the law, and let most employers avoid an
across-the-workforce $2,000-per-worker penalty for firms that offer nothing.

It is unclear how many employers will adopt the strategy this year.
There are dozens of brokers and benefit administrators discussing this strategy
with their clients. I bet many will adopt this strategy.

"There
had to be a way out" of the penalty for employers with low-wage workers,
said Todd Dorton, a consultant and broker for Gallagher Benefit Services Inc.,
a unit of Arthur J. Gallagher AJG -0.44% &
Co., who has enrolled several employers in the limited plans.”

Obamacare
requires employers with 50 or more workers to offer coverage to their workers
or pay a 2,000 per worker penalty.

The
employers and benefits experts initially thought the rules required robust
insurance with a long list of "essential" benefits.

Federal
officials confirm the mandates affect only plans “sponsored by insurers” that are sold to small businesses and
individuals.

Healthcare
insurance “sponsored by insurers”
that are sold to small businesses and individuals affect only about 30 million
of the more than 160 million people with private insurance.

Employers
provide these “insurer sponsored plans”
to 19 million out of the 30 million people. These plans are going to disappear.

Some benefits advisers feel they face
regulatory uncertainty. New regulation can cancel older regulations. These
advisors say they would adjust to new regulations as regulators clarify the
law.

According
to Obamacare, regulations written by the multiple new agencies, larger
employers with more than 50 workers only have to provide preventive services,
without a lifetime or annual dollar-value limit, in order to avoid the
across-the-workforce penalty.

Such policies would generally cost far
less to provide to employees than paying the penalty or providing more
comprehensive benefits.

Most low-benefit plans would cost
employers between $40 and $100 monthly per employee, according to benefit
firms' estimates.

These
plans essentially provide no insurance for healthcare problems if someone needs
insurance. The financial burden falls directly on the consumer.

Obama
administration officials confirmed in interviews that the low benefit plans
would be sufficient to avoid the across-the-workforce penalty.

Several
Obama administration officials expressed surprise that employers would consider
the low benefit approach.

"We
wouldn't have anticipated that there'd be demand for these types of band-aid
plans in 2014," said Robert Kocher, a former White House health adviser
who helped shepherd the law. "Our expectation was that employers would
offer high quality insurance."

Another trick benefit managers are offering
small employers in order for them to avoid higher costs of premiums due to
compliance with some of the provisions in Obamacare is early yearly renewal of
preexisting healthcare coverage. UnitedHealth, Aetna and Humana are offering
small companies this option. The savings is significant.

Self-insured
companies face fewer changes under Obamacare. Many small companies are now switching
to self-insurance. Large corporations have been self-insured for years.

I
have previously discussed the large trend to hire only part time employees to
avoid the penalty as well as the requirement to provide insurance.

Many
employers are trying to get out of providing healthcare insurance to employees.
Employers fear they will be penalized by the Obama administration at a later
time. The administration is constantly changing regulations. This has lead to
tremendous uncertainty.

Some
Obama administration regulators worry that some of these strategies will be
widely adopted. If this happens it could decrease the effectiveness of
Obamacare’s online health-insurance exchanges.

Only
older and sicker workers, who need real healthcare insurance coverage will opt
out of low benefit employer coverage and join the health insurance exchanges.

The
premium cost for good coverage in Obamacare’s health insurance exchanges is
high already. The adverse selection will drive these costs even higher.

The
whole idea behind Obamacare’s health insurance exchanges is to force healthy
people to pay for the resources used by sick people. (“Redistribution of
wealth”)

The
Obama administration refuses to believe options to avoid Obamacare will be a
widespread trend.

How
come? Didn’t congress exempt itself from Obamacare?

"Any
activities that take place on the margins by a small number of employers would
not have a significant impact on the small group or the individual
market," said Mike Hash, director of the department's Office of Health
Reform.”

These
new plans are a substitute for the Obamacare exempt Minimed plans. Companies
that provided Minimed plans received over 13,000 waivers for Obamacare until
January 2014. Companies such as McDonald and Burger King provided Minimed Plans
to employees.

All
of these twists and turns make Obamacare look like it is unworkable. It is!

President
Obama’s goal is to create more chaos and dysfunction in the healthcare system.

Only
then can the government really step in and say let me help you.

Then
the government can provide a single party payer system and complete the journey
to socialized medicine.

Based
on past experience in many other countries, the result will be skyrocketing costs
and increased deficits.

Americans
have a lot to look forward to. The only was out is to repeal Obamacare and
replace it with a consumer driven healthcare system.

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

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One Picture Is Worth 1,000 Words

September 25, 2013

inDisinformation and the healthcare system, Healthcare Insurance Industry, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley
Feld M.D.,FACP, MACE

One picture is worth 1,000 words.
The second picture says it all.

The list of one humdred and fifty nine new bureaucratic new agencies can be found at https://libertylegalfoundation.org/obamacare-class-action/quagmire-of-new-obamacare-agencies/#.UkNfRmRgZlQ

The one hundred and fifty–nine new agencies generated by the
Accountable Care Act (Obamacare) increases the complexity of an already
uncontrollable bureaucracy. Americans have seen many examples of the
inefficiency and waste because of the growth of bureaucracy in everyday life.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2013/09/employer-mandate-confusion.html

To date, before Obamacare
has been in full swing, these agencies have created the pile of regulations
demonstrated by Mitch McConnell.

What are the chances the
recipients of these regulations will understand and obey all these regulations?

What are the chances the
government bureaucrats can enforce these regulations?

What are the chances favored,
privileged parties will be exempt from these regulations?

What is the value added cost
these agencies and regulations provide for the direct treatment of patients
with disease?

These are all good questions.
The answers are not readily available. The administration, our congressmen or the
traditional media do not discuss these questions.

The American public has
already felt the consequences of the growth of bureaucracy and regulations.

Seventy seven percent of new
jobs have been part-time jobs. A person working less than 30 hours a week is
not required to receive healthcare insurance from his employer. Employers have
done this to avoid an Obamacare penalty.

Healthcare insurance
premiums for next year are skyrocketing. The Obama administration continually
tells the traditional media that insurance premiums will be affordable and
decrease in 2014.

True unemployment rises to
over double digits while government statistics claim it is falling. It is a
statistical trick.

Americans are noticing the
sting of the 20 hidden taxes Obamacare has put in place. Despite these taxes,
the deficit for this year remains one trillion dollars. It means the
administration is spending more despite the tax increases.

The Democrats keep saying we
must raise the debt limit. The Federal Reserve keeps saying we need to print
more money. President Obama keeps saying you must pay the bills Americans and
congress voted to incur. America cannot default on its debt.

Few are saying we must
decrease the debt by decreasing bureaucracy, regulations and inefficiency.

Fewer are saying we must
stop this overspending.

President Obama has given
countless waivers to countless companies. The first waver was MacDonalds which provides
Mini-Med insurance to their low wage employees. Mini-Med insurance is worthless.
It provides practically no healthcare insurance coverage.

President Obama figures that
all these people would sign up for the Health Insurance Exchange rates. These
exchanges would provide tax credits for the low wage income earner by law. The
law seemed to change in the last few months from tax credits to subsidies
without congressional approval. Law wage earners do not pay taxes and cannot
benefit from tax credits.

After October 1 we will see
if young healthy persons without pre-existing condition sign up for healthcare insurance
through these health insurance exchanges.

The only insurance rates
seen through these exchanges so far are the California health Insurance exchange
rates. The rates are too high to buy adequate healthcare coverage for someone
making $40,000 per year. The affordable rates do not provide adequate healthcare
insurance coverage.

The Obama administration
claim’s that the New York State rates are lower than the private insurance
rates. It might be true for certain levels of coverage. The reality is the
private insurance rates in New York are too high. The New York State Board of
Insurance permits healthcare insurance companies to receive an unconscionable
return on investment.

A one year delay of
Obamacare for corporations will get President Obama past the mid term
elections. It will permit public awareness of the harm Obamacare is doing to
the economy which the administration is striving to keep hidden.

After the election cycle it
will dawn on the majority of the public that Obamacare is a destructive
train-wreck to the economy and economic growth.

The delay will also have a
lesser effect on the tremendous increase in deficit spending that would
diminish the debate on the administration’s overspending.

President Obama doesn’t seem
to think deficit spending is an important issue. He is also not bothered by the Federal Reserve’s
quantitative easing.

The most offensive action by
President Obama is exempting congress and the congressional staff from
Obamacare.

Why should the individual
hard working person suffer the effects of Obamacare when government officials
do not?

Can Obamacare work when we
have so many agencies generating so many regulations? Can it work when so many
people have waivers and exemptions?

I doubt it!

No only is it not fair to
hard working people. It is probably unconstitutional.

It doesn’t look like the
American individual taxpayers that are not exempt from Obamacare are going to
get much help from the Supreme Court.

Maybe President Obama’s goal
is to destroy the healthcare system’s infrastructure. He is setting up the
failure of Obamacare.

Obamacare seems to be designed
to destroy our healthcare system. Maybe Obamacare is not supposed to work. Maybe
it is designed to cost so much that the entire economy will fail.

This can be the only reason
Obamacare has been permitted to continue to exist by both Democrats and
Republicans.

Obamacare is neither affordable
nor executable.

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

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