Stanley Feld M.D.,FACP,MACE

There is good reason for the negative approval rating polls of the congress and the President. They have proven over and over again what they tell us is not what they mean. The public does not trust the Congress or Senate. The public is starting to mistrust President Obama. I suggest he not say trust me anymore. He needs to give the public reason to trust him.

The healthcare insurance industry has little desire to repair the healthcare system. It wants want the healthcare system to generate increased revenue and profits.

“In the first half of 2009, the health service and HMO sector spent nearly $35 million lobbying Congress, the White House and federal healthcare offices, according to data from the Center for Responsive Politics.”

The healthcare lobbying effort has been extremely profitable for healthcare lobbyists. President Obama had promised to decrease the influence of lobbyists.

 
“With more than 900 lobbyists, that sector — whose top spenders are insurance giants UnitedHealth, Blue Cross Blue Shield and Aetna — was poised to spend more than in 2008, a record lobbying year.”

President Obama promised America a change. The president’s directives against lobbyists were among his first official acts. His stated goal was to make government more open and accountable to the public.

“We are here as public servants, and public service is a privilege,” Obama said, addressing his White House staff and Cabinet on his first full day in office. “It’s not about advancing yourself or your corporate clients.”

Tom Daschle is an unregistered and highly paid lobbyist. He is President Obama’s go to man for healthcare reform. Yet he is a consultant for a lobbying firm Alston & Bird whose clients are the healthcare insurance giants like UnitedHealth and hospital associations.

President Obama said; “We need to close the revolving door that lets lobbyists come into government freely and lets them use their time in public service” to promote their own interests when they leave.”

The public does not forget Presidential candidate’s promises. They have recognized the contradictions in President Obama’s actions. His actions only lead to the public’s increasing cynicism and mistrust in him and his administration. There is great public hesitation to trust the government to take care of their healthcare needs.

“The LA Times article that the "change" being supported by the White House is going to make the for-profit companies fatter and wealthier at the expense of a healthcare system bloated by the excessive administrative, profits, and grossly high salaries of the health insurance and drug companies.”

The public protests are not only about the public option. They are about the government offering “affordable” public insurance to all. An entitlement the government cannot afford. The protests are about the control over our freedom of choice.

The healthcare insurance industry will make more money when the insurance pool is increased. The government will subsidize all policies to keep the price “affordable”. The healthcare insurance industry’s profit will increase. President Obama will raise taxes and inflate the economy.

“Undermining support for the public option wasn’t the only gain scored by insurance lobbyists.

Public option was a diversion by the healthcare insurance industry. Its purpose was to frighten and distract the public from the healthcare industry’s other goals. The healthcare lobbyists have made deals with congress and the President. The deals are not transparent.

“In May, the Senate Finance Committee discussed requiring that insurers reimburse at least 76% of policyholders’ medical costs under their most affordable plans. Now the committee is considering setting that rate as low as 65%, meaning insurers would be required to cover just about two-thirds of patients’ healthcare bills. According to a committee aide, the change was being considered so that companies could hold down premiums for the policies.”

You bet. President Obama promised to provide affordable premiums. He also promised to regulate the healthcare insurance industry. The terms are favorable to the healthcare insurance industry and not favorable to consumers. President Obama has said nothing about the increase in out of pocket expenses.

“Most group health plans cover 80% to 90% or more of a policyholder’s medical bills, according to a report by the Congressional Research Service. Industry officials urged that the government set the floor lower so insurers could provide flexible, more affordable plans.”

The healthcare insurance industry is going to get its wishes. Healthcare insurance premiums might be more affordable but out of pocket expenses will be higher.

 
"It is vital that individuals, families and small-business owners have the flexibility to choose an affordable coverage option that best meets their needs," said Robert Zirkelbach, spokesman for America’s Health Insurance Plans, the industry’s Washington-based lobbying shop.”

Isn’t that disingenuous? The greater tragedy is our representatives are going to approve the change in the deductibles. President Obama will call it a victory for healthcare reform. The Democratic party’s goal is to ultimately have a single party payer system.

Who is roping which dope? Who is the dope? The government thinks it is manipulating the healthcare insurance industry. The healthcare insurance industry thinks it is manipulating the government.

The net result is they are both manipulating consumers of healthcare. Consumers will get less healthcare coverage at greater out of pocket expense and higher taxes. The American consumer is the dope.

“Consumer advocates argue that a lower government minimum might quickly become the industry standard, placing a greater financial burden on patients and their families.”

"These are a bad deal for consumers," said J. Robert Hunter, a former Texas insurance commissioner who works with the Consumer Federation of America.”

Consumer advocates have seen through the charade. However they do not have enough money and consumer support to make others aware of what is going on behind the scenes. AARP is not providing awareness. Consumers know they have been promised transparency by President Obama but they have seen little transparency.

"They have beaten us six ways to Sunday," said Gerald Shea of the AFL-CIO. "Any time we want to make a small change to provide cost relief, they find a way to make it more profitable."

Meanwhile, companies would probably see a benefit by providing less insurance "per premium dollar," Hunter said.
Taxpayers do not want more government control over their lives and freedoms. They do not trust government to do things efficiently. Recent experience has confirmed consumer distrust. One only has to look at the inefficiencies in the bank bailouts, the economic stimulus package, the two wars, and the mounting deficits. All theses inefficiencies are at the taxpayers’ expense.

It is time for consumers to take over and demand control of their healthca
re dollars and their own healthcare decisions no matter what socioeconomic level they are in.

The government’s role should be to encourage and incentivize consumers to pursue a path toward better health without permitting them to be taken advantage of by the other stakeholders. This will be the only way to control healthcare costs.

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

Stanley Feld M.D.,FACP,MACE

The healthcare debate is becoming more confusing daily. President Obama has promised change. Fifty-three percent of Americans voted for change. We are not going to get change. It turns out President Obama represents status quo except at a greater expense to the taxpayer.

The healthcare insurance industry controls the healthcare dollars across all insurance lines. These insurance lines are private insurance for small companies, corporations that are self insured, Medicare, Medicaid and self insured local and state governments.

This broad control of the health care dollar comes about because all these healthcare insurance providers outsource their administrative services to the healthcare insurance industry. The major healthcare insurance companies disguise this control by creating differently named subsidiaries that “win the administrative services contracts.”

Fifteen to twenty percent (15-20%) of the healthcare dollar goes to administrative services fees. This is a very high fee. Medicare claims it only pays 2.5% for administrative services. This is probably true for its in-house administrative services but not for outsourced administrative services.

The healthcare industry has also had a stranglehold on all providers of healthcare insurance by increasing premiums and decreasing reimbursement to physicians and hospitals while maintaining its outrageous administrative services fees.

All the stakeholders are captives of the healthcare insurance industry. This stranglehold has caused an increase in the uninsured and destroyed the ill conceived Massachusetts universal healthcare plan.

President Obama’s healthcare reform plan is not focused on eliminating this stranglehold. The Obama healthcare reform plan will still outsource the administrative services to the healthcare insurance industry while increasing the government’s bureaucracy to try contain costs.

When are our politicians going to figure out the only way to repair the healthcare system is to eliminate the middlemen and let the transactions be between patients and physicians?

“This year alone, the healthcare industry has spent over $34 million to hire 923 lobbyists to influence Congress, according to the Center for Responsive Politics.”

Why? Because the healthcare insurance industry has positioned itself so it cannot lose no matter which modified healthcare reform plan is adopted.

Some insurance company leaders continue to profess concern about the unpredictable course of President Obama’s massive healthcare initiative. I believe this is an act. Do not let it fool you. Patient welfare is not the healthcare insurance industry’s concern.

“The half-dozen leading overhaul proposals circulating in Congress would require all citizens to have health insurance, which would guarantee insurers tens of millions of new customers — many of whom would get government subsidies to help pay the companies’ premiums.”

"It’s a bonanza," said Robert Laszewski, a health insurance executive for 20 years who now tracks reform legislation as president of the consulting firm Health Policy and Strategy Associates Inc”.

The healthcare insurance industry hired the Lewin Group, a health policy consulting firm that is owned by UnitedHealth Group to do a study opposing the “public option”. The healthcare insurance companies contended that a government-run plan would put the healthcare insurance companies out of business.

I believe this is a diversion. The healthcare industry will make out like a bandit either with or without a public option. The consumer will not be so fortunate. .

Laszewski said the industry’s reaction to early negotiations boiled down to a single word: "Hallelujah!"

"The insurers are going to do quite well," said Linda Blumberg, a health policy analyst at the nonpartisan Urban Institute, a Washington think tank. "They are going to have this very stable pool, they’re going to have people getting subsidies to help them buy coverage and . . . they will be paid the full costs of the benefits that they provide — plus their administrative costs."

Tom Daschle has emerged, according to the mainstream press, as Obama’s key go-to guy. It is as though he never left. He has the ear of the President as well as the healthcare insurance industry and the pharmaceutical.

“He still speaks frequently to the president, who met with him as recently as Friday morning in the Oval Office.”

Tom Daschle declared after meeting with President Obama that the President is becoming impatient with the debate and might force his healthcare reform bill through the Senate with a 51 vote majority.

“He remains a highly paid policy adviser to hospital, drug, pharmaceutical and other health care industry clients of Alston & Bird, the law and lobbying firm.”

It seemed strange that UnitedHealth and other healthcare insurers would hire Alston and Bird to represent them by a “liberal” Democrat (Tom Daschle) until it became clear that with or without a public option the healthcare industry would experience a bonaza.

“UnitedHealth spent the most, $2.5 million in the first half of 2009, and hired some of Washington’s most prominent political players, including Tom Daschle.”

With the public now opposed to a public option the White House and Senate Democratic leaders have introduced the concept of a on nonprofit insurance cooperatives.

“Mr. Daschle began promoting a cooperative two months ago as a politically feasible alternative to a more muscular government-run insurance plan. It is an idea that happens to dovetail with the interests of many Alston & Bird clients, like the insurance giant UnitedHealth and the Tennessee Hospital Association.”

Liberal democrats are opposed to the nonprofit insurance cooperatives. They fear it will take longer to evolve into a single party payer system than the public option would. Liberal Democrats believe the only way to repair the healthcare system is to have total government control over the healthcare system.

They do not realize that as long as the healthcare insurance industry controls the healthcare dollar the healthcare system will not be repaired. As long as consumers do not have financial incentives to control their health and their healthcare dollar the healthcare system will not be repaired

The healthcare insurance industry does not want the healthcare system repaired. They want the healthcare system to generate more income for them rather than better health for consumers.

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

Stanley Feld M.D.,FACP,MACE

In response to my last post I received this note.

“Stan

This is interesting.  You may like this but it is very obvious that it is just another stall tactic.  If the current bill, with reconciliation, passes, we still have to address these points.  So where are this fellow’s solutions?”

I watched President Obama’s town hall meeting in Grand Junction on Saturday evening. He is a compelling and seductive speaker. If I thought his plan would work and at the same time be budget neutral I might be seduced.

It will not work for the consumer and it will not be budget neutral. He needs a better plan.

What is missing?

President Obama’s generalities are correct. The country needs a system that provides universal care at an affordable cost and an increase in quality. I believe his strategy is wrong. His strategy is reflected in his healthcare reform bill.

He is correct in pointing out that the healthcare insurance industry controls the healthcare dollar. His prescription to destroy the healthcare insurance industry is wrong because it will penalize patients. President Obama’s healthcare reform bill is not doing anything to limit the healthcare insurance industry 20% gross administrative fee whether we have a single party payer or a private insurance system.

He promises to get rid of the waste in the system. He claims eliminating the waste will pay for two thirds of the 1.1 trillion dollars his healthcare billion will cost in the next ten years. The remainder will be paid for by taxing people making over $250,000 a year. He needs to redo the math.

President Obama’s system sounds pretty simple. However, it seems the government hardly ever does anything efficiently. The costs are always underestimated. There are always uncontrolled abuses or unintended consequences.

President Obama is ready to create a massive new bureaucracy and employ approximately 110,000 new employees. Bureaucracy is always a prescription for inefficiency.

President Obama is ignoring the waste created by defensive medicine. The total cost of unnecessary testing is about $750 billion dollars a year. Nonetheless, tort reform is off the table. Defensive medicine is blamed on physicians wanting to generate more money for themselves. I think defensive medicine came first, and then physicians figured out how to generate more income in response to decreasing reimbursements for their services and an increase in malpractice lawsuits. Placing a cap on malpractice awards destroyed the malpractice business in Texas and California.

Where is the role of patients’ responsibility for their own health and healthcare. Patients with adequate healthcare insurance are satisfied. The healthcare inflation problem is the result of medical care costing little for the patient with insurance except for the deductibles.

Our healthcare system is a fix the sick system. The healthcare system is not geared to prevent an illness. The administration’s healthcare reform plan speaks of prevention but does not provide incentives to patients or physicians to prevent illness or even deal with the obesity epidemic..

“Consumers are receiving quality medical care at little direct cost to themselves. This creates runaway costs that have to be addressed. But ill-advised reforms can make things much worse.”

The public has no great love for the healthcare insurance industry. Their protests about the healthcare reform bill are not to protect the healthcare insurance industry. It is to protect their freedom of choice. The public does not trust the government to make choices for them.

Both political parties have extremely low approval ratings. President Obama’s approval rating is sinking because of the perception of his half truths and a mounting distrust by independent voters.

“An effective cure begins with an accurate diagnosis, which is sorely lacking in most policy circles. The proposals currently on offer fail to address the fundamental driver of health-care costs.”

President Obama’s public option and increase in bureaucratic decision making is not going to solve our healthcare systems problems. He is not focusing on repairing the perverse incentives that are presently in the dysfunctional healthcare system.

Consumers must solve the healthcare system problems just like they solved the auto industries problems. Government role should be to provide the appropriate regulations to level the playing field.

“The health-care wedge is an economic term that reflects the difference between what health-care costs the specific provider and what the patient actually pays. When health care is subsidized, no one should be surprised that people demand more of it and that the costs to produce it increase.”

The solution is not a public option or a single party payer system. Consumer driven healthcare is the solution through the use of the ideal medical savings account.

“To pay for the subsidy that the administration and Congress propose, revenues have to come from somewhere. The Obama team has come to the conclusion that we should tax small businesses, large employers and the rich.”

President Obama’s plan will not work because the health-care recipients will lose their jobs as businesses can no longer afford their employees. The economy will get worse and the wealthy will flee to tax havens.

General anxiety will increase, patients will get sicker and the healthcare system will be overused creating more debt and more taxes.

A few economic self evident truths are:

1. A free marketplace with appropriate rules encourages innovation and productivity.
2. In the United States profitability is a strong market driver. If inappropriate rules are set up entities will try to figure out how to benefit from the rules to the disadvantage of others.
3. The higher the taxes the lower the productivity. The lower the taxes the higher the productivity.
4. The greater the bureaucracy the lower the added value productivity.
5. Consumers will try to maximize their purchasing power.

“According to research I performed for the Texas Public Policy Foundation, a $1 trillion increase in federal government health subsidies will accelerate health-care inflation, lead to continued growth in health-care expenditures, and diminish our economic growth even further. Despite these costs, some 30 million people will remain uninsured.”

Rather than expanding the role of government in the health-care market, Congress should implement a consumer driven approach to health-care reform. A consumer driven approach focuses on the consumers being the policemen for their own healthcare dollar. If would focus on the doctor relationship and empower the patients and their physicians to make effective and economical choices.

The patients would be proactive rather
than passive. The result will be an increase in efficiency in the healthcare system rather than a further decrease.

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

Stanley Feld M.D., FACP, MACE

The House of Representatives Healthcare Bill is 1018 pages long. Many Representatives and Senators did not read the entire economic stimulus bill because “we did not have time” before we experienced a severe economic recession. They claimed to be saving us from another great depression.

I have read a good portion of HR3200. The provisions are unacceptable and sinister. It represents a complete government takeover of our healthcare system. It is not in the interest of the consumer. It is not in the interest of our precious freedom of choice.

A reader of my blog sent me a summary of HR 3200 written by Larry Schweikart. The reviewer FamilySecurityMatters.org Contributing Editor Larry Schweikart is the author o 48 Liberal Lies About American History: (That You Probably Learned in School) and A Patriot’s History of the United States: From Columbus’s Great Discovery to the War on Terror.   He blogs at patriotshistoryusa.blogspot.com. Mr. Schweikart is not the most liberal person on the planet. However, his analysis is about 80% accurate by my reading of the sections Mr. Schweikart summaries.

Every Americans, especially our Senators and Representative must know what is actually in the bill before it is passed. President Obama’s generalities do not cover the details of HR 3200.

It feels like Ayn Rand’s Atlas Shrugged all over again.

The mainstream media is not covering the real story.

Below are few video clips that try to tell the real story

http://online.wsj.com/video/can-americans-keep-their-current-health-care/6043F8F9-0BEB-4E36-8589-7AEEE4C7AB9E.html

http://online.wsj.com/video/can-americans-keep-their-current-health-care/6043F8F9-0BEB-4E36-8589-7AEEE4C7AB9E.html

Mr. Schweikart evaluated 498 of the 1107 page bill. The summary of one half HR3200 is frightening. His summary is a good reference guide to the appreciation of the harshness of the bill. It also explains President Obama’s urgency in getting a bill passed before anyone realizes the implications of the bills contents.

Representatives who vote for this bill should not be reelected. They are not representing their constituents’ rights or protecting their freedoms. Your healthcare, health and freedoms are at stake.

You can check the reviewer’s summary against the actual bill at the link below.

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf

“Take a look at what actually is in the Health Care bill. Obama makes disingenuous comments like "You’ll still keep your doctor" or "You’ll keep your existing health care."

Pg 22 of the HC Bill mandates the Government will audit books of all employers that self insured. Can you imagine what that will do to small businesses? Everyone will abandon “self insurance” and go on Government insurance. So when Obama says that there will still be private health care, it’s simply a lie: this mandate will force employers to abandon their private plans.

Pg 30 Sec 123 of HC bill – a Government committee will decide what treatments/benefits a person may receive.

Pg 29 lines 4-16 in the HC bill – YOUR HEALTHCARE WILL BE RATIONED! President Obama has been saying healthcare is to be rationed all along in code.

Pg 42 of HC Bill – The Health Choices Commissioner will choose your HC Benefits for you. You will have no choice!

Pg 50 Section 152 in HC bill – HC will be provided to ALL non US citizens, illegal or otherwise.

Pg 58 HC Bill – Government will have real-time access to individual’s finances and a National ID Healthcard will be issued! Government has real-time access to your tax return presently and means test Medicare recipients’ premiums

Pg 59 HC Bill lines 21-24 Government will have direct access to your bank accts for election funds transfer. A further impingement on freedom and privacy.

Pg 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations (read: ACORN).

Pg 72 Lines 8-14 Government will create an HC Exchange to bring private HC plans under Government control.

Pg 84 Sec 203 HC bill – Government mandates ALL benefit packages for private HC plans in the Exchange.

Pg 85 Line 7 HC Bill – Specifics of Benefit Levels for Plans = The Government will ration your Healthcare!

Pg 91 Lines 4-7 HC Bill – Government mandates linguistic appropriate services. Example – Translation for illegal aliens.

Pg 95 HC Bill Lines 8-18 The Government will use groups, i.e. ACORN & AmeriCorps, to sign up individuals for Government HC plan.

Pg 85 Line 7 HC Bill – Specifics of Benefit Levels for Plans. AARP members – your Health care WILL be rationed.

Pg 102 Lines 12-18 HC Bill – Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.

Pg 124 lines 24-25 HC No company can sue Government on price fixing. No "judicial review" against Government Monopoly.

Pg 127 Lines 1-16 HC Bill – Doctors/ AMA – The Government will tell YOU what you can earn.

Pg 145 Line 15-17 An Employer MUST auto enroll employees into public option plan. NO CHOICE.

Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.

Pg 149 Lines 16-24 ANY Employer with payroll $400k & above who does not provide public option pays 8% tax on all payroll.

Pg 150 Lines 9-13 Businesses with payroll between $251k & $400k who don’t provide public option will pay 2-6% tax on all payroll.

Pg 167 Lines 18-23 ANY individual who doesn’t have acceptable HC according to Government will be taxed 2.5% of income.

Pg 170 Lines 1-3 HC Bill Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay.)

Pg 195 HC Bill -officers & employees of HC Admin (the GOVERNMENT) will have access to ALL Americans’ finances and personal records. Big brother will be watching your every move.

Pg 203 Line 14-15 HC – "The tax imposed under this section shall not be treated as tax" Yes, it says that.

Pg 239 Line 14-24 HC Bill Government will reduce physician services for Medicaid. Seniors, low income, poor affected. Kill off the poor and elderly.

Pg 241 Line 6-8 HC Bill – Doctors – doesn’t matter what specialty – will all be paid the same.

Pg 253 Line 10-18 Government sets value of Doctor’s time, professional judgment, etc. Literally, value of humans.

Pg 265 Se
c 1131Government mandates & controls productivity for private HC industries.

Pg 268 Sec 1141 Federal Government regulates rental & purchase of power driven wheelchairs.

Pg 272 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS – Cancer patients – welcome to rationing!

Pg 280 Sec 1151 The Government will penalize hospitals for what Government deems preventable readmissions.

Pg 298 Lines 9-11 Doctors who treat a patient during initial admission that results in a readmission – Government will penalize you.

Pg 317 L 13-20 OMG!! PROHIBITION on ownership/investment. Government tells Doctors what/how much they can own.

Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion – Government will mandate hospitals cannot expand.

Pg 321 2-13 Hospitals have opportunity to apply for exception BUT community input required. Can you say ACORN?!

Pg 335 L 16-25 Pg 336-339 – Government mandates establishment of outcome-based measures which of course forces health care rationing.

Pg 341 Lines 3-9 Government has authority to disqualify Medicare Adv Plans, HMOs, etc., forcing people into Government plan.

Pg 354 Sec 1177 – Government will RESTRICT enrollment of Special needs people!

Pg 379 Sec 1191 Government creates more bureaucracy – Telehealth Advisory Committee. Healthcare by phone.

Pg 425 Lines 4-12 Government mandates Advance Care Planning Consultations. Think Senior Citizens end of life prodding.

Pg 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of attorney. Mandatory!

Pg 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in how to die. EVERYONE on Social Security, (will include all Senior Citizens and SSI people) will go to MANDATORY counseling every 5 years to learn and to choose from ways to end your suffering (and your life). Health care will be denied based on age. 500 Billion will be cut from Seniors healthcare. The only way for that to happen is to drastically cut health care, the oldest and the sickest will be cut first. Paying for your own care will not be an option.

Pg 427 Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.

Pg 429 Lines 1-9 An "advanced care planning consultant" will be used frequently as patients’ health deteriorates.

Pg 429 Lines 10-12 "advanced care consultation" may include an ORDER for end of life plans. AN ORDER from the Government to end a life!

Pg 429 Lines 13-25 – The Government will specify which Doctors can write an end of life order.

Pg 430 Lines 11-15 The Government will decide what level of treatment you will have at end of life.

Pg 469 – Community Based Home Medical Services/Non profit orgs. (ACORN Medical Services here?)

Pg 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORGANIZATION. 1 monthly payment to a community-based organization. (Like ACORN)

Pg 489 Sec 1308 The Government will cover Marriage & Family therapy. Which means they will insert Government into our marriages.

Pg 494-498 Government will cover Mental Health Services including defining, creating, rationing those services. You’d better speak up now before you are on the "advanced care consultation" list.

It gets worse: the Health Care Reform bill that is now about to come up for a vote will absolutely eliminate private health care options. Do not kid yourself: They are going to say that they aren’t going to interfere with your right to go to your "own doctor" or have your own "private health insurance." But there won’t be non-government doctors or private health insurance if the government mandates them out of existence.

Even still, I hear people who want to "get past all this partisanship." Sorry, but GROW UP.

Our system from the beginning has pitted one group against another out of fear of the very giant government that is metastasizing before our eyes. James Madison didn’t like "parties" or "factions," but he finally admitted that they were absolutely necessary to fragment power.

For our system to work there has to be a clear choice, not a mushy middle, because the mushy middle always, always, always gravitates left. There is a "presumption of power" on the left –conservatives, by nature, do not like government, don’t trust it, and do not want to use it to advance their ends, which they see as advanced through liberty, individual achievement, and entrepreneurship.

FamilySecurityMatters.org Contributing Editor Larry Schweikart is the author o 48 Liberal Lies About American History: (That You Probably Learned in School) and A Patriot’s History of the United States: From Columbus’s Great Discovery to the War on Terror.   He blogs at patriotshistoryusa.blogspot.com.

It is hard to read H3200 and comprehend its implications. However, a careful reading leads me to similar conclusions to those of Mr. Schweikart.

Do you think your representatives have studied the bill? If they have and vote for it they should lose your vote. If they have not read it and vote on party lines they should lose your vote.

This bill is not going to Repair the Healthcare System. It will make the healthcare system more complex, restrict access to care, restrict the delivery of care, ration care, limit freedom of choice, and increase the deficit.

Americans have to demand that congress tackle the real problems in the healthcare system. Have you contacted your Representative and Senators? If you have, good for you. If not , what are you waiting for?

Let your Senators and Representatives know the proposals are unacceptable.  Write, fax, call, email, twitter. Tell them:

“We do not want the government to control our lives. We want affordable, universal healthcare coverage that does not limit access to care. We want control over our healthcare dollars. We do not want government to control our lives and our money.”

https://writerep.house.gov/writerep/welcome.shtml

http://www.senate.gov/general/contact_information/senators_cfm.cfm

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

Stanley Feld M.D.,FACP,MACE

Between Thursday July 15^th and Friday July 16^th the President and the House committees somehow persuaded Douglas Elmendorf, head of the Congressional Budget Office, to change his assumptions and score the healthcare reform bill budget deficit differently. He had been very definitive on Thursday July 15^th. It is hard to believe that the next day the negative scoring of the House bill could drop from 1.5 trillions dollar deficit to a $239 billion deficit over the next ten years.

“Late on Friday, hours after two House committees—Ways and Means and Education and Labor—approved healthcare reform legislation, the Congressional Budget Office (CBO) had bad news: HR 3200 would result in a net increase in deficit spending of $239 billion during the next 10 years, according to its analysis. But House leadership immediately challenged the findings—and CBO changed its tune hours later.”

How did administrative pressure manage to change this number overnight? Republicans are not demanding an answer.

“The House bill, CBO said, was able to target key areas for savings. However, a key trigger in increasing Medicare spending occurred when the existing annual "sustainable growth rate" (SGR) in the Medicare physician fee schedule (with a 21% reduction in payment rates scheduled for 2010) was replaced with an inflation-based update.”

This calculation was done using today’s inflation rate. What if inflation skyrockets to 10 or 15%? The bill would create a deficit of greater than 1.5 trillion dollars in 10 years.

CBO estimated that those changes in the physician payment rates ultimately would add up to $245 billion in changed physician rates between 2010 and 2019.

Who are they going to hurt? The weakest link is the physicians because they are the most disorganized and lack leadership and effective representation.

Meanwhile the traditional media has immediately stopped publishing the $1.5 trillion dollar deficit in the “news” this week and replaced the deficit with the $239 billion dollar deficit.

“Peter Orszag, director of the Office of Management and Budget (and former CBO director). "The only reason that the bill shows a deficit" is because of the "payments to physicians…once you take that part out, the bill is deficit neutral," Orszag told Fox News on Sunday.”

This is exactly how you cook the books. You recalculate the figures using assumptions to your advantage. President Obama now has his deficit neutral bill. Magic!!

“Those reformed Medicare physician payment costs, however, should not have been included. CBO’s net calculations, according to a release from the three House committee leaders issued.”

“ Instead, they will be absorbed under the upcoming statutory "pay-as-you-go" budgetary legislation that currently is pending in the House. (With so-called "paygo," the federal government cannot launch new tax cuts or entitlement programs without finding a way to pay for them.) This would make HR 3200 deficit neutral over the 10 year budget window—and even produces a $6 billion surplus.”

If anyone wants a bridge I have one to sell. The deficit money will come from another pot.

“It also would create Medicare and Medicaid savings of $465 billion, coupled with the $583 billion revenue package reported by the Ways and Means Committee on Friday. It would "fully finance" the previously estimated $1.042 trillion cost of reform, which will provide healthcare coverage for 97% of Americans by 2019, the House committee leadership said. About 17 million nonelderly residents would be left uninsured (about half of whom would be unauthorized immigrants).”

It is unbelievable. We still have 17million uninsured. It is no wonder the House and Senate’s approval rating is so low. If the American public believes all this nonsense they will deserve what they will get. Only public opinion can stop this train. When it is all over there will be too few physicians taking care of patients just as there are too few physicians taking care of Medicaid patients.

“CBO and the Joint Committee on Taxation said that approximately $583 billion would be obtained through increasing federal revenue by methods such as issuing a surtax on higher incomes, which was approved by Ways and Means on Friday. Another $219 billion (plus physician payments) would be saved by Medicare and Medicaid by:

• Making permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee for service sector (excluding physicians’ services)—yielding budgetary savings of $196 billion over 10 years
• Setting payment rates in the Medicare Advantage program based on per capita Medicare spending in the fee for service sector—providing savings of approximately $156 billion over the 2010 2019 period.
• Changes to the Medicare Part D program to establish a new prescription drug rebate program for those eligible for both Medicaid and Medicare.”

After all these manipulations of the numbers they have the gall to make the following statement:

"This fulfills the strong commitment of the President and House leadership to enact health reform on a deficit neutral basis," said the release signed by House Committee Chairmen Henry Waxman (D-CA), Charles Rangel (D-NY), and George Miller (D-CA).”

President Obama then says he is correct. He told us he would not sign a healthcare reform bill that was not budget neutral.

President Obama has previously said that he would not sign healthcare reform legislation that was not budget neutral.

Can President Obama be trusted with numbers? His numbers were wrong with the economic stimulus package and we trusted him.

The unemployment rate today is 9.5% — nearly 20% higher than the Obama White House said it would be with the stimulus in place. Keith Hennessey, who worked at the Bush White House on economic policy, has noted that unemployment is now higher than the administration said it would be if nothing was done to revive the economy. There are 2.6 million fewer Americans working than Mr. Obama promised.

The President did tricks with the numbers to pass the economic stimulus package. All of this seems much too confusing to the traditional media and their love affair with President Obama. We are not getting critical reporting.

“

The Blue Chip consensus is an average of some four dozen economic forecasts. In January, the consensus estimated that GDP for 2009 would shrink by 1.6% and that unemployment would top out at 8.3%. Team Obama assumed both higher GDP growth (it counted on a contraction of 1.2%) and lower peak unemployment (8.1%) than the consensus.”
T

he calculations for surplus and deficit depend on the assumptions applied. If you make the wrong assumptions you can get numbers you like. If you make the correct assumptions you might get public disapproval.

So why should we trust President Obama and his Democratic controlled House committees with the assumptions about health care costs? The goal of the present administration is to dominate and control healthcare. Can you trust the administrations with your healthcare needs?

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

Stanley Feld M.D., FACP, MACE

The congressional budget office has scored the House healthcare reform bill and declared it will increase the budget deficit by 1.5 trillion dollars in the next ten years. During his testimony to congress Douglas Elmendorf head of the CBO had the courage to do his job honestly. He contradicted President Obama contention that the House bill will be budget neutral.

“Douglas Elmendorf, head of the Congressional Budget Office, provided a bleak assessment in his testimony on Thursday on whether he thought the healthcare cost curve—which has been steadily rising upward—would finally bend downward under newly introduced reform legislation.”

His response to Sen. Kent Conrad (D-ND), chairman of the Senate Budget Committee, who asked the question: An unequivocal "no."

The legislation expands federal responsibility for healthcare costs without any real structural change in the healthcare system. The only structural changes will be a decrease in reimbursement to physicians and an ineffective pay for performance system.

"In the legislation that has been reported, we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount," Elmendorf said. "On the contrary, the legislation significantly expands the federal responsibility for healthcare costs."

The CBO is not even including the money allocated to healthcare reform in President Obama’s economic stimulus package i.e. the $60 billion dollars allocated to electronic medical records and the $30 billion dollars allocated to Federal Health Board.

On Friday July 16^th ,President Obama responded with an emergency press conference. He gave Congress a pep talk. His message was not to give up in the home stretch.

On Saturday morning he told the nation:

“I want to be very clear,” Mr. Obama said in his weekly address to the nation. “I will not sign on to any health plan that adds to our deficits over the next decade. And by helping improve quality and efficiency, the reforms we make will help bring our deficits under control in the long term.”

He crafted his message carefully. He claims even though there is a deficit in the first few years the reform will create a surplus at the end of the decade.

How will he create a surplus?

He might achieve his goal by decreasing access to care.

He could decrease care (rationing).

He could decrease reimbursement to physicians.

He could increase taxes.

He could also cook the financial books to create a profit.

One way to pay for the bill is to raise taxes. Is that a smart idea? Is raising taxes a good idea during a recession? The answer of most economists is no! President Obama,s reply reply is he is only going to tax the rich. Who create the jobs that will revive the economy?

How does President Obama maintain his high approval ratings? He maintains his high ratings by leaving the dirty work up to others while he speaks in generalities and gives pep talks. He uses powerful new media tools to provide Americans with a “voice in government.” The problem is he does not tell us what we are signing up for other than his healthcare reform. He asks us to help defeat his opponents who want to maintain the status quo.

“The same folks who controlled the White House and Congress for the past eight years as we ran up record deficits will argue — believe it or not — that health reform will lead to record deficits,” Mr. Obama said. “That’s simply not true.”

He argued that his proposals would cut “hundreds of billions of dollars” in unnecessary spending and change incentives so health providers “will give patients the best care, not just the most expensive care.”

It sounds great. It gives me a bad feeling. It sounds like big brother will take care of us. We should be empowered to take care of ourselves.

And, he said, he has urged Congress to adopt a plan for a standing commission of doctors and other medical experts to oversee cost-saving measures.

Shorty thereafter, David Plouffe, who crafts his new media internet campaign, sent a note to all his email addresses to have all of us sign up for President Obama’s healthcare reform plan blindly.

Dear Supporter

President Obama is in the White House today because last year people like you got involved and made it happen.
Passing health care reform in 2009 is a top priority for the President. Achieving it will require everyone working together — we can’t do this without you.
Please listen to the President’s call and then sign your name, asking Congress to deliver health care reform that lowers costs, guarantees choice, and ensures affordable care for all.

http://my.barackobama.com/ObamaCall
Thanks for getting involved,
David Plouffe
Organizing for America

America: It is all doubletalk!!

Think about the double talk in the last six months, the economic recovery plan, the financial sectors bailout and then huge profits to Goldman Sachs. Think about the continued huge bonuses and taxpayers’ burdens. Think about the increasing unemployment rate beyond President Obama’s predictions.

Do you trust the government to dictate your healthcare options? Do you think government should decide the course of your medical care for you and your doctor?

Government should regulate the abuse of our healthcare options not dictate medical care.

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

.