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Stakeholder Mistrust

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Socrates Is A Man

January 13, 2013
inDisinformation and the healthcare system, Medicare, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
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Stanley Feld
M.D.,FACP,MACE

 

All Men Are Mortal

Socrates Is A Man

Socrates Is Mortal

This is the classical syllogism. Syllogisms are a
form of decisive logic that leads to a certain conclusion.

“A
syllogism (Greek: συλλογισμός – syllogismos
– "conclusion," "inference") is a kind of logical
argument in which one proposition
(the conclusion) is inferred from two or more others (the premises)
of a specific form. “

In my last blog I reported the 3.5% tax the Obama
administration is levying on the healthcare insurance industry for ever
healthcare insurance policy it sells through Obamacare’s health insurance
exchanges. 

In 2014 the healthcare insurance industry is going to
be required to sell healthcare insurance policies through the health insurance
exchanges.

The healthcare insurance industry will also be
required to sell plans that comply with the rules and regulations of the Obama
administration.

The 3.5% tax “users fee” was published on a Friday
afternoon at the end of November. The tax received little media attention. I
said the healthcare insurance industry would pass this “users fee” on to the
consumer.

At the end of December the healthcare insurance
industry did better than that. It increased healthcare insurance premium rates
by double digits.

“Health
insurance companies across the country are seeking and winning
double-digit increases in premiums for some customers, even though one of the
biggest objectives of the Obama administration’s health
care law was to stem the rapid rise in insurance costs for
consumers.”

The consumers most affected by the higher rates are
small businesses and consumer who must purchase insurance on their own.  

"In California, Aetna is proposing rate increases of
as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of
California 20 percent for some of those policy holders.

The rate requests are in
addition to the 39% increase in rates last year.

In other states, like Florida and Ohio, insurers have been
able to raise rates by at least 20 percent for some policy holders. The rate
increases can amount to several hundred dollars a month.

 In 2010 the
increase in healthcare insurance premiums increases provided springboard for
public opinion sympathy of the Affordable Care Act (Obamacare).

Obamacare will go into full effect in 2014. 

Why would a business (the healthcare insurance
industry) facing loss of its customers because of high premiums increase
premiums even further?

Why, if the traditional media has published articles
stating that the cost of healthcare has been decreasing would a premium
increase be justified?

 “A report issued by the Department of
Health and Human Services today includes findings that might surprise
some people.


“During
the fiscal year that ended Sept. 30, 2012, the amount Medicare spent per beneficiary
rose by just 0.4 percent. That's three percentage points less than the economy,
as measured by gross domestic product, grew during that same period.”

 If Medicare spending has risen only
.4% why would Medicare premiums increase by at least 33% while private healthcare
insurance premiums are increasing by 10-30%?

Annually physicians’ reimbursement continues to
decrease.

Why do consumers’ deductibles continue to increase
each year?

It is illogical. The numbers do not make sense. The
actions do not follow the syllogistic logic.

How can Medicare be losing money? Medicare premiums
are means tested and represent a redistribution of wealth.

 The average
premium for Medicare with after tax dollars for a couple with a reasonable
pension fund is $15,000 dollars.

The average direct cost of care per Medicare patient
is $6,600 dollars.

In 2014 Medicare premiums are scheduled to increase
to more than $20,000 for full Medicare insurance coverage.

Seniors have paid for Medicare insurance in payroll taxes
continuously for the last 47 years.

There is something wrong with the numbers. They do
not add up. Where is the extra money going?

Consumers must start becoming aware of these facts.

Only consumer protest will bring out the truth about
these illogical numbers.

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



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The Destruction of Private Healthcare Insurance

January 9, 2013
inHealthcare Insurance Industry, Medicine: Healthcare System, Stakeholder Mistrust
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Stanley Feld M.D., FACP, MACE

One of these days Americans
are going to pay attention to how President Obama is destroying private
healthcare in America.

Many people will fine this
hard to believe because he is such a nice guy and many people like him.

He is making the healthcare
insurance industry destroy itself by forcing them to increase healthcare
insurance rates.

The destruction is so well
designed that the public cannot take notice. The healthcare system will not be
more affordable or accessible to anyone in the nation.

The changes will provide
President Obama with another tool to redistribute wealth and increase the individual’s
dependence on the federal government. This defines President Obama’s goal in affecting
all areas of our life.

Americans are on the Road To
Serfdom.

I remember Barney Frank and
John Kerry saying that healthcare reform would not work without a “Public Option.”
I also remember President Obama saying we can make it work without a “Public Option.”

President
Obama’s original plan was to eliminate private insurance. Americans would have
no choice but a “Public Option.”  (National Health Plan)

 

 Kathleen
Sebelius, the secretary of health and human services
said, she “retains authority to make the
final decision” on insurance rates if she finds that a state acted in an
arbitrary or capricious way in denying a rate increase sought by a nationwide
health plan.

 

This is the first time I
have seen President Obama’s administration use the words “National Health
Plan.”

It was obvious President
Obama was not truthful when he said “if
you like your physician you can keep him” and “if you like your healthcare insurance you can keep it.”

Congress made a gigantic while
passing Obamacare and transferring all healthcare policy decision making power
to the executive branch of government.

President Obama’s goal is to
have complete control over the healthcare system. He wants to force the private
healthcare insurance industry out of business. He wants to socialize the entire
medical care industry into a single party payer system.  The government will be the single party payer.

Healthcare will then be a
ubiquitous entitlement program that the government cannot afford unless it increases
taxes entire population according to the taxpayers means.

This is the pattern behind many
of the articles written in isolation by the traditional media.

The unintended consequences
resulting from each policy change will be overwhelming.

I have been fascinated by President
Obama’s negotiating strategy.  

Americans are going to wake
up to the fact that President Obama has increased taxes for the funding of
Obamacare by $1 trillion dollars over the next ten years aside from the tax
hikes effective January 1st.

Americans are going to wake
up and feel deceived by President Obama when they realize they are getting
little for their increased taxes except government control over their freedoms.

I predict President Obama’s
plans will blow up in his face.

Consumers will protest when
they recognize the impact these multiple new taxes will have on their
discretionary income. President Obama will not get the funding he needs from
congress.  

His physician workforce will
not cooperate. Hospitals are starting to wake up and are seeing they were
deceived. They thought they would do better because they have bought physician
practices.

Recently they automatically
received cuts in reimbursement while the doctor fix was extended for another
year. Physician reimbursement will be cut and the physician workforce will
dwindle.

On Friday afternoon November
30th 2012 the Obama administration pulled a stunt on the healthcare
insurance industry.

“The Obama administration
said Friday that it would charge insurance companies for the privilege of
selling health insurance to millions of Americans in new online
markets run by the federal government.”

The cost of these “user
fees” can be passed on to consumers. The proposed fees could add 3.5 percent to
premiums for private health plans sold in insurance exchanges operated by the
federal government.

The "user fees" are another tax to consumers.

The government is
disregarding the fact that healthcare insurance premiums are too high for
employers to provide healthcare insurance for employees now.

Employers are opting to drop
healthcare insurance coverage and pay the government penalty. Some are dropping
healthcare insurance and avoiding the penalty by decreasing the number of
employees to under 50 employees or decreasing employees work hours to under 30
hours per week.

This will increase, not
decrease the tax burden on the consumer.

The exact effect of the
health insurance exchange on the healthcare industry is muddled.

It looks as if President
Obama is rapidly moving toward a “Public Option.”

Consumer advocates, insurers,
and some state officials had expressed concern about delays in publication of
the rules for this new proposal.

President Obama has used
this is the same tactic before. Consumers and agencies must accept the changes
before the rules are published.

Consumers and state
governments do not trust President Obama. They are afraid to say yes when they
do not know what they are saying yes to. In the end it  looks like the state governments and the
consumers will get stuck with the bill and the federal government will have
complete control over the healthcare system.

CMS said. “These plans will
be offered by private insurance companies under contract with the United States Office of Personnel Management. The agency already provides insurance to eight
million federal employees, retirees and dependents.”

The scary part is the administration said,
“It (the government) retains
authority to make the final decision” on rates if it finds that a state acted
in an arbitrary or capricious way in denying a rate increase sought by a
nationwide health plan.”

The term “Nationwide Health Plan” and “final authority” sounds as if the
government is taking over.

The federal government will
also have control over physicians and hospital fees.  It will also control access to care and the
rationing of care.

It is almost too late for
consumers to wake up.

No one can say President
Obama didn’t tell us.

It can only be said the plan
was so obfuscated, final rules so delayed and unsubstantiated promises made and
not publicized on a Friday afternoon the week after Thanksgiving that the
public did not understand what was going on and could not express an opinion.

The games President Obama
and his administration play are dizzying. The irresponsibility of our elected
congressional officials who are supposed to be our surrogates is
unconscionable.

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



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Problems With State Health Insurance Exchanges

December 17, 2012
inMedicine: Healthcare System, Stakeholder Mistrust
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Stanley Feld M.D.,FACP,MACE

December 15th was the deadline
for states to sign up to implement state health insurance exchanges.

President
Obama was hoping all 50 states would agree to set up and implement health
insurance exchanges.

Health
insurance exchanges might be able to dis-intermediate the healthcare insurance
industry. They might also cause the insurance industry to leave the healthcare
business.  

If that happens President
Obama would not have anyone to provide administrative services for Medicare and
Medicaid.

Why
would President Obama be interested in expanding a failed entitlement program
such as Medicaid? Medicaid is bankrupting the healthcare system.  States would 
go deeper in debt if they try to implement health insurance exchanges.
In order to survive states would have to increase state taxes.

Businesses
and people are leaving California in droves because of the real effective tax
rate will be over 60% of gross income on January 1, 2013.  

Governors
realize their state can have a competitive advantage over others in  attracting corporations to move to their state
if they balance their budget. They are trying to avoid this federal government
disaster. 

Over
60% of the population is opposed to Obamacare.  

States
refusing to set up state health insurance exchanges are reflecting public
opinion.

President
Obama’s goal should be to improve entitlement programs such as Medicare and
Medicaid so that the programs would save money and improve the healthcare
system.

 “Even
President Obama has recognized Medicaid is broken," says Mike Schrimpf,
spokesman for the Republican Governors Association. "For many states,
placing more individuals into a broken system would be like adding more
passengers to the Titanic. And regardless of whether it's federal dollars or
state dollars, taxpayers are still on the hook."

A total of 30 states are leaning toward rejection
of the health insurance exchange concept. Only 17 states plus DC have agreed to
run a health insurance exchange.

The federal government will have to set up 30
health insurance exchanges. The latest reports are the administration is not
prepared to set up run the exchanges.

“As
of November 19, 2012, seventeen states, NY, MA, RI, NH, DC, KY, DE, W VA, MS.
NM, CO, CA. OR, NV, MN, WA, and HI have declared their intention to establish a
State-based Exchange (SBE).”

After my recent articles about health insurance
exchanges several readers asked why the health insurance exchanges were a bad
idea from a state’s point of view.

There are many reasons:

 1. States are under
no obligation to create a health insurance exchange that could create a large
financial burden to the state and its citizens. A Supreme Court ruling has given
states that option.

2.  14 states have
enacted either statutes or constitutional amendments (or both) forbidding state
employees to participate in an essential exchange function. It made operating
Obamacare illegal in the following states; Alabama, Arizona, Georgia, Idaho,
Indiana, Kansas, Louisiana, Missouri, Montana, Ohio, Oklahoma, Tennessee, Utah,
and Virginia

States passing these amendments was by a state was part of
the strategy to reject Obamacare.

 3. State governors
estimated that health insurance exchanges would cost the state $10 to $100
million dollars a year. State constitutions prohibit budget  deficits. Health insurance exchanges would
necessitate increased taxes.

Increasing taxes has a negative effect when states are trying
to lure businesses. i

4. Deadlines have continually been delayed. Concrete rules
and regulations have not been published. Uncertainty prevails as if a trap is
going to be sprung on the states.

 President Obama has
not yet provided the crucial information for
states to make an intelligent decision about setting up a health insurance
exchange. President Obama wants the states to trust him, sign up, and then
accept federal regulations.

5. States have been given the option to create health
insurance exchanges at a later date. Some state politicians fear the loss of
federal funds. Others see the federal funds as a carrot that will cost their
state more in the long run.

6. In the preliminary rules the “state-created exchanges”
are not controlled by a state-controlled exchange.
The exchanges are to be controlled by rules created by the Obama
administration.

7.  President Obama has authorized payment to the states
for start up costs and expenses for Medicaid Expansion until 2017.

Congress has not authorized these
funds. President Obama might not be able to get the funds from congress to fund
the states’ health insurance exchanges.

The states’ would be stuck with
the bill.

8. State officials responsible for setting up the exchanges
believe Obamacare will fail. Many feel it will increase private insurance
premiums and deny assess to care.

These state officials do not want to take the blame for this
disastrous mess that they have no control over.  

9. President Obama’s ultimate goal is to create a “Public Option”
and then have the federal government control all the stakeholders in the
healthcare system.  His ultimate goal is
to have a single party payer system.

State governors understand that public outcry will stop it.
States want to control their own destiny.

10. If the federal government must set up health insurance
exchanges because the state refuses, the Obamacare law as written exempts a
state’s employers from the employer mandate of $2,000 per employee per year.

The Supreme Court called the mandate a tax but everyone
knows it’s a mandate.

11.  If the states
avoided the mandate and save $2,000 per state employee it would put the state
at a competitive advantage to improve the prospect for job creation. It would
protect individual and states rights. It would protect some tenants of
religious freedom that Obamacare ignores.

 There is no evidence that Medicaid is
cost effective, that medical outcomes are improved or that access to medical care
for the poor would improve.

“There is scant reliable evidence that Medicaid improves health
outcomes, and no evidence that it is a
cost-effective way of doing so.” 

In the short term it has been predicted that healthcare insurance premiums for the
middle class will increase by 50% and access to medical care will decline.

State health insurance exchanges
will result in higher state taxes, fewer jobs, and less protection of religious
freedom. States are better off defaulting to a federal exchange.

Neither the states nor the federal government has the money
to expand Medicaid.

Theoretically,
health insurance exchanges are a good idea. Practically, they are not.

If all states refuse to set up health insurance exchanges
and avoid falling into President Obama’s trap Obamacare will be doomed.

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

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An Unintended Consequence of Obamacare.

December 12, 2012
inDisinformation and the healthcare system, Medicaid, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP,MACE

As we get closer to full implementation of Obamacare in 2014 corporations
such as Wal-Mart are figuring out ways of avoiding healthcare insurance
coverage for their employees.

Darden Restaurants, owner of Olive Garden and Red Lobster,
and a New York-area Applebee’s franchise owner has
announced that they will limit hours worked to under the thirty hours a week
threshhold. They will simply hire more employees who will work less than thirty
hours a week.

It will
mean that those workers will be forced to work two jobs if they can. With the
unemployment rates remaining high this might be difficult.

“iNew Obamacare rules that require companies
with at least 50 full-time workers to offer health coverage to all employees
who work 30 or more hours a week or pay penalties.”

However,
these people might not be eligible for Medicaid coverage under Obamacare.

The
definition of eligibility depends on the state rules. HHS just announced rules
for Medicaid expansion. The goal of these “Medicaid Expansion Rules” is to
force states to participate in the expansion of Medicaid.

States must increase Medicaid eligibility to 133% of the poverty level in
order to receive 100% of
the matching federal funds made available under Obamacare.  A state will receive mating funds from January
1,2014- January 1,2017.

After
January 1,2017 the states are on their own. The increase in enrollees will
become a huge burden.

President Obama is counting on the states to
assume the cost of Medicaid as he has the CBO calculate his fictitious scoring
on the cost of Obamacare.

The Federal Poverty Level was defined inaccurately in 1955. The U.S.
still uses the 1955 criteria.

133% Federal Poverty Level for one person means an annual income of $14,856.
For a family of four it means $30,657.

Many states have poverty levels above the nationally defined levels. In Indiana
the eligibility level for Medicaid is an annual income below $63,000 for a
family of four.

An independent
restaurant owner and caterer, in the smallish town of McKinney Texas, employs
55 people full time.  He told me he is
going to have to fire 6 people in order to avoid the Obamacare rule. He must
also reduce hours worked to below 30 hours per week.

He must
also contract his business rather than expand it.  He cannot afford the $110,000 Obamacare penalty.

Wal-Mart is the nation’s
largest private employer. Wal-Mart employs 1.4 million workers.

It plans to begin denying
health insurance to newly hired employees who work fewer than 30 hours a week
starting January 1st 2013 to avoid the Obamacare penalty for not
providing healthcare coverage for employees.

Wal-Mart also reserves the
right to eliminate health care coverage for employees whose hours drop under 30
hour per week.

Tom Billet
a senior consultant at Towers Watson said,

”Some of his clients were planning to track workers’ hours
more carefully. “I expect health plans like Walmart’s won’t be uncommon as
firms adjust to this law.”

 Wal-Mart’s decision to exclude
workers from its healthcare plans is an attempt to limit costs while taking
advantage of Obamacare.  Obamacare is
going to have to expand Medicaid coverage well beyond 31 million people.

Many of Wal-Mart’s employees would qualify for the expanded
Medicaid program.

Wal-Mart would rather pay the $3,500 penalty than pay $12,000 to
$18,000 dollars a year healthcare insurance premium for their employees.

There are many other companies that are going to follow suit such
as McDonald’s, Burger-King and thousands of others that got waivers from
President Obama for Mini-Med healthcare coverage.

Mini Med healthcare coverage is in reality zero healthcare
insurance coverage. It is a giant rip off of people making minimum wage.

“Walmart is effectively
shifting the costs of paying for its employees onto the federal government with
this new plan, which is one of the problems with the way the law is
structured,” said Ken Jacobs, chairman of the Labor Research Center at the
University of California, Berkeley.

“Medicaid Expansion” is a big joke. The uninsured workers will increase
from 31 million to some higher number when companies drop healthcare insurance
coverage and pay the penalty.

“The Supreme Court ruled earlier this year
that the decision to expand the Medicaid program is voluntary for the
states. At least eight states, including Texas, have said
they will not expand the program,’ 

At present before “Medicaid Expansion” the entire Medicaid program is
unaffordable. Medicaid cost will now escalate. President Obama will not be able
to afford to keep his promise to the poor.

States realized President Obama has set them up to get stuck with the
increased Medicaid cost. States are not signing up for the “Medicaid Expansion“
even though they would like the matching federal funds.

The nation’s governors were told,

“States that don't expand
their Medicaid rolls to include residents at 133% of the federal poverty level
won't get 100% of the matching federal funds made available under the Patient
Protection and Affordable Care Act (Obamacare).

The unintended consequence of large employers and corporations not
covering their employees with healthcare insurance is escalating.

Who is going to qualify for Medicaid? Who will get stuck being uninsured?

The poor people earning an annual income of less than 133% Federal
Poverty Level will qualify for Medicaid coverage. 

Anyone earning a penny more than the Federal Poverty Level will be rejected
and not qualify to receive Medicaid coverage.

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

 

 

 

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Price Competition for Medical Care

December 9, 2012
inDisinformation and the healthcare system, Healthcare Insurance Industry, Innovations in Healthcare, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld
M.D.,FACP,MACE

Thank goodness many physicians are starting to recognize the problems of abuse
and waste in government run healthcare programs.  The run up in cost is secondary to the
healthcare insurance industry taking 40% of the healthcare dollars off the top
as patient care dollars and the hospital systems over inflating the costs to
patients because of inflated operating expenses and administrative salaries.

Physicians realize that an efficient free market system will reduce the
cost of care. Physicians are tired for being blamed for the entire healthcare
systems problems. They do not deny being part of the problem.

Many physicians have decided to move forward and develop consumer driven
free market systems of care. 

One example is Nextera Health in Longmont Colorado. I have discussed this
previously.

Nextera Healthcare
is a new model for delivering primary care at an affordable price. It follows
many of the principles embodied in my ideal medical savings account
model.  Nextera delivers compassionate care at an affordable cost and
encourages patients to be responsible for their health.

Nextera
Healthcare services all of a families needs at an affordable monthly cost. It is
combined with a high deductible healthcare insurance plan to cover costly
illness.  

The
reason I am so high on Nextera Healthcare is that it closely fits a model of
healthcare delivery that will work to decrease the cost of medical care. It
will increase the quality of medical care and permit primary care to be a
viable specialty. 

Nextera Healthcare has the potential to permit the patient
to be responsible for managing their health and their healthcare dollars.

Nextera
Healthcare has the potential to reduce healthcare cost to individuals, employer
sponsored self insured plans, associations and even government funded
healthcare plans while permitting consumers to make their own healthcare
decisions.

Surgeons are developing their own innovative systems.  In free standing surgery centers they are
developing surgical procedures that cost at least 70% less than Medicare is
paying hospitals for the same procedure.   

 Dr. Keith Smith, co-founder and managing
partner of the Surgery Center of Oklahoma, took
an initiative that would only be considered radical in the health care
industry.

Dr. Smith posted a
list of prices online for 112 common surgical
procedures. Dr. Smith ,an anesthesiologists, became disillusioned about how
patients were treated and charged at St. Anthony Hospital in Oklahoma City.  

Dr. Smith’s goal
was to create a for-profit facility that could deliver first-rate care at a
fraction of what traditional hospitals charge. The goal was to eliminate the
hospital and healthcare insurance industry as the middlemen while decreasing
the cost of surgical care without decreasing the quality of care.

He wanted to create a system in which consumers and their employers
could receive surgical value at an affordable price. In the existing healthcare
system patients have no incentive to look for dollar value.

A healthcare system in which consumers buy goods or services from a
physician, surgeon or hospital systems all being paid for by the healthcare
insurance industry or government does not constituent incentive for consumers
to seek value and quality.

The lack of patient responsibility and value hunting is one of the major
causes of exploding U.S. heath care costs.

Physician owned transparent Surgery Centers are becoming increasingly
common as Americans look for alternatives to the traditional health care market
which is unaffordable and out of reach.

Consumer-driven models are appearing as fewer people have healthcare
coverage from their employers and are on their own

The unintended consequences of Obamacare are creating more uninsured not
less. The Medicaid insurance coverage that Obamacare is offering is
unappealing.

Patients may have no choice but to look outside the traditional health
care industry in the face of higher costs and reduced access to doctors and
hospitals. It is only going to get worse as we get deeper into Obamacare.

The Oklahoma Surgery
Center demonstrates that it’s possible to offer high quality care at low
prices. Surgeons can do twice as many surgeries in an outpatient surgery center
than they can in a traditional hospital surgical suite.

Most industries
try to improve efficiency. However, simple efficiencies have not occurred in
most traditional hospitals. Surgeons spend half their time waiting for the
patients to come to the operating room or for the availability of operating
rooms and equipment.

The Surgery
centers have solved these efficiency problems. They can service surgeons’ needs
at less than half the cost without the wasted time.

A key reason is
there are not multiple administrators creating multiple regulations and
collecting multiple $500,000 to $3 million dollar a year salaries. Surgical
centers have one head nurse responsible for everything and zero administrators.

The cost of a “complex
bilateral sinus procedure” at the Surgery Center was an all-inclusive $5,885.
The traditional hospital bill totaled $33,505 without the surgeon’s and
anesthesiologist’s bill included.

It was discovered
at the time of the nasal surgery that the hospital charged $360 for a
dexamethasone injection. A dexamethasone injection cost the hospital $.75.

 A fentanyl shot which is a pain-killer cost the
hospital system $1.50 but the bill to the insurance company was $630.00 dollars.
Everyone has heard of the $45.00 hospital aspirin   

A traditional
hospital discounted non-inclusive bill to the healthcare insurance industry for
a carpel-tunnel release would be $7,452. The fee for the procedure pre-op is
not be available. The same procedure done for the all-inclusive transparent
cost at the Surgery Center was $2,775.

More tragic was
that the patient would have had to pay $5,299 out-of-pocket  to cover her deductible and co-pay for the
hospital bill before she even received the bills for physicians’ services. 

Below are some
examples of the differences in costs for procedures.

 
Transparency-Matters-larger jpg
A list of the surgical fee for the Oklahoma Surgery Center is on its web
site. http://www.surgerycenterok.com/pricing.php

How do hospital systems get away with this?

The more the hospital bills the more the insurance company puts in reserve.
The reserves are in the medical costs column and include the non-discounted
costs. The result is greater profit for the insurance company.

President Obama does not want physicians to be innovative in this way.
He wants physicians to be dependent employees of hospital systems. His goal is
to control physicians and dictate their medical care.

President Obama has provided some non-transparent favors to hospital systems
that are forcing physicians to be employed by hospitals. 

"A new provision buried in Obamacare effectively prohibits doctors from starting their
own hospitals or expanding the hospitals they already own, which has been
widely interpreted as a give-away to the American Hospital Association."

Hospital systems claim they must charge more to cover their overhead and
bureaucratic inefficiencies. So fix your system. Surgery centers have.

Dr. Smith says: "Everyone can
see what the prices are at the Surgery Center, and that affordable health care
is possible. So the jig is up.”

Dr. Smith believes that despite the obstacles being put in the way by
Obamacare, market-driven facilities like his will thrive and proliferate as
consumers catch on to costly collusion between big government and big health
care.

I totally agree. As Obamacare’s unintended consequences proliferate
consumers and captured physicians (hospital employed) will pay more attention
to physician innovation. The jig for big government and big healthcare will
certainly be up.

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

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It Is All About Trust

November 4, 2012
inDisinformation and the healthcare system, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley
Feld M.D.,FACP,MACE

I
voted for President Obama in 2008 because he promised us hope and change. I
knew little of his past or present ideology. He was an attractive candidate and
promised hope.  The New York Times never
went into depth about his past, past interests or past performances.

Americans
trusted him and voted for him. He looked like and acted like the candidate of
hope. I trusted him to lead America on the right path.

President
Obama has done so many things wrong in the last 4 years that it is amazing to
me that anyone trusts him today.

Yet
he even said in one of his stump speeches “you
know me and you know you can trust me.”

Immediately
after his inauguration America was confronted with an $800 billion dollar
stimulus package that promised to produce millions of shovel ready jobs. 

There
weren’t many shovel ready jobs. He baled out some companies and not others. All
the bale outs were at taxpayer expense.

This
stimulus package provided lots of money to increase the size of government. In
fact, President Obama used a sizable about of this money to build a government
bureaucracy for a healthcare bill that was yet to be written.

A
few things developed that made me suspicious of President Obama’s ideology.  President Obama is dedicated to big
government and big spending even though it is inefficient and not directed
toward its original goal.

I
have not been a fan of John Maynard Keynes since I read Fredrick Hayek ‘s “Road to
Serfdom.” 

FDR
did not spend his way out of the depression. World War II got us out of the
depression.

Keynesian
economic has not worked. President Obama was clearly putting us on a “Road to
Serfdom” with his out of control spending and increased national debt by over
$4 trillion dollars.

President
Obama has made many annoying moves in the last four years to fake out the
American public.

Common
denominators have been a lack of transparency, a disregard for the legislative
branch of government and an overuse of executive orders.

Recent
lack of transparency is illustrated by Fast and Furious and the tragic Benghazi
tragedy.

The
mainstream media’s coverage has been disgraceful.  http://query.nytimes.com/search/sitesearch/#/Bengasi%2C+Libya+consulate/

Other
annoying actions have been the transfer of power from the congress to the
executive branch and the intimidation of the Supreme Court.

It
seems that he either ignores the constitution or gets around its meaning in
some way. The notion that the constitution is an antiquated document is
offensive and appalling.

The
media as been manipulated by the way events and facts are presented.  November 2nd unemployment results are an
outstanding example.

Americans
have been conditioned over the years to get their news from sound bites and not
detailed facts. Whichever sound bite is present the most times becomes the
fact.

The
economy is not doing well. It is growing at a very slow pace. Job growth is
slow. The presentation of the monthly data is confusing.

The November 2 unemployment
headline was; “Latest Jobs Report Shows Persistent Economic
Growth.”

 The first sentence was there were 171,000 new
jobs in October. The economy needs 500,000 new jobs per month for a normal recovery.

Consumers
still cannot get jobs, credit or loans from banks.

The
last sentence in the press release stated that unemployment rate rose from 7.8%
to 7.9%. No one remembers the last sentence

Since
the media is the message and 171,000 new jobs sounds like a big number that is
better than expected. It gives the illusion that the economy is improving on
President Obama’s watch.

Americans are not
stupid. The New York Times is trying much too hard to get President Obama re-elected.

President
Obama has generated mistrust by Americans for the promises he made about Medicare
and Obamacare. The amount of money spent, so far, by the President Obama on
Obamacare is not available to the public.

The
analysis of the increase in middle class taxes already in place as a result of
Obamacare are not discussed by the main stream media nor by President Obama.  

There
are 10 hidden taxes on citizens making less than $250,000 a year i.e. the
Medicare payroll tax. This tax is going up from 2.9 percent to 3.8 percent. There is an additional 3.8
percent Medicare tax added to investment income. Together, this will cost
taxpayers $318 billion from 2013 to 2022. These taxes were not obvious to the
great majority.

The
impact of future Obamacare taxes on the middle class is going to be
overwhelming. The new taxes were written into Obamacare but not presented to
the public. This serves to increase the mistrust for President Obama and his
promise for transparency.

The
one thing I learned from Hayek is that you cannot manipulate the economy by
edict or force without limiting freedom. In a “free” society “ the unintended
consequences and costs are certain to get out of control.

Costs
can be controlled in a level playing field competitive free market. The
consumer driven market is non-existent. Consumers must start to understand
their power in society.

Government
should make rules that level the paying field for all and then get out of the
way. No spinning the facts and no non-transparent activities. No favoritism to
lobbyists, associations or unions.

Rules
should be made for the benefit of the people in a competitive environment.

Medicare
premiums and deductible expenses for senior will raise not decrease as promised
by President Obama. Out of pocket expenses will rise.

Seniors’ standard Medicare
Part B monthly premiums will jump from $99.90 to $128.20 at the low end of the
means testing while their Part B deductibles will rise from $140 to $180. Seniors’ Medicare hospital deductible on admission will
increase from $1,156 to $1,336, while their daily hospital
coinsurance will climb from $289 to $334 in out of pocket expenses.

I
have pointed out that Obama care’s main feature, ACO’s, will be impossible to
execute and will subsequently fail. This will lead to greater distortions of
the healthcare system.

The
result will be a decrease in choice, a decrease in the freedom to choose your
physicians or recommended care, a decrease in access to care and rationing of
care once the government has total control.

This
does not included increases in costs to seniors and the middle class that has
been scheduled by Obamacare.   

All
the stakeholders have taken advantage of the healthcare system in its present
form. The stakeholders are the healthcare insurance industry, the hospital
systems, the government, the patients and the physicians.

The
healthcare system needs a new business model in order to survive. President
Obama’s business model is not the one. The public does not trust it.

The
actions of the stakeholders are natural as these stakeholders try to survive.

 It is government’s job to make the rules so
these dysfunctional survival methods cannot flourish.  

President
Obama cannot be an effective leader in the future. The public does not trust
him any more.

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

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Twisting the Facts About Health Care

October 24, 2012
inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP,MACE

I have been a New York Times reader since 7th grade. At
that time I delivered the New York Times to all the classrooms in my Junior
High School.

The New York Times has become pretty shabby in recent
years. It has stopped printing unbiased news. It does not print,  “All
The News Fit To Print.”

It has been publishing biased news, news leaks as well as
opinions that have contained innuendo and not based on facts.

A glaring example is the healthcare editorial on Sunday October
21,2012.

The New York Times is trying very hard to help defeat
Mitt Romney and push President Obama over the finish line.

I hope intelligent readers can see through the Times’
smokescreen of no facts and evaluate the candidates objectively.

The editorial’s first sentence is absolutely correct.

“The outcome of the presidential election will determine which of
two opposing paths the nation will follow on health care for all Americans.”

One
path represented by Obamacare is a path of government takeover of healthcare.
It will convert the healthcare system totally to an entitlement system.  The government will make the rules and create regulations.
Many will be difficult to follow and impossible to enforce.

This
path leads to restriction of freedom of choice, rationing and a decrease in
access to healthcare.

Americans
did not expect this option when they elected President Obama.

It
is easy to remember the sound-bite, “ If you like your present
insurance you can keep it. If you like your physicians you can keep them.”

His
campaign principles were vague. His promises were broad brushstrokes of
policies and not a specific outline of policies. At the end of these vague
promises was the appealing promise of affordable healthcare insurance coverage
for all.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/09/is-medicare-an-effective-bureaucracy-part-1.html

It
turns out that after four years healthcare insurance coverage has become more
expensive. There is no relief in sight. All Americans are subjected to 10
hidden taxes that in effect increases the cost of healthcare insurance
coverage.

America
has passed a 2400 page bill that few read and fewer understand. The bill has
generated over 44,000 new regulations so far and massive new government
bureaucracies.

The
bill was supposed to decrease the cost of healthcare by over $125 billion
dollars during the next ten years.

It
is now estimated to cost taxpayers an additional $1 trillion dollars over ten
years.

The
New York Times editorial goes on to say:

“If voters re-elect President Obama, he will
protect the health care reforms that are his signature domestic achievement.”

It
sounds like the New York Times believes this is a good thing. My guess is the
Times is not a very good judge of sound business practices because it is itself
on the verge of bankruptcy.  Obamacare is
unsustainable and destined to drive America into bankruptcy.

So
far President Obama has done nothing to decrease the number of uninsured and
nothing to decrease the cost of care. In fact the cost of care has escalated as
patient deductibles have increased, premiums have increased and the quality of
employer coverage has decreased. Employer sponsored healthcare insurance
coverage is expected to decrease further in the next two years.

The
New York Times editorial goes on to state:

“If they elect Mitt
Romney, they will be choosing a man who has pledged to repeal the reform law
and replace it with — who knows what?”

The biggest defects in today’s healthcare system are ;

1. It does not encourage individuals to be responsible for the
maintenance for their own health

2, it does not give consumers control of their healthcare dollars
or incentives to preserve those dollars.

3. It does not discourage the practice of defensive medicine with
effective tort reform.

4. It does not create a competitive healthcare market that must
become consumer driven in order to control costs.

The New York Times invites us to visit Mitt Romney’s web site
after this biased preamble:

“The competing visions are often difficult to evaluate because the
Republican candidates — Mr. Romney and his running mate, Paul Ryan — have
become so artful about obfuscating their plans for Medicare, Medicaid and what
they will do to reform the whole system.”

I went to the web site to see what Mitt Romney’s plan is. He has
very specific proposals in his healthcare plan. The proposals could Repair the
Healthcare System if implemented correctly.

I imagine the New York Times did not pay attention to any of the
words in the plan because they are drinking President Obama/Mr. David Axelrod’s
"Kool Aid."

The Times tells us in the very next sentence;

“Almost nothing the Republican candidates say on these or other
health care issues can be taken at face value.”

I would say this is not objective reporting.

What is Mitt Romney’s healthcare plan? I would like readers to
read it carefully and judge for themselves.

He first explains the Obamacare failures. The failures are
important to keep in mind because Obamacare has been shoved down the mouth of
Americans.

OBAMA'S FAILURE

Unfortunately,
the transformation in American health care set in motion by Obamacare will take
us in precisely the wrong direction. The bill, itself more than 2,400 pages
long, relies on a dense web of regulations, fees, subsidies, excise taxes,
exchanges, and rule-setting boards to give the federal government extraordinary
control over every corner of the health care system. The costs are
commensurate: Obamacare added a trillion dollars in new health care spending.
To pay for it, the law raised taxes by $500 billion on everyone from
middle-class families to innovative medical device makers, and then slashed
$500 billion from Medicare.

Obamacare
was unpopular when passed, and remains unpopular today, because the American
people recognize that a government takeover is the wrong approach. While
Obamacare may create a new health insurance entitlement, it will only worsen
the system’s existing problems. When was the last time a massive government
program lowered cost, improved efficiency, or raised the consistency of
service? Obamacare will violate that crucial first principle of medicine: “do
no harm.” It will make America a less attractive place to practice medicine,
discourage innovators from investing in life-saving technology, and restrict
consumer choice.

In short,
President Obama’s trillion dollar federal takeover of the U.S. health care
system is a disaster for the federal budget, a disaster for the constitutional
principles of federalism, and a disaster for the American people.

MITT'S PLAN

On his
first day in office, Mitt Romney will issue an executive order that paves the
way for the federal government to issue Obamacare waivers to all fifty states.
He will then work with Congress to repeal the full legislation as quickly as
possible.

In place
of Obamacare, Mitt will pursue policies that give each state the power to craft
a health care reform plan that is best for its own citizens. The federal
government’s role will be to help markets work by creating a level playing
field for competition. 

Restore
State Leadership and Flexibility

Mitt will
begin by returning states to their proper place in charge of regulating local
insurance markets and caring for the poor, uninsured, and chronically ill.
States will have both the incentive and the flexibility to experiment, learn
from one another, and craft the approaches best suited to their own citizens.

  • Block grant Medicaid and other payments to
    states
  • Limit federal standards and requirements on
    both private insurance and Medicaid coverage
  • Ensure flexibility to help the uninsured,
    including public-private partnerships, exchanges, and subsidies
  • Ensure flexibility to help the chronically
    ill, including high-risk pools, reinsurance, and risk adjustment
  • Offer innovation grants to explore
    non-litigation alternatives to dispute resolution

Promote
Free Markets and Fair Competition

Competition
drives improvements in efficiency and effectiveness, offering consumers’ higher
quality goods and services at lower cost.  It can have the same effect in
the health care system, if given the chance to work.

  • Cap non-economic damages in medical
    malpractice lawsuits
  • Empower individuals and small businesses to
    form purchasing pools
  • Prevent discrimination against individuals
    with pre-existing conditions who maintain continuous coverage
  • Facilitate IT interoperability

Empower
Consumer Choice

For
markets to work, consumers must have the information and the power to make
decisions about their own care.  Placing the patient at the center of the
process will drive quality up and cost down while ensuring that services are
designed to provide what Americans actually want.

  • End tax discrimination against the individual
    purchase of insurance
  • Allow consumers to purchase insurance across
    state lines
  • Unshackle HSAs by allowing funds to be used
    for insurance premiums
  • Promote "co-insurance" products
  • Promote alternatives to "fee for
    service"
  • Encourage "Consumer Reports"-type
    ratings of alternative insurance plans

 

Mitt Romney’s plan is an outline of his healthcare plan that
corrects all of the defects in our healthcare system. Obamacare has amplified
the healthcare system’s defects.

By giving states the opportunity to select a waiver from Obamacare,
Governor Romney is eradicating all the new taxes, regulations, bureaucracy, and
impingement on individual choice, individual freedoms and access to care
issues. He is also opening the door for subsidized healthcare coverage for
those in need.

It is much more specific than the plan President Obama presented before
his election in 2008. I have reviewed my articles on his proposals. President
Obama disguised his real intentions. He made it sound much better than he
intended. If one reads between the lines it is clear President Obama wanted the
federal government to control the healthcare system.

The blog post from 2008 make interest reading. Please click on
them.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-1.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-2.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-3.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-4.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-5.html

President Obama is the pot calling the kettle black.

Government Romney puts the consumer first, not the government. His
plan also strengthens states rights which have been severely discounted during
his term in office. The states can be a little more efficient that the central
government.

President Obama has presented nothing about his healthcare plan
during his reelection cycle,

Many of the regulations have not been written yet. President Obama
is waiting until after the election when “he
will have more flexibility. ”

Please remember I voted for him in 2008. President Obama has been a
tremendous disappointment to me. He does not understand the American psyche and
is ignoring Americans’ wishes.

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

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Individual Freedom – Stand for it now or lose it forever.

October 2, 2012
inMedicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

 
 Stanley Feld M.D.,FACP,MACE

I have spoken to and corresponded with many practicing physicians about
Obamacare. A universal sense among physicians is Obamacare is closing in on
their freedom to make clinical judgments and care for their patients in the
best way.

President Obama claims to be promoting best practices but the sense is
the results of Obamacare will be bad for them and their patients.

Some physicians have taken a defensive position and sold their
practices to hospital systems. They are willing to let the access to care and
the rationing of care become a problem the hospital systems will deal with.

Many of those physicians have forgotten the mistrust they have had for
the hospital systems in the past.  

Intuitively, physicians understand that hospital systems will take
advantage of their intellectual property and technical skills for the hospital
system’s benefit and profit.

The physicians who have joined hospital systems are hoping they will
make an adequate living and have less aggravation. They will be sheltered from the
government, the healthcare insurance industry and patients.

I believe those physicians will be surprised when they realize they
will be serfs of the government, the healthcare insurance industry and the hospital systems.

I have read some awful contracts physicians have signed with hospital
systems.

Physicians know the winner under Obamacare will be the government and
its quest for control over the healthcare system.

They also know that the healthcare insurance industry knows how to
control the government and its spending thereby increasing its profits. The
government is totally dependent on the healthcare insurance industry for its
administrative services.

Hospital systems are afraid they will not receive what they consider
their corporate share of the government largess.

Many physicians feel Obamacare is a government ploy claiming to reduce the cost
of medical care to the detriment of patients and physicians under the guise of
improving the quality of healthcare. President Obama is ignoring the underlying
problems.

Most physicians are not political activists. They also do not
understand their enormous political power. Patients, government, hospital
systems and the healthcare insurance industry desperately need physicians as
their workforce. 

If one physician has 2,000 patients in his practice he has 2,000 that
like him and approve of his care. These patients will listen to him.

Few physicians explain the coming threat of Obamacare to the practice
of medicine to their patients.

David McKalip, M.D., Neurological
Surgeon, wrote the following letter to his physician friends for them to distribute
it to their patients. The distribution does not take much of physicians’ office
time.

The threat to patient care is discussed
well.

Every physician and his patients
should distribute the letter to their entire email list.

President Obama is trying hard to
distract both physicians and patients from the effects of his horrible law. He and
the press do not want to talk about it with only 6 weeks to his possible re-election.

All that has to be done is to copy and paste the letter and email or give it to
your patients and friends.

Feel free to copy and paste the entire blog to include my comments. I believe this letter is appropriate one day before the first debate.

Hello all,

This is a
letter I will be sending out to my physician colleagues. I will then be placing
fliers in my waiting room supporting Romney and a large sign on my property.

The time is
now or never. Please take this letter and send it to your entire
referring list. The cost of the mailing will be worth it so you know you did
what you could….

David

Dear
Colleague,

I write you
at a critical time in American History as a dangerous threat faces the future
of our medical profession and our patients.

 I
am asking for your help to save medicine by reaching out to the only people
that can save it: your patients.  For most of my career I have
been working to protect our profession from control by the self-serving
interests of the government and insurance companies.

I have
greatly appreciated the often-quiet support of so many of you who could be
confident that I was working with many other medical leaders on your
behalf.  However, now I ask you to do something more:  to stand
up with me and so many others to ensure that American Medicine is
protected by electing Mitt Romney as President and stop President
Obama’s government and corporate takeover of medicine.

It is
certain that a President Romney won’t be perfect, but at least he is someone we
can hold accountable.  President Obama and his administration have been
granted extraordinary powers by Congress to implement Obamacare in any way they
see fit through rule-making authority – they will keep coming after doctors.

Obamacare is
a bridge too far for medicine and must be stopped now so we can implement
better reform that drives down costs, and truly improves access and quality (as
offered by the Florida Medical Association).

So I will
ask you to speak directly to your patients and do something that is rarely
warranted – advocate that they elect Mitt Romney President. 
Such dramatic actions should only occur in historic times like these; but we
must take action now while we still can.

Here are the
messages I would ask you to give to your patients.

Obamacare will ration the health care you deserve.

1.   
Rationing
will occur through a panel of 15 unelected bureaucrats called the Independent
Payment Advisory Board (IPAB) set a budget for patients doctors
cannot go over when you need it (working through tens of thousands of
pages of Obamacare rules).

 
2.   
 Rationing
will occur by greatly strengthened private and government-run HMO’s that will
also place your doctors on a budget.

 

 
3.   
 Doctors
that provide the best care you expect will be penalized financially and
professionally.

4.   
Doctors will
be forced to report your private medical data to the government and then forced
into spending valuable patient care time on social behavior counseling such as
smoking, alcohol cessation and weight loss.

 5.   
 Doctors
will be intimidated into working for less, while spending more on complying
with regulations, until they finally have to leave practice. They will be
replaced by doctors that serve the government and insurance companies more than
patients.  Doctors you can’t trust.

 
6.   
 Government
bureaucrats will have the power to assign you to a new doctor with a history of
spending less money on their patients.

 
7.   
 Obamacare
siphons $700 billion from Medicare through such rationing tactics –
a program that is running out of money in the Medicare Trust Fund since
Congress spent it on their pet projects.  Medicare will not be
changed for any patient over the age of 55 by Mitt Romney or Paul
Ryan. You will still have the benefits you expect.

 8.   
Medicare
will be saved for future generations by Mitt Romney by transforming it into a model that our children and
grandchildren can afford and that they own – not one that is owned by the
government that would ration their care and take their money from the Trust
Fund.

I know I am
asking a lot to ask your patients to vote for a particular candidate by using
your first amendment right of Free Speech. 

You can do
this by wearing a Romney button, putting up a campaign sign in your office,
printing out the bullet points from this flier and putting them in your waiting
room and asking them to vote for Romney. 

If you do not take this action now you will not have a chance to
do so again.  Will
you join me and help elect Mitt Romney?  Then I will go back to work
holding him accountable through organized medicine.

 

Sincerely,

 

David

David
McKalip, M.D., Neurological Surgeon 

Individual Freedom – Stand for
it now or lose it forever.

 Replace David's name with your name if you like

President
Obama has lied about Obamacare and bullied everyone in his path including the Supreme
Court.

Don’t let
him do it to patients and physicians. It is up to both physicians and patients
to make Dr.David McKalip’s letter viral by copying and pasting it and sending
it to your entire email list.

If you are a patient or potential patient please distribute this letter as well.

Thank you.

Stanley
Feld M.D.,FACP,MACE  

Individual Freedom – Stand for
it now or lose it forever.

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

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The Healthcare System in Switzerland Works

September 28, 2012
inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld
M.D.,FACP,MACE

Paul
Krugman is starting to drive me crazy with all his fact free declarations about
the healthcare system.

He recently declared that consumer driven healthcare has
been a bust everywhere it has been tried. Paul Krugman as an “expert” has once
again made a declaration that contradicts the facts. He is clearly not
interested in being confused by facts.

Paul Krugman is against putting consumers in
control of the healthcare system. He feels,
as President Obama feels, that a central committee (IPAB) should be in charge
of deciding what to do with limited health care resources. 

He has said,

 "Consumer-based" medicine has been a
bust everywhere it has been tried. Medicare Advantage was supposed to save
money; it ended up costing substantially more than traditional Medicare.

Medicare Advantage costs the government more
money because the government gave the private insurance companies a $3,000 bonus
per senior to get Medicare out of the government’s hands.

This is one of the principle reasons I am not a fan of
Medicare Advantage.

In reality Medicare Advantage provides more
services at lower premiums and deductibles for seniors. Seniors with Medicare Advantage use
fewer services resulting in a lower cost of total services and more profit for the
healthcare insurance industry.

“America has the most "consumer-driven" health care
system in the advanced world. It also has by far the highest costs yet provides
a quality of care no better than far cheaper systems in other countries.”

Paul
Krugman is wrong.  Switzerland has the
most consumer driven healthcare system in the world and the Swiss government
pays far less than most countries while the Swiss get a high quality of care.

His ideology
blinds his mind. The healthcare system in Switzerland is a consumer driven
healthcare system that works for the Swiss. The Swiss government makes the
rules and then gets out of the way.

The
Swiss healthcare system can be used to start a constructive conversation about
healthcare reform in America that can satisfy both conservatives and liberals
and save the U.S. from bankruptcy resulting from expanding entitlements.

The
healthcare system in Switzerland is a consumer driven healthcare system in
which consumers have choice. It has resulted in a low income tax rate,
universal healthcare, and satisfied stakeholders

The
Swiss system could not be totally transformed into an American system because
of America’s embedded ideology and prejudices as well as stakeholder vested interests.
However it outlines the government’s role in a healthcare system and highlights
the power of a consumer driven system.

America’s
healthcare system must undergo significant changes. Most of these significant
changes have been ignored by President Obama in Obamacare. It empowers
government and not the consumer.

Paul Krugman has stated flatly, "Patients
are not consumers"

“Patients get illness that others (government) should decide on
whether it is cost effective to treat.”

This
attitude toward patients points out the disrespect for the intelligence and
judgment of consumers.

The elements
critical to meaningful reform of America’s healthcare system must include the
following changes.

1.
There must be significant and meaningful Tort Reform to decrease the practice
of defensive medicine.

2.
There must be significant reform of the healthcare insurance industry’s
financial rules to stop the industry from listing non-direct care expenses as
direct patient care.

3.
There must be regulations to cause the healthcare industry to be competitive
for consumers’ business. Government should not be the consumer of healthcare.

4.
There must be legislation to change the healthcare insurance industry’s incentives
for profitability in order to create innovative healthcare insurance products
that will reduce healthcare costs.

5.
There must be significant financial incentives for consumers to be motivated to
save healthcare dollars.

6.
Consumer must responsible for their health and healthcare dollars. The
entitlement mentality must be eliminated.

7.
Hospital systems should be competing for patients’ healthcare dollars and not
government healthcare dollars.

8.
Physicians must be responsible to consumers and not hospital systems or the
government.

9.
Insurance costs must be community rated.

The
healthcare system must be a consumer driven system just as purchasing
groceries, automobiles, computers and televisions are. If the product is poor
the company will go out of business.

America’s goals should be universal healthcare
coverage with freedom of choice, and reduction of healthcare costs.

It is worth understanding the Swiss healthcare
system as a starting point to meaningful reform of the American healthcare
system. 

These are the major features
of the Swiss Healthcare System:

1.Swiss citizens
buy insurance for themselves.

2.There are no
employer-sponsored or government-run insurance programs.

3.Insurance
prices are transparent to the beneficiary and community rated.

4. The
government defines the minimum insurance benefit packages that must be offered.
 Everyone must have the minimum
healthcare insurance coverage.

5. All
packages require beneficiaries to pick up a portion of the costs of their care
(deductibles and coinsurance) in order to incentivize citizens to be
responsible for their health and the control of healthcare dollars spent.

6. My ideal
medical savings account would provide a positive incentive by rewarding
citizens who did not spend the first $6,000 dollar to keep that money in a
retirement account.

7. Patient
incentive is a critical element in healthcare reform because incentives provide
consumers with a reason to take care of their health and healthcare
dollars 

8.The Swiss government
subsidizes health care for the poor on a graduated basis, with the goal of
preventing individuals from spending more than 10 percent of their income on healthcare
insurance.

9. Citizens
can be responsible for a significant component of healthcare costs in Switzerland.

10. Consumers
often opt for the cheaper healthcare insurance packages. They have freedom of
choice.  Many Swiss consumers choice chose
minimal insurance plans combined with high-deductible insurance plans.

11. Citizens
are free to choose comprehensive insurance coverage or some form of
supplemental coverage. It is not a one size fits all system.

12. Ninety-nine
percent (99.5%) of Swiss citizens have health insurance.

13.There are
about 100 different private insurance companies in Switzerland with multiple
healthcare insurance plans.

14. It is clear
that the government has made the rules and then has gotten out of the way. The
rules have set up a market driven competitive healthcare system.

15. The result
has been that healthcare insurers are competing for consumers’ business on
price and service. Consumers gravitate to the best price and service that fits
their needs.

16. The Swiss
healthcare system not only helps to curb health care inflation but most
beneficiaries have complete freedom to choose their doctor.

17. The setup
of the system has resulted is low waiting times for physician and hospital
services with a minimum of bureaucratic slow downs. 

18. The Swiss healthcare
system aligns all the stakeholder incentives by empowering the consumer while
helping less fortunate consumers.

19. Government
spending on health care in Switzerland is only 2.7 percent of GDP, by far the
lowest in the developed world.

U.S.
government spending on health care was 7.4 percent of GDP in 2008 and will
exponentially grow under Obamacare.

 “ If the U.S. could move its state health spending to Swiss
levels, it would save more than $700 billion a year.”

Dr. Regina Hertzlinger has an excellent description of the
Swiss healthcare system in the following You Tube.


 

http://youtu.be/E5bsz_oewDA

Switzerland’s
healthcare system cannot be superimposed on the U.S. healthcare system. It can
be used as a starting point to empower consumers to drive the healthcare system
and be part of the solution. 

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

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  • insurance • November 12, 2012

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