Stanley Feld M.D.,FACP,MACE

The media is the message. President Obama controls the media and his messages come out loud and clear even if they are lies.

On the 50^th anniversary of Medicare and Medicaid President Obama said, “Obamacare is “finishing the job” begun by Presidents Kennedy and Johnson”.

President Obama also claims that, “the two federal health care programs are not in crisis, and those who say they’re in trouble are playing politic.”

This is the Saul Alinsky attack method to marginalize your enemies whether they are right or not.

“According to Obama, those who say “Medicare and Medicaid are in crisis” are doing so as “a political excuse to cut their funding, privatize them, or phase them out entirely.”

President Obama was the one that cut Medicare funding not his political enemies.

 No one wants to phase out Medicare or Medicaid entirely.

Sensible critics know both programs are not economically sustainable in their present form.

They are suggesting making the recipients of Medicaid and Medicare more responsible for themselves and their care in order to convert each program to an economically sustainable one.

President Obama is the one playing politics. He is using the media via his bully pulpit to proclaim his indefensible message.

Even Medicare actuaries and the Centers for Medicare and Medicaid Services – say both programs are “unsustainable.”

Anyone on Medicaid would be surprised to learn they are receiving “efficient, high quality care” with their difficulties in seeing a doctor and their rapid non-communicative visits.

It is not “efficient high quality care.” Price constraints do not permit efficient high quality care.

President Obama prefers to live in his own fantasy world about this issue as he does with most issues including the Iran nuclear bomb deal.

The current supposed percentage decrease in spending is fiction as I explained in my last post. The decrease in the percentage of the budget deficit is the result of an increase in taxes.

The advantage of tax increases without service increases is about to disappear. Then the budget deficit resulting from Obamacare will skyrocket.

Additionally there will be a doubling of the Medicare population as a result of the aging baby boomers. This increase will require combinations of benefit cuts, eligibility changes and cost-share increases.

All of these changes are occurring right now. Seniors who are aware of the changes only because they are presently receiving care are feeling it and are complaining. Soon a great percentage of seniors will begin complaining.

President Obama will have no hesitation to increase taxes and decrease payment to providers even further.

As baby boomers age into Medicare eligibility, a significant and growing proportion of doctors don’t accept Medicare patients. Many primary care physicians are becoming concierge doctors. They will only accept Medicare patients if the patients pays $2,000 to $30,000 per year to be a member of his panel. Medicare and Medicaid reimbursement is too low. Physicians have to see many patients to make ends meet.

 According to the nonpartisan Medicare Payment Advisory Commission, 29% of Medicare beneficiaries who were looking for a primary-care doctor in 2008 already had a problem finding one.

All of this is beyond President Obama’s vision even though it is happening right now.

Obamacare is causing private insurance to become unaffordable for the middle class.

Obamacare’s regulations on pricing and coverage have already forced termination of private health insurance for more than at least five million Americans in the individual insurance market.

The Congressional Budget Office is now projecting that as many as 10 million people will be forced off their chosen employer-based health insurance by 2021.

This increase represents at least a tenfold increase in the 2011 projections at the onset of the law.

“Numerous reports in the top medical journals like Cancer, American Journal of Cardiology, Journal of Heart and Lung Transplantation, and Annals of Surgery clearly show that patients with private insurance have better outcomes than similar patients on government insurance. It is highly likely that restrictions in access to important drugs, specialists and technology account for these differences.”

All one has to think of is the VA hospital system and its scandals to visualize the effect of government bureaucracy and its bureaucrats on a healthcare system.

Another example is the government bureaucracy’s inefficiency in building the web site for the federal health insurance exchanges.

Why are Americans not protesting? Why are Americans letting President Obama get away with destroying the healthcare system?

Medicaid’s problems are more complicated than Medicare’s problems as a result of Obamacare. I have a feeling the Democratic congress that voted for Obamacare is realizing they should have read the law and understood the law before they passed it.

Originally Medicaid was healthcare insurance for people receiving welfare. Obamacare expanded coverage to all people below 138% of the definition of poverty. In most states the yearly salary is below $38,000 per year.

The federal government originally subsidized the states at the 50% level for Medicaid costs. For the next year the subsidy is 100%. Then the federal government will decrease the matching rate to 90% and subsequently to 80%.

States cannot print money to cover their obligations. States must balance their budgets. One of the reasons thirty-seven (37) states opted out of the program is because they would have to increase state taxes even further. Somewhere along the way Medicaid coverage for the poor has to be revised. Medical care is poor and reimbursement is terrible. The poor cannot find doctors. It is unsustainable and medical care needs to be improved.

President Obama keeps on lying to the American public as he tries to protect his “legacy” legislation Obamacare. It has become a legacy history will prove he should not be proud of.

To declare on Medicare’s and Medicaid’s 50^th anniversary that both of these programs are not in crisis is a bold faced lie.

Medicare and Medicaid will decimate the federal budget unless something positive is done about these two programs.

Medicare and Medicaid in their present form will crowd out funding for vital priorities like national defense, infrastructure security and homeland safety while failing to deliver on their promises of quality health care at an affordable price for seniors and the poor.

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

Stanley Feld M.D.,FACP,MACE

In July 2015 in a speech on the economy at American University, Barack Obama  made the following statements.

“The cost of “health care is now the single-biggest factor driving down” the federal budget deficit.”

The American public is tired of listening to President Obama’s lies, mostly lies and half truths.

Politifact analyzes many of President Obama’s statements of fact and grades them with Pinocchio’s and scores these statements.

President Obama’s statements by ruling

• True               119         (21%)   (119)
• Mostly True   149          (26%)  (149)
• Half True       151          (27%)  (151)
• Mostly False    67         (12%)    (67)
• False                70          (12%)   (70)
• Pants on Fire     9             (2%)   (9)

Total                                    100%          565

Politifact determined that President Obama was telling the whole truth only 21% of the time.

He was mostly truthful 26% of the time. We have seen these mostly true statements over and over again.

A recent example is that he has not seen the private agreements in the Iran Nuclear Deal. He has not seen the agreement in writing but he has heard about it as John Kerry heard about it.

I consider this an act of deceiving the American public.

Half true, Mostly false, False and Pants on fire classifications add up to 53% of the time President Obama has used the bully pulpit of the President Of the United States to deceive the American people.

If you add the 26% of the mostly true statements to the rest of the deceptions you get an astonishing 79% of the time an attempt has been made to deceive the American public.

This brings me to President Obama’s statement at American University. “Obamacare is driving Down the Federal Budget Deficit”

Politifact gave this statement a mostly true.

The statement is mostly false in my opinion. The devil is always in the details. President Obama has mastered the details of deceptions.

“Partly because health care prices have been growing at the slowest rate in nearly 50 years, the growth in what health care costs the government is down,” Obama said in a speech about the economy last week at the American University.

The budget deficit is a result of revenue generated as compared to expenses. If a government spends more money than it takes in it has a deficit. The size of the deficit is a function of the deficit over the revenue. A deficit reduction from one year to another is that percentage difference one year to another. It is a percent and not a real amount.

A deficit reduction can result from many factors. One very important influence on the deficit is an increase in revenue resulting from an increase in Obamacare taxes. There has been a tremendous increase in taxes resulting from Obamacare. The effective tax rate as I have shown previously as a result of Obamacare is up to 50%.

Another influence on the deficit is a decrease in spending.

Medicare spending has decreased as a result of a very clever maneuver by the Obama administration. It claims it has increased reimbursement by around 2%.

Originally Medicare would pay 80% of the allowed reimbursement and the patients would be responsible for 20% of the fee allowed. The allowed fees have decreased. Fees previously allowed have been changed to non allowed fees.

Physicians’ claims for services might be for $200. Medicare might allow $80. Medicare would pay $64 and the patient or his Medigap coverage would be responsible for $16.

This has not changed. However the percentage of the claim allowed has been reduced and patients without Medigap insurance are responsible for the difference.

This is in addition to Medicare premiums and deductibles increasing yearly. Medigap premiums have also increased yearly.

Medicare recipients are experiencing greater out of pocket costs. Many cannot afford the cost and are not going to get medical care.

This has two potential effects. Office visit claims are reduced and Medicare payments are reduced. It decreases the deficit but could result in a sicker patient. Patient cannot afford the out of pocket expenses.

The result is Medicare experiences a decrease in the percentage it affects the federal deficit.

It could result in a valid decrease in office visits or an increase in sicker patients and higher Medicare expenses.

Obamacare might have helped decrease the resulting government deficit but it could result in increased spending in the future.

It did not result in better quality care.

All of this is very difficult for a casual observer to follow. Meanwhile, President Obama has established the media message that Obamacare is working to decrease the budget deficit.

Then pundits like Paul Krugman, can ridicule opponents of Obamacare for saying Obamacare will fail.

President Obama uses an argument that is a half-truth. However, it does not represent real numbers. He uses percentages.

In addition, many of the costs of Obamacare such as the web site and the website navigators are left out of the real costs of healthcare.

Other costs are left out of deficit reduction analysis such as the direct cost to the consumers and the direct loss of revenue to providers.

“Since the Affordable Care Act was first proposed, policymakers have been debating its potential effect not just on health care but on the economy as a whole. The bill effectively increases some types of spending, reduces other types and increases some taxes.”

Growth in national health spending, which had dropped to historic lows in recent years (deficit reduction), has snapped back and is set to continue at a faster pace over the next decade, federal actuaries said last week.

Senator Ron Johnson, member of the budget committee, discusses the real present and future costs of Obamacare. He also discusses President Obama’s misleading promises about Obamacare. Senator Johnson gives us a real understanding of the Obama administration’s manipulation of the facts.

https://youtu.be/gIN50dswlL0

Obamacare is a bad deal. It is destroying the medical profession. It is destroying the economy and America’s chances for economic growth.

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