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How Can I Be So Misinterpreted?

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Better Care Reconciliation Act (BCRA)

Stanley Feld M.D.,FACP,MACE

It looks like the Senate is making a mess out of its version (BCRA) of repeal and replace Obamacare.

My first reaction was that Better Care Reconciliation Act is a stupid name for a bill to repeal and replace Obamacare.

I have not heard a single specific criticism of BCRA by the Democratic leadership.

Nancy Pelosi said the bill will kill hundred of thousands of people. Hillary Clinton said it was a death bill. Chuck Schumer told the American people it is a terrible bill and leave millions uninsured. They all said it is going to make the rich richer and the poor poorer.

The evidence for these statements has not been presented.

Democrats have used these scare tactics so often that no one believes them anymore.

Americans are smarter than that.

Republicans have not explained the strategy behind BCRA in making the healthcare system better than Obamacare either.

All I have heard from President Trump is that it is a beautiful bill. It will make our healthcare system great.

If no one understands BCRA how can a media driven public poll with a 17% approval rate have any meaning?

The survey of public opinion is meaningless.

At present Obamacare has left 26 million uninsured and rising. It has only insured less than ten million people in the individual market.

Obamacare is also unaffordable. The deductibles are as high as $6500 before any insurance kicks in. People who buy the insurance have no insurance until they spend more than $6500.

I don’t understand the Senate Republicans who want a perfect conservative bill. They are not going to get it. They will yield the floor to the minority Democrats.

The turkey buzzards are circling the corpse already. The corpse being Obamacare and the Republican replacement

Elizabeth Warren said we must go to the next steps which is a single party payer system now.

I believe Obamacare is going to self-destruct in 2018 if nothing is passed immediately.

The choice for the Republicans who are oppose compromise and the passing of BCRA is clear to me.

Either the Republicans pass this bill and have a chance for a free market healthcare system or reject it and end up with a failed Obamacare healthcare system.

Everyone knows the replacement for a failed Obamacare system is a single party payer system just like the VA Healthcare System.

A single party payer system will be an unaffordable disaster.

I will not comment on the specifics of the Better Care Reconciliation Act (BCRA) except to say it is not perfect.

Let us see if it passes and what form takes. I will make some comments at that time.

President Trump needs BCRA to pass in order to make significant inroads in reforming the tax code.

I would be a pity if his fellow Republicans tied his hand on significant tax reform to simplify the tax code.

My hope is that Tom Price knows how to fix the healthcare system once the house and senate agree on specifics of the bill in conference.

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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It Is All about How You Look At Things

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Senate Republicans Are Making Repeal and Replace Harder Than It Should Be

 Stanley Feld M.D.,FACP,MACE

I think the Republican establishment in the senate is trying to undermine President Trump’s agenda.

It would be easy to repeal and replace Obamacare if the reasons for its failure where publicized. The main reason is that it does not align the initiatives of most of the stakeholders. The cost of administration is a close second.

Obamacare is about redistribution of wealth and control over the healthcare system. It ends up penalizing the middle class the most because of premium increases.

People like entitlements because they are free. Someone else is paying for them.

Politicians want to keep their jobs. They do not want to upset people who receive these entitlements.

“But the revisions may well alienate the Senate’s most conservative members, who are eager to rein in the growth of Medicaid and are unlikely to support a bill that does not roll back large components of the current law.

Even with more moderate Republicans on board, party leaders would have a very narrow margin for passage on the Senate floor.”

The healthcare insurance companies do not want to lose money selling healthcare insurance. They are getting out of the healthcare market because, by their calculations, they are losing money.

The Republicans establishment in the Senate want to continue to provide subsidies to the healthcare insurance industry.

Congress needs the healthcare insurance industry’s ability to provide administrative services whether it is for Medicare, Medicaid, health insurance exchange coverage (Obamacare) or private insurance.

The government’s goal is to provide enough financial incentives for the healthcare insurance industry to provide affordable healthcare insurance coverage while saving money.

President Obama subsidized the healthcare insurance industry for any perceived losses through the Obamacare reinsurance program. Then President Obama reneged on the agreement. He only paid 12% of what was owed according to the insurance industry’s calculations..

Democrats want a single party payer system. They want everyone on Medicare or Medicaid. It is simple. The result is the government provides healthcare insurance for everyone. Everyone receives first dollar coverage. This would be the mother of all entitlements.

The single party payer system would also provide the government with tremendous power over the people. It would control consumers’ freedom of choice.

Along with this simple single party system comes a complex bureaucracy with all the inefficiencies that I have described previously.

Consumers would be chained to the inefficient healthcare system. The inefficiencies in the system have been graphically demonstrated by the VA Healthcare System and its ever increasing costs.

It would be nice if a single party payer system were efficient and affordable. Canada has a universal healthcare system. Canadians who are not sick and do not need their healthcare system believe the Canadian system is great.

They ignore the fact that the Canadian provinces are paying 50% of their GNP to provide free healthcare to all Canadians.

Canada’s health-care wait times costing patients many millions in lost time, wages”

Ontarians wait longer for health care than citizens of other universal health-care countries”

The fact is single party payer systems do not work for all the stakeholders.Both Democrats and Republicans are missing the essential point about what would work to provide an affordable healthcare system that aligns the incentives of all stakeholders.An essential element is to develop a system that encourages consumers of healthcare to be responsible for their health and have control over their healthcare dollars.

The Senate’s present revision does not consider this. The Senate is considering the needs of the healthcare insurance industry and not the needs of consumers.

The Senate should be considering the following in order to repeal and replace Obamacare.

  1. My Ideal Medical Savings Account should be instituted immediately. It will provide financial incentives for consumers as well and incentives to maintain health.

Self-management of chronic disease is essential for a healthcare system to become affordable. My Ideal Medical Saving Account provides that financial incentive.

1. The Ideal Medical Saving Account will provide instant adjudication of medical care claims.

  1. The ideal Medical Savings Accounts will encourage patient responsibility for their health, the care of their disease and their healthcare dollars.
  2. The Republican Party should establish an organized system of disease management education for persons with chronic disease. The education system should be designed to be an extension of physicians’ care. It should not be a free-standing education system. Physicians should be provided with incentives to set up these educational systems.

http://stanfeld.com/chronic-disease-management-and-education-as-an-extension-of-physicians-care/

  1. A system of social networking with physicians and their patients should be developed. The government could provide the template for physicians and their team.

http://stanfeld.com/social-networks-patient-education-and-the-healthcare-system/

The networks could be physicians to patients networks, patients to patients networks, patients to their physicians’ healthcare team networks. These networks need to be an extension of the physician’s care. All encounters should be imported to the patient’s chart with certain restrictions.

  1. Social networking between physicians should also be developed.
  2. Integrated care systems with generalists to specialists must be developed for both treatment and cost transparency for the physicians and patients.
  1. There must be instant communication between physicians and patient via an effective electronic medical record. The EMR must be a teaching tool for physicians. It must not be a tool to judge physicians’ care and penalize them. The EMR should be cloud based. Maintenance and upgrades should be free and seamless. Physicians should be charged by the click.

http://stanfeld.com/?s=EMRs

  1. Tort Reform is an essential element in a healthcare system that would work and be affordable. It would decrease the cost of over testing. It would also decrease the cost of malpractice insurance and legal fees. These cost are built into the cost of care. The cost of care would be reduced significantly. http://stanfeld.com/?s=tort+reform

The goal of effective healthcare reform should be to align all the stakeholders’ incentives. Patient incentives should be at the center of this alignment.

Align patient 1

Align government

Obamacare did not bother to try to align any of the primary stakeholders’ (patients and physicians) incentives. In fact Obamacare destroyed the patient/physician relationship.

The house bill to repeal and replace Obamacare touches on some alignment.

The senate is fighting about issues that are not significant in aligning all stakeholders’ incentives.

The healthcare system will not be repaired until all the stakeholders’ incentives are aligned. Healthcare policies must be put in place to align those incentives.

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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It Looks Like The Dice Are Loaded

Stanley Feld M.D., FACP, MACE

Everyone is probably familiar with Leonard Cohen’s song “Everybody Knows.” If you are not you should read the words and /or listen to it.

https://www.google.com/#q=leonard+cohen+song+everybody+knows

The first paragraph says it all.

“Everybody knows that the dice are loaded
Everybody rolls with their fingers crossed
Everybody knows the war is over
Everybody knows the good guys lost
Everybody knows the fight was fixed
The poor stay poor, the rich get rich
That’s how it goes
Everybody knows”

Leonard Cohen nailed it.

That is what is going on with the repeal and replacement of Obamacare in the congress.

“Everybody knows” the Republicans have shown little enthusiasm in repealing and replacing Obamacare. House Republicans barely got it passed. They had seven years to develop a replacement plan.

I think Republicans do not want replace Obamacare. They have used repeal and replace as a calling card to get a majority in both the house and the senate.

It looks like the American public has been used as a pawn for Republican to gain control of congress.

The Republicans talked a good game for the seven years that Obamacare has been the law of the land.

Obamacare has been a disaster. The majority of people have seen large increases in their healthcare insurance premiums and deductibles along with poor access to care.

Obamacare has cost our treasury trillions of dollars because of it poor business model design and mismanagement.

Obamacare claims it has provided healthcare coverage for twenty million Americans. It is not true. Thirteen million of those twenty million have been added to the enrollees in Medicaid.

Medicaid is a single party payer system that does not provide effective insurance coverage. It does not provide easy access to care in most parts of the country. There is also built in rationing of care.

“Everybody knows”

The healthcare insurance industry insurers are dropping out of Obamacare’s health insurance exchanges. Almost all the state insurance exchanges have gone bankrupt and are out of business.

Americans heard over and over again from Republicans that Obamacare is going to die from it own weight. It is true.

There will continue to be insurance to coverage for the nine million insured with preexisting illness. The government mostly subsidizes these nine million patients. However they have unaffordable deductibles.

“Everybody knows that the dice are loaded.”

This week both Mitch McConnell and other Republican senators were publicly pessimistic about their prospects of repealing and replacing Obamacare this year.

Senate Republicans remain publicly pessimistic about their prospects of repealing and replacing Obamacare this year with several raising concerns this week about the party’s central campaign promise even as one of their leaders vowed to pass such a bill this summer.”  

The fix is in. The dice are loaded! Everybody knows.

Russ Limbaugh blew his top when he heard this.

“Rush Limbaugh said during his show that Republicans are road blocking the President’s agenda to a greater extent than Democrats are.

Limbaugh specifically pointed to remarks by Senate Majority Leader Mitch McConnell (R-KY), specifically about the Obamacare repeal bill.

Check it out:”

“I don’t understand how people don’t get that it’s not just the Democrats in Washington that are road blocking Trump. I mentioned it earlier.

 “Mitch McConnell says he can’t see a way to getting 50 votes for the House Obamacare repeal bill?

Now, stop and think here, folks. Back when the only element that we had was the House of Representatives and Republican voters were constantly saying, “Why aren’t you doing more to stop Obama? Why aren’t you trying to do something to stop Obamacare?”

The answer was always, “Well, all we’ve got is the House. W-w-we can’t get anything through the Senate because the Democrats own the Senate. Obama’s in the White House! He’ll veto anything if it did make it there.”

Limbaugh continued that prior to this year, Republicans always blamed failed policy attempts on a lack of majority in the Senate.

“Then, when we won the Senate, they blamed failed agendas on President Obama.”

So we’ve given Washington a Republican House, Republican Senate, and a Republican president in the White House, and it still feels as though nothing is getting done.”

How come?

“It’s the Republicans standing up and saying, “I just don’t see how we’re — there’s no room here.

“ I don’t know how we’re goanna lower rates when you have this exemption over here and you have this exemption there.”

 Mitch McConnell is giving hollow excuses. The Republican establishment’s motives and method are becoming very transparent.

Everybody knows the dice are loaded.

Rush Limbaugh continues,

“ And I just read this stuff and I shake my head. They don’t want to cut taxes.

  Either they don’t want to cut taxes institutionally, they don’t want to cut taxes economically, or they just don’t want to do the heavy lifting.”

The Republican and Democratic establishment has built a very successful swamp for themselves. It is both socially and economically rewarding. It is a strong powerbase that neither is willing to relinquish.

 “ I don’t know what it is. My guess is they don’t want to help Trump.”

President Trump has pledged to drain the swamp. He has pledged to put power back into the hands of the people. He represents a real threat to the power the establishment in both parties has over the people and their freedoms.

Neither party anticipated his victory and neither party understands his popularity. The Democrats are trying to hobble him directly with fake scandals. The mainstream media are trying to hobble him with fake news.

“They just don’t see how they can do it,” Limbaugh said, remarking how especially incredible it is:”

Because, of course, there’s a way.

 They just don’t want to do it.

I think it’s all establishment, all the time anti-Trump, throw the media in there as well.

 But even in the middle of this I can tell you almost assuredly that Trump is not off his game. He’s not despondent. He’s not sitting there worried about why all these people hate him.

 He’s not worried about all that. He’s just head down and moving ahead full speed as he can…

Rush Limbaugh should not be confused. Republicans are defending the swamp they built. These guys are not going to let President Trump disrupt the powerbase that is in the swamp.

While the Republican establishment is stonewalling President Trump, the Democratic establishment is rolling out a single party payer option again. The Democratic establishment is going to try to sneak it in.

The Democrats argue that it is obvious the Republican establishment does not have a plan. The Democrats proclaim they have a replacement for Obamacare. They claim that a single party payer is easy to understand. Their proclamation is, “Doesn’t Medicare work for seniors?”

“At rallies and in town hall meetings, and in a collection of blue-state legislatures, liberal Democrats have pressed lawmakers, with growing impatience, to support the creation of a single-payer system, in which the state or federal government would supplant private health insurance with a program of public coverage

Medicare does work for seniors. The problem is the premiums and co-payment is becoming higher each year. Supplemental insurance increases each year. Healthcare insurance coverage for seniors is unaffordable to many.

Medicare is also unsustainable for the federal government. The premiums do not cover the costs of coverage.

The Democrat-controlled California State Senate approved a preliminary plan for enacting single-payer system. 

This is a joke. California has a huge budget deficit presently. Where are they going to pay for its proposal?

When are Democrats going to realize the importance of fiscal responsibility?

They don’t now. The expansion of Obamacare to a Medicare model is unsustainable and will bankrupt the state.

This kind of thinking by liberals and Democrats is not going to repair the healthcare system. It will result in collapse of the healthcare system as politicians try to increase their power over the people.

 

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Trump Is Not the Real Target – You Are

Stanley Feld M.D.,FACP,MACP

Many of my readers have been upset by the slowness and the lack of progress from the Republican senate in repealing and replacing Obamacare.

The country is approaching enrollment time for 2018. Insurance companies need to submit available healthcare plans to the health insurance exchanges soon.

Maybe there will be no healthcare plans available for people in the individual healthcare market with pre-existing illness. This will signify total collapse of Obamacare.

Maybe the Republicans are hanging around waiting for the public to realize that there will be insufficient healthcare plans submitted.

Then the Republicans could blame the Democrats for Obamacare’s failure.

Obamacare has failed for all the reasons I have already written about. There is no reason to debate if it has failed. There is also no reason to debate that President Obama’s vision for Obamacare failed.

President Obama and the Democrats are responsible for its failure. Obamacare was an ill conceived healthcare plan that could not be sustainable.

There are plenty of reasons to support the people who might lose insurance. Those people do not include the 12 million new enrollees in Medicaid.

President Trump is not going to touch their insurance.

The 9 million people enrolled with pre-existing illnesses that have signed up for Obamacare on the individual market must be covered with affordable insurance in some way.

There are many more people in this category who do not have insurance under Obamacare because it is unaffordable.

Within the House Republican plan there are provisions for these people.

It is clear that the liberal mainstream media is on the Democrats’ side.

It’s goal is to do everything it can to obstruct President Trump’s agenda and what he promised the American people.

President Trump won the election on his agenda, not on his personality.

It is clear that the mainstream media is against President Trump. A recent study showed that over 80% of articles written in our daily newspapers are negative articles about the Trump administration.

Many of the 20% positive articles have a negative subtext. Many of these negative articles have no basis in fact and have been proven to be untrue.

President Trump uses the words “fake news” because it angers the press and excites his base.

The Democrats are trying to make as many issues as possible treasonous without any basis for the use of the word treason.

In fact they roll out Maxine Waters every day saying President Trump should be impeached without her presenting a single piece of evidence for impeachment.

It should be clear that is a Saul Alinsky tactic. I have not heard one conservative or Republican accuse the Democrats of using Alinsky tactics.

President Obama did many things that were unconstitutional. He was never called out for them with congressional investigation. When the issues were investigated they were all given a pass. I can think of the IRS and Lois Lerner investigation, the attorney general issue, the CIA issue, and most of all the Hilliary Clinton hearing in which she said nothing for nine hours. The press, the congress and the President let her get away with it without at least an indictment.

James Comey of the FBI said she was careless and unindictable.

The other day I received the following article from a reader declaring the target of these attacks is not President Trump.

The target is the voters who want constructive legislation in Washington for the people. The country cannot survive with the corruption and unconstitutional behavior much longer.

Tim Daughtry is a conservative speaker and co-author of Waking the Sleeping Giant: How Mainstream Americans Can Beat Liberals at Their Own Game wrote a beautiful article explaining what is going on.

I have never thought of the establishment game in these terms. I have reprinted Mr. Daughtry’s entire article so that all of us will take a moment “to reexamine out premises” as Ayn Ryan suggested 70 years ago in Atlas Shrugged.

Trump Is Not the Real Target; You Are

Tim Daughtry

“As we watch the daily barrage of accusations and innuendo directed against President Trump by the far left, the liberal media, and even some in his own party, those of us who voted to put him in the Oval Office need to remember one crucial point: President Trump is not the real target.  You are.

Even considering his outsized persona and the stunning phenomenon of an outsider who has never held political office winning the presidency against one of the most powerful political machines in American history, the new movement that elected Donald Trump has never been about Trump. In the 2016 election, the “forgotten men and women of America” were hell-bent to send a message to the powerful elites of both parties.

The message was that the Washington elites are serving themselves and their own agenda and ignoring the rest of the nation.  The message was that Washington has become a swamp of corruption and self-serving collusion among powerful interests and that Main Street America is ready to see that swamp drained. 

Donald Trump was our messenger.

Because his candidacy was not about Trump the man but Trump the messenger, he was able to withstand the smears and assaults of the Clinton Machine that would have sunk any other candidate.  They siphoned all the way to the bottom of their slime barrel, and still the message prevailed. 

That message was simple and grounded in common sense.  No country can survive unless it has control over its borders.  People coming into American should be vetted to make sure that they pose no danger to us.  After eight years of stifling taxes and regulations, we should once again make America a healthy place in which to do business, make products, and create jobs.  Political correctness may seem silly and laughable, but in reality it poses a serious threat to free expression and open exchange of ideas. If it’s terrorism, call it that.  Say what is obvious to our common sense even if it offends the delicate sensibilities of the elite.

Now the denizens of the Washington swamp are sending a message back to the forgotten men and women who voted for Trump and his reforms: “Forget you.” 

The leftists who worked to radically transform the nation under Barack Obama are telling us that they hold the reins of power and that we the people don’t run anything.  They are telling us that their agenda will prevail regardless of how we vote or what we want.  They are telling us that they can subvert, attack, and destroy any messenger that we send into their territory.  And feckless leaders in the GOP seem, at best, more afraid of displeasing the Democrats than betraying their own voters, and, at worst, in cozy collusion with the opposition.

What is at stake in the barrage of innuendo, twisted news, and “investigations” is not just the future of the Trump presidency, but the future of the very idea that governmental power rests ultimately on the consent of the governed.

Of course there is much at stake in the actual policy questions facing the country.  But underneath the debates about border security, court appointees, tax and regulatory policy, and so on lies a deeper question that is at the very heart of our system of government: Can the American people still change the direction of the country if we believe that the country is headed in the wrong direction?  Or will the powerful and self-serving elites impose their agenda even when we don’t consent to it?

When the voters put leftists in power, as they did with the election of Barack Obama in 2008, the country moves left.  But when voters try to change course, as we did in the elections of 2010 and 2014, the country still careened towards open borders, government control of healthcare, rule by rogue judges, and lawless license for those in the power elite.

And so we went outside the traditional path and elected Donald Trump in 2016.  The liberal news anchors had barely dried their tears after Election Day when the left began to cloud the real meaning of Trump’s election by pushing the bizarre claim that the Russians had somehow hacked the election.

In their gaslighting version of reality, you didn’t really vote to drain the swamp.  You didn’t really vote to secure our borders.  You didn’t vote to repeal and replace Obamacare and put doctors and patients back in charge instead of Washington bureaucrats.  You didn’t vote to restore rule of law and common sense to Washington.  The Russians somehow threw the election to Trump.  You can go back home now and let the experts run things.

It’s swamp gas.  Don’t breathe it.

There is plenty in Washington that merits investigation, from foreign influence through the Clinton Foundation to Obama’s use of intelligence data for political purposes.  Congress has the power to do just that, but we need to give them the will.

Let’s remind our representatives that they might forget us, but we won’t forget them.”

 

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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What Are The Republicans in the Senate Doing?

Stanley Feld M.D.,FACP,MACE

I am rapidly coming to the conclusion that the Republican establishment in both houses of congress are trying to torpedo Donald Trump’s agenda.

Republicans had seven years to coordinate a bill to repeal and replace Obamacare.

The House of Representative’s bill has finally past. Senate committees are stalling progress of the bill.

Both houses should have had all the debates and consensus reached to during the last seven years.

Why would congressmen try to stall the passage of the bill? President Trump has stated that passage of the budget bill is dependent on passage of the healthcare bill.

The reason is obvious to me.

President Trump has pledge to those who voted for him that he is going to drain the swamp in Washington. He is going to eliminate corruption and streamline the bloated bureaucracy.

The Republican establishment is a big part of the swamp. They are thriving in the swamp they helped create.

President Trump represents a direct threat to their power. The Republican establishment does not realize that the only reason they have a majority in both houses is because of the rebellion within the party against the Republican establishment.

Tea partyers and independents voted for unknown candidates and defeated many establishment Republicans in the primaries.

The goal of the Republican establishment is to weaken President Trump’s agenda.

They don’t understand that they are destroying the Republican Party while they are trying to save their own swamp.

It is time the Republicans in the Senate passed the bill.

Regulations that should be eliminated are any regulations that increase bureaucratic control over the healthcare system and the practice of medicine.

The healthcare community knows how to control the costs of chronic diseases. It is by decreasing the onset of complications. Patients have to participate in controlling their chronic disease.

If a healthcare system was developed to control the costs of these chronic diseases, the United States would not only have the best healthcare system in the world we would have the most cost effective healthcare system in the world.

“In the case of diabetes, for example, the American Diabetes Association reports that the total cost of that debilitating disease amounted to $245 billion in 2012. This includes $176 billion in direct medical costs, and $69 billion in lost productivity.”

The key to diabetes control and the avoidance of diabetes complications is to control blood sugar to a close to normal as possible. This takes a lot of work on the patient’s part. Patients need the education and the motivation to become the professor of their disease and control their blood sugar.

  As Rep. Tom Price (R-Ga.), a physician, recently noted, diabetic seniors enrolled in traditional Medicare still do not have access to continuous glucose monitors (CGMs), a medical technology today covered by 95 percent of private health plans. ’’

It is bizarre. Yet, Republican Senators who should have figured this out over the last seven years are debating small points that will have little effect on the clinical outcomes. The Republican Party has an opportunity of a lifetime to fix the healthcare system for the American people.

Republicans are going to waste this opportunity to serve the people in order to preserve their swamp that has gotten the people into this horrible position.

I am afraid we are going to see this behavior of perpetuating waste when it comes to education, the environment and energy.

The Democratic Party is worse. They are not acting in the peoples’ interest. They are trying to obstruct everything President Trump is trying to accomplish.

They criticize every initiative saying it is bad without providing reasons for why it is bad.

I believe it is time for the members of both parties to get off the stick. They must stop thinking about themselves and start thinking about the welfare of Americans.

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Democrats Still Think Americans Are Stupid

Stanley Feld M.D.,FACP, MACE

The House Republicans finally got their act together and passed their version of the Obamacare repeal and replace act. It seems that many representatives do not trust Paul Ryan, Tom Price and President Donald Trump.

The Republican house version of the bill does not repeal and replace Obamacare completely.

The Affordable Care Act (Obamacare) permitted Kathleen Sibelius, the Secretary of HHS, to issue regulations to administer the act at her discretion. Many of her regulations were destructive to the healthcare system.

Tom Price, the new Secretary of HSS can eliminate many of these destructive regulations. The goal of the Obama administration’s regulations was to cause the healthcare system to fail and be replaced not by free market principals but by a single party payer system.

Her regulations were designed to eliminate any modicum of free choice for patients and physicians.

Tom Price’s actions and regulation eliminations should complete the repeal and replacement of Obamacare.

President Obama ignored the fact that a single party payer system would be destined to bankrupt the country. His plan was to get the health care insurance industry out of the healthcare picture.

The defect in his logic was that the government would have to continue to outsource the administrative services to the healthcare insurance industry. The government now outsources the administrative services for Medicare and Medicaid.

The government then lies to the public declaring that its overhead is only 2.5% while the healthcare insurance industry takes 30% for services that are charged as direct patient care.

The healthcare insurance industry would continue to rip off the healthcare system in a single party payer system for all.

The completion of the repeal and replace act will be done as promised by Ryan, Price and Trump in three stages.

As soon as the house bill is passed the House Democrats came out with their talking points criticizing the act. These talking points had little substance and no compelling evidence. They only declared that the legislation was terrible without any explanation of why it was terrible.

They just said 20 million people are going to lose their insurance coverage. The Republican health care act is going to kill people.

The talking points are mostly lies.

A recent study had reported that Obamacare has cost 80,000 people to die.

“Democrat’s immediately made the accusation that the GOP “repeal and replace” bill will kill Americans.  It seems that Obamacare has already done that.” 

In a previous blog I pointed out that more people have lost insurance in the individual market that have gained insurance from Obamacare’s health insurance exchanges.

Fourteen million lost insurance in the individual market in 2009 and at most 8 million gained insurance through Obamacare’s health insurance exchanges.

The 20 million new insured comes from the 12 million new people receiving healthcare insurance through Medicaid.

“Quoting Oren Cass over at National Review, it turns out that fewer people – not more people – had health insurance after Obamacare.  The only increase in “coverage” was Medicaid, but, sadly, it turns out that Medicaid kills people.  It’s better to have no medical insurance at all.” 

 Researchers have found that in 2015 Medicaid patients experienced worse outcomes than similar uninsured Medicaid eligible patients.

Public-health data from the Centers for Disease Control confirm… [that had mortality continued to decline during ACA implementation in 2014 and 2015 at the same rate as during the 2000-13 period, 80,000 fewer Americans would have died in 2015 alone.”

The Democrats are using the typical progressive tactic of creating a lie. Many people died because of Obamacare but the Democrats threaten that the Republican bill will cost many lives. It diverts attention from the Democrats’ failure with Obamacare.

This is fear mongering for the progressives’ political gain.

This is one of Sol Alinsky’s favorite tactics. One should do everything to marginalize opponents even if it needs to be done by lying.

“Democrats are hurting real people with their scary shrieking about death by Republican.”

The Democrats criticize without facts. The Democrats will lie about the effects of the bill without evidence. I would guess that many have not even read it.

One should expect nothing less from Nancy Pelosi and Chuck Schumer.

The Democrats have even rolled out Jonathan Gruber, the MIT professor of economics and co-author of Obamacare, who infamously said, “the stupidity of the American voter” helped get the measure to become law.

This week Gruber blamed President Trump for Obamacare’s failure on one of the Sunday news programs.

“Whose fault is this (rising premium costs)?” Gruber asked on “Fox News Sunday.” “Since President Trump has been elected … premiums are going up and insurers are exiting.”

This is total nonsense.

Jonathan Gruber still thinks Americans are stupid. However he has no credibility with the American public. Therefore his opinion has no impact on the discussion about the new bill.

Nancy Pelosi and Chuck Schumer’s lack of credibility with the American public does not seem to bother them.

Every lie they tell decreases their credibility even further.

Nancy Pelosi said, “the new Obamacare repeal bill is a ‘a very sad, deadly joke’

This is the same woman who said we will not know what is in the Affordable Care Act (Obamacare) until it is passed.

What is so deadly about it? She does not explain her statement. She figures the media is the message. The media will carry the message for her.

Chuck Schumer’s quote was even worse. He said, “Senate GOP should toss House healthcare bill ‘out the window’”

He called on Senate Republicans,

“To avoid following the lead of their colleagues in the House and to work on a bipartisan basis on healthcare reform rather than pushing for repeal of the Affordable Care Act.”

He is trying to save President Obama’s legacy Obamacare. Obamacare is an unmitigated disaster. It is beyond saving.

It was a poorly constructed healthcare bill aimed at giving big government total control of the healthcare system. President Obama totally ignores the fact that Americans did not want it, have not joined it. He felt he clearly know what is best for America.

He goal was to get it passed by the partisan vote. President Obama lied to Americans and lied to his party members.

Obamacare is unsustainable economically to America and is in the process of destroying the economy.

Chuck Schumer said, “Trumpcare is a giant, broken promise to working people, the hard-working people of this great country of ours.

It would be valid if Chuck Schumer could prove his statement.

President Obama broke his promise to the working people, the hard working people of this great country of ours, when he said, “ If you like your doctor you can keep your doctor and if you like your insurance you can keep your insurance.”

Chuck Schumer did not see it then and he does not see Obamacare’s failure now.

I suggest that Chuck Schumer read the Republican bill carefully before he makes his false statements.

Clearly, he was dead wrong in his judgment about Obamacare

If he read the Obamacare law carefully and voted for doing the right thing, America’s healthcare system might not be in the mess it is in.

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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I Don’t Get The Republican Leadership

Stanley Feld M.D., FACP, MACE

The media and Democrats in congress are stonewalling every initiative President Trump has presented whether or not it has merit. .

The American people have spoken. Donald Trump is President. Republicans control both the House of Representatives and the Senate.

I should think the Democratic leadership would realize they are not connecting with the people. They should fear for their jobs and the jobs of other party members.

Nancy Pelosi, chair of the House Democrats, said, “We are the opposition party and it is our job to be the opposition.”

She is wrong. The Democrats should be doing what is right for the American people.

Recent elections have proven Americans do not approve of the Democrats’ policies at federal, state or local levels.

President Obama’s Democratic court appointed judges are slapping temporary injunctions on some of President Trump’s executive orders for no logical reasons.

These injunctions are occurring despite the terrorist disruptions that have occurred in American cities.

President Obama and the Democrats did nothing to neither stop this loss of life nor decrease the fear these terrorists generated.

The judges are slowing his initiatives down until they get to higher courts.

Democrats are acting juvenile.

Paul Ryan and the Republican establishment are not helping President Trump fulfill his agenda. They seem to be tripping up President Trump at every turn.

At the same time they are making the Republicans look bad and the Democrats look good.

If some of President Trump’s executive orders need congressional approval the Republican leadership in both houses should start the legislative process to get that congressional approval.

It seems like the Republican establishment is doing everything to make President Trump an ineffectual president.

The Republican establishment is bickering over the fine points of the initiatives. They are not looking at the big picture.

The American public gave the Republicans both houses of congress in order to allow them to be effective. The nuclear option in the senate should guarantee legislative effectiveness.

President Trump has some good ideas to fix the healthcare system and create economic growth.

Paul Ryan is supposed to be a legislative genius.

Paul Ryan seems to be intimidated by the Democrats and the mainstream media. He has not been bold in stepping out and supporting President Trump’s initiatives.

He should realize that the majority of the American public is not paying attention to the mainstream media.

This is reflected in the decrease in readership of the New York Times and the viewership at CNN and MSNBC. The mainstream media should not be influencing Paul Ryan’s actions.

Everything President Obama did during his presidency slowed the economy and polarized the nation. Paul Ryan should be doing the opposite.

Everything President Obama did with Obamacare made the healthcare system less efficient and more dysfunctional. Paul Ryan should have had a Republican consensus plan ready to repeal and replace Obamacare.

It is embarrassing that he did not have a plan ready after seven years.

My advice to the Republican controlled congress is to give President Trump a break and give him some support.

Stop playing politics. You are playing right into the Democrats’ obstructionist hands.

Paul Ryan’s healthcare fiasco is the prime example. He wouldn’t be speaker if it would not for the election of members of the Freedom Caucus.

Paul Ryan should take the bill the house previously passed and send it to the Senate. If there are things in that bill that do not pass the sequestration test for the Senate to pass the bill with 51 votes modify the bill.

Ryan has not made it clear to the public what he thinks is wrong with the old bill. He has also been secretive about the ongoing negotiations to repeal and replace Obamacare.

Now Paul Ryan is delaying President Trump’s wall appropriation request. He seems to be delaying President Trump’s tax cut initiative until 2018 without explanation.

If it is because the healthcare bill is not passed then pass the old healthcare bill.

He and the establishment Republicans confuse me. I think the American people are confused. Maybe the Republican establishment has to be voted out of congress in order to get anything passed.

I believe what President Trump is trying to accomplish is pretty logical. President Obama and the Democrats messed us up over the last eight years.

Many Americans are hurting. Americans who are not hurting do not understand it. Perhaps they refuse to understand it.

It is time government starting working and trying new ideas.

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

All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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