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Why Vermont’s Single Party Payer Healthcare Plan Failed

 Stanley Feld M.D., FACP,MACE

Vermont’s single party payer healthcare plan was doomed to fail from the onset for several reasons.

Healthcare policy consultants do not understand the medical care system. The healthcare policy consultants for the Vermont healthcare system were the same consulting architects President Obama used for Obamacare.

The consultants were Harvard’s William Hsiao and MIT’s Jonathan Gruber.

William Hsiao has spent most of his academic career helping governments install healthcare systems. William Hsiao is the K.T. Li Research Professor of Economics in Department of Health Policy and Management and Department of Global Health and Population, at Harvard T.H. Chan School of Public Health.

Jonathan Gruber is a professor of economics at the Massachusetts Institute of Technology, where he has taught since 1992.[1]

He is also the director of the Health Care Program at the National Bureau of Economic Research, where he is a research associate.

Jonathan Gruber has been heavily involved in crafting public health policy.

He has been described as a key architect[2] of both the 2006 Massachusetts health care reform, sometimes referred to as “Romneycare”, and the 2010 Patient Protection and Affordable Care Act, sometimes referred to as the “ACA” and “Obamacare”.

There is little evidence that the systems he and Dr. Hsaio have built are overwhelming successful, cost effective or preserve consumer freedom of choice.

In fact, a study by NPR and Harvard’s T.Chan School of Public Health concluded that Obamacare is a complete failure.

Dr. Hsaio is on the faculty the Harvard T.Chan School of Public Health.

NPR AND HARVARD T.H. Chan School of public Health SAY: OBAMACARE IS A COMPLETE FAILURE

In a New York Times interview in 2009 Dr. Hsiao discussed the system of healthcare Reform he installed in Taiwan.

The question was:

What’s the most important lesson that Americans can learn from the Taiwanese example?

Dr. Hsiao.

You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.

The Taiwan government managed to insure 98 percent of the population with a premium cost of 4.6 percent of wages.

Q.

Has your system of healthcare in Tiawan translated into better life expectancy or lower complication rates from major diseases?

Dr. Hsiao.

“There is evidence of positive health results for select diseases, like cardiovascular disease and kidney failure.”

There is no medical or financial data available to prove outcomes have improved.

“Overall, it’s really difficult to say that national health insurance has improved the aggregate health status, because mortality and life expectancy are crude measurements, not precise enough to pick up the impact of more health care.”

“That said, life expectancy is improving, and mortality is dropping. And everyone now has access to good health care”.

This is not good science. It is not even good social science. This is a biased opinion.

Q.

What are the system’s weaknesses?

Dr. Hsaio

“In the legislative process, compromises had to be made. First, the president yielded on payment reform, so Taiwan kept its fee-for-service payment system. Unfortunately, that encourages doctors and hospitals to give more treatment in order to boost their income.

“Second, the Taiwanese system doesn’t have a systematic way to monitor and improve quality of care.”

“Third, in the legislative process, they rejected a provision to adjust the premium automatically when the national health system depletes its reserves.”

“In every country, health care costs are increasing faster than wages. When that happens, the premium has to go up. But that provision wasn’t incorporated into the law. As a result, the system is running a deficit.”

“National health insurance tries to cut the fees for hospital and physician services. But eventually these fee reductions will adversely affect the quality of health care.”

President Obama was so anxious to change the healthcare system in the United States to fit his socialist ideology that he picked two professors, Dr. Hsaio of Harvard and Jonathan Gruber of MIT to be the architects of Obamacare.

Jonathan Gruber has been introduced as the ‘architect’ of the Massachusetts law and/or Obamacare”.[52]

Neither professor had scientific evidence that a single party payer system would work efficiently.

Obamacare was not working efficiently yet the progressives in Vermont hired Dr. Hsaio and Dr. Guber to be the architects for Vermont’s single party payer system.

Jonathon Gruber has turned out to be a honest about the Obama administration’s lies.

Many of the videos show him talking about ways in which he felt the ACA was misleadingly crafted or marketed in order to get the bill passed, while in some of the videos he specifically refers to American voters as ill-informed or “stupid”.

In October 2013, Gruber we said: “the bill was deliberately written “in a tortured way” to disguise the fact that it creates a system by which “healthy people pay in and sick people get money”.

Some of Americans are waking up to the fact that they cannot trust President Obama and his administration to be our surrogate. This is true not only in healthcare but in his decision making in every area of the economy and our live.

Gruber said this obfuscation was needed due to “the stupidity of the American voter” in ensuring the bill’s passage. Gruber said the bill’s inherent “lack of transparency is a huge political advantage” in selling it .[31]

 In 2010, Jonathan Gruber expressed doubts that the ACA would significantly reduce health care costs. He thought lowering costs played a major part in the way the bill was promoted by the Obama administration.[36]

President Obama said he never met Jonathan Gruber and did not think he came to the White House. President Obama forgot he hired him and paid him a $400,000 consultation fee.

In 2014, the Obama administration claimed that Gruber did not have a major role in creating the PPACA.[50]

President Obama acted irresponsibly to the public by hiring healthcare policy wonks to change America’s healthcare system without evidence for the success because their thoughts fit his ideology.

I don’t think President Obama understands he has changed the way hospitals and physicians have changed their approach to healthcare and medical care.

In my opinion, healthcare and medical care has changed for the worse.

Rich Lowry said that the videos were emblematic of “the progressive mind, which values complexity over simplicity, favors indirect taxes and impositions on the American public so their costs can be hidden, and has a dim view of the average American”.[41]

The American public eventually figures it out.

Commentator Charles Krauthammer called the first Gruber video “the ultimate vindication of the charge that Obamacare was sold on a pack of lies.”[42]

 The Vermont governor hired Dr. Hsaio and Dr. Gruber to create a single party payer system in Vermont figuring,the system would be easier in one small state than in the nation.

Vermont Governor Peter Shumlin (D.) announced that he was pulling the plug on his four-year quest to impose single-payer, government-run health care on the residents of his state.

“In my judgment,” said Shumlin at a press conference, “the potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.”

Watch out Colorado!

Why doesn’t a single party payer system work?

All of the healthcare policy wonks, especial Dr. Hsaio and Dr. Gruber, leave out the most important ingredients in a successful healthcare system.

Consumers cannot be treated as a commodity. Consumers cannot be forced to take what is given to them. The healthcare system must have a viable physician patient relationship provision.

The physician patient relationship is a big part of the therapeutic index. If treatment is to be successful patients must participate in their care.

Consumers of the healthcare system must drive the healthcare system. It must not be government or the healthcare insurance industry.

Consumers must be a the center of the healthcare system.

A system needs to be developed that puts patients in charge, not the government. Consumers must be responsible for their healthcare and their healthcare dollars.

This will motivate doctors and hospitals to compete for patients’ business.

My Ideal Medical Savings Account will provide incentives for the consumers to have a consumer driven healthcare system. This system will in turn drive hospital systems and physicians to compete for their care.

The end result will be to decrease the cost of the healthcare system and improve medical care and consumer satisfaction with the healthcare system.

 

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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The Folly of Obamacare

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More ACOs Rules Will Mean More Problems For Obamacare

Stanley Feld M.D.,FACP,MACE

 I have written many articles on why I believe Accountable Care Organizations (ACOs) will fail.

ACOs are critical to the success of Obamacare as are many the other programs introduced by the Affordable Care Act.

If one listens to the Obama administration’s propaganda about how wonderful Obamacare has been for the American public, one would be living in a dream world, not the real world.

Obamacare has failed on many levels. The administration believes the public will not remember the previous failures.

Here are the failed promises.

  1. You can keep your doctor if you like your doctor.
  2. You can keep your health insurance policy if you like your health insurance policy.
  3. Each family will save $2500 dollars on healthcare each year.
  4. Anyone making less than $250,000 a year will not pay one red      cent in new tax.

The failures of Obamacare

  1. Obamacare will bend the healthcare cost curve. It bent the cost   curve for the first three years because Obamacare collected new taxes without providing healthcare services until 2014.
  2. Thirty-two (32) states refused to expand Medicaid.
  3. Twenty-two (22) of 50 states signed up to have state health insurance exchanges.
  4. All of the states that developed state co-ops with federal loans are under water. Fourteen of the 22 are bankrupt now. All will be bankrupt by 2017 or 2018.
  5. Private insurance enrollment though the federal health insurance exchanges has not increased for the last 3 years. Many of the buyers of health insurance exchange insurance have pre-existing illness. The health insurance exchanges are the only available insurance.
  6. The hospital system and private practice meaningful use electronic medical records have not increased percentage wise as expected.
  7. Worthless electronic medical records have increase at high costs to medical practices and hospital systems. These electronic medical records are providing some false big data information to the government and healthcare insurance industry to generate defective policy regulations. Hospital systems and physicians benefit little from the data generated.
  8. Healthcare.gov is still not right after spending billions of dollars over budget.
  9. Healthcare insurance premiums have skyrocketed for companies providing healthcare insurance to its employees.
  10. Healthcare insurance premiums have skyrocketed for people buying healthcare insurance from the federal and the few remaining state health insurance exchanges.

The only success I have seen is in Medicaid enrollment for the poor and illegal immigrants. The access of care has not improved for tax paying people.

These are just a few of the Obamacare failures. The public would never remember there have been so many failures reading the propaganda and press releases that appear from the government in the traditional mass media.

The Obama administration’s information has blurred those failures. I sense the public does not want to know about the impending disaster in the healthcare system.

Many intelligent people ignore these facts. They keep reciting the administration’s talking points about Obamacare’s success.

ACOs were supposed to lower healthcare costs. They were supposed to provide incentives for hospital groups and private practice groups to save money by providing more efficient medical care.

If these groups did lower the cost of care they would share in the savings along with the government.

There are many ways to achieve these savings and many measurements to determine these saving.

In short, ACOs were designed to shift the financial risk of care from the government to the physicians. If the physicians didn’t hit the benchmark they would lose money. The goal was also to shift to a flat rate payment for each illness from the individual fee for service based payment system.

Physicians will get paid a flat rate for a particular illness. It means that the risk for taking care of the illness at a particular cost shifts the financial burden to physicians and not the insurance company or the government.

The gigantic defect in the system is there is no burden on the consumer nor is there an incentive for consumers to be responsible for their health or healthcare dollars.

No risk is placed on the patient for compliance with treatment advice.

I have pointed out most of the defects in the ACO model in past blogs. ACOs are essentially an HMO on steroids. Hillary Clinton did not do too well in 1993 with the HMO model

ACOs do not address the problem of the high salaries of hospital administrators and healthcare insurance executives (who provide administrative services for the government). These salaries increase the cost of the healthcare system.

Last week CMS released another final rule intended to improve the way Medicare pays accountable care organizations (ACOs) in its Medicare Shared Savings Program (MSSP).

It is clear that if another final rule is made the last final rule is not working.

The hype of this new final rule is that the Obama administration has solved what many viewed as a critical flaw in the bonus structure for Medicare’s accountable care organizations.

I think the new final rule might make ACOs fail completely.

CMS spokesman said, ”Physician buy-in is critical for the long-term sustainability of the ACO program, which could play an important role within Medicare’s broader reforms to physician payments under the Medicare Access and CHIP Reauthorization Act, or MACRA.

MACRA is another poorly designed program that makes payment for physician service more difficult to understand.

MACRA could inspire physicians to quit the whole ACO enterprise.

A group of executives on the MACRA (Medicare Access and CHIP Reauthorization Act) task force said,

“The goal is to force physicians and payers determine how to most effectively tie payment to performance and value.”

“A panel of healthcare experts and organizational leaders who began adapting to value-based payment years before the Medicare Access and CHIP Reauthorization Act started fleshing out regulations talked about their programs at the event sponsored by the Commonwealth Fund.”It is obvious to me that you cannot force anyone to do anything they do not want to do. You can only provide motivation and incentive for people to do what is best for themselves from their point of view.

MACRA will not get physician buy in because it will be too restrictive, arbitrary and controlling.

So far there are only 433 Medicare Shared Savings Program ACOs. There are 3000 hospital systems that should be participating in the Obamacare’s ACO program.

Only 14% of the hospital systems are participating after 3 years.

There are many large physician practices that should be participating in the ACO program. The number of these groups are unknown.

The lack of participation is a result of the complexity of the ACOs, the inability to form a unified culture of physicians in a hospital system and the difficulty hospital systems have with pricing risk.

Pricing risk is the job of the healthcare insurance industry and not physicians or hospital systems.

The government wants to put that task on the shoulders of the physicians and hospitals.

There are two risk tracts for ACO. Tract one is called one-sided risk.

The ACO only shares in the savings and does not participate in the losses if they spend more than the benchmark costs.

Tract 2 is call two-sided risk. The ACO shares in the savings with a more generous bonus from Medicare than the bonus of the tract 1 participants but pays a penalty to Medicare if doesn’t save money or demonstrate high quality care.

Only 22 of the shared-savings 433 ACOs or 5% of the participating ACOs have chosen two-sided risk. The Obama administration’s goal is to have all 3000 hospital systems participate the two-sided risk model.

The participation rate is .7% participation rate for the 3,000 hospital system that should be participating. It is far short of the Obama administration’s goal.

I would not rate the ACO participation rate as a success after 3 years.

This absolute failure has not been acknowledged by the Obama administration or the Obamacare praise singing traditional mass media.

The new final regulations and MACRA will not fix this failure. It will only make the failure worse. I will discus both the new final rule and MACRA next time.

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

All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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More Double Digit Obamacare Price Increases

Stanley Feld M.D., FACP,MACE

Its getting boring to hear about Obamacare’s double-digit health insurance premium increases each year. The healthcare insurance industry is now preparing the public for another round of double-digit premium increases in 2017.

It is important to remember the public experienced double-digit health insurance premium every year since 2014.

The cost of buying insurance has skyrocketed since Obamacare was enacted. The public is not forgetting this.

The table below compares health insurance premiums before and after Obamacare.

This table includes both the numbers in the federal and state exchanges and the private healthcare insurance markets.

Ost of Obamacare on individual market 2014

President Obama and his administration are bragging that the healthcare insurance markets are stabilizing.

All the federal funded state health Co-ops will be bankrupt before the 2017 enrollment period.

Updated state reports on enrollment since the close of 2016 extended enrollment period indicates that more than 1 million of the 12.7 million who were reported to enroll for 2016 have dropped their Obamacare healthcare insurance policies.

In 2015 only 1.5 million consumers out of 11.7 million enrollees dropped out the entire year.

Arielle Levin Becker of the Connecticut Mirror reported“In Connecticut of the 18,800 customers who dropped out (16%), 20% failed to provide required information; 53% didn’t pay; 10% asked to have their plans canceled; and 12% shifted to Medicaid.

Those exiting customers were partly offset by nearly 8,000 latecomers, more than one-third of whom lost Medicaid.”

The truth is the Obamacare health exchanges are not stabilizing the healthcare insurance markets. Obamacare is destabilizing the healthcare markets.

It is becoming more and more difficult to believe anything President Obama says or his administration reports.

United Healthcare declared they are dropping out of most of the exchanges they are participating in because of the toll the health exchanges have taken on their bottom line.

Aetna just announced it lost more than $100 million on its healthcare exchange business last year (2015) but hopes to break even this year (2016).

This is a pipe dream on Aetna’s part. Less people have signed up for Obamacare and the people who signed up have been sicker people with pre-existing illnesses.

Aetna chairman and CEO Mark Bertolini said Thursday, “ the nation’s third-largest health insurer still sees a good business opportunity, but Congress needs to provide leeway for companies to design lower-cost plans tailored to young, healthy people.”

President Obama is not going to let insurers design lower cost policies tailored for young, healthy people. His legacy legislation is built on equal premiums for all.

These announcements can put the healthcare debate back in the headlines for the general election. It can re-ignite consumer and voter backlash once again.

President Obama ignored the backlash before. Can Hillary Clinton ignore the upcoming price increase backlash?

“Hillary Clinton is the only one promising to build on the Affordable Care Act. She’s proposed an aggressive effort to increase enrollment along with measures to reduce consumer costs.”

Hillary Clinton is mouthing words that sound good but are impossible to fulfill. People understand these empty promises now.

“ The Republican candidates all want to repeal “Obamacare.”

No one has come up with a solid proposal. Not even Donald Trump.

“Vermont Sen. Bernie Sanders would incorporate it into a bigger government-run system covering everyone.”

 Bernie Sanders is dead wrong. America cannot afford the cost and it has been proven not to work in the healthcare systems in the rest of the world.

The health law has many problems. The problems are too numerous to list here. The biggest problem in terms of costs for next years premiums (2017) are the lower-than-hoped-for enrollment, sicker-than-expected customers, and a bloated bureaucracy that is not an efficient business model.

Obamacare has created a financial drain for many healthcare insurance companies. The increase in premiums and the government pressure to keep prices low have in turn created pressure on insurance companies to lower reimbursement to physicians and hospitals.

Hospitals have to participate in the health exchanges, Medicare and Medicaid for survival. Physicians do not. Obamacare has created a more severe physician shortage.

The healthcare insurance companies would never consider becoming more efficient and lowering their cost. Some top executives are making more than 100 million dollars a year.

The healthcare insurance industry is setting the stage for 2017 premium hikes that could reach well into the double digits.

Virginia has nine returning insurance companies participating in Obamacare in 2017. These companies have submitted premium price increases ranging from 9.4 percent to 37 percent to the state board of insurance.

I am sure the Virginia state board of insurance will start negotiating with the participating insurance companies.

Obamacare will only cover 11 million enrollees in 2016. As more enrollees drop out of Obamacare because they cannot afford the premiums the total might be closer to 8 million. Many of the enrollees are subsidized. These subsidized enrollees have dropped out because they cannot afford the remaining premiums and deductibles.

The healthcare insurance industry increases premiums in the individual and group private markets to protect its profit margin.

This is occurring on top of the destruction of Health Saving Accounts and does not speak well for a stable healthcare insurance market.

President Obama’s goal is to destroy the healthcare system and replace it with a single party payer system.

Does anyone think a government run single party payer system will be more efficient or deliver cost effective care?

If you do, please think of the efficiency and effectiveness of the VA healthcare system?

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

All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Obamacare Co-Op Folly

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The Obamacare Spin Goes On

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Single Party Payer Will Fail

Stanley Feld MD, FACP, MACE

Socialism does not work!

Intellectually, socialism is attractive and easy to understand.

 

Simple Definition of Socialism

 

Full Definition of socialism

  • 1
:  any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods

  • 2
a :  a system of society or group living in which there is no private property
b :  a system or condition of society in which the means of production are owned and controlled by the state

  • 3
:  a stage of society in Marxist theory transitional between capitalism and communism and distinguished by unequal distribution of goods and pay according to work done.”


It would be nice to have the government tend to all our needs equally.

Everything would be free to the public.

  • Not one would need to “get ahead.”
  • No one would have special privilege.
  • Everyone would live the same housing.
  • No one would have to have responsibility for anything.
  • No one would have incentive to be creative or inventive.
  • No one would need to take the initiative to be innovative and create new good and services.

The government would then run out of money because people would have little to be innovative about or have any incentive to work hard to provide for their family.

People would have little incentive to produce income that would generate taxes for government to spend on goods and services to support the benefits offered the people in a socialistic system.

The government would have to borrow more money from others because the people would not produce enough income to tax.

What lender would be inclined to lend money to a country that could not pay it back?

The socialistic system would then become unsustainable and collapse.

This explanation might be considered by some to be a fifth grade explanation of socialism. It is simple to understand but direct and to the point.

America is headed in that direction. The present healthcare system as is unsustainable.

Government cannot spend other peoples’ money when the money is not there.

In America the federal government and state governments keep making the same mistakes over and over again.

Obamacare’s regulations caused 335,000 healthcare insurance policies to be cancelled in Colorado. In 2010 Obamacare made these Coloradan healthcare insurance policies illegal.

Obamacare has failed for the citizens of Colorado.

The state’s politicians tried to fix Obamacare by borrowing hundreds of millions of dollars from the federal government to set up Colorado HealthOP the state’s co-op health insurance plan.

The goal was to stimulate competition among insurance companies by providing lower priced insurance. The co-op is in debt to the federal government for hundreds of millions of dollars.

Colorado HealthOP became the largest insurer on a state health insurance exchange in Colorado.

Colorado HealthOp lost so much money that it could not borrow any more. The Colorado HealthOp had to shut down in October 2015 leaving the federal government to absorb its loan to the state of Colorado.

The closure of Colorado HealthOP left 80,000 Coloradans without health insurance coverage for 2016.

The other state insurance plans are increasing premiums an average of 11.7% to stay above water according to state calculations.

It has made premiums and deductibles too expensive for many of these uninsured 80,000 people.

Coloradans are tired of all the insurance changes, increasing prices and uncertainty. They want something new.

The knee jerk reaction is to change to something easy to understand. A socialistic single party payer system (SPPS) is the easiest to understand. Let the state provide healthcare insurance to everyone. Healthcare would be universal and free to the public.

The problem is nothing is free. The advocates in Colorado (progressives and liberals) are mobilizing to replace Obamacare with either the Canadian or United Kingdom healthcare system.

However, both of these nations healthcare systems are unsustainable. They are failing because of the cost, inefficiency, long wait times for diagnosis and treatment and lack of services despite the governments claims and some of the consumers’ perceptions.

The progressive advocates accumulated 100,000 Coloradans’ signatures. These progressive democrats have gotten a single party payer (SPPS) proposal on the 2016 ballot.

“ColoradoCare,” as it is being called, would replace private insurance with health care funded completely by the government, substituting higher taxes for premiums.

The conservatives in Colorado do not have a proposal to replace Obamacare to put on the ballot in 2016. They have been asleep at the switch.

Conservatives and libertarians have been sleeping at the switch in every state except Vermont.

Conservatives and libertarians did nothing in Vermont. Peter Shumlin was elected governor to institute a SPPS.

The Vermont experiment with a single party payer system has been a disaster already.

“In 2010 Vermont voters elected Democratic Gov. Peter Shumlin, who promised to institute single payer in lieu of ObamaCare.”

Jonathan Gruber, who designed Obamacare, and thinks Americans are stupid, along with William Hsiao, who thinks price controls work designed the system for Vermont.

“Helping design the system was advisers such as Jonathan Gruber, the MIT economist often described as the architect of Obamacare, and William Hsiao, the Harvard economist who developed the Medicare price controls that are driving up prices around the country.”

Vermont played right into President Obama’s goal of creating a single party payer system (SPPS). Colorado is trying to follow the same path to disaster.

The Obama administration provided Vermont with many millions of dollars in federal grants in order to accomplish President Obama’s dream of a single party payer healthcare system.

In order to pay for Vermont’s SPPS the state proposed an 11.5% payroll tax on businesses, which would have taken the total payroll-tax burden to nearly 20%.

Vermont contemplated a new state income tax of 9.5% to pay for the SPPS on top of the existing 3.55-8.95% individual state tax.

The state budget would need to be doubled with the SPPS, therefore taxes would need to be doubled.

Even with these increases in taxes the plan would be deep in the red in three to five years.

Gov. Shumlin (Vermont) was elected to create a SPPS. In 2014 he abandoned single payer system he was about to create because of its effect on the state economy.

Gov. Peter Shumlin woke up to the impending disaster, “The potential economic disruption and risks,” he remarked, “would be too great to small businesses, working families and the state’s economy.”

Ben and Jerry might even flee the state and move to Texas because of the high taxes and economic disruption.

The people of Colorado should look carefully at Vermont’s mistake. The Denver Post has already predicted tax increases that would drive business and job growth out of the state.

Colorado also has a large VA Hospital System. In April 2015 the Colorado Springs Gazette reported that four of Colorado’s VA facilities were among the 10-worst in terms of wait times of all VA hospitals.

The Veterans Affairs hospital system is a pure a single-payer system.

A September report by the agency’s inspector general supports the conclusion that thousands of veterans may have died while waiting for the care they needed, although shoddy record-keeping made it impossible to know for sure.”

All Coloradans have to look at is their state’s VA SPPS that cannot take care of the 400,000 veterans in the state. Why should Coloradans expect a SPPS would work for five (5) million residents it their state?

What have conservatives and liberations offered as a substitute for the failed Obamacare experiment?

Nothing!

Leaders should start looking at My Ideal Medical Savings Account system that would put consumers in charge of their health and healthcare dollars.

Please send my summary blogs about an alternative to Obamacare and my Ideal Medical savings accounts to your elected representatives.

Spread the word about My Ideal Medical Savings Account as an alternative to Obamacare.

I wish everyone a HAPPY AND HEALTHY HOLIDAY SEASON

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

All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

 

 

 

 

 

 

 

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Obamacare Is In Big Trouble!

Stanley Feld M.D.,FACP,MACE

There are so many parts of Obamacare that are failing it would be impossible to describe each failure in a single blog..

President Obama and his administration keeps telling the American people that Obamacare is working great. It is here to stay.

I cannot believe Americans believe him. I cannot believe he thinks Obamacare is doing great.

It could be true that everything is going great for him if he wants Obamacare to fail and cause hardship for millions of Americans.

At that point Americans would beg President Obama or another progressive president loke Hillary Clinton to institute a single party payer system.

A single party payer system has been Hillary’s dream since Hillarycare 1993. Now she is saying she wants a private insurance based system. The purpose of this statement is to neutralize (freeze) her free market system critics.

Once more America is being exposed to Hillary Clinton’s use of a typical Saul Alinsky tactic. The tactic in his “Rules for Radicals” is to freeze your opponent by stating his position as yours even if it is a lie.

Hillary wrote her senior Wellesley College thesis on Saul Alinsky and “Rules for Radicals”. She also became a big fan and good friend of his.

Hillary Clinton and President Obama know Obamacare is failing. They are just waiting for the tipping point. The tipping point will be when the American people say please help us and give us a single party payer system.

At that point we will hear the typical gee shucks, I guess we will have to try a single party payer system.

A single party payer system will be a bigger financial and patient care disaster than what we have now.

The data on the first week of applications for Obamacare’s healthcare.gov was announced to the rave reviews by the Obama administration.

Since few pay attention to the actual numbers President Obama can get away with the lie.

The CBO predicts 19 to 21 million will sign up for Obamacare for 2016. The administration estimates they are going to have 9.1 to 11 million enrollees for 2016.

The Obama administrations estimate is 30% lower than the announce 13 million enrollees in 2015. In reality only 9.7 million enrollee paid for healthcare insurance through healthcare.gov 2015. Of those 9 million only 6.5 million kept their insurance premiums current for the entire year.

The www.acasignup.net quoted the Obama administrations claim that 595,590 filled out applications to get price insurance quotes. Only 8% of the reported applicants or 47,243 paid their first month’s premium for 2016.

These numbers are not a cause for celebration unless you want to misinform the public by claiming a successful first week enrollment.

Let’s do the math. The enrollment period for 2016 is from November 1st until December 31st 2015 or eight and one have weeks with four major holidays, Veterans Day, Thanksgiving, Christmas and New Years.

Let us the assume all 600,000 that filled out applications will pass the application requirements and pay their assigned premium for each month. Let us also assume the average weekly application rate is 600,000 per week for the 81/2 weeks. The grand total enrollees would be 5.1 million enrollees for 2016. This is 4.5 million less paid enrollees than in 2015.

There was an attrition rate 2% a month in 2015. President Obama extended the enrollment period several times to get more people to sign up.

2015 FULL YEAR ENROLLMENT/ATTRITION RATE TABLE PROJECTION:

2015_full_year_projection_effectuated

2014 FULL YEAR ENROLLMENT/ATTRITION RATE TABLE (FINAL):

  Microsoft ExcelScreenSnapz 2014 458

It is clear that President Obama’s victory laps celebrating the success of Obamacare is unwarranted.

However the media is the message. He controls and manipulates the media. It would have been much easier to provide Medicaid and CHIP coverage to the poor outright than destroying the healthcare system with changes that are not working.

The final enrollment for 2014 was 6,338,622 not over 13 million. The final enrollment for 2015 was 9,736,350 and not over 13 million. This is a net gain of 3.5 million new paying enrollees in 2015.

This year the Obama administration estimates that 9 million will purchase insurance through the health insurance exchanges. At the present rate only 5.1 million will purchase insurance for 2016 at the end of the enrollment period December 31, 2015.

The CBO’s estimate was 19-21 million paid enrollees.

It does not represent a very successful net gain when the government publishes that there are 34 million uninsured Americans. No one knows if the 90 million unemployed Americans are counted in the number uninsured.

Unaffordable care act

All anyone hears is the Obama administration’s reasons our taxes, and insurance premiums are going up, while our insurance coverage is going down. The Obama administration is blaming the healthcare insurance industry and Republicans.

President Obama has used, with the help of the mainstream media, the Saul Alinsky tactic to freeze opponents by shocking them with unsustainable factoids.

 The Avalere Health consultancy’s analysis of 2015 signup data showed surprisingly weak ObamaCare enrollment at modest income levels. At between 150% and 200% of the poverty level, just 41% of those eligible signed up for coverage. The number falls to 30% among those between 200% and 250% of the poverty level.

 In 2016 President Obama is going to penalize people that do not have healthcare insurance.

It’s now clear that the actual impact of ObamaCare’s individual mandate tax penalty will be far worse than the benign intent that the Obama administration claimed.

“What we’re talking about is a penalty for the few people who will refuse to buy health insurance — even though they can afford it — and who expect the rest of us to pick up the tab for their care,” a September 2009 White House defense of the individual mandate states.”

Reality should be coming into focus by now for the average American taxpayer and the poor. Obamacare is ripping everyone off.

The mandate’s primary impact will be to compel low-income households to buy bronze coverage with deductibles of up to $6,850 per adult that are well beyond their capacity to afford.

Even after these poor people pay the $6,850 deductible they have a 40% deductible on the rest of the billing.

Who said poor people are too stupid to handle their own money and be responsible for their healthcare dollars?

They are smart enough to know the government is ripping them off.

George  Shore101  3 months ago

If the Obama administration and Democrats love the poor why did they force the poor to purchase something they can not afford and then penalize them for not being able to afford it?

It is a horrible thought to think President Obama is working to make the poor poorer and make the healthcare system fail the American people.

It looks like he is. His plan to replace it with a single party payer system will result in a bigger failure.

Why are Republicans just standing around doing nothing? Why don’t they publicize my Ideal Medical Saving Accounts?

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Wanting Something To Fail?

Stanley Feld M.D.,FACP,MACE

If someone wants something to fail, make it complicated enough so no one understands what is going on.

I am convinced that President Obama wants Obamacare, Medicaid and Medicare to fail.

President Obama wants a single payer health care system. He said it as far back as 2003. This You Tube was uploaded on Aug 12, 2009.

 

https://youtu.be/LhEX3rHssJI

President Obama won’t tell the American people the truth about his plans for health care. Watch President Obama declaring his intention in his own words.

The result is everyone will receive the same healthcare under the government direction and control.

The ultimate goal is to make people dependent on the government.

The people will have no power to choose their physician or their treatment. It is true that every country in the western world has this system.

No country has proven that a single party payer system works for countries with the single party payer systems economy or their citizens. Surveys have shown that their citizens are satisfied.

The main reason people like it is because it relieves anxiety of being able to receive medical care even though they have relinquished their freedom to choose their physician or insurance company.

The biggest loss is independence from the government bureaucracy. People will be dependent on the decisions of unelected government bureaucrats.

The big questions that are never answered about medical costs are; who is spending most of the healthcare dollars and what are the healthcare dollars being spent on?

Do you want the government to decide if you are young enough to get an artificial hip or knee when you need it?

Do you want the government to decide about your treatment or do you want your doctor to help you decide on what your best treatment is?

President Obama is changing medical care in a methodical way. He is utilizing executive orders and rules and regulations written by non-elected bureaucrats, who are forced to follow his orders. Our elected officials should be in charge of government spending.

Many in congress know better and would not let President Obama do what he is doing. Most in congress are happy that he has exempted congress from Obamacare.

President Obama and his administration have been trying to do bad things very quietly to avoid political uproar. The mainstream media has been a great Obamacare ally.

The mainstream media has helped Obamacare keep these destructive regulations and their subsequent failures out of public view.

The media has also publicized President Obama’s lies about the success of Obamacare.

President Obama is adept at diverting blame for errors and failures in pursuit of his single party agenda.

At the same time he is trying to take power away from the states he is trying to persuade states to not permit big insurance premium rate increases requested by many health insurance companies for 2016.

President Obama’s Obamacare is the cause of the increases. He is positioned to blame the state regulators for the insurance companies not showing up to sell insurance for 2016.

If the states act to cut back rate increases the insurance companies will not participate in the federal and state exchanges for the 2016 enrollment period. The result will be the erosion of the possibility of competitive pricing.

The Obama spin machine started working at the beginning of the summer to shift the blame and/or force insurance companies out of the market.

Kevin J. Counihan, the chief executive of the federal insurance marketplace said in letter to state insurance commissioners, “Recent claims data show healthier consumers.

He also said, “The federal tax penalty for going without insurance will increase in 2016, he said, and this “should motivate a new segment of uninsured who may not have a high need for health care to enroll for coverage.”

This claim of costs data by Obamacare does not square with the healthcare insurance companies’ costs data. They are finding that new customers were sicker than expected. The insurance industry is also losing money because the Obama administration has paid them $2.5 billion dollars less than they were promised.

Health insurance plans sold through Obamacare’s Federal and State Health Insurance Exchanges are seeking 10 to 40 percent increases in premiums.

They are also seeking the same increase in the private sector as well as in Medicare and Medicaid.

The Obama administration is making up its own story to force state regulators to not allow the increased premiums.

The Obama agenda is choreographed to prove that insurance choices do not work. He is hoping that the public will conclude the only solution is a single party payer system.

The problem is the government cannot afford a single party payer system and the people will not tolerate it.

What is more bizarre is the Obama administration made loans to help start up state co-ops. These state co-ops were supposed to compete with the big insurance companies. They were supposed to sell insurance on the health insurance exchanges. The Obama administration invested $38 billion in startup costs and solvency loans to these co-ops.

Nevada Health Co-op received $66 million in federal loans. It is closing down on January 1,2016 because it ran out of money.

Louisiana Health Cooperative announced in July that it was voluntarily shutting down operations.

CoOportunity Health, which sold policies in Iowa and Nebraska, was liquidated and forced to close earlier this year.

Many state Co-op’s are on the way to bankruptcy. In Nevada alone one third of the health insurance exchange population will lose insurance coverage.

Nevada Health CO-OP’s departure will leave a big hole in Nevada’s exchange market. Open enrollment begins Nov. 1, and consumers will have to shop for plans with other carriers. The co-op had 21,300 members as of the first quarter this year. Nevada’s exchange population was about 63,000 at that time.

A.M. Best’s report shows a majority of the nation’s 22 co-ops have combined medical and administrative expense ratios above 100%.

All these failures and impending failures mean that either the Obama administration is stupid or things are going precisely as  President Obama had planned.

The healthcare system is on its way to destruction. The federal government as the payer of last resort will replace it.

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

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