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Accelerating The Destruction Of The Healthcare System

January 18, 2016

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

Most of you are familiar with my slide of the demise of the healthcare system.

Obamacare is accelerating the total collapse of the healthcare system. Once total collapse has occurred Americans might beg for a complete government taken over of the healthcare system with a single party payer system.

I have pointed out most of Obamacare’s new rules causing the unintended consequences and accelerating the healthcare system’s demise.

An unintended consequence in the Accountable Care Organization leads to a new rule to correct the consequence. Unelected officials then create another rule. The new rule results in other unintended consequences. All of these consequences accelerate the healthcare system’s demise.

Obamacare’s first year in operation was 2014. The Obama administration started taxing everyone in 2010 to support the added expenses Obamacare would generate.

Only the individual insurance portion of Obamacare was initiated.

The following are examples of unintended consequences.

Fourteen million people lost their individual healthcare insurance coverage in 2012 because of Obamacare’s new rules. Insurance coverage premiums increased because of the ACA’s required coverage.

Many workers lost their full time jobs. They were put on part-time employment in order for employers to avoid Obamacare penalties.

CMS reported that 13 million signed up for Obamacare in 2014 despite the healthcare.gov website disaster. The number of enrollees was revised a few of times down to 6.6 million because of counting errors.

The direct and indirect costs of Obamacare were never reported to the public.

Obamacare activated a reinsurance program that was built into the Affordable Care Act. The reinsurance program was a bailout to entice the healthcare insurance industry to participate in the Federal Health Insurance Exchanges without experiencing any loses.

The insurance industry has claims the Obama administration owed it 2.5 billion dollars in 2014. The Obama administration was able to pay only 12%. The law restricted the government’s reinsurance payment to a certain percentage of the premiums paid. The amount owed as promised to the healthcare insurance industry for their participation in Obamacare was $2.2 billion short.

I believe the healthcare insurance industry will be loath to participate in the Federal Health Insurance Exchanges in 2017. UnitedHealth has already threatened to quit participating.

This year (2016) during open enrollment only 8.1 million enrolled in the Federal Health Insurance Exchanges.

It has been difficult to trust CMS’s overall claims for the number of enrollees. It has nothing to do with how many people have paid first premium or the anticipated number who will continue to pay premiums throughout the year.

President Obama stated in his state of the union speech that 18 million previously uninsured have received insurance under Obamacare. This is not true.

For argument’s sake let say his number is correct.

More than half the enrollees received Medicaid. President Obama is urging states to expand Medicaid.

What is going to happen when Medicaid is expanded? More people will get free government supplied healthcare insurance but will not be able to find physicians. Medicaid reimbursement is so poor that few physicians participate.

The healthcare system’s demise is rapidly accelerating. Obamacare’s claiming to increase people being covered but these people cannot obtain healthcare services.

Obamacare does not incentivize these people to be responsible consumers. Obesity continues to increase and the dollars spent for healthcare continues to increase.

The truth is enrollment has been terrible for 2016. President Obama is expanding the enrollment period again this year to try to increase enrollment.

“Eager to maximize coverage under the Affordable Care Act, the Obama administration has allowed large numbers of people to sign up for insurance after the deadlines in the last two years, destabilizing insurance markets and driving up premiums, health insurance companies say.”

“The administration has created more than 30 “special enrollment” categories and sent emails to millions of Americans last year urging them to see if they might be able to sign up after the annual open enrollment deadline.

The Obama administration has done nothing to verify whether these late arrivals are eligible for insurance. They just sign up and are insured.

People have figured out they can wait until they become ill or need medical services to sign up. They then sign up and pay their premiums a few months’ premiums. They stop paying their premiums after they have received their medical services. They figure they do not need insurance any more.

“Individuals enrolled through special enrollment periods are utilizing up to 55 percent more services than their open enrollment counterparts” who sign up in the regular period, the Blue Cross and Blue Shield Association, whose local member companies operate in every state, told the administration.

The Obama administration has told the healthcare insurance industry that it has heard their concerns. The problem is that CMS has not done anything about the insurance industry’s concerns.

“Many individuals have no incentive to enroll in coverage during open enrollment, but can wait until they are sick or need services before enrolling and drop coverage immediately after receiving services, making the annual open enrollment period meaningless,” Steven B. Kelmar, an executive vice president of Aetna.”

Twenty five percent of Aetna enrollees have signed up during the special extended enrollment periods. It has been reported that last year 950,000 people enrolled during the special enrollment period between February and July 2015.

“Kevin J. Moynihan, the chief executive of the federal insurance marketplace, said it shows the marketplace is working to meet people’s needs. He said certain life changes like losing your coverage, having a child, turning 26, moving or getting married may qualify you for a special enrollment period.”

People who are qualified for insurance do not get verified for insurance. It is easy to understand that this leads to unstable insurance markets and subsequent increases in premium prices.

It is o.k. for progressives if healthcare insurance is considered a right under a single party payer system with the losses taken by the government even if the deficit increases.

It is not o.k. if the Obamacare healthcare system pretends to be developing an efficient free enterprise system with the healthcare insurance industry experiencing the loss under the weight of unidentified risks created by the federal government.

The number of people not continuing to pay their insurance premiums their entire year is enormous. The healthcare insurance industry had no way of anticipating this occurrence.

“On average,” Aetna said, “special enrollment period enrollees stay with us for less than four months, while enrollees who come to us during the annual open enrollment period maintain their coverage on average for eight to nine months.”

The same turnover rate has happened to UnitedHealth. It is one of the many reasons UnitedHealth has threatened to quit participating in Obamacare in 2017.

The result will be even higher insurance premiums next year. Most of the Obamacare insurance rates are unaffordable this year.

“Enroll America, a nonprofit group with close ties to the Obama administration, said the government “should not tighten eligibility or verification standards in ways that could place an undue burden on consumers.”

There is no verification for late enrollment. The last statement by “Enroll America” reflects President Obama’s progressive and irresponsible attitude toward fiscal responsibility.

It is no wonder the national debt has grown to $19.2 trillion dollars.

It is another way to accelerate the collapse of the healthcare system.

I believe President Obama knows exactly what he is doing. His problem is he does not understand or care about the significance of the effect the deficit increase will have on America’s financial stability.

Middle class Americans are getting slaughtered.

Additionally he does not understand that Americans will not accept a government controlled single party payer system.

The Republican Party must get on the stick right now. They must offer a viable alternative to President Obama’s goal of a single party payer system. They should not wait until after the election.

The alternative should work in an efficient way. It should put consumers in charge of their health and healthcare dollars.

It would be a good idea for Republicans to understand and offer as an alternative My Ideal Medical Saving Accounts.

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

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Destroying The Healthcare System

January 6, 2016

inMedicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D, FACP,MACE

I believe President Obama’s goal is to destroy the healthcare system. The people will then beg the Obama administration to institute a single party payer system with the government being in full control.

The fact is Obamacare is not working despite the Obama administration’s convincing the mainstream media to advertise that it is very successful.

I was shocked at a December 9^th New York Times article stating:

“ A million new customers have signed up for health insurance during the Affordable Care Act’s third open-enrollment season, Obama administration officials said on Wednesday, and call centers have been deluged.”

This statement is an optimistic statement and a distraction from the true. A readers impression would be Obamacare is doing great.

The Obama administration simply ignored last year’s enrollment numbers. Ten million people were supposed to have signed up for healthcare coverage through the Federal Health Insurance Exchanges. Only seven million of those who signed up paid their premiums for the entire year.

The premiums and deductibles were too high even for the poor who received federal subsidies.

Most of the people remaining in the Obamacare in the federal exchanges were people with a pre-existing illness. One diabetic told me her individual premium for Obamacare was $12,500 dollars with a $6,000 dollar deductible. Her bill for last year, being hospitalized one time, was almost $100,000. She felt Obamacare was a very good deal for her.

The insurance company covering these kinds of patients with a pre-existing illness cannot make money for the insurance coverage they are required to provide.

If all the patients have pre-existing illnesses, the only thing the insurance companies can do is raise the premiums or stop selling insurance in this Federal Health Exchange market.

The Obama administration promised it would limit the insurance industry’s loss with its reinsurance program. The Obama administration reneged on its word and only paid 12% of what was due for 2014. The administration did not have the money to pay for it.

In 2014, the first year of coverage, we were told 13 million signed up, but only 7 million had coverage at the end of the year.

The administration provided data to the CBO to predict the number of enrollees Obamacare will have in 2016. The CBO predicted 21 million would be signed up for 2016. The CBO used data provided by the Obama administration to make this calculation.

What happened to the remaining 7 million enrollees for 2015? We are not told how many enrollees automatically re-enrolled.

We only hear that, ‘ A million new customers have signed up for health insurance.”

We can now understand the concerns expressed by UnitedHealth Group and other insurers that say they are losing money in the Obamacare Federal Health Insurance Exchanges.

Open enrollment is due to end January 1, 2015. In mid December CMS announced,

‘We are now seeing a surge of interest as we get closer to the deadline,” “Each day has been bigger than the day before.”

The last two weeks in December had less that 100,000 people sign up. Yet the government published these numbers. Many wonder how real these numbers are. If they are real there has been no increase in enrollment in the last year.

Confirmed 2016 Exchange QHPs: 9,584,850 as of 12/30/15
Projected Exchange QHPs: 11.32M by 01/02/15 (8.60M via HC.Gov)
In the last week in December only 80,000 people signed up compared to 96,000 the same week last year.

The coverage is poor and too expensive for most people.

Open enrollment has now been extended to January 31 for enrollment March 1^st.

“People who go without insurance next year may be subject to tax penalties of $695 a person or more, although some may be able to qualify for hardship exemptions.”

This is a joke. However, the joke is on the consumers and taxpayers.

So far, Obamacare has created a 10% increase in federal taxes middle-class taxpayers.

It has increased coverage for the Medicaid eligible poor. However, these people cannot find a doctor who will treat them.

The healthcare system is costing over three trillion dollars a year and increasing our deficit more than $1.5 trillion dollar a year. There are still 34 million people uninsured. How many people are under insured because their jobs have been changed to part time jobs? They cannot afford to buy Obamacare’s insurance?

2017 is the year the healthcare insurance markets are supposed to stabilize. These markets have not stabilized. Healthcare insurance companies, and business groups can not understand how the new CMS’ proposals will regulate and expand provider networks and standardize plan options let alone have insurance markets result in lower premiums.
“We remain deeply concerned that this proposed rule will not stabilize the individual market,” Steven Kelmar, Aetna’s executive vice president for corporate affairs, wrote in a letter to the CMS. “Unless some fundamental flaws are corrected, we believe there is a grave risk that the federal exchange will not operate as a viable, competitive market in 2017.”

One of the more significant and controversial provisions in the proposed rules involves the adequacy of provider networks. The CMS proposal demands that ACA-compliant health plans sold on the federal exchanges in 2017 would have to abide by new network standards.

All plan networks would have to include hospitals and doctors within certain travel times or distances from members. There would also be minimum provider-to-member ratios for some medical specialties.

CMS proposed that all health plans in each metal tier on the federal exchange have the same benefits. For example, all 2017 bronze options would have a $6,650 deductible, and all plans would have no more than one provider tier.

This proposal practically guarantees that the healthcare insurance industry selling insurance under Obamacare’s exchanges would lose money. Therefore, the industry would choose not to participate.

The big losers would be patients with preexisting illnesses. They would lose their insurance.

The traditional mainstream media is already cranking up the Obama administration spin machine to promote a single party payer system as the best and simplest option to provide insurance for all Americans.

Nobody is thinking about who will pay for a single party payer system after the administration emotionally conditions the public to beg for a single party payer system.

The hardest by increased costs in the system are consumers at every income level.

As the cost rises to unaffordable levels all consumers are starting to take think about taking responsibility for their health and healthcare dollars.

“The new research also finds that as a result of the increase in health care costs, focus group participants are changing how they operate within the health care system.

They are questioning their doctors recommendations more frequently, comparing cost and quality information for local providers, and even putting off seeking care altogether.”

Despite the low of enrollment in 2016 (that the Obama administration denies), CMS is about to publish new 2017 rules for the insurance industry. These rules are guaranteed to make the healthcare system more dysfunctional.

The fact is the structure of Obamacare is failing and about to collapse.

All of the Obama administration’s tinkering to stop the free fall is creating greater momentum for total collapse of the healthcare system.

The answer to fixing the healthcare system is not a single party payer system.

The answer is a consumer driven healthcare system with the aid of smart phones and the Internet and Medical Savings Accounts.

Progressives have a tendency to forget the math. They have more interest in satisfying an emotional response. The resulting entitlement policies lead to the unintended consequences and only make things worse.

Neil Cavuto demonstrated this logic recently in an interview with a student campaigning for free student loans.

https://youtu.be/Zmji36q8E4o

Progressives’ logic is faulty. It demonstrates a lack of understanding of the affects of entitlements and their unintended consequences.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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Making Medicine Function: Five (5) Key Elements From Stanley Feld M.D.,FACP,MACE : Repairing the Healthcare System

January 4, 2016

inSummary Blogs

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Scott Becker of Becker’s Healthcare asked me to write an article on Element needed to Repair The Healthcare System. Becker’s Healthcare is the leading source of cutting-edge business and legal information for healthcare industry leaders.

His portfolio includes five industry-leading trade publications:

Becker’s ASC Review
Becker’s Infection Control & Clinical Quality
Becker’s Spine Review
Becker’s Hospital Review
Becker’s Dental Review

My article appeared in the latest addition and with permission from Scott Becker. I am reprinting it on my site. Becker’s Healthcare is a valuable information site.

Making Medicine Function: Five (5) Key Elements From Stanley Feld M.D.,FACP,MACE : Repairing the Healthcare System

Patients, physicians, hospital executives, healthcare insurance executive and government all believe the healthcare system is dysfunctional and unsustainable in future years.

All the stakeholders are unhappy with Obamacare.

Clinical Endocrinologist, Stanley Feld, MD, FACP, MACE, is a physician who believes Obamacare’s business model is seriously flawed. He also believes that Obamacare has accelerated the dysfunction in the healthcare system.

Dr. Feld believes Obamacare has increased the healthcare system’s unsustainability by causing an increase in bureaucracy, a decrease in efficiency and encouraging the gaming of the healthcare system by all stakeholders.

The Obamacare business model must be changed to a consumer driven healthcare business model with the consumer in charge and in the center of the healthcare system, not the government or other secondary stakeholders.

Consumers must be taught and incentivized to use all the 21^st century technology tools available including smart phones. The goal must be to improve medical care and treatment outcomes, not improve the measurement of medical process outcomes.

Dr. Feld became interested in the causes of the healthcare system’s dysfunction in 1991 while he was on the steering committee of a nascent medical organization, the American Association of Clinical Endocrinologists (AACE).

He became AACE’s third President and was chairman of the Type 2 Diabetes Guideline committee. He was the chief author of “A System of Intensive Self-Management of Type 2 Diabetes Mellitus.”

In 1991 there was little government and healthcare insurance industry support for the concept of teaching the Type 2 Diabetics how to be the “Professor of Their Disease” even though there was a Type 2 Diabetes epidemic.

The epidemic was the result of lack of understanding by consumers (patients) of how to prevent and treat Type 2 Diabetes Mellitus. Uncontrolled Type 2 Diabetes causes complications that are coronary heart disease, kidney failure, blindness and amputations. Quality of life of is decreased. The complications are costly to the patients and the healthcare system.

America was in the midst of an obesity epidemic. The epidemic continues today. Obesity predisposes consumers to Type 2 Diabetes Mellitus and its subsequent complications.

Dr. Feld said everyones goal for the healthcare system is to have a healthier population at an affordable price. The goal can be accomplished by putting consumers in control of their health and healthcare dollars. Consumers must also be given financial incentives to control their health. No one is focused on the consumer’s responsibility to lower cost in the Obamacare business model.

Dr. Feld believes Obamacare’s business model has too many faults to repair. Each time President Obama alters the business model to fix a fault, the healthcare system becomes more costly, dysfunctional and unsustainable.

Dr. Feld developed a business model that would accomplish the goal of providing a functional and efficient healthcare system at an affordable cost to consumers, employers, healthcare insurance companies and the government.

Dr. Feld’s business model would eliminate most of the government’s inefficiency that absorbs 40% of the healthcare dollars. The inefficiencies must be eliminated or at least significantly decreased.

Here are Dr. Feld’s five key elements necessary to Repair the Healthcare System.

All the key elements listed are explained in detail in Dr. Feld’s blog “Repairing the Healthcare System”. Each link will have a full list of my blog posts on the topic.

The Ideal Medical Savings Accounts (MSAs).

Dr. Feld’s Ideal Medical Savings Account is the insurance model in his business plan.

Medical Saving Accounts are different than Health Savings Accounts. Health Saving Accounts are the fastest growing healthcare insurance plans. Medical Saving Accounts provide consumers with more financial incentive.

The Ideal Medical Saving Account transfers the premium dollars saved by consumers into a tax-free retirement trust that is not restricted to medical care. The financial incentive will cause consumers to be responsible for the control of their health and wisely spend their healthcare dollars.

The Ideal Medical Savings Accounts are democratic. The employer, the individual or the government could fund the Medical Savings Account. The deductible must be high enough to provide enough financial incentive for consumers to be motivated to become responsible for their health and their healthcare dollars. Once the deductible is reached the consumer receives with first dollar coverage for an illness.

If the deductible is not spent the consumer gets it tax-free in their retirement trust.

Ideal Medical Savings Accounts provide consumers the choice of physician. The environment is created where consumers decide on who will provide the best value for their healthcare dollars rather than the government, the healthcare insurance industry or the government.

MSAs would create a Consumer Driven Healthcare System with the benefit of consumers creating competition among the stakeholders in the healthcare system rather than stakeholders deciding for consumers. For greater details go to this link.

The Importance of Tort Reform

Most politicians have ignored the importance of Tort Reform. They have been led to believe that Tort Reform is an insignificant cost to the healthcare system.

Dr. Feld points to study by the Massachusetts Medical Society. Every practicing physician believes the data of this study. The resulting data is an excellent and truthful indicator of the huge cost of over-testing to prevent malpractice claims.

The lack of Tort Reform costs the healthcare system $200 billion to $750 billion dollars a year as a result of over testing by physicians to avoid malpractice suits.

Physicians who order a test usually do not receive the profit built into the test he/she has ordered.

The Importance of Self-Management of Chronic Disease

The unsuccessful management of chronic diseases results in 80% of the cost of care for those diseases. Most important is to prevent the chronic disease from occurring in the first place. Diseases with the highest costs are Diabetes Mellitus, Heart Disease, Hypertension and Cancer. Obesity and consumer’s genetic makeup are responsible for most of these chronic and costly diseases.

Consumers are in control of the development of obesity. They must be responsible for preventing it. However all of our cultural stimulation encourages obesity. Consumers must make a choice. Government can provide public education programs to help consumers make the correct choice. When consumers are educated and are at financial risk for developing obesity, they will become responsible and avoid becoming obese.

The reformed healthcare system could prevent the onset of complications of these chronic diseases. The cost of the complications of chronic disease is 80% of the cost of treating that disease.

These teams must be an extension of their physicians care and responsible to their physician.

The Magic of the Patient/Physician Relationship.

Obamacare tries to quantify patient care. Twenty thousand rules and regulations have been produced so far to measure the care delivered by physicians to patients.

Maybe the measurement criteria for quality care are wrong? Maybe the government is measuring the wrong thing.

There is no quality measurements made about patients’ compliance or adherence. There are no rules to measure the patient/physician relationship.

These would be important measurements for bureaucrats to measure in order to quantitate the effectiveness of care.

If one wanted to commoditize the delivery of quality medical care, consumer responsibility for compliance with their treatment is an important measurement.

The patient/physician relationship is magical. It can result in improved patient compliance and self-management of both acute illness and avoidance of the complications of chronic diseases. The end result is that it can decrease the cost of healthcare by at least 50 percent. The healthcare system would then be affordable.

As the government and healthcare insurance companies try to decrease their cost they have decreased reimbursement and increased regulations and paperwork for physicians

A physicians work product is intelligence, skill and time. Physicians do not have enough time to develop a patient/physician relationship today.

The patient/physician relationship is difficult to measure. It cannot be commoditized into a universal report that a computer program can generate.

The Rule of Information Technology

Physicians are not opposed to information technology. They are against information technology generating data that is being used as a tool to judge their clinical competence and reimbursement by bureaucrats. Many times the “big data” is inaccurate.

Information technology should be used as a tool to extend a physician’s ability to patients. It should be used as a tool to improve physicians’ care.

In order to reduce the cost of medical care and increase the patient’s ability to be a “Professor of Their Disease”, medical care must be delivered by a team approach.

Information technology must be a part the team with the consumer being in the center. Physicians must be the coach; the other members of the team must be physician extenders (assistant coaches).

There are many websites generating both good and bad information. As the manager of the team the physician and his assistant managers should pick the websites for his/her patients to use.

Physicians and his/her healthcare management teams should develop social networks so his/her patients can relate to each other and learn the subtleties of their chronic disease from each other. Physicians and his patient extenders would monitor and correct any false information generated through the social network.

These social networks would be very effective in motivating consumers to be responsible for their care and their healthcare dollars.

These are five elements that would decrease the cost of America’s healthcare system. They would avoid the trap and unintended consequences of a single party payer system.

The real cost curve has not been bent downward. It has been bent upward in the actual cost to taxpayers. The government is not measuring all the costs, including new taxes, as payment for Obamacare.

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

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Single Party Payer Will Fail

December 21, 2015

inDisinformation and the healthcare system, Repairing the Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld MD, FACP, MACE

Socialism does not work!

Intellectually, socialism is attractive and easy to understand.

Simple Definition of Socialism

“: a way of organizing a society in which major industries are owned and controlled by the government rather than by individual people and companies.”

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.

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More Bad News For Obamacare And Taxpayers

July 13, 2014

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

The Obama administration and the traditional mainstream media are working very hard to keep the bad news about Obamacare away from the general public.

The Colorado exchange (Connect for Health Colorado) expects nearly 24% of the enrollees to drop health exchange coverage in fiscal 2015.

This is a direct contradiction to the Obama administration’s projection of the growth of health insurance exchanges.

“In April 2014 after open enrollement closed, the staff of Connect for Colorado projected 13 percent of people enrolled will drop or not pay for policies in fiscal 2015, but now they are expecting about 24 percent to drop their policies, according to the latest model.”

“And in fiscal 2016, the revised figures show dropped policies going from the 16 percent projected in April to nearly 22 percent.”

The Colorado Health Insurance Exchange’s chief financial officer Cammie Blais said the staff is using the higher drop rate in more recent models because that is how national figures are tracking.

President Obama and the Obama administration are aware of these figures. As usual they are keeping it from the public.

Why is happening nationally? There are multiple reasons.

Eighty five percent of the people who have enrolled have qualified for subsidies on the basis of the information they gave on the enrollment form.

The federal government was not set up to verify the information given on the enrollment form at the time of enrollment.

President Obama told everyone he would take his or her word for the information’s accuracy. This was a tremendous defect in the Obamacare system.

Many enrollees are going to lose part or the total subsidy provided by Obamacare. For some, the original subsidy was not enough to reduce the burden of insurance. In many cases the burden included high deductibles and copays that were unaffordable.

Many of the remaining fifteen percent of the enrollees had preexisting illnesses and could not buy insurance on the open market and/or were making over $50,000 a year.

Their premiums plus deductibles and copays are so high that enrollees making over $50,000 a year realize they cannot afford the insurance and have to drop out of next year’s exchange.

As a result of this adverse selection healthcare insurance industry’s premiums are going to skyrocket in 2015 as they have skyrocketed in 2014.

If the government starts convincing the majority of the public that the free market solution of the health insurance exchanges doesn’t work, the only choice will be a single party payer system for the entire population.

The VA system is an example of a single party payer system run by the government. It is a bureaucratic mess that is inevitable with a government run single party payer system.

A large bureaucratic single party payer systems relying on rules and regulations will end up with as non-transparent bureaucracy built for the benefit of the bureaucrats and not the people.

I think the public understands this. I think the Obama government is out of touch with the people.

President Obama ought to reexamine his premises.

The Obamacare system being built is destined to fail. It is not a consumer driven free market system. It does not follow that a single party payer system will work.

In reality none of the government controlled single party payer systems throughout the world work. They are just free. However, these systems are unsustainable.

The 8 million enrollees that President Obama ran his Obamacare victory lap on continues to dwindle at an accelerated rate.

If the DC appeals court rules against the federal government ability to provide subsidies, the number of enrollees will decrease even further.

The law states that only State health insurance exchanges can provide subsidies.

Obamacare is getting further and further away from being functional.

The Obama administration and the traditional media are working very hard to keep this information from the general public.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.  Please have a friend subscribe

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Big Data Is A Major Problem For The Healthcare System.

October 31, 2012

inChronic Disese Management, Consumer Driven Health Care, Information Technology in Healthcare, Medicine: Healthcare System

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Stanley Feld M.D.,FACP,MACE

President
Obama is blinded by his ideology. His healthcare policy goal is to eventually
have a single party payer system. Medical care will be commoditized with
treatment decisions made by the central government.

It
is a charade that his health insurance exchanges will lead to affordable
private insurance. It is misguided to believe that a non-elected central
committee (IPAB) will be tolerated to make treatment decisions for the
population.

The
larger pretense is that President Obama is building an inexpensive bureaucracy.
Last week he again stated that government overhead for Medicare and Medicaid is
very low. He again declared that the overhead expense is only 2½ percent.

It
cost two and one half percent for the central government to outsource administrative
services to the healthcare insurance industry. The healthcare insurance
industry, in turn, charges the government 18-40% to administer the programs.

Everyone
knows most everything government run is inefficient. President Obama is
enlarging the scope of government in all areas at a time when government is too
large and inefficient. The government’s income is $1 trillion dollars less than
its expenses per year since he has been President.

President
Obama thinks if he spends enough money he will spend his way out off the jam.

President
Obama believes one way to become more efficient is to gather more data. He can
then figure out which hospital systems and physicians are inefficient and
penalize them.

This
philosophy has two potential pitfalls. If the data is faulty the conclusions
are wrong. The second pitfall is that penalties do not encourage cooperation
and meaningful improvements.

“Decision-making in
healthcare can be painfully slow, as any physician will tell you. Hospital systems and
physicians are being spurred on in part because healthcare is beginning to deal
with a shift in reimbursement toward one that rewards quality and disincentives
inefficiency and waste.

One problem is that quality is not clearly
defined and is sometime false. The government must reexamine its premises.

Most hospitals and health systems have lots of
data that might improve outcomes and cut waste.

The
problem is getting that data, which is often unstructured, into a format that
allows clinicians to make decisions faster and in a more coordinated fashion.

All
of the innovation is happening without input from physicians. It is being done
to decrease the cost of the hospitals. One thought would be to get rid of a few
excess salaried, $750,000 a year hospital administrators and $2,000,0000 plus
healthcare insurance company administrators which would go a long way to reduce
the cost of healthcare coverage.

Instead
the government is looking to penalize physicians. Physicians are the providers
that deliver medical care.

There
is software being developed that deals with real time processing of clinical
data. The software can communicate those data to networked physicians instantly
and help physicians deliver more timely care.

Many
hospital systems are trying to install these real time systems. Unfortunately,
many hospital administrators do not understand its power as a teaching tool to
increase the efficiency and effectiveness of medical care.

The hospital systems’ only interest is in the
financial result and the question of whether the huge investment is worth the
capital expenditure.

Some
physician group practices, independent of hospital systems, are incorporating
these software systems into their electronic medical records. These groups recognize the potential
importance of having instantaneous predictive data.

Most
physicians do not have an EMR and only 7% of physicians have a fully
functioning EMR.

In
the monograph from “Pathways to Data Analytics” two things were very apparent. It
looks like the healthcare insurance industry controls the committee and its
plans is to continue to control the healthcare dollars and hope to control the
healthcare data.

Increasingly, a
data-driven approach to healthcare is necessary.

The complexity of clinical care requires it, says Glenn Crotty
Jr., MD, FACP, executive vice president and chief operating officer at CaMC.

“We’re moving from an
individual practitioner cottage industry to a team-based process now . . .. [Medical
care] is beyond the capacity of any one individual to be expert enough to do
that. So we have to do it in a team.”

A team requires information. The changing dynamics of healthcare
spending and reimbursements also require data to navigate.

“Our analytics are not just for finance, which traditionally is
what hospitals invested in,” says St. Luke’s Chief Quality Officer Donna Sabol
, MSN, RN. “When you look at how [hospital] payment is changing [to] a value-based
equation, you have to have good analytics for finance and for quality.”

Absent from the report is the patient and his/her responsibility
to the therapeutic unit. Until some policy maker understands the role of
patients to the therapeutic unit they will get nowhere in improving the
healthcare system.

A glaring example is the money spent by hospital systems to
improve the discharge process to avoid re-hospitalization within the 30 days
post discharge.

Obamacare has instituted the rule November1,2012 that if a
patient is re-hospitalized within 30 days of the initial hospitalization the
hospital system will not get paid.

I can think of 5 ways hospital systems can get around this rule
without suffering the penalty.

None-the-less the hospital systems are buying software to study
and automate the process to avoid re-hospitalization using its clinical data in
real time.

The Seton Hospital System in Austin Texas
might have figured it partially out.

It started what it calls an extensivist
program. It is acting as an extension of its physicians care to help avoid re-hospitalization
and use the best data it can collect.

Its is helping clinicians identify patients who
would benefit most from extra attention following discharge. The program
started with congestive heart failure patient

"A
lot of it is about enabling decision-making," Ryan Leslie says

"It's taking the whole universe of
information we have and cutting out what's extraneous and giving clinicians the
information they need to make decisions."

Ryan Leslie is vice
president of analytics and health economics at Seton Healthcare system. He is taking
unstructured clinical information and connecting that with billing or
administrative information and social demographic information.

He says, "you start connecting all those things
together and you get a more complete picture of the patient as a person, rather
than as a recipient of a bill," he says. "That's been the exciting
thing recently. You realize that a patients' success or failure may not have to
do with the care plan details or the clinical attributes of the patient as much
as the social attributes."

Physicians
outside the hospital work with a team of social workers, nurses, and others to
visit patient homes and figure out what's keeping a patient from effectively
following treatment protocols that will likely keep them out of the hospital.

The software
helps determine, based on a host of combined data, which patients are most
likely to be re-hospitalized within 30 days. Targeting the patients is like
looking into a crystal ball. The hospital system cannot afford to service all
the patients with congestive heart failure. The program is in its early stages.
If successful the plan is to expand it to diabetes and other chronic diseases.

This will
happen well beyond November 2012 and January 1,2014. This hospital system
finally realized that it can and must be an extension of its physicians’ care
and not a competitor for patient care.

Missing is the
patients responsibility and incentive in not being readmitted to the hospital.
This can only be accomplished when consumers not only have a desire to be
healthy they have a financial interest to stay healthy.

This can be
accomplished in a consumer driven healthcare system where the patients are responsible
for their health and own their healthcare dollars. The easiest way to get there
is using my ideal medical savings accounts.

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

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There Is A Way To Fix The Healthcare System!!

October 14, 2012

inUncategorized

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Stanley Feld M.D.,FACP,MACE

The healthcare system cannot be fixed using a
broken business model.

It can only be fixed by changing the business
model to a consumer driven business model that would include personal
responsibility and individual freedom of choice.

President Obama believes the healthcare system
can be fixed by a single party payer system run by the government.

I do not believe the government has run things
very well. Many examples come to mind in many areas. Two recent examples are
the Fast and Furious scandal and the lack of security for the murdered ambassador
in Benghsi Lybia.

When things go bad with government policy it is
difficult to discover the reasons. I believe consumers are very hesitant to
trust the government to make their healthcare decisions for them. On the other
hand consumers would be happy to allow the government and taxpayers to pay for
their medical costs.

A cultural shift in the healthcare system must
occur. The shift must be toward
individual responsibility. Consumers must be responsible for their health and
their healthcare dollars if Americans are to be healthier and the cost of
healthcare decreased. The government must allow and encourage the introduction
of innovative forms of healthcare insurance.

The role of government must be to educate
consumers maintain health and to be smart purchasers of healthcare insurance.
Government should make the rules so secondary stakeholder cannot take advantage
of the primary stakeholders (consumers)
and then get out of the way.

Government should help those who are less well
off with subsidies and equal access to medical care. Consumers must be
financially incentivized to take responsibility for their health or healthcare
dollars. They must not be penalized if they do not take responsibility for
their health and healthcare dollars.

I presented a new healthcare business model a
few months ago. It deserves to be restated.

This is the way the healthcare system looks
today.

Since 1965, as a result of government intervention,
healthcare costs have escalated. This escalation has been the resulted of
increasing government intervention over the years. The path to accelerated
collapse of the healthcare system has started.

The result has been destruction of the patient-physicians
relationship. Effective medical care has been disrupted along with the
impersonal fragmentation of care.

All of the underlined headings represent links
to articles that explain these problems. I will publish functional links in the
next blog.

President Obama’s goal is to have a single
party payer healthcare system. He believes this is the only way to an efficient
system.

He realizes he cannot achieve this goal immediately.
He must do it one step at a time.

The methodology he is using will not work. He is imposing an accountable care
organizations model onto hospital systems and large physician practices. He
plans to pay one fee for certain diseases based on financial outcomes.

The fee is to be divided between the
stakeholders. President Obama wants to collect data to evaluate and direct
physicians and hospital systems care.

It sounds good but it will not work because he
will encounter physician resistance.

He wants to make cost effective judgments about
patients care without giving patients the right to make their own decisions.

It is going to very difficult to divide the
shrinking pot of money between physicians and hospital systems.

President Obama refuses to admit that the
government outsources the administrative services to the healthcare insurance
industry. The healthcare insurance industry’s fee for this service is about 40%
of the healthcare dollar.

In a recent debate he again stated that CMS’s
overhead is very low at 2.5%

President Obama’s ACA (Obamacare) is proceeding
with the same business model that has failed except he wants complete control
and no competition. If the U.S. continues with the same business model the total
collapse of the healthcare system will accelerate.

The healthcare system is at a critical turn.
The disadvantages of President Obama’s healthcare reform act are obvious. The present
healthcare systems model has lead to all of the disadvantages on the above list.

It is going to take many years to get an
accountable care organization to effectively function if at all. It will take
many years to have a fully functional EMR installed in every hospital system
and physician’s office. If something is not done to correct the business model
we will experience total collapse of the healthcare system.

Two things have to happen to change course. The
business model has to change to transfer power from the government to the
consumer.

The healthcare system is good at curing
infectious disease and replacing kidneys, lungs, livers or hearts.

The big question is, “how does the healthcare
system prevent disease from occurring?”

The greatest expense is diseases that can be
prevented such as diabetes mellitus and heart disease. The root causes are not
preventable yet because they are genetic. The expression of the diseases and
its resultant and costly complications can be prevented.

Obesity causes the expression of these diseases.
The avoidance of obesity requires a drastic change in society’s food industry
and culture.

Americans have been programed over time to eat
more calories and do less activity. There is no quick fix for obesity. People
must eat less and be more active in order to lose weight.

The government has not devoted adequate
resources for education and innovation to change this culture.

Mayor Bloomberg had the right idea by
decreasing the size of the soda pop being sold in N.Y.C. but his approach is
wrong.

He must use education and provide real incentives.
He is trying to legislate behavior. It has never worked in the past.

Americans’ attitude toward food must change by creating
hype for decreasing intake and increasing exercise tied to financial
incentives. Penalties do not work. Incentives and freedom to choose does work.

This is the main problem with President Obama’s
business plan for the healthcare system. He is imposing his will on the
consumers, hospital systems and physicians.

It will not work. It must stop now because it
is unsustainable for taxpayers.

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

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My Impression Of The Canadian Healthcare System

September 19, 2012

inMedicine: Healthcare System

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Stanley Feld M.D.,FACP,MACE

Cecelia ad I just returned from a trip to
Halifax, Cape Breton Island and Prince Edward Island. It was a phenomenal trip.

It was too early in the fall season for the
trees to turn color but the weather was great and the countryside was glorious.

We had planed to go there 49 years ago on our
honeymoon.

We did not have time to get all the way to
Halifax, Cape Breton or Prince Edward Island. We had to drive back to New York
City to start my medical internship on July 1^st. 1963.

Cecelia and I decided it was time to go for it.

We stayed in Port Hood on Cape Breton for five
days, enjoyed the singing and dancing and had a wonderful drive around the
Cabot Trail.

I am a friendly guy and I was curious about how
the folks on the street like the Canadian healthcare system. I was tired of
listening to the Democratic Party’s propaganda.

The propaganda contradicts Canadian and former
Canadian physicians feeling about the system.

I spoke to a lot of people in the town we visited
about their feelings about the Canadian healthcare system.

I came away with several impressions.

Dr. Kurisko practiced surgery in Canada before coming to the
United States to practice surgery.

Dr. Kurisko description
of the Canadian Healthcare System is very accurate. It reflects the feeling of
the people who have need to use the system.

http://youtu.be/At9q6uFR3gU

Canadians are comfortable
with their medical entitlement. Everyone said they like the fact that if they get sick
they will not get “wiped out” by the costs as Americans might be.

I found a You Tube about the
Canadian system with responses of the common man. It clearly expresses this
sentiment.

http://youtu.be/VQFX32Ed7ZQ

This is the impression of a
group of people. The question is the possibility of a bias in selection of the
people interviewed.

Upon deeper questioning of
the people I spoke to, my conclusion is that once people get used to a medical
entitlement they are very hesitant to give it up even if it restricts their
freedom of choice. Only 20% of the population uses the healthcare system at any one time.

The second conclusion is
that this is the way the healthcare system is in Canada. Canadian feel they must
live with it and get over complaining about it.

The things they did not like
about their healthcare single payer system is the very high sales tax in
addition to federal and provincial taxes.

The income tax baseline is lowe than
the U.S. and the income earned at the top rate of tax is lower than in the U.S. If you combine all taxes paid the rate is above 50% for some income brackets and at least 30% for
the lowest income bracket.

I was not aware of the fact
that the sales tax on everything in Canada is 15% in addition to business taxes
and personal income taxes. There is both
a province tax and a central tax on purchases.

Federal Tax Rates

Up to $41,544 15.00%

41,545–83,088 22.00 %

83,089–128,800 26.00 %

128,801 and over 29.00 %

Everyone pays federal
income tax in Canada. Fifty percent of U.S. citizens do not pay Federal income
tax

In addition to federal
income tax each province tax is slightly different Below are a few examples.

British Columbia

Up to $36,146 5.06%

36,147–72,293 7.70 %

$72,294–83,001 10.50%

$83,002–100,787 12.29%

$100,788 and over 14.70%

Alberta

10.00% All income

Saskatchewan

Up to $40,919 11.00%

$40,920–116,911 13.00%

$116,912 and over 15.00%

Ontario

Up to $37,774 5.05%

$37,775–75,550 9.15%

$75,551 and over 20%

New Brunswick

Up to $37,150 9.10%

$37,151–74,300 12.10%

$74,301–120,796 12.40 %

$120,797 and over 14.30%

Nova Scotia

Up to $29,590 8.79%

$29,591–59,180 14.95%

$59,181–93,000 16.67%

$93,001–150,000 17.50%

$150,001 and over 21.00%

We visited Halifax, Nova
Scotia and Charlottetown, Prince Edward Island but spent most of our time in
the countryside.

The long waiting times to
see a physician in the office and in the ER was a constant complaint.

The people complained about
the shortage of physicians. Their impression was that a lot of physicians fled
to the U.S. causing the physician shortage.

There were few small towns
with physicians. Bigger towns had small hospitals and physician shortages.
Larger towns had tertiary hospitals. These hospitals were full service hospitals.
These hospitals rationed care

The emergency rooms of any
size hospitals are always jammed. Sometimes you can wait for 6 hours and not
see a physician taking care of anyone.

One lady told me she had a
tremendous stomachache. She went to the ER waited more than 6 hours without
anyone in the ER seeing a physician. After 6 hours the pain started to subside.
She was so fatigued she went home.

I guess that is one way to
cure a patient. It took her 4 days before the pain to subside.

Another complaint was
follow-up visits by a patient with her own physician. The patient was a 65-year-old
diabetic female. Her physician was diligent. He wanted to see her every three
months. She could only get an appointment in 5 months.

One 55-year-old male with
heart disease said the healthcare system has been fine for him. He calls his
cardiologist at home. He is an interesting case and the cardiologist will see
him the next day.

Many complained about the
waiting time for special test such as CAT scans and MRIs, hip and knee
replacements and cardiac catherizations.

Waiting times for hip and
knee replacements can be more than one year.

The Fraser Institute released
a report outlining the government financial difficulties with the Canadian healthcare system.

“A 2011 report by the Fraser Institute concluded that
Canada’s health care system is spending at an unsustainable rate. Six of ten
Canadian provinces are on track to spend half of their revenues on health care,
according to the institute.”

“We conclude
that Canada’s health system produces rates of growth in health spending that
are not sustainable solely through redistributive public financing,” the report
concluded.

I think it is about time Americans paid attention to
Obamacare. It will be worse for all.

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

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Here Comes The Public Option. Next: Single Party Payer.

May 16, 2010

inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

Barney Frank declared during the healthcare reform bill debate, if we do not have a public option healthcare reform will fail.

Senator Kerry felt we must have a single party payer system. He stated the Democratic Party did not have the votes to put it in the bill.

President Obama and the Democrat figured out how to sneak a single party payer system into the healthcare system in America by default.

President Obama’s signature promise about the healthcare reform bill was "If you like your health care plan, you can keep your health care plan. If you like your doctor you can keep your doctor.”

What President Obama left out of his promise was that if your employer stops your healthcare insurance coverage there will be no choice but to use the subsidized government healthcare plan from the healthcare insurance exchange “Public Option”.

President Obama uses this move a lot. It is called misdirection.

“As companies crunch numbers on what the new law means for their bottom line, some have concluded they might be financially better off canceling their health care coverage and moving their workers to government-subsidized "exchanges" that will be created in four years. “

Corporate action to drop healthcare insurance will make Barney Frank, Nancy Pelosi, John Kerry and President Obama happy. I do not think the Democrats have thought about the unintended consequences. Just think what the influx of consumers to the government subsidized plan will do to the CBO’s estimate of the healthcare reform bill reducing the deficit by $115 billion dollars in ten years and 1 trillion dollars over the next 10 years.

The CBO revised its estimate this week. It stated that the bill will increase the deficit by that amount in the tenth year instead of decreasing it. I believe this is an underestimate.

AT&T Inc has concluded that eliminating employees’ healthcare insurance could mean a $1.8 billion dollar saving per year. It is much cheaper to pay an estimated penalty $2,000 per employee than $15,000 to 18,000 in non deductible dollars for employee healthcare insurance coverage.

“The documents, obtained by Fortune magazine and posted online this week, reveal that four companies – AT&T, Verizon Communications Inc., Caterpillar Inc. and Deere & Co. – had investigated to varying degrees the impact of dropping health care coverage and pushing their workers onto the new exchanges, where they will be able to buy their own insurance.”

This year AT&T spent about $2.4 billion to cover medical costs of its 283,000 active workers. Next year they are scheduled to pay more.

AT&T instantly denied that it has a plan in place to drop healthcare insurance for employees. AT&T would only have to pay an annual penalty of $600 million, or $2,000 a worker if the company dropped the healthcare insurance.

The burden would be on the employee and the government. President Obama promised us all affordable healthcare insurance.

Large companies are sick of dealing with increasing insurance premiums, insurance paperwork and regulatory compliance. These large companies would pocket huge savings by eliminating healthcare insurance for employees.

"Even though the proposed [penalties] are material, they are modest when compared to the average cost of health care," Hewitt Resources said in its report. "To avoid additional costs and regulations, employers may consider exiting the employer health market and send employees to the exchanges."

All the large corporations are denying they have plans to drop healthcare insurance. However it is o
bvious this is just what they should do to protect their vested interests.

Just as bad an unintended consequence is firms fewer than 50 full time employees do not have to pay a penalty for dropping insurance. A firm at the 50 employee threshold could fire workers to get below the 50 mark. They could then hire them back as part time employees.

If al these people lose healthcare insurance they will be forced to go into Medicare, Medicaid or the government subsided “Public Option” through the healthcare insurance exchange. Either option will increase government spending. The estimate increases are low at $160 to 300 billion dollars per year.

President Obama’s little trick will work. The losers will be consumers. Everyone will be forced into the “Public Option” by default. The single party payer (the government) will automatically take over the healthcare system in America (socialized medicine).

The federal deficit will increase without Repairing the Healthcare System.

Taxes on everyone will have to be increased . Does President Obama understand all of this?

Americans must wake up. The 2010 midterm elections are near.

“It is time to trow da bums out”

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

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