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Dear President-elect Trump Part 3

 

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Pre-Election Obama Administration Lies

Stanley Feld M.D.,FACP,MACE

The Obama administration is out in force telling pre-election lies so that the Democrat’s base that loves entitlements stays calm.

New data from Joint Commission on Taxation led the TPC to cut the number of people paying federal income taxes by 3.9 million. In total, 77.5 million individuals and married couples — or tax units. as they are defined by the TPC — won’t pay income tax this year out of a total of 171.3 million. The previous estimate was for 66.2 million out of 163.8 million tax units not paying income tax in 2015.

In 2015, this represented 45.2% of the taxpayer units.  In 2013, 40.4% of taxpayer units paid no taxes. With the influx of illegal immigrants paying no taxes the percentage of non taxpaying units will increase.

The illegal immigrants will receive Medicaid and other entitlements.

Hillary Clinton has pledged to increase illegal immigration with open borders and increase Medicaid enrollment.

Taxes will have to be increased. The middle class will be crushed. Hillary Clinton will hide some of these taxes as President Obama has done for Obamacare..

President Obama is trying desperately to save Obamacare from self-destruction.

I have recently reviewed the phony enrollment figures for 2014, 2015 and 2016 published by the Obama administration. There has not been a significant increase in enrollment in the last three years.

The claim that there are 20 million enrollees as a result of Obamacare is not even a half-truth. There are only 10 million enrollees from the Health Insurance Exchanges.

The failed Medicaid entitlement program has an added 10 million enrollees and insufficient physician coverage.

The first pre-election day lie was HHS Secretary Sylvia Burwell telling a group that the 2017 Open Enrollment period was going to sign up an additional 1 million enrollees. She said the Federal Health Insurance Exchange marketplace was strong.

The Marketplace is strong – and will continue to be strong – because it is offering a product people want and need.

This year, we know the Marketplace is strong, but we think it will grow even more.”

“As we look to this next open enrollment period, we project that the Marketplace will grow by another million people. By the end of open enrollment for 2017, we expect 13.8 million people to have selected a plan.”

Obamacare enrollment through the Health Insurance Exchanges was supposed to grow to 21 million last year according to the CBO estimate. At best, 11 million people are enrolled not 12.8 as claimed. Eighty-five percent of the enrollees receive subsidies.

President Obama’s goal is to have a single party payer in control, namely the government.

Secretary Burwell goes on to conclude;

“In closing, as the President said during the debate over the law, “we did not come to fear the future. We came here to shape it.”

It looks like President Obama is shaping the future in a way Americans did not anticipate or want.

The next big pre-election lie was President Obama’s lie admitting that Health Insurance Exchange premiums will go up 22% in 2017. He also said that the government would cover the premium increases for those receiving subsidies.

He did not discuss the government’s position on the increases in deductibles. Is President Obama also covering the deductible increases?

Where is President Obama getting the money? I think the money for the increased subsidies was built into the budget by telling the CBO that there were supposed to be 21 million enrollees in the Federal Health Insurance Exchanges. Only 10 million enrollees showed up.

The reason for these continuing lies is to calm the public. President Obama and Hillary Clinton want us to believe that Obamacare is good and is working well.

The obvious message of these lies is that the public should vote for Hillary Clinton to continue this good work.

 

https://youtu.be/ziVfvWO8oUE

This You Tube is an excellent summary of all the lies President Obama and the Obama administration have told the America public since the Affordable Care Act (Obamacare) was passed.

It is worth ten minutes of your time to review this deception.

This week he tried to dodge the responsibility for the Health Insurance Exchanges demise and also claimed he should not be blamed for the rise in premiums in the private group insurance market.

Of these major cities, the places with the largest increases in the unsubsidized second-lowest silver plan were Phoenix, AZ (up 145% from $207 to $507 per month for a 40-year-old non-smoker),

Three hundred dollars a month or $3,600 dollars a year is a lot of money for a person making between $40,000 and $50,000 per year.

 The premium increases in Birmingham, AL (up 71% from $288 to $492) and Oklahoma City, OK (up 67% from $295 to $493).

 “ Meanwhile, unsubsidized premiums for the second-lowest silver premiums will decrease in Indianapolis, IN (down -4% from $298 to $286 for a 40-year-old non-smoker), Cleveland, OH (down -2% from $234 to $229), and Providence, RI (down -1% from $263 to $261) and increase just 1% in Little Rock, AR (from $310 to $314).”

 In many states there isn’t any competition in healthcare insurance for consumers business.

“Marketplace insurer participation in states using Healthcare.gov in 2017 ranges from 1 company in Alabama, Alaska, Oklahoma, South Carolina, and Wyoming, to 15 companies in Wisconsin.”

Hillary Clinton bragged that healthcare reform was called Hillarycare long before it was called Obamacare.

I would not be very proud of that statement, if I were her.

I do not believe the American public is not going to be fooled again by progressive rhetoric and lies.

Obamacare is a disaster. I have described the disaster and its potential consequences for since its passage in 2010.

It has caused both the public and private healthcare markets to escalate insurance premiums to unaffordable levels for all Americans. The cost to the federal government is unsustainable.

The present awareness of the Obamacare disaster is the straw that is going to break the back of Hillary Clinton’s campaign.

All Americans deserve a better healthcare system than Obamacare.

My ideal medical saving account is the solution to the healthcare problem.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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When Its Not Your Money

Stanley Feld M.D.,FACP,MACE

No one should be surprised at the money wasted by federal government programs. President Obama has been the biggest offender of wasting taxpayers’ money in my lifetime.

He increased the national debt from 10 trillion to 20 trillion dollars.

The volume of regulations, the creation of bureaucratic agencies, bureaucratic czars and the lack of enforcement of existing laws have served to create much of this waste.

However the public is unaware of the amount of taxpayers’ dollars spent because of the lack of government transparency. Congress ought to be standing on every mountain screaming about the waste.

I have observed the opposite. All we have to do is remember how congress marginalized Tom Coburn’s efforts to eliminate waste by eliminating duplication.

Obamacare is no exception to immeasurable waste while it destroys the healthcare system.

Improper payments for Obamacare are soaring because of a defective law and government inefficiency and incompetence.

A study by HHS shows that the improper payment rate for Medicaid will be 11.5% for 2016. It means that more than one out of every 10 dollars spent is wasted on either fraud, errors in payment or accounting inaccuracy.

The pre-Obamacare improper payment rate was 5.8% or one in 20 dollars spent. In 2015 it was reported that the improper payment rate was 9.7%.

This is the waste rate for only 10 million people added to the Medicaid roles.

I would suspect all three reports are an underestimate of the real improper payment rates.

The actual dollar amounts of improper payment rates are increasing because Obamacare has expanded Medicaid enrollment.

As the number of Medicaid recipients increase the wasted dollars will increase.

With President Obama’s new executive order to expand the eligibility of illegal immigrants for Medicaid coverage, the rate and amount of dollars improperly deployed will skyrocket.

To my amazement a lot of intelligent people are ignoring this simple arithmetic.

Medicaid eligibility is increasing rapidly. In 2015 Medicaid enrollment increased by 13.8%. One in five Americans as well as all illegal immigrants are entitled to Medicaid coverage.

I guessed that HHS would blame physicians for the waste. I was correct.

Medicaid reimbursement is so low that physicians have figured out ways to see more patients per day. They are using physician extenders extensively.

These physicians are accused of running Medicaid mills. They are accused of Medicaid fraud.

Then these physicians are put through a costly audit and are penalized. Many get fined for fraud and abuse due to overbilling.

There are many other reasons for this waste. Most important is HHS’ lack of proper diligence in administering the program. It smacks of reasons similar to the VA Healthcare System scandals.

“There’s no particular reason the error rate should be spiraling upward other than overwhelming incompetence.”

On closer look, home health agencies are probably the biggest abuser along with an ineffective bureaucracy that becomes more ineffective as the program grows.

“In recent audits of Medicaid in Arizona, Florida, Michigan and New Jersey, the GAO uncovered 50 dead people who recouped at least $9.6 million in benefits after they died; 47 providers who registered foreign addresses as their location of service in places such as Saudi Arabia; and $448 million bestowed on 199,000 beneficiaries with fake Social Security numbers—12,500 of which had never been issued by the Social Security Administration.”

The problem is not discussed by the traditional mass media. The public has no idea this is occurring.

Medicaid is a single party payer system completely controlled by the government. Patients have no control over which doctors they will see for an illness.

Medicaid is another clear example of the lack of concern or incompetence by government agencies for spending other peoples’ money.

Even worse, the system does not work for patients or physicians. Patients are the most important stakeholders in the healthcare system. They are treated like a commodity.

Medicaid is inefficient and costly.

Twenty percent of our population is now in this system. There is limited access to care and rationing of care.

There is a better way. It is a consumer driven healthcare system using my ideal medical saving account.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Bill Clinton Is Crazy As A Fox

Stanley Feld M.D.,FACP, MACE

 Many Republicans and Democrats thought Bill Clinton had lost his mind when he made his Obamacare statement earlier this week.

Most of the conservative traditional and alternative media also thought he lost his mind. They repeated Bill Clinton’s statement over and over again. The media’s goal on both sides of the aisle simply wanted to make sure it sunk into the head of the American people.

Notable & Quotable: Bill Clinton on ObamaCare

Former President Bill Clinton speaking about ObamaCare at a rally Monday in Flint, Mich.:”

 “The people that are getting killed in this deal (Obamacare) are small business people and individuals who make just a little too much to get any of these (Obamacare’s) subsidies.”

 “ Why? Because they’re not organized.”

 “ They don’t have any bargaining power with insurance companies. And they’re getting whacked.”

 “ So you’ve got this crazy (healthcare) system where all of a sudden 25 million more people have health care, and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half.

 It’s the craziest thing in the world.”

Clinton

 


https://youtu.be/ETVcsPRTSHM

 

Trump

https://youtu.be/jziTLD0Gc7Y

Bill Clinton knew exactly what he was doing. Hillary Clinton’s position on Obamacare has been clearly stated. She is for Obamacare and for the public option. She has stated that she is going to expand Obamacare.

Bill Clinton’s position sounds totally opposite his wife’s position.

Hillary Clinton’s website explains her position on healthcare clearly.

She wants to : Defend and expand the Affordable Care Act, which covers 20 million people.

Hillary Clinton stating that 20 million people were covered by Obamacare is untrue. In 2016 the health insurance exchanges only cover 10 million people. Obamacare has expanded Medicaid coverage by 10 million people. Medicaid coverage is less than ideal.

The comments in the WSJ about Bill Clinton’s comments are more entertaining than Bill’s comments about Obamacare.

One comment suggested that Bill Clinton is jealous of his wife.

“This is called a “Bill bomb”, designed to passive aggressively tank Hillary’s campaign so he doesn’t have to go back on the leash.”

“She was lagging in the polls, Bill had nothing, but she is surging again and Bill can’t have that.”

Some of the comments applaud Bill Clinton for finally speaking the truth.

       1.” You gotta love it when Bill sounds like a Republican.”

  1. It is so refreshing to hear a Democrat politician speak the truth. And oh, so rare. Perhaps Bill forgot to take his medication.”
  1. “Give the Democrats credit whenever they do something intelligent, and non-ideological, even if they do it for a confounding reason.”

      4. “Leave it to Bill to hit the nail on the head.  Pure genius.”

      5.”Perhaps there is one Clinton who tells the truth.”

This commentator forgot all of the lies Bill Clinton’s told us (the public) when he was president such as his most famous lie, “I did not have sex with that woman.”

      6.” I don’t know what’s more shocking: Bill slamming Obama’s signature law or a Clinton telling the truth.”

      7.” He must have been off his meds at the time he made the comment, the next day he was back on track. I guess Hillary had to break another lamp over his head.”

I believe Bill Clinton did a brilliant thing for his wife. Obamacare is going to fail. He and Hillary do not want to have anything to do with Obamacare’s failure.

Consumers have discovered that their premiums and deductibles for 2017 are rising to unaffordable level. These increases are because of Obamacare. The private sector has also experienced tremendous increases in premiums and deductible because of Obamacare.

Open enrollment for the health insurance exchanges are supposed to start November 1, 2016, seven days before the Presidential election. If Hillary Clinton does not separate herself from Obamacare it will sink her chances to be elected.

I think the Obama administration will delay open enrollment until after the Presidential election.

President Obama might be able to pull Obamacare’s failure out of the dirt if he is able to illegally obtain theJudgement Fund” money to pay the healthcare insurance industry the money he owes them.

The Republican establishment in congress should make a stink about the release of this money. The Republican establishment should not sell out to President Obama.

President Obama is pulling another illegal fast play on congress and the American taxpayer by getting this money.

President Clinton’s statement is his effort to distance his wife from the Obamacare impending failure.

His statement demonstrates the Clintons’ character. After President Obama and Michelle Obama went all out to endorse Hillary Clinton for President, Bill Clinton stabs President Obama’s legacy legislation in the back.

“Now that the Obamas have given Hillary their full-throated endorsement, Bill can take policy positions more in line with suffering middle class voters. In Clintonworld expedience supersedes truth.” 

Hillary Clinton’s goal is to usurp credit for healthcare reform from President Obama.

She wants to be able to say that healthcare insurance plans do not work.

America needs a single party payer system and it needs it now.

Bill Clinton’s assessment is correct on the issue of Obamacare. All Obamacare is doing is merely shifting costs from those who cannot pay to those who can pay.

It is truly a healthcare system that redistributes wealth as Dr. Don Berwick said a long time ago.

The Clintons want a single party payer system real fast so that they look like they are coming to the rescue of the American people.

Democrats running for congress have rapidly gotten on the Clinton bandwagon.

Clinton’s proposal is simply bait and switch.

The problem is a single party payer system detrimentally affects the middle class taxpayer the most as I have explained.

They are trying to make Obamacare’s failure into an election issue asset for Hillary Clinton who will come to the rescue with her single party payer system.

A single party payer system is unsustainable and has huge defects.

I also know the majority of the middle class does not trust Hillary or Bill Clinton.

The Clintons will not fooled the majority of the middle class again.

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

 All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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What Exactly Is A Public Option?

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Hillary Clinton On Healthcare Reform

Stanley Feld M.D.,FACP, MACE

The next two blogs will review the published position on healthcare of Hillary Clinton and Donald Trump.

Obamacare has not been a big issue in the presidential campaign yet. It will become a big issue in mid October when the new premium schedules will leak to the press and by the November 1 publication of premium date healthcare will be a full-blown campaign issue.

Obamacare is on the verge of failure. Democrats are starting to talk up a Public Option as the Obamacare salvation. The Public Option is not going to save Obamacare.

The healthcare Co-Ops were supposed to provide a competitive force for the healthcare insurance companies to keep down the premium costs. However, 17 out of 22 have failed. The other five will fail before the end of the year.

The Public Option is a federally controlled competitive force. However, because of healthcare insurance companies distrust for the Democrats and Obamacare few insurance companies will show up to compete.

The presidential campaign has been such a circus that our attention has been diverted from healthcare.

The failure will be noticed when the new premiums are published on November 1, 2016, five days before we go the polls.

This late date has been set deliberately by the Obama administration in order not to give Americans enough time to respond with anger toward Democrats and the potentially new Hillary Clinton administration and vote her down.

Hillary Clinton’s website’s first sentence in her preamble on healthcare says it all.

“As your president, I want to build on the progress we’ve made with Obamacare.

She will build on Obamacare. Obamacare is a failure by all measures once we see through President Obama, Paul Krugman, and Ezekeil Emanuel’s lies. Why would anyone want to build on that failure?

Hillary supports President Obama’s call for a near tripling of the size of the National Health Service Corps. It will also triple the cost with not evidence that it will be successful.

“ I’ll do more to bring down health care costs for families, ease burdens on small businesses, and make sure consumers have the choices they deserve.”

 It sounds like President Obama’s empty promise.

  1. If you like your doctor you can keep your doctor.
  2. If you like your insurance company you can keep your insurance company.
  3. If you make less than $250,000 dollars a year you will not pay one red cent more in taxes.

 “And frankly, it is finally time for us to deal with the skyrocketing out-of-pocket health costs, and particularly runaway prescription drug prices.”

This statement is important but is minor compared to what needs to be done.

The main body of Hillary Clinton’s position paper says the same thing. It does not give any details on how she will accomplish any of her promises.

Her campaign and the traditional media led by the New York Times have attacked every one of Donald Trump’s proposals because they claim he does not spell out how he would accomplish them.

Below are her website healthcare policies.

Defend and expand the Affordable Care Act, which covers 20 million people.

 In 2016, Obamacare’s Health Insurance Exchanges insure only ten million people.

Most of those 10 million have a pre-existing illness. These people could not buy healthcare insurance on the private market. Eighty-five percent of those people receive government supplements. There has been no increase in Obamacare enrollment since 2014. There has been a lot of lying about enrollment yearly.

It would be less expensive if a system of care were developed to provide these people with medical care without the bloated bureaucracy and falsely promised insurance benefits.

The expansion of Medicaid eligibility decreased the uninsured an additional 10 million. With Hillary Clinton’s plan to increase Syrian immigration to 500,000 a year and provide them with Medicaid the failure of Medicaid will be accelerated.

Medicaid is another failed government program. Medicaid patients have difficulty finding a physician and have decreased access for medical care.

Bring down out-of-pocket costs like copays and deductibles.

Hillary Clinton offers no plan on how she is going to accomplish this.

Reduce the cost of prescription drugs.

Again, there is no explanation for how she is going to reduce these high costs.

Protect consumers from unjustified prescription drug price increases from companies that market long-standing, life-saving treatments and face little or no competition.

Promises, promises, promises with no explanation of a plan. It sounds great but there is no plan explaining fulfillment.

Fight for health insurance for the lowest-income Americans in every state by incentivizing states to expand Medicaid—and make enrollment through Medicaid and the Affordable Care Act easier.

President Obama and his administration have told us over and over again that it is easy to enroll in Medicaid and Obamacare. The Obama administration even pays enrollment navigators $48 an hour.

Expand access to affordable health care to families regardless of immigration status.

Hillary Clinton clearly has no regard for cost. She also wants to expand the immigration of Syrians to 500,000 per year. When this happens the cost of Medicaid will explode.

The federal government will eventually try to dump those costs on the states. Most states have budget deficits that have to be cured now.

Taxpayers will be forced to endure both federal and state tax increases for a failed federal program.

President Obama’s original promise is that the Affordable Care Act (Obamacare) will be budget neutral.

Expand access to rural Americans, who often have difficulty finding quality, affordable health care.

Hillary Clinton pledges to explore cost-effective ways to make more health care providers eligible for telemedicine reimbursement under Medicare and other programs.

Please notice she is only exploring the possibility of telemedicine reimbursement. Americans have heard empty promises before.

Defend access to reproductive health care. 

Hillary will work to ensure that all women have access to preventive care, affordable contraception, and safe and legal abortion. This is not a promise. How she will accomplish this goal is not outlined.

Double funding for community health centers, and supports the healthcare workforce: 

This is an initiative that is part of Hillary Clinton’s comprehensive healthcare agenda.

She is going to double present funding for primary-care services at community health centers over the next decade.

This is another ideological plan whose effectiveness has not been proven.

The goal of community healthcare centers is to provide low-level care for illness. It does not promote a patient/physician relationship or patient responsibility. It does not provide patient choice.

It is another step to commoditize medical care.

There you have it. Hillary Clinton’s healthcare policy as described on her website.

It is an extension of President Obama’s failed healthcare policy of the last 7 years. There is no mention of patients or their responsibility for their health or healthcare.

None of these proposals will lower the price of healthcare or increase the quality of care.

Hillary Clinton’s proposals will increase spending on a failed program (Obamacare) that has increased America’s deficit.

Hillary Clinton believes: Together these steps will get us closer to the day when everyone in America has access to quality, affordable health care.”

I believe Hillary Clinton does not know what she is talking about. I know the American people are seeing what is happening to our healthcare system.

If you want more of Obamacare with its tremendous costs to individuals and the American people along with the lack of improvement in medical care vote for Hillary Clinton.

Hillary Clinton is a tax and spend progressive democrat who does not think about what consumers need. Her attitude is that consumers are not smart enough to choose.

She believes that the federal government knows best.

There is nothing in her healthcare plan to Repair 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 Deception and Disinformation Continues

Stanley Feld M.D.,FACP,MACE

When Co-Op Health Insurers close, what happens to customers’ all ready paid in deductibles?

The new insurer will not credit the already paid deductibles in 2016. Consumers will have to start all over again with new deductibles. This is despite President Obama’s implied promise that consumers will get credit for the deductibles paid.  

President Obama’s goal was to make Obamacare as complicated as possible so no one could understand it.

I believe neither he nor his administration understand all the interwoven parts and the unintended consequences.

Obamacare was built to fail.

Obamacare was built so that whatever part of the component policy failed, that policy would ultimately default to a single party payer system. The original goal was to have complete government control of the healthcare system.

The federal government would control choice and restrict access to medical care.

Americans’ free choice would be disappear.

Obamacare’s healthcare exchanges have only been attractive to people who could not obtain healthcare insurance because they had pre-existing illnesses.

That was a good thing. However, premiums were too high for the healthy uninsured.

The healthy uninsured would pay for the consumers with preexisting illnesses and spread the risk. The thought was that it would lower the cost of insurance.

The Obama administration lent $2.5 billion dollars to only 22 states that opted to set up Co-Ops to compete with the healthcare care insurance companies offering insurance through the health insurance exchange in those states.

These Co-Ops were destined to fail. The Obama administration’s plan was to low ball the insurance premiums and force the healthcare insurance companies to compete and lower their premiums.

President Obama’s reinsurance program to subsidize and protect insurers from loss fell apart because of budget restraints that he signed into law.

High-risk people with pre-existing illnesses flocked to sign up for the Co-Op’s healthcare insurance. The Co-Op insurance plans were poorly advertised and constructed. Few healthy people bought the plans.

We are constantly told how many people lost their insurance and their deductible.

In reality the Co-Ops was the “public option” without the approval of congress.

So far, seventeen of the twenty-two have declared bankruptcy so far. The remaining five Co-Ops are on the way. The federal government will never get paid back for the $2.5 billion dollars in loans.

Illinois’ Co-Op “ Land of Lincoln” declared bankruptcy and closed out over 49,000 patrons. The have to get new insurance to cover them for October, November and December.

A large insurer (Blue Cross and Blue Shield of Illinois) on the Illinois’ Obamacare exchange has decided not to credit former Land of Lincoln members for money they’ve already paid toward their deductibles despite a request from the state to consider doing so.”

“They will likely have to start from zero again on their deductibles and out-of-pocket max payments — in some cases costing them thousands of additional dollars.”

The other large insurers have not commented yet. President Obama has not come through with his promise to cover these deductibles.

President Obama and his press secretary deny Obamacare is in trouble. The casual observer who reads are Paul Krugman’s articles in the New York Times and believes he personally has adequate healthcare insurance would also believe the lie.

Paul Krugman is President Obama and Hillary Clinton’s hatchet man. When something goes wrong in any area of the economy Mr. Krugman blames it on the Republicans without evidence or data.

The New York Times and his readers believe him without critically evaluating his statements.

Paul Krugman: “Most of the news about health reform has been good, defying the dire predictions of right-wing doomsayers.”

 This is lie. He has no positive evidence for this statement except that Obamacare has added 10 million people to the Medicaid program.

This could have been accomplished without Obamacare by simply raising the definition of poverty from its obsolete 1955 level.

Paul Krugman :“But this week has brought some genuine bad news: The giant insurer Aetna announced that it would be pulling out of many of the “exchanges,” the special insurance markets the law established.”

 Others have pulled out in addition to Aetna.

UnitedHealth, Cigna, Blue Cross and Blue Shield and other smaller insurance companies such as Baylor/ Scott and White have pulled out because they have lost huge amounts of money. Their losses are unsustainable for their business.

Seventeen of the 22 federally funded Co-Ops have gone bankrupt and closed down. They were supposed to create competition like the public option to keep premium prices and deductibles down.

Paul Krugman says: “This doesn’t mean that the reform is about to collapse.”

What does it mean? He does not say.

Then he goes on to attack the Republican Party and Donald Trump.

“They’re problems that would be relatively easy to fix in a normal political system, one in which parties can compromise to make government work.

Maybe the Republicans cannot compromise because Obamacare was so poorly conceived and constructed.

Obamacare has been a waste of government money and taxpayers’ money. It is destroying the delivery of medical care. I would call this a failure.

Maybe the Republicans are correct in opposing a law that is increasing the federal deficit while claiming is that it is budget neutral.

It is unbelievable that Hillary Clinton wants to expand Obamacare. Isn’t it because Obamacare is failing and unsustainable?

Then Mr. Krugman goes on to take an inappropriate swing at Donald Trump.

“But they (the problems) won’t get resolved if we elect a clueless president (although he’d turn to terrific people, the best people, for advice, believe me. Not.).”

Paul Krugman then goes on to tell lie after lie about the success of Obamacare and how unfairly Republicans view Obamacare.

“Paul Krugman says:” The economy of race prevents Medicare and Obamacare expansion.”

“White voters “don’t like the idea of helping neighbors who don’t look like them”

“New York Times columnist Paul Krugman argued Monday that the opposition of red states like Texas to accepting federal money to fund Medicaid expansion isn’t based, as claimed, on a commitment to smaller government and the superiority of the free market so much as it is the politics of race, and who would receive those funds.

Medicaid expansion, Krugman noted, disproportionately benefits nonwhite Americas, and voters in red states — particular the white ones — “don’t like the idea of helping neighbors who don’t look like them.

Paul Krugman is an economics professor. Can’t he figure out that the system has failed economically? American needs a better system with responsible consumers driving the system.

Who is stimulating race wars without facts or evidence?

Paul Krugman is stimulating race wars with unfounded statement like this in order to defend Obamacare and President Obama’s legislation. Legislation that has failed.

Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law.”

Higher than expected costs have led UnitedHealth, Aetna, Humana and many smaller companies such as Baylor/Scott and White to pull out of Obamacare’s federal health insurance plan.

With the demise of the state Co-Ops the competition is even slimmer.

“The Kaiser Family Foundation, in a study commissioned by the Wall Street Journal, estimates that 19% of Obamacare enrollees seeking coverage in 2017 will be in a market with just one insurer, up from just 2% in 2016. Another 19% will have access to just two carriers, up from 12%.

Forty percent of 10 million people is 4 million people who are going to be affected by a decrease in competition. The total enrollment in Obamacare has been stagnant the last 3 years.”

We must repeal this debacle called Obamacare and start a new system that could work. A consumer driven healthcare system for all as described in my article “My Ideal Medical Saving Account is Democratic.”

It includes everyone. It provides financial incentives to everyone to be responsible for their own health and healthcare dollars.

“What do we have to lose?”

 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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We Never Learn: Watch Out Colorado

Stanley Feld M.D.,FACP, MACE

“You can always count on Americans to do the right thing – after they’ve tried everything else.”

 Winston Churchill

There are many smart people in America.

Americans form opinions from the information presented to them. When the information presented in incorrect or incomplete it is easy to form the wrong opinion.

The art of presenting misinformation and disinformation has been perfected.

The people of Colorado are now being bombarded with the need to pass Amendment 69 or ColoradoCare.

Most Coloradans have not paid sufficient attention to the amendment. Their opinions are being influenced by misinformation or inadequate information concerning the unintended consequence that are inevitable.

Many might look at ColoradoCare’s official website. http://www.coloradocare.org/know-the-facts/increases-savings/ and read the following.

  • With Amendment 69, ColoradoCare, every Colorado resident can contribute their best, knowing ColoradoCare has everyone covered with universal health care.”   Sounds wonderful.
  • “ Imagine life with ColoradoCare. If you’re a resident and you need any kind of health care (including mental health), you just go to see your provider, and ColoradoCare pays the bill.”Free is great.
  • “Without the layers of hassles, businesses, providers, and everyone in the state can go about their important work of contributing to their families and communities knowing ColoradoCare has everyone covered.”   The problem is nothing is free.                                                                                                        
  •  In a statement to the Colorado Independent October 2016, Bernie Sanders lent his support to the single-payer measure.
  • “Colorado could lead the nation in moving toward a system to ensure better healthcare for more people at less cost. In the richest nation on earth, we should make healthcare a right for all citizens.”

Hillary Clinton has not yet supported ColoradoCare. I believe she is afraid it will steal her thunder by having large increases in government healthcare expenditures she has planned. She plans to increase taxes and get healthcare governance firmly in the hands of the federal government.

The ColoradoCare website goes an to say,

“An economic analysis of health care spending in Colorado has calculated that comprehensive health coverage for every resident could be paid for with pre-tax payroll premiums of 3.33% for employees and 6.67% for employers.”

There has been no effort to prove these numbers are correct.

In fact, all of the Republican establishment politicians in Colorado are against ColoradoCare as well as many high ranking members of the Democratic establishment.

The Democratic establishment includes Governor John Hickenlooper and former governor Bill Ritter. They are opposed to Amendment 69’s passage because they understand the financial burden ColoradoCare would put on the state’s budget and growth.

The size of the current state budget is $25 billion dollars. The tax increase for ColoradoCare would be an additional $25 billion dollars. Everyone can assume the state would need more to implement the program.

ColoradoCare would be far and away the largest tax increase in state history, and would give Colorado the highest tax rate in the nation.”

“ This would be implemented as a payroll tax that would be split into 3.33% for employees, and 6.67% by employers.

An additional $18billion dollars would be asked of the federal government, as well as a waiver to let the state opt out of the Affordable Care Act in order to fund Colorado care.

If voters approve ColoradoCare, it would be written into the state constitution, making it very difficult to dismantle and impossible to amend.

The president of the Denver chamber of commerce is opposed to ColoradoCare because the chamber knows this will drive businesses out of the state and inhibit businesses from coming into the state. The Denver chamber of commerce has worked very hard and very successfully to bring business into the state.

Most of all these politicians know that Obamacare has failed. Oregon’s attempt at the state being the single party payer has failed.

Most recently, Vermont’s attempt at a single party payer system has failed.

Both Oregon’s and Vermont’s governance realized the great fiscal burden to the state budget as well as its businesses and residents.

These states quit before the taxpayers realized the extraordinary tax burden the single party payer system would have on their state.

However, most progressive thinking people cling to the ideology that a single party payer system is the way to universal coverage.

Why did Vermont fail to institute a single party payer system after the state legislature passed the bill?

I will describe the reasons for failure in my next blog.

Walker Stapleton, the Colorado state treasurer said, “a major part of his responsibilities is attention to the fiscal and economic condition of the state.”

He goes on to say,

“If passed by the voters, the provisions of Amendment 69 will have a great negative impact on the state’s fiscal and economic health, as well as impacting individual residents fiscally.”

“If passed, Amendment 69 — creating a governmental entity called ColoradoCare to administer the health care payment system — would amend the Colorado Constitution. It would not be a legislative issue to which the Colorado Legislature could make amendments as needed.”

Walker Stapleton said the state health exchange was supposed be self-sustaining. However, the state health exchange has blown through federal dollars provided.

The State has no way to fix the state exchange or has a way to pay back the federal loan. Walker Stapleton acknowledged the problems with Colorado Health Benefit Exchange, saying, “The exchange was intended to be self-sustaining, and it is anything but, and we have blown through federal dollars.”

United Health and others are leaving the exchange. The exchange has one-fifth of the enrollment anticipated because of cost, network size and service.

“The exchange is in a hole and we have not yet come up with a way to fix it,” he said.

He added that Amendment 69 would assume the state health exchange burden in addition to its debt.

This burden is not good for the single party payer financial burden.

ColoradoCare (Amendment 69) was proposed by a Boulder State Senator, a progressive M.D., with support of the other progressive M.D.s in the Boulder, Colorado community.

Most of the M.D. practices in the Boulder community are owned by Boulder Community Hospital.

I wonder if the M.Ds understand the unintended consequences to the state’s fiscal health, the unintended consequence to the business environment as a result of the increase in tax rate and the unintended consequence to residents experiencing increases in taxes.

I wonder if these physicians are aware of the unintended consequences to their ability to practice medicine.

I suspect the author of the amendment and her followers have not thought about the unintended consequences.

Consequences.

1. Amendment 69 authorizes state taxes be increased $25 billion annually in the first full fiscal year and by such amounts that are raised thereafter.

2. ColoradoCare would be exempt from Taxpayer’s Bill of Rights (TABOR).

3. “A 10 percent payroll tax for every employer in Colorado,” Stapleton said.

The employer would pay 6.7 percent and the employee 3.3 percent. If a taxpayer were self-employed, he/she would pay both, for a total 10 percent.

4. Investment income is subject to this tax.                                                                                                                                                                         5. If the employer is outside the state, the tax does not apply for the employer’s 6.7 percent so the employee pays the full 10 percent.                                                                                                                                                                                                                                     Walker Stapelton said, “It is possible retirement income would be taxed,”

Also of great concern to Stapleton are these additional provisions in Amendment 69:

Transferring administration of the Medicaid and children’s basic health programs and all other state and federal health care funds for Colorado to ColaradoCare;

• Transferring responsibility to ColoradoCare for medical care that would otherwise be paid for by workers’ compensation insurance;

• Requiring ColoradoCare to apply for a waiver from the Affordable Care Act to establish a Colorado health care system;

• And suspending the operation of the Colorado health benefit exchange and transferring its resources to Colorado Care.

I hope the people of Colorado understand what this dangerous amendment represents to the fiscal health of the state.

The population will only understand its negative connotations if it starts paying attention to the consequences.

If it only believes that free medical care is good they do not understand that nothing is free.

A system in which the state offers free medical care will fail at the expense of all the taxpayers.

It has already been proven in Oregon and Vermont.

There is a more effective and less expensive way!

If you are interested please read the following links.

My ideal medical savings account is democratic and provides universal coverage with the consumers being responsible for their choice of medical care while being in control of their healthcare dollars.

Consumers’ responsibility for their health is always left out of models of healthcare reform.

If the federal government or a state government wants a business model to be successful, it should adapt my future state business model.

It is a consumer driven model with consumer responsibility built in so that consumers control their healthcare dollars.

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

All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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President Obama Continues to Deceive i.e. The Public Option

Stanley Feld M.D., FACP,MACE

President Obama continues to deceive the American people about Obamacare’s success as his term in office is winding down.

He is trying to use his charming personality to erase the fact tat Obamacare is failing.

The public must keep their eyes and ears open.

Obamacare is falling apart as the months continue. President Obama and the liberals are queuing up to pour more money into a failing healthcare reform model by reintroducing the need for a public option.

On June 30, 2016“CMS division of the HHS Dept. released the HHS Dept. released the actual Q1 effectuation report,

Each year the Obama administration has lied to Americans about enrollment in the health insurance exchange program.

As of June 30,2016, only 11.1 million people have signed up and continued to pay their premiums for Obamacare coverage in the 38 federal health exchanges as opposed to over 13 million that were published. State exchanges are closing monthly.

The latest prediction is that only 10.2 million will have insurance through Obamacare for the entire year. Eighty-seven percent of those insured through the federal health insurance exchanges have government subsidies in the government’s attempt to make health insurance purchased through the exchanges affordable.

If President Obama is correct about Obamacare providing insurance for 20 million people who did not have healthcare insurance previously then 9 million new people have signed up for Medicaid coverage.

Medicaid coverage is completely free to the recipients and is a single party payer system. The federal government presently pays for Medicaid coverage. The increased enrollment is also increasing the federal deficit.

Soon the federal government is going to dump some of the financial responsibility on participating states that are already running budget deficits.

It is only a matter of time before all the 23 state Co-Ops will go out of business and the federal health insurance exchange will take over.

Illinois is the 16th state to close its Co-Op doors. It followed one week after Oregon Health Co-Op closed its doors.

Land of Lincoln Health received $160.1 million in loans from the Centers for Medicare and Medicaid Services. More than 54,000 enrolled in coverage from the co-op through March 31.

 Where are these 54,000 people going to go for healthcare insurance?

 “It’s a bad day for the marketplace in Illinois and our consumers,” Jason Montrie, Land of Lincoln Health’s CEO said. “This is the end.”

Who is going to pay CMS back for these federal loans? The state of Illinois cannot afford to pay CMS back. The American taxpayers will re-pay the loan.

So far the total number of federal loans given to the failed nonprofit insurers is more that $1.5 billion for an experiment that was destined to fail from the start.

When are the liberals and progressives going to learn? You cannot keep spending other peoples’ money. You will eventually run out.

These last two weeks have been a big distraction because of party conventions.

Hillary Clinton announced her healthcare proposals. She has proposed an increase of $40 billion dollars in mandatory federal spending insulated from annual budget fights over the next 10 years to develop community health centers.

Hillary Clinton also wants to expand Medicare by letting people age 55 years old or older to opt into Medicare.

In addition she wants a public option.

“Bernie Sanders tweeted. “Together these steps will get us closer to the day when everyone in America has access to quality, affordable health care.”

Who is paying? The middle class taxpayer will pay the burden of the increase in taxes. It will not be paid by the 50% of the entitled citizens who do not pay taxes.

This is an attempt by Hillary Clinton to expand coverage for middle-aged adults. It also gives us a glimpse at how she wants to make Obamacare her own.

President Obama was not taking this lying down. He published an article in the Journal Of the American Medical Association, a “scientific journal.” This article is complete progressive propaganda. Why the AMA permitted this publication is beyond my understanding?

In his “special communication” President Obama once more presents another Trojan Horse (A destructive program that masquerades as a benign application.) to the physicians of America and the consumers of healthcare.

Some parts of the country have struggled with limited insurance market competition for many years, which is one reason that, in the original debate over health reform, Congress considered and I supported including a Medicare-like public plan.

Public programs like Medicare often deliver care more cost-effectively by curtailing administrative overhead and securing better prices from providers.59,60

The public plan did not make it into the final legislation. Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited.

Adding a public plan in such areas would strengthen the Marketplace approach, giving consumers more affordable options while also creating savings for the federal government.61

In 2009 Barney Frank and John Kerry insisted that a public option was essential for Obamacare to evolve into a single party payer system.

President Obama told them they would get to a single party payer system without a public option.

He has now changed his mind.

https://youtu.be/f3BS4C9el98

 

I have written extensively about the defects in a public option. http://stanfeld.com/?s=public+option

The New York Times writers did not describe the meaning or consequences of the public option in articles about both Hillary Clinton’s and President Obama’s call for a public option.

The American people should be told the real reason for the public option.

The combination of a “public option” within a health insurance exchange system was originally developed by liberal health policy analysts as a dual action mechanism to secure a “single payer” system. It presents the facade of a free market system but the end game is a full-scale government monopoly.

“If a public option became part of government-run health, the Health and Human Services secretary would establish such a plan, set its benefits, and fix its payment rates.

While private plans must negotiate market rates with doctors and hospitals, a Medicare-like “public option” would fix payment rates by fiat, well below the rates that would otherwise prevail in a real market.”

The “public option” would be a better deal for consumers rather than private healthcare coverage. The government would artificially force premiums down with subsidies. It could indiscriminately lower non-negotiated reimbursement to physicians and hospitals and force insurance companies out of the healthcare market.

It would result in an increase in federal taxes.

Additionally, the result will be a defacto single party payer system with less choice and access to care.

President Obama continues to ignore the fact that the government is dependent on the healthcare insurance industry to perform the administrative services for this government program. He ignores the fact that he needs doctors and hospitals to treat and care for sick patients.

He is only interested in financing the healthcare system and controlling the consumer’s ability to choose.

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

All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE