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Politics of Electronic Medical Records

Politics of Electronic Medical Records

Stanley Feld M.D.,FACP,MACE

The EMR project that President Obama forced on the medical profession in 2009 has not yet produced any evidence that EMR will save the country $350 billion in inpatient care and $150 billion dollars in outpatient care over a 15 year period of time.

The RAND analysts claim that more than $350 billion would be saved on inpatient care and nearly $150 billion on outpatient care over a 15-year period of time. 

The RAND EMR study was wrong. The study sounded good to President Obama because he thought EMRs would enable the federal government to control medical and surgical practices in America.

Unfortunately, data from three other studies, a cardiology group, a Harvard group and Canadian group showed there is no savings difference between paper records and electronic records.

The project has been a $38 billion dollar failure. I predicted the EMR project would fail in 2011. EMRs are a great idea. The EMR projects goals were wrong.

Wall Street Journal article in 2012 stated,  The electronic medical record (EMR) is touted as the key to containing costs, reducing errors, improving quality, and simplifying administration: an “elegant exercise in wishful thinking.

The RAND Corporation study was paid for by all the vested interests stakeholders involved in medical care except physicians and patients.

Allscripts Healthcare Solutions, the Cerner Corporation and Epic Systems of Verona, Wis. are the major EMR software companies who paid for the study.

In February 2009, after years of behind-the-scenes lobbying by Allscripts and others, legislation to promote the use of electronic records was signed into law as part of President Obama’s economic stimulus bill.

GE and the healthcare insurance industry were also major funders of the RAND Study. The Obama administration funded the implementation of the EMR project to the detriment of the healthcare system.

The healthcare system has not contained costs, reduced errors, improved quality or simplified administration. Each category has gotten worse.

I do not think the Obama administration’s primary interest was to fix the existing healthcare system.   If the EMR project hobbled the healthcare system, the population would beg the government to completely take over institute his “Public Option” and subsequently “Medicare for All.” There was no consideration of the fact that that Medicare and Medicaid are unsustainable.

The complete control of the VA Healthcare System has not worked out very well for the government. One important reason for the VA Healthcare System’s failure is the bloated government bureaucracy. Effective medical care takes instantaneous judgement and rapid execution. Government regulations inhibit the process leading to long waiting times and ineffective and costly treatment.

Medicare and Medicaid costs have been unsustainable and are getting worse. Why would a politician think complete government control over 20% of the GDP, the healthcare system, would be any better than a free market system where patients would take responsibility for their healthcare and healthcare dollars?

The government could provide the dollars to the needy with financial incentives attached for all in the system.

Ideal EMR should be for the benefit of physicians and their patients. The EMR should not be only for the financial benefit of healthcare insurance companies, the government,  the pharmacy benefit managers and the software companies.

The EMR project places the secondary stakeholder in the position to judge physicians’ behavior and subsequently penalize them if they do not comply with government regulations and expected results.

The EMR should be a tool to continually educate physicians to help them become better. It should educate patients so they can become professors of their disease and help them avoid the complications of their chronic diseases.

The EMR should not be a tool used by secondary stakeholders to penalize physicians and patients. This will not decrease the ever-increasing cost of healthcare.

At the moment EMRs are relatively useless. A lot of money has been spent by all the stakeholders with very limited benefit. There have been hundreds of examples published by all stakeholders about the defects in the present EMRs that do not allow for an increase in the quality of care and a decrease in the cost of care.

 My ideal EMR along with my ideal medical saving accounts can go a long way toward repairing the healthcare system. http://stanfeld.com/is_an_ideal_ele/

 

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



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Describing Fake News

Stanley Feld M.D.,FACP,MACE

The front-page headline in the Sunday New York Times on August 26 read;

“Health Insurers Start To Prosper.

The subtitle was; Trump’s Warnings on Affordable Care Act Masks Upside.”

 “Supporters of the Affordable Care Act achieved a major victory this past week when, thanks to cajoling and arm-twisting by state regulators, the last “bare” county in America — in rural Ohio — found an insurer willing to sell health coverage through the law’s marketplace there.”

“So despite earlier indications that insurance companies would stop offering coverage under the law in large parts of the country, insurers have now agreed to sell policies everywhere.”

 A casual Sunday Times reader would respond to this headline and initial paragraph by thinking that President Trump is frightening the public about Obamacare’s failures.

The casual reader would conclude this is just another one of President Trump lies. Obamacare is not failing. He is just trying to scare the public.

The New York Times is telling the public that the insurance industry is going to offer insurance through Obamacare in every county in the country.

The American people cannot trust President Donald Trump.

The causal reader got the message. Obamacare is doing fine. It is not necessary to continue reading the article.

The online Sunday NY Times headline of the dame article was different than the headline that appeared in print.

Trump’s Threats on Health Law Hide an Upside: Gains Made by Some Insurers”

This headline is also misleading. One insurer in a bare county signed up. This does not represent a upside gain or create a competitive market place.

“The Centers for Medicare and Medicaid Services (CMS) reported that 1,476 counties, over 45 percent of counties nationwide, will only have one health insurer on the Obamacare exchanges next year.”

This article is an example of “fake news.” It is totally misleading to the casual reader

Why a single insurance company will sell insurance in that bare county in Ohio is not explained. All the other insurance companies have pulled out of that county.

If the reader got this far into the story he could still be satisfied that Obamacare was not imploding.

However, the article goes on to explain the potential failure of Obamacare.

“But a moment of truth still looms for the industry in the coming weeks under the law known as Obamacare.”

“Companies must set their final plans and premiums by late September, even as the Trump administration continues to threaten to cut off billions of dollars in government subsidies promised by the legislation.”

This is more fake news aimed at blaming Donald Trump for Obamacare’s failure.

The NYT ignores the fact that President Obama promised the healthcare insurance industry the reinsurance subsidy in order to get them to participate in Obamacare in the first place.

President Obama paid the healthcare insurance industry only 12% of what the insurance companies claimed President Obama promised them in their reinsurance package.

President Obama promised the healthcare insurance industry a subsidy through the government backed reinsurance package, if there were cost overruns in Obamacare.

The costs overruns were massive according to the healthcare insurance industry. The legislator only budgeted 12% of that claimed by the healthcare insurance industry.

President Obama could not find the money to pay the remaining 88%.

The industry continues to demand the remaining 88% promised in order to participate in this year’s (2018) Obamacare health insurance exchanges.

All twenty-two of the state run insurance administrative companies that received loans from the federal government have gone bankrupt and have not paid the insurance industry.

Those federal loans will never be paid back to taxpayers.

The Democrats and the mainstream media are trying to blame President Trump for this deficiency in payment and the lack of insurance company participation.

The shortfalls resulted in healthcare insurance premium raises for both the Obamacare health insurance exchanges and the premiums for private group insurance.

Subsequently, most of the healthcare insurance companies have dropped out of providing the insurance through the Obamacare health insurance exchanges.

A third piece of fake news is the success of providing insurance for twenty million enrollees.

The NYT article ignores the fact that Obamacare through the health insurance exchanges only enrollee nine million people in the individual market. Fourteen million lost individual coverage lost their insurance at the onset of Obamacare.

The 22 million additionally insured includes the additional thirteen million were added to the Medicaid roles. Some of those thirteen million are illegal immigrants.

Soon a portion of the financial burden of the Medicaid increase will be dumped on the states.

The Obamacare law requires comprehensive insurance coverage packages for both the individual market and the group markets driving the price of coverage up.

These increases make Obamacare unaffordable. Obamacare is not successful as implied in the New York Times article.

President Trump did not do anything to distort the Obamacare coverage. President Obama did it with his tremendous cost overruns.

It is possible President Obama wanted to prove that an insurance-based healthcare system couldn’t work. It would have to be replaced with a government controlled single payer system.

It is the reason he wanted to include the “Public Option.”

However he placed so many regulations in the way of any possible success.

President Obama believes that the only system that would work is a single party payer system with the government being in control of the money, the coverage and the freedom to choose by the public.

President Obama had no concern for the government inefficiency or cost to the government.

There was no consideration for a more cost efficient and affordable healthcare system.

“The fate of the landmark law, Obamacare, depends in large part on the health of the insurance marketplaces and the ability of insurers to make a viable business out of selling coverage to individuals.”

Healthcare insurers have tried to make a viable business plan out of Obamacare. When the law passed seven years ago, insurers saw a potential bonanza: tens of millions of brand-new paying customers, many backed by generous government subsidies and required by the new law to have health coverage.

The burdensome regulations, lack of coverage flexibility and one size fits all coverage all have cause people not to sign up for Obamacare. They would rather pay the penalty even though they can ill afford it.

On Thursday, Northwell Health, the largest hospital system in New York State, announced that it would shut down its insurance unit, CareConnect, which had been selling coverage in the state marketplace. The move forces tens of thousands of its customers to find another plan for 2018. Northwell’s chief executive put much of the blame on Washington.

As we get closer to enrolling participants in Obamacare for 2018 and the insurance industry’s publishing their premiums more insurance companies are dropping out of participating in the health insurance exchanges.

Most of the startup insurance companies and state sponsored have closed down their business.

The article quoted is fake news.

The article starts off giving the casual reader the impression that Obamacare’s insurance coverage is doing fine.

The reality is It is not fine. Americans have to worry about it. Affordable healthcare insurance will not be available at an affordable price.

The Democrats are happy because then the country will be offered a single party payer system.

The problem is that the federal government cannot afford a single party payer system. At this moment Medicare and Medicaid are not sustainable. A single party payer system will be inefficient and unsustainable.

I don’t know how Mitch McConnell can to say most of the news is not fake news.

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

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

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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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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 Don’t Need A Public Option

Stanley Feld M.D.,FACP.MACE

When President Obama told Barry Frank and John Kerry “We don’t need a Public Option in the Affordable Care Act legislation” he was right.

https://youtu.be/SHPsEVQ9dGQ

 

https://youtu.be/4iR_iKRKewQhttps://youtu.be/4iR_iKRKewQ

 

Senator Chuck Grassley know all along what President Obama’s scheme was. His problem was none of his Republican friend would listen to him or do anything about it.

https://youtu.be/-522hcm3woA

President Obama’s goal all along was to sneak in a Public Option in through the expansion of Medicaid. He wanted the local states to be administratively and financially responsible for Medicaid while the Federal government controlled the system through regulations.

President Obama had figured out the way to get to a single party payer without a Public Option. However, he and his advisors misjudged the defects in Medicaid.

Republicans have been opposed to a single party payer system and government control of the healthcare system. Republicans felt government control would increase the cost of healthcare, increase inefficiency in the administration of healthcare care, ration healthcare and decrease access to healthcare.

President Obama thought he could use a myriad of regulations to help Obamacare back into a single party payer system. The State and Federal Health Exchanges (“so called Obamacare competitive model”) has resulted in both the health exchange and the private insurance industry increasing the cost of healthcare to unaffordable levels, decreasing access to care, rationing of care and destroying the healthcare system.

The politicians, in a state like California, by following the federal money, ignored the will of the people. The people hate Obamacare because it is restrictive. They are angry about the lie President Obama told them to get their support. “If you like your doctor you can keep your doctor. If you like your insurance you can keep your insurance.”

President Obama has created a healthcare system infrastructure that played on states’ greed. Many states have tremendously high budget deficits. They have over taxed state residents.

State citizens and businesses are leaving for more tax friendly states. The migration has created larger state budget deficits. State politicians say a way of getting more federal money into the states and perhaps attracting people back to the state will be by expanding Medicaid. The federal government promised to pay 100% for the first three years of the Medicaid expansion program

Twenty-two states fell into President Obama’s trap. These states are on their way to a single party payer system without even knowing it.

I predict his scheme will fail.

California was the first state to jump into this pot of boiling water.

The federal government is going to pay 100% of newly qualified enrollees to Medicaid until 2017. Medicaid is under state control.

A record number of people have signed up for Medi-Cal in California. This has led to huge cost increases in Medi-Cal. Its price tag has jumped from $59 billion to $91 billion.

Where does President Obama get the money to pay for it? He increased the federal deficit. I guess $32 billion dollars would be considered a rounding error to most Democrats in congress.

States will have to start paying 5% of the bill for the newly eligible and enrolled enrollees in 2017. In 2020 the states will start paying 10% of the bill.

Medi-Cal is the state’s Medicaid plan for low-income Californians. Nearly one in three Californians now receive coverage in Medi-Cal. With its continued Medi-Cal expansion it is predicted to expand to 20 million by 2020.

Medi-Cal Explosion

Medi-Cal Growth of enrollment

The people of California are going to be the first victims of the increased costs and decreased services.

Every government program creates a complex bureaucracy along with money wasting inefficiencies and abuses.

California politicians were bragging about the great deal the government had given them.

That’s a really great deal for California,” said Scott Graves, research director at the California Budget & Policy Center. “You don’t find that anywhere else.”

Advocates say the expansion, with the huge infusion of federal money, should in fact eventually yield savings for states, possibly enough to make up for the costs.”

UC researchers calculated that each new federal dollar brought to California by Medi-Cal will generate 5.4 cents in tax revenue for the state, which would mean several billion dollars. That’s because the money creates jobs in healthcare, which creates income and sales tax.”

Over the years because of the cost overages, Medi-Cal has been forced to decrease reimbursement to physicians and ration both care and access to care. Physicians have opted out of Medi-Cal participation. As Medicaid has grown as a result of Obamacare, Medi-Cal patients cannot find a physician to care for them.

I suppose President Obama could force physicians to accept Medicaid payment in order to retain their license to practice medicine. This executive action would attack freedom of choice and propelling the United States further down the road to serfdom.

As predicted, a group of Californians filed a civil rights complaint against Medi-Cal, alleging that failures in the program have prevented Latinos from accessing their healthcare they needs.

“But the complaint filed with the U.S. Department of Health and Human Services claims that because Medi-Cal administrators don’t pay doctors enough to see patients, they “effectively deny the full benefits of the Medi-Cal program to more than seven million Latino enrollees.”

Many complain that Medi-Cal’s reimbursement rates, among the lowest in the nation, create a shortage of doctors willing to see Medi-Cal patients.

The audit confirmed our long-standing concerns about access for Medi-Cal patients,” said Anthony Wright, executive director of the advocacy group Health Access California. “The findings of the audit cry out for more oversight.”

Gov. Jerry Brown’s budget for the 2014-15 fiscal year accommodates an influx of uninsured residents into Medi-Cal.

However, at Governor Brown’s request, the Legislature left in place a 10 percent recession-era cut in reimbursement to most doctors, dentists and other health care providers who treat Medi-Cal patients.”

Health providers predicted this harmful contradiction. The contradiction is that Medi-Cal expansion will provide more of the poor with adequate healthcare coverage. It is, in fact, reducing  poor persons ability to get into clinics, practices and even hospitals.

The California HealthCare Foundation reported that 76 percent of primary physicians accept new patients through private insurance. Only 57 percent accept new Medi-Cal patients.

Medicaid and MD

The optimism of politicians for the expansion of Medi-Cal improve state revenue has vanished. California’s deficit is increasing rapidly as a result of Obamacare’s largess.

In California, state officials are discussing how they’ll afford the program next year (2017). Gov. Jerry Brown called a special legislative session this year to address funding for Medi-Cal.

“It’s a strained system,” said Hernandez, “and I really believe we need to figure out how to resolve.

The 20 states that have not accepted President Obama’s offer to expand Medicaid were correct. These states wanted to make their own decision in the name of states’ rights. Many of the states could not afford expansion in the way President Obama was dictating it. Their budget deficits and taxes would have to increase.

California has just proven these states fears. In 2017 California will start paying 5% into the Medi-Cal expansion. It will make the budget deficit worse.

California will, once again, start begging the federal government to bale it out.

President Obama’s plan was to dump the financial burden on the states while controlling the system and creating a single party payer by default.

There is a much better way to provide healthcare to all people at an affordable cost.

The better way is to put consumers in control of their healthcare dollars.

They will control their health to avoid costly complications of chronic diseases. The people will be given financial incentive to be responsible for their health to try to avoid the onset of chronic disease.

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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Here It Comes!

Stanley Feld M.D.,FACP, MACE

The mainstream media has been very quiet about Obamacare lately as the defects in its execution keep rolling along.

You may recall President Obama telling Senator John Kerry and Representative Barney Frank not to worry about including a Public Option in the bill. He told them they would not have to include the Public Option in the Affordable Care Act.

Barney Frank said we would never get a single party payer system unless we have a Public Option in the bill.

President Obama was right. He didn’t need a Public Option because the single party payer system was already embedded in the bill without anyone knowing it.

Medi-Cal is California’s name for its Medicaid program. California is one of the states that have expanded the Medicaid program under Obamacare.

Twenty states have not expanded their Medicaid program for fear of the federal government impinging on states rights while sticking their state with the bill.

The states also feared increases in their budget deficit. States are required to balance their budget. The result would be an increase in state taxes.

The increase in state taxes would render the state unattractive to companies and their business. Less company growth would mean an increase in unemployment and a decrease in state tax revenue. A decrease in tax revenue would result in a decrease in state services.

President Obama said, “Don’t worry.” He promised to fund Medicaid expansion fully for the first 3 years. Federal funding would decrease after the first three years to 50%. The funding percent has changed a few times since that promise. One could not know the present decrease unless one read the Federal Register daily.

Expanding Medicaid was a key part of the Affordable Care Act (Obamacare). It was also a hidden trap set by President Obama to slip the healthcare system into a single party payer system by default. That is why President Obama insisted we did not need a Public Option.

Obamacare required nearly all Americans, under penalty of law, to have insurance starting in 2014.

Though a surprise, the high Medi-Cal enrollment is generally hailed as a success. California’s uninsured population has been cut in half since Obamacare, in large part because so many Californians signed up for Medi-Cal, which is free for beneficiaries.

Medi-Cal was opened to all low-income Californians starting two years ago, with the federal government paying for those new enrollments.”

In 2016 one third (1 in 3) or 12.7 million Californians are covered by Medi-Cal.

The total cost of the Medi-Cal explosion is $91 billion dollars, up from $54 billion dollars in 2012. California is responsible for $12 billion dollars. It will increase California’s budget deficit and may result in another tax increase.

The cost per insured is $7,165.35.

“The Medi-Cal program continues to grow at a very substantial rate, which is great. We are very happy that we’re able to provide healthcare to getting close to 13 million Californians,” said Mari Cantwell, chief deputy director at the state Department of Health Care Services, at a hearing in downtown L.A. this month. But, Cantwell added: “Obviously with that comes cost.”

The Medi-Cal is viewed by many state officials as being underfunded.

Medi-Cal patients are struggling to find doctors.

Many patients are receiving low quality of care by government standards.

A psychiatrist in Los Angeles told me that all the private practice internists in L.A. require an upfront concierge fee of at least $2,000 a year at the beginning of the year to be in their panel. If this is true, Internists in L.A. are insulating themselves against the low reimbursement of Medi-Cal. This concierge fee increases the California physician shortage.

The result has been that groups of activists have filed a federal civil rights complaint alleging that Latinos are being denied access to healthcare because the program does not pay doctors enough.

The Affordable Care Act allowed states to open up Medicaid to anyone making less than 138% of the federal poverty level.”

Twenty states did not sign up for the expanded Medicaid because of the fear of federal takeover and the further impingement of state rights.

Pre-Obamacare, states were required to pay 43% of Medicaid’s cost and the federal government paid 57% of the costs. States ran the program and determined reimbursement.

As costs increased reimbursement was decreased and physician participation decreased because of the decreased reimbursement.

As a result of the 20 states resisting Medicaid expansion the federal government will pay 100% of the cost of new expansion enrollees and 93 percent off the cost of expanding Medicaid over the next nine (9) years instead of the next two (2) years.

The present rule looks like a great deal for the states. However with the federal government paying most of the Medicaid bill for the next nine (9) years the federal government will want to control Medicare.

Who needs a Public Option to get to a single party payer?

Who is going to stop the federal government from changing the eligibility for Medicaid to 200 or 400% of the poverty level?

Who is going to force doctors to participate in Medicaid if they want to practice medicine with a federal license?

Where is the government going to get the money without having skyrocketing increases in taxes?

Tax laws and lack of pro-growth tax reforms are inhibiting America’s economic growth.

America has been set up to have the future state of healthcare be a single party payer system. President Obama has done it in a clever way. He has had no regard for being fiscally responsible in the face of a 19 trillion dollar, and rising, debt.

Single party payer systems have failed in England and Canada.

Why should America create another failure?

Can Americans have a future state healthcare system that is not destined to fail?

Yes we can!

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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Where Is The Missing Money?

Stanley Feld M.D.,FACP,MACE

Does anyone know how much Obamacare cost each year? Does anyone know if Obamacare is the cause of America’s more than one trillion-dollar deficit each year despite the Obamacare tax increases that are supposed to pay for it ?

If someone knows they sure are not telling taxpayers. A good friend who is a liberal and a big fan of President Obama said to me he is not worried about the federal deficit. Neither is President Obama. President Obama has convinced his base that the budget deficit and America’s escalating debt is an insignificant problem.

It follows that he can spend money as he wishes and waste money with impunity. I was taught that is not the way to run a business. Especially when the waste fullness gets negative results that leads to more deficit spending.

The problem is the waste of money is reported in dribs and drabs and usually on a Friday afternoon.

We have seen that happen in the VA system. After one year and billions of dollars spent the waiting times have decreased slightly. The medical service to veterans has not improved. No one in the bureaucracy has been held responsible. Veterans have been complaining more loudly since nothing has improved.

Missing Money

The federal government awarded over $5 billion to help states set up Obamacare exchanges, with the vast majority – $4.6 billion – going to 16 states and Washington, D.C.” 

The Government Accountability Office (GAO) recently reported that most of the money has not been accounted for. Several of those State Health Insurance exchanges have gone out of business this year.

$1.4 billion of that has been spent on IT projects. This sounds very high for 16 different web sites. Why couldn’t everyone use the same website?

Three ($3 billion) has been “spent or drawn down.” Only some of the drawn down spending has been detailed.

At least $1.6 billion is unaccounted for. Only three states returned any portion of the money. The federal government has only received back $1 million.

It sounds like government bureaucracy inefficiency at best and fraud and abuse at worst with no one being held accountable.

Can Americans trust the government to run our healthcare system?

Where did those taxpayer dollars go?

More Missing Money

Obamacare created the co-ops to encourage State Health Insurance Exchanges to increase competition in state insurance markets.

The intent was to offer consumers choices with the hope of holding down premiums.

Co-ops were snuck into Obamacare to replace the public option. No one has spoken about this being a substitute for the “public option.” The public option is an obvious ploy to convert the healthcare system quickly to a single party payer system.

The public option was designed to compete with private insurers on the state level by offering lower premiums in order to force the insurance industry to lower its premiums. The co-ops were designed to do the same thing.

President Obama offered state co-ops $6 billion dollars for start-up costs. Since there were only 23 states co-op formed instead of 50 Congress decreased the total payment to $2.4 billion to the 23 start-up co-ops.

All 23 co-ops received their proportional federal loans to meet solvency requirements as well as start-up costs.

President Obama now claims the Republican house denied Obamacare enough money for the co-op to be successful.

Twelve (12) of the 23 nonprofit insurance co-ops announced they will not offer coverage to consumers who bought healthcare coverage in 2015 in 2016. They are bankrupt. Where did the money go?

Somewhere between 300,000 and 600,000 people will be shopping for more expensive healthcare coverage for 2016.

The remaining 11 standing co-ops are $500 million dollar in the hole.

There is no accounting available to explain why these co-ops have failed

Does anyone think these $2.4 billion dollar loans will be paid back to the federal government? I do not. It will simply be added to the federal deficit.

  • “CMS said the government would “use every tool available to recover taxpayer dollars” from the co-ops going out of business, but it declined to say how much she expected to recoup.”

There are many reasons these co-ops have failed. Republicans not giving the co-ops more money, as progressives and Democrats have claimed, is not one of the reasons.

Another area of missing taxpayers’ dollars.

The Senate Finance Committee is looking into the millions of taxpayer dollars being spent on ads to promote Obamacare enrollment.

The total federal government budget for ads and PR was nearly $1 billion in fiscal 2013. How much was spent on Obamacare?

The Health and Human Services budget for “paid media” is about $35 million for the current enrollment period. The $35 million dollars will be spent in the 38 states using HealthCare.gov in the 2016 enrollment period.

Chairman Orrin Hatch, R-Utah, raised concerns about agency ad spending and sent a letter to the acting head of the Centers for Medicare and Medicaid Services (CMS) asking for a full accounting of agency ad spending.

“Increased transparency on government spending on advertising will improve accountability and help ensure that the taxes from hardworking Americans are not squandered and wasted on ineffective or misguided government programs,” he wrote to Acting Administrator Andrew M. Slavitt.

Senator Hatch demanded the accounting by November 25th. Does anyone think he received it?

In 2010, the nonpartisan Government Accountability Office (GAO) reported the Obama administration spent nearly $20 million on a Medicare brochure that contained “instances in which HHS presented abbreviated information and a positive view of Patient Protection and Affordable Care Act (PPACA) that is not universally shared.”

The GAO papered over the ridiculous expenditure.

GAO concluded that “nothing in the brochure constitutes communications that are purely partisan, self-aggrandizing, or covert.” 

CRS reported HHS was second only to the Department of Defense, spending $197.4 million on advertising in fiscal 2013.

“The total federal government budget for ads and PR was nearly $1 billion in fiscal 2013.”

Would healthcare be so expensive if the government was transparent and congress was really on top of everything?

Physicians only receive 20% of the healthcare dollars spent.

President Obama and his administration spend taxpayer’s money at will.

Americans have to demand “more efficiency and much more transparency.”

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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Healthcare Insurance Industry Moves Against Obamacare

Stanley Feld M.D.,FACP,MACE

The 3 R’s are not working out well for the government, the patients or the healthcare insurance companies.

The temporary reinsurance portion of the 3R’s is about to expire. It was meant to support the healthcare insurance industry as enrollment in Health Insurance Exchanges grew.

Patient enrollment figures in State and Federal Exchanges have not grown significantly in the last two years. Enrollment ii exchanges has been from high risk and elderly patients.

High risk and comprehensive coverage has meant decreasing profit for the healthcare industry.

The numbers the Obama administration publishes are confusing and mostly false. State exchanges are failing. The State Health Insurance Exchanges are causing (in states that have State Health Insurance Exchanges) greater budget deficits.

The reinsurance program is not covering the healthcare industry’s expected profit because of the redistribution of wealth component in the 3R’s.

The significance of the redistribution of profit and wealth component of the 3R’s was not fully appreciated by the healthcare insurance industry as was the reinsurance subsidy was.

The industry’s first step to combat this barrier to profit was to increase next year’s insurance premiums by 20-30 percent in both the private sector and the State and Federal Health Insurance Exchanges.

This has created inflationary pressure on the private sector and unaffordable healthcare in both the private and public sectors for consumers and companies that provide healthcare coverage to their employees.

Its effect is the opposite of what President Obama promised. He promised to make healthcare insurance coverage affordable to all.

It is also forcing corporations to switch their healthcare coverage plans from defined benefit plans to defined contribution plans. The net effect is to increase employee out of pocket expenses.

We do not know how many more people have lost healthcare insurance because of Obamacare’s rules and regulations.

The public is also unaware of the exact number of people who have gained healthcare insurance through the Health Insurance Exchanges.

The real figures are not easily available.

The next step by the healthcare insurers is to merge.  A series of merger negotiations are occurring. In the last three weeks two merger negotiations have been completed.

Anthem Inc. agreed to buy Cigna Corp. for $48 billion, capping months of merger frenzy among top U.S. health insurers that is set to reshape the industry.

“The merged company is projected to have around $115 billion in annual revenue and cover about 53.2 million people.

The deal, which needs regulatory approval, would help reshape health insurance industry.”

Three weeks ago Aetna agreed to buy Humana for $34 billion. The two deals accelerated the rapid-fire reconfiguration of the U.S. health-insurance industries. The two deals would decrease the industry from five major companies to only three.

The traditional media has not discussed the reasons the healthcare insurance industry is merging or the details of the mergers.

I will try to connect the dots.

The healthcare insurance industry realizes that the Obama administration is trying to play one insurance company against another. The redistribution of profit from insurance companies that profit to those that make less profit must be irritating to the healthcare insurance industry.

Perhaps they did not appreciate the intricacies of the 3 Rs. Maybe there was a small window where the temporary reinsurance was profitable.

I would guess that the healthcare insurance industry would try to stop the redistribution of profit. These mergers will increase their individual profits.

The companies will be in a position to force the government to discontinue the redistribution of profit or lose a company that is an administrative service provider.

The losers will be taxpayers and non-subsidized insurance consumers. The increases in premiums to consumers that are subsidized will be passed on to taxpayers. Non-subsidized taxpayers will also be paying increased healthcare premiums.

This will create non-affordable insurance premiums for all as a result of the Affordable Healthcare Act (Obamacare).

The healthcare system will collapse. The government will move in with a single party payer system and a bloated and wasteful government bureaucracy.

Remember Senator Kerry and Representative Barney Frank saying the ACA would not work without a Public Option? Remember President Obama saying we don’t need a Public Option?

President Obama is backing healthcare insurers into a Public Option corner and a single party payer system.

The government will be forced to limit access to care and ration care. Americans will not have freedom of choice.

The problem is the government will still have to hire one of the three healthcare insurance carriers for its administrative services instead of one of five major carriers. The price to the taxpayer will probably be high along with all of the government’s bureaucratic inefficiencies.

Remember the VA? The VA scandal is continuing without any apparent improvement in VA services or in reforming the dysfunctional VA system.

Congress is simply giving the VA more money to continue its dysfunctional ways.

The latest step in the healthcare insurance industry’s attempt to protect itself is the hiring of Marilyn Tavenner as CEO of America’s Health Insurance Plans (AHIP) the lobbying group for the healthcare insurance industry.

Marilyn Tavenner is the former head and CEO of CMS overseeing Medicare, Medicaid and ACA (Obamacare) implementation.

Marilyn Tavenner oversaw the botched rollout of the federal insurance exchange and the ACA-mandated cuts in payment rates to Medicare Advantage in additional to a myriad of new Obamacare generated Medicare and Medicaid regulations.

Some of these regulations are unconstitutional according to lawmakers. However, the legislators have done nothing about these unconstitutional regulations.

They have not even attempted to make Americans aware of them.

Health Insurance Exchange plans and Medicare Advantage plans are two areas of tremendous profit and significant growth for private insurers. The Obama administration knows this and has tried to limit or eliminate this growth.  AHIP hopes Marilyn Travenner can help the industry continue this growth by pointing out the bureaucracy’s weaknesses to healthcare insurance company’s executives.

The healthcare industry (AHIP) hired her for her political connections inside the administration, inside the CMS bureaucracy and inside the congressional committees that regulate them,” said Tim LaPira, political science professor at James Madison University.”

 The mainstream media parroting the AHIP’s press release said, that the insurance industry has accepted Obamacare (the Affordable Care Act) as the new business environment. AHIP wants a CMS insider to help during the next phase of its market development.

According to the AHIP press release, “her government experience will be invaluable to AHIP given how rapidly the public sector is dominating the financial, market and regulatory facets of health plans”

It is obvious to me that AHIP did not hired Ms. Travenner in order to understand the new business environment better for an instant.

I believe AHIP hired her as CEO for her connections in,

1.   CMS,

2. The Obama administration,

3. The administration’s bureaucracy.

4. Congress

Along with her impressions of CMS’s weaknesses.

Weaknesses the AHIP can exploit.

Neither the Obama administration nor AHIP are working for the benefit of the American consumer of healthcare.

This behavior must be stopped somehow.