Stanley Feld M.D, FACP,MACE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The coverage is poor and too expensive for most people.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

https://youtu.be/Zmji36q8E4o

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

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

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Stanley Feld M.D.,FACP,MACE

There are at least two ways to balance the budget. Increase taxes or decrease spending.

If you increase spending without increasing taxes, you increase the budget deficit. If taxes are increased enough the budget deficit might be reduced.  

It was the Obama administration’s hope that if taxes were raised slowly, Americans would not notice the increases.

This is exactly what President Obama and the tax and spend Democrats are doing.

A frustrated reader writes about the slow rise but unrelenting rise in taxes.

“Here is a message from my buddy Brad.

As Jim Naybors/Gomer Pyle used to say – "surprise surprise."

Here is what happened on January 1, 2015:

These taxes were all passed under the Affordable Care Act, aka 
Obamacare.

The problem is taxes are at the tipping point. The rich and the middle class are now noticing the yearly tax increases. They are starting to shout, “no new taxes. Where is the value of these new taxes?”

A problem in America is an increasingly large  group of people who pay no taxes. These people have no choice but to accept government handouts to survive.

It has been reported that government handouts are equivalent to about a $50,000 a year post tax income. The entitlements blunt incentives to take the initiative and find work in order to be productive citizens.

Working people are experiencing the increased tax burden and are unhappy.

I have written a few articles listing Obamacare increases in taxes. President Obama has steadily increased taxes each year for the last six years.

The most irritating thing about the increased taxes is Americans are not getting value for their money.  All they are getting is lies and failed programs.

Administrator Marilyn Tavenner is resigning her post overseeing Obamacare just months after she admitted that the Obama White House’s highly publicized 8 million Obamacare enrollment figure was inflated by at least 1.3 million.

There is always a fall guy. It is never President Obama or his policies that are at fault. There is never full disclosure or transparency about these failed programs.

A vivid example of the lack of transparency is a recent disclosure by the budget committee about the Obama administration’s using unauthorized funds to pay for Obamacare cost overruns. Congress is supposed to authorize the use of funds according to the constitution.

Obamacare was having trouble getting insurance companies to participate in Obamacare’s health insurance exchanges. President Obama activated the government guarantee reinsurance program to subsidize the insurance industry. The goal was to induce the healthcare insurance industry to participate in the health insurance exchanges. The Obamacare reinsurance program guarantees the insurance industry that it cannot loss money in providing insurance through the health insurance exchanges.

 The Treasury Department has rebuffed a request by House Ways and Means Chairman Rep. Paul Ryan to explain $3 billion in payments that were made to health insurers even though Congress never authorized the spending through annual appropriations.

At issue are payments to insurers known as cost-sharing subsidies. These payments come about because President Obama’s healthcare law forces insurers to limit out-of-pocket costs for certain low income individuals by capping consumer expenses, such as deductibles and co-payments, in insurance policies. In exchange for capping these charges, insurers are supposed to receive compensation.

What’s tricky is that Congress never authorized any money to make such payments to insurers in its annual appropriations, but the Department of Health and Human Services, with the cooperation of the U.S. Treasury, made them anyway.

There are several other incidences of money shifting without congressional appropriation.

President Obama continually forgets that the constitution provides for three independent branches of government. They were formed in order to maintain checks and balance so one branch does not become all powerful.

The apparent disregard for the constitution is ubiquitous in the Obama administration.

If anyone is bothered by these actions by the Obama administration, please write to your representatives in congress.

If you think it is important that everyone in the U.S. should 
know these things, feel free to pass this on.

If there is value to the healthcare system with Obamacare, a debate about the need for increased funds is appropriate.

Most Americans do not like Obamacare. Most physicians do not like Obamacare. America’s budget cannot stand Obamacare.

President Obama loves Obamacare. Isn’t President Obama supposed to represent the will of the people?

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

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