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Social networks can express the feelings and preferences of various groups. They have given people an individual voice. If there is universal agreement on a social network, the social network can change the supply chain of any organization, government policy or even government.
Ms. Brinker and the board were not very transparent for the reasons of its policy change in the first place. The original defunding policy was probably the result of the Foundation’s own funding pressures by pro-life contributors.
The rapid reaction of the Susan Komen Foundation social network, which was so skillfully developed by Ms. Brinker, was the probable reason for the switch back to the original policy.
The new policy was to withdraw funding for Planned Parenthood’s providing mammograms for needing women. The new policy contradicted the mission of the Susan Komen Foundation. The social network reacted and the new policy was rescinded.
It took only a week to change the policy back to the old policy.
The real question is how do you mobilize the power of the people to fix the healthcare system?
Everybody of all age groups knows the sound bite,“the healthcare system is broken.”
Not many people understand the reasons it is broken. Nor are many people interested in creating the bandwidth to know those reasons until they become sick.
People who are not sick really do not care as long as they perceive they have adequate healthcare insurance coverage.
Many President Obama fans think he is doing a great job reforming the healthcare system because of his use of well-known sound bite that the healthcare system is broken. He has promised to fix it.
He has promised to decrease healthcare costs and provide adequate access to healthcare for all people.
I have shown that President Obama’s healthcare reform act will increase healthcare costs, increase the budget deficit, decrease access to care and ration care.
Even before his healthcare plan is fully implemented it has resulted in an increase in cost of care, decrease access to care and rationed care.
Below is a comment from a neurosurgeon who was returning from a CMS seminar about restriction of access to healthcare.
It is a worthwhile to listen to his comment on new HHS regulations limiting access to care.
A way to mobilize “the people power” is get people 20 to 50 years old to understand what is being done to destroy the healthcare system. Everyone is going to need the healthcare system eventually.
These younger people understand how to develop social networks and get them to have a desired effect.
In order to reduce the cost of healthcare and increase the quality, the system must be converted from a government and healthcare insurance industry driven system to a consumer driven system.
I was “called out” by a reader because I called the new system a consumer driven system. He wants to call it a patient driven system. He defines all consumers as patients.
“ In my opinion, everybody is a patient, and a member of one of three groups: The first group is composed of
"Patients in waiting" (the well, who require periodic screening and health information to stay well, and the worried well, who are coping with issues of some sort for which they have yet to seek professional advice);
The ailing, composed of people who are actually coping with conditions of one sort or another that make them less than well; and
The recovered, those who have regained an adequate measure of good health and functional capabilities after having experienced and recovered from a spell of illness.
What we need to do is to work to make all three publics (to use a marketing term) aware of the fact that regardless of which group they may currently occupy, they are all stakeholders in the mess we currently call the healthcare system.”
This is a great point. It might inspire the “patients in waiting” to get involved now before it is too late.
Patients would own their healthcare dollars. They have incentive to be wise consumers of healthcare and take responsibility for their health and healthcare. They would also have the incentive to make prudent healthcare and medical care choices.
Both would become facilitators at the edges of the healthcare system and not the gigantic hairball in the middle of the system obstructing the patient physician relationship.
Social networking could force the government to relinquish its quest to control everybody’s choices and access to care.
A consumer driven system would decrease the demands for expensive excessive care by the patients because they have “skin in the game.” The result would be to decrease the cost of healthcare.
These results would occur if all the other spokes of my 2020 business plan on the wheel were accomplished at the same time.
“I cannot finish my career in Medicine without finding a way to integrate experienced people with great ideas and insight with young people who know how to create the tools to bring innovative approaches to actually create a functional healthcare system.”
It is my hope also.
Innovative software can be built for the future state that empowers patients in waiting, the ailing patients and the recovered patients (consumers) with the tools to express their needs.
Patients in all three groups can accept and take responsibility for their care.
In order to transform the healthcare system you do not need all the consumers in the country to be in the social network. It simply has to be compelling enough for people to join as the goals get the attention of others.
Consumer (Patient) Driven Healthcare along with the Ideal Medical Savings Account will be the foundation of this transformative healthcare system.
The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone
I love Costco. Its prices are great and its selection is abundant. Last week I was dazzled by the display of megavitamins as soon as I walked into the store.
Americans want to be healthy. Few have a death wish but many (60%) are obese. Megavitamins have been touted as the instant route to healthy living. The megavitamin business has grown into a $30 billion dollar a year business.
Megavitamins have been successfully oversold.
There is no evidence that megavitamins are the route to health and healthy living.
There is little good evidence to support the widespread use of dietary supplements.
The US Preventative Health Services Task Forces reviewed some of the literature on megavitamins and dietary supplements. The group stated there was insufficient evidence for or against the use of multivitamins with folic acid or antioxidants. It also stated that the use of Vitamin A, C or E did not have sufficient evidence for or against its use.
I think these supplements could be helpful if the requisite dosage was known. There is no evidence that these dietary supplements are helpful at the present dosage. There are no scientific studies about which doses would work. There are only testimonials attesting to usefulness.
”Beware of the man with one case.”
A friend of mine worked for thirty years proving the existence of Vitamin D deficiencies in 50% of the elderly population. It took him half that time to convince the medical population that he proved something.
The dosage necessary ended up being 6 times the dosage in multivitamins. Therefore USPHTF conclusions are correct with the present data. However they might have drawn their conclusions from the wrong data.
This is not an unusual occurrence in clinical medicine as I have pointed out previously.
The American Medical Association hedged its bet by stating,
Chances are people who are starving or dying from cancer will have a multivitamin and mineral deficiency.
The American Dietetic Association advises,
“low-dose multivitamin and mineral supplements depending on individualized dietary assessment.”
The ADA’s statement is obviously self-serving.
The American Heart Association made the only logical statement in the whole bunch.
“The AHA emphasized healthy eating patterns rather than supplementation with specific nutrients. “
The recommendations against the routine use of supplements are grounded in fairly good evidence if one believes in a methodology used by the Cochrane intervention review.
A Cochrane intervention review of 77 randomized controlled trials with 232,550 participants found no evidence to recommend antioxidant supplementation for primary or secondary prevention of mortality.[7].
There is shabby evidence that cannot be generalized regarding possible harm related to the use of some supplements.
“For example, the Alpha-Tocopherol Beta-Carotene Cancer Prevention Trial demonstrated that beta-carotene supplements increased the risk for lung cancer among male smokers.[8]”
At this point there is no good scientific evidence for the use of megavitamins. “People believe what they want to believe.” The placebo phenomenon is extremely important.
The media is the message. Somehow the power of advertising has convinced the public that it is good to take megavitamins.
Costco is trying to take advantage of the hype. Consumers are driving this healthcare choice. The result is a $30 billion dollar a year business. The money is coming directly out of the consumer’s pocket. It is not included in healthcare costs.
Consumers are trying to be responsible for their health on the basis of hype. It is much easier in the mind of most to stay healthy taking a pill than do the heavy lifting required for healthy living.
Why can’t someone create an anti-obesity hype that works as well as the megavitamin hype?
Increases in obesity lead to increased Type 2 Diabetes, hypertension, hyperlipidemia and the resulting Diabetic complications of stroke, heart attack, blindness, amputations, chronic renal disease and cancer.
Many schemes have been devised to decrease the increasing obesity rate. None have worked except eating less and doing more.
With the increasing obesity in children there is an increased incidence of Type 2 Diabetes in kids, teenagers and young adults.
Gastric bypass has become the rage for these young super obese people. To my dismay more and more insurance plans are paying for gastric bypass procedures. Even Medicaid is paying for the procedures.
Is the world going nuts? I guess Medicaid’s logic is if the people become thinner it will decrease the incidence of Diabetes, decrease the complications of Diabetes and therefore decrease the cost of healthcare for these people.
To me it is like painting over rust. The rust will bleed through and the money for the paint will be spent already.
Americans do not get any help from society norms. We are flooded by manufactured foods with tons of calories and tons of salt. Mayor Bloomberg passed an educational law that fast food stores must publish calorie counts on foods.
This is helpful is the calorie count is accurate and people pay attention.
Home cooking served in small portions is essential. The fat, calories and salt can be controlled. There is no need to have a home cooked meal anymore.
All you have to do is go to Costco or Sam’s and buy any precooked meal you want. Dinner is a 3 to 10 minute microwave pop away. Why would any busy person bother to prepare a home cooked meal? The harmful consequences prepared meals are in the distant future.
If you have dinner at a restaurant an average meal contains more calories than the average person burns in a day. My wife and I have been sharing for years.
Consumers want to be responsible but it is very difficult in the cultural milieu of our society.
Ken Cooper M.D. created an exercise craze in the 1970’s. It has lasted until the present. He did not figure out how to get people to sustain their exercise program. He also did not figure out how to get people to decrease their intake in our sea of manufactured food and pre-cooked food.
The incidence of obesity is growing.
Most consumers are not stupid. They seek to be responsible in the easiest way possible.
Someone will come along and initiate a legitimate health craze.
The Ideal medical savings account (by providing financial incentives along with intense public education through appropriate advertising) can be as successful as the Dietary Supplement industry.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
“If any innovations and innovative activities are excluded you end with a “stationary state.”
Schumpeter's theory is that “the success of capitalism will lead to a form of corporatism. In turn corporatism will foster values hostile to capitalism. He contends this is especially true among “intellectuals.”
The intellectuals and the social climate must allow entrepreneurship to thrive. If not capitalism will be replaced by socialism in some form.”
The hero of his story is the entrepreneur.
We are seeing this now as corporations are trying desperately to hold on to their power using obsolete technology and suppressing entrepreneurship with the government’s help.
The Internet has provided people with information, a choice and a voice. It has stimulated entrepreneurship and the current software revolution.
The government is making a big mistake in attacking freedom. I do not think it will get away with it because of the power of the Internet.
The hero of my story about "Repairing the Healthcare System" will be the software entrepreneur.
Technology has caused legacy business models to be replaced by innovative software models. These innovative software models have reduced costs and provided more choice for consumers at a cheaper price.
America cannot afford socialized medicine. A paradigm shift must take place. This shift will occur as a result of innovative software. The challenge is who will get there first.
Britain, Canada and Europe’s socialized medical systems are failing financially. These countries are changing their healthcare systems from government controlled socialized systems to private systems.
Entitlement healthcare systems do not work because patients are not responsible for their healthcare dollars. Patients overuse the system because they are not responsible for payment.
When governments are overextended financially they restrict access to medical care.
Secondary healthcare stakeholders are fighting to maintain the “stationary state” because they receive 90% of the healthcare dollars.
Secondary stakeholders use a hollow excuse for maintaining control over the healthcare dollars. They maintain that consumers are too stupid and too powerless to take care of themselves.
Software companies are trying to improve the healthcare system. They have failed because they are focused on the wrong customers.
Secondary stakeholders are a giant hairball between the patient/ physician relationship. This hairball must be disrupted.
Much of the software necessary to disrupt the hairball is available. It is not focused for the benefit of patients and physicians.
An innovator is going to come along and disrupt this hairball just as Steve Jobs disrupted the music industry.
Dis-intermediating software can only become viral and effective if it enhances the patient physician relationship.
Consumers are starting to realize that they must become responsible for their own medical care and control their healthcare dollars. The government is too unreliable.
Patients are the customers/consumers of heaslthcare. Consumers must learn to manage their health and medical care dollars wisely. They must be provided with education and financial incentives to become responsible for their own health and healthcare choices.
What are the areas in which innovative software can dis-intermediate the failing structures in the healthcare system?
Ideal Electronic Medical Record.
Ideal Medical Saving Account.
Chronic Disease Management.
Tort Reform
Patient Education as an Extension of Physicians Care.
Integrated Care Between Family Practitioners and Specialists.
Patient Responsibility: Health and Healthcare Dollars.
Consumer Driven Healthcare.
No one likes to be forced to do anything. President Obama’s Healthcare Reform Act is forcing patients and physicians to do things they do not understand or do not approve of. Americans are refusing to buy into his system.
In the words of the great singer/philosopher Leonard Cohen, ”Everybody knows.”
A software innovator with a prepared mind between the age of 20-50 years old is going to come along and initiate a software revolution in healthcare. It will improve medical care for all. It will decrease healthcare costs and increase patient satisfaction. It will restore the patient physician relationship.
I will be happy to help anyone who will listen.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
Government, hospital systems, pharmaceutical companies, pharmacies, pharmacy middlemen, and healthcare insurance companies are secondary stakeholders in the healthcare system.
The primary stakeholders are patients and physicians. They also comprise the medical care system. Without the primary stakeholders there would be no need for a healthcare system.
The secondary stakeholders have long ago taken over the healthcare system. All businesses and the government deal with the hand they are dealt using their best judgment. The people running the business or government pursue their vested interest. The difference between businesses and government is businesses work to make as big a profit as possible. Government, depending on the political party in power, pursues fulfillment of its ideology.
Since 1942 and the Economic Stabilization Act of President Roosevelt the market place for medical care has been distorted. In 1946 healthcare insurance was introduced. At that time the interaction between the primary stakeholders, physicians and patients, started to be destroyed by secondary stakeholders.
The cost of healthcare has progressively increased since the government passed the Medicare and Medicaid in 1965. Costs increased further in 1980 when the government said we couldn’t keep paying these increasing costs and instituted price controls for Medicare and Medicaid.
This led to cost shifting of the difference to the private healthcare insurance sector. Businesses providing healthcare insurance for their employees accepted the resulting premiums associated with cost shifting until 1985. At that time they said, “stop.”
The healthcare insurance industry asked corporations what percentage of your gross revenue could you afford for healthcare insurance benefits. The healthcare premiums were 18% of gross revenue.
The corporate answer was they could afford up to 12% of gross revenue. The healthcare insurance industry’s response was, no problem.
HMO pricing became the most economical option for corporate employers. HMO fixed healthcare cost for corporations and healthcare insurers.
HMOs shifted the risk to physicians and hospitals. HMOs failed because physicians and hospital did not know how to assess risk. They accepted risk initially because they were afraid to lose patients.
Hillarycare failed to become law because of the potential for patient abuse, restrictions of access to care, rationing of care and loss of freedom of choice. Patients did not want the government to dictate their medical decisions.
Obamacare was passed by a Democrat controlled congress with a very liberal ideology.
Many congressmen did not read the entire document or debate the potential unintended consequences.
The difference in ideology between liberal and conservative is easy to understand.
The healthcare system is not a true marketplace. The healthcare marketplace has been continuously distorted by government regulations and adjusted regulations since Medicare passage in 1965.
All the stakeholders have distorted the market even further by adjusting to government regulations in order to purse their vested interest.
If real repair of the healthcare system is to occur a real marketplace has to be created. Obamacare is another adjustment in an already distorted marketplace. Obamacare is accelerating the dysfunction in the healthcare system until it implodes and results in increasing costs not savings.
The healthcare insurance industry controls costs. Many Democratic healthcare policy experts have ignored the facts. The healthcare insurance industry’s goal is to maximize its profit. It takes 30% of the healthcare dollars off the top.
The healthcare insurance industry should not be in control of the economics of the healthcare system.
Personal medical care decisions should not be left to the munificence of the government. The government has never done anything efficiently.
Private and Medicare insurance has kept control of medical decisions out of consumers’ hands. Consumers purchase healthcare insurance individually or from Medicare. Consumers also can receive healthcare insurance from their employers as a job benefit.
The healthcare insurer directs consumers to use physicians and hospital in its network. The insurer negotiates reimbursement rates for the insured with hospitals and physicians.
Consumers are given little or no information about the comparative cost or quality of any particular doctor or hospital. Consumers go to a doctor in their network.
Physicians do a history and physical exam and order tests and procedures on patients’ behalf. When the test and procedures come back physicians prescribe the appropriate medication after a follow-up visit.
The healthcare insurance company reimburses physicians.
Patients receive a copy of the bill from the insurer with patient portion of the co-pay. The explanations of benefits are impossible to interpret.
This is not a marketplace transaction. Patients have no control over the reimbursement. Patients and physicians have little incentive to restrain overuse of the healthcare system. They have no incentive to even scrutinize the bill. Patients’ have no incentive to control costs.
The use of healthcare services is divorced from marketplace forces that constantly assess cost benefit ratios. Neither physicians nor patients have incentive to get the best care at the lowest price with the best quality.
As healthcare costs increase each year the source of the increase remains opaque. The increasing costs are made to appear to be the result of patients’ and physicians’ overuse of the healthcare system.
The increase in cost could be the result of the healthcare insurance industry and the pharmaceutical industry’s increased profits.
All stakeholders pursue their vested interests. The only way to align vested interests is to have consumers be responsible for thei health and healthcare dollars.
Only then will a true market place exist. Entitlements and price controls do not work. The cost of healthcare will skyrocket with Obamacare and create a larger budget deficit.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
Somehow, large hospital systems have been able to stay under the radar. They have been able to avoid the responsibility of the rising costs of healthcare.
Large hospital systems and large hospital chains know that insurers need them to service their network of patients. The healthcare insurance companies know that the hospital systems can hold them hostage to increased reimbursement.
When a large hospital system demands an increase in reimbursement the healthcare insurance industry simply increases premiums.
An example is the increasing premiums and costs that resulted from Romneycare in Massachusetts. Romneycare’s structure is one large driver of rising costs in Massachusetts.
Hospitals in Boston were extremely competitive before 1990.
The race in the late1980’s was to build the best hospital/physician network in town. The goal was to attract patients, overwhelm the competitors and get the best reimbursement from insurers.
The merger between two eminent Harvard-affiliated hospitals, Massachusetts General Hospital and Brigham and Women’s Hospital developed a hospital system (Partners) that would control the marketplace.
The two most prestigious hospitals in the state forced the healthcare insurance industry to increase their reimbursement for providing care. Meanwhile, the Tufts hospital system offered a lower reimbursement rate but patients wanted to go to Partners.
Many hospitals are merging throughout the country to take advantage of this market leverage and increase reimbursement from the healthcare insurer.
Hospital systems are frantically trying to buy primary care physicians’ private practices to enjoy this leverage. The statistics claim that from 30% to 70% of practices have been bought by hospital systems.
The fiction is that medical schools are producing a different breed of physicians. The fiction is all the present day physicians want is a salary. I do not think this is true.
The barrier of entry to opening a private practice is cost. Physicians completing medical school have already incurred large debt.
The problem with being employed by hospital systems is the hospital system controls the overhead expenses. These expenses are inflated. Many salaried physicians do not realize the unfair overhead expenses because the expenses are opaque.
It takes a while for physicians in the system to figure out that they are not getting their fair share of the reimbursement for their productivity. At that point physicians start fighting with the hospital system. Some physicians quit en mass and open their own practice.
Partners’ physicians figured it out. Partners is still intact but the physicians are now getting their fair share.
Physicians are starting to realize they have leverage over their hospital employee and that they must have control of their overhead.
“But the long history of hospital mergers shows no evidence that consolidation leads to either. Indeed, according to FTC lawyer Matthew J. Reilly, the merged Toledo hospitals immediately went to work jacking up rates:”
“Soon after the acquisition was consummated,” Mr. Reilly said, “ProMedica approached certain health plans to obtain higher reimbursement rates.”
“The higher rates, he said, are typically passed on to consumers in the form of higher premiums, co-payments and other costs.”
Businesses act in the pursuit of their vested interests. Government sets the rules and businesses seek to take advantage of those rules.
Somehow, secondary stakeholders must be controlled. It will take a consumer driven healthcare system to control it.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
I wonder how many Congressional Representatives and Senators read HR3200. It is amazing that our representatives would permit the federal government to restrict our freedoms so severely.
This morning I received this You Tube from a reader. It describes the restrictions on our freedoms created by President Obama’s healthcare reform plan. The restrictions have not be publicized by the traditional media.
I was reminded of the blog I wrote on July 30,2009. Below is the link to the original bill and a copy of my 2009 blog.
It is easy to forget all the restrictions imposed on Americans’ freedoms by this piece of legislation.
On Thursday, Oct 20, 2011 at 8:52 AM a reader sent this You Tube and comment
"This has to be one of the scariest pieces I've seen. If you have the stomach, take the few minutes to review. Maybe even compare the statements with the actual bill." Here's the link to HR3200:
I have compared the You Tube to the original bill. Obamacare is defective. Americans will not tolerate centralized control over our lives and choices once they understand the concepts in the bill.
President Obama has been effective in manipulating the media to keep Americans in the dark.
The House of Representatives Healthcare Bill is 1018 pages long. Many Representatives and Senators did not read the entire economic stimulus bill because “we did not have time” before we experienced a severe economic recession. They claimed to be saving us from another great depression.
I have read a good portion of HR3200. The provisions are unacceptable and sinister. It represents a complete government takeover of our healthcare system. It is not in the interest of the consumer. It is not in the interest of our precious freedom of choice.
Every Americans, especially our Senators and Representative must know what is actually in the bill before it is passed. President Obama’s generalities do not cover the details of HR 3200.
Mr. Schweikart evaluated 498 of the 1107 page bill. The summary of one half HR3200 is frightening. His summary is a good reference guide to the appreciation of the harshness of the bill. It also explains President Obama’s urgency in getting a bill passed before anyone realizes the implications of the bills contents.
Representatives who vote for this bill should not be reelected. They are not representing their constituents’ rights or protecting their freedoms. Your healthcare, health and freedoms are at stake.
You can check the reviewer’s summary against the actual bill at the link below.
“Take a look at what actually is in the Health Care bill. Obama makes disingenuous comments like "You'll still keep your doctor" or "You'll keep your existing health care."
Pg 22 of the HC Bill mandates the Government will audit books of all employers that self insured. Can you imagine what that will do to small businesses? Everyone will abandon “self insurance” and go on Government insurance. So when Obama says that there will still be private health care, it’s simply a lie: this mandate will force employers to abandon their private plans.
Pg 30 Sec 123 of HC bill – a Government committee will decide what treatments/benefits a person may receive.
Pg 29 lines 4-16 in the HC bill – YOUR HEALTHCARE WILL BE RATIONED!President Obama has been saying healthcare is to be rationed all along in code.
Pg 42 of HC Bill – The Health Choices Commissioner will choose your HC Benefits for you. You will have no choice!
Pg 50 Section 152 in HC bill – HC will be provided to ALL non US citizens, illegal or otherwise.
Pg 58 HC Bill – Government will have real-time access to individual’s finances and a National ID Healthcard will be issued! Government has real-time access to your tax return presently and means test Medicare recipients’ premiums
Pg 59 HC Bill lines 21-24 Government will have direct access to your bank accts for election funds transfer. A further impingement on freedom and privacy.
Pg 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations (read: ACORN).
Pg 72 Lines 8-14 Government will create an HC Exchange to bring private HC plans under Government control.
Pg 84 Sec 203 HC bill – Government mandates ALL benefit packages for private HC plans in the Exchange.
Pg 85 Line 7 HC Bill – Specifics of Benefit Levels for Plans = The Government will ration your Healthcare!
Pg 91 Lines 4-7 HC Bill – Government mandates linguistic appropriate services. Example – Translation for illegal aliens.
Pg 95 HC Bill Lines 8-18 The Government will use groups, i.e. ACORN & AmeriCorps, to sign up individuals for Government HC plan.
Pg 85 Line 7 HC Bill – Specifics of Benefit Levels for Plans. AARP members – your Health care WILL be rationed.
Pg 102 Lines 12-18 HC Bill – Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.
Pg 124 lines 24-25 HC No company can sue Government on price fixing. No "judicial review" against Government Monopoly.
Pg 127 Lines 1-16 HC Bill – Doctors/ AMA – The Government will tell YOU what you can earn.
Pg 145 Line 15-17 An Employer MUST auto enroll employees into public option plan. NO CHOICE.
Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.
Pg 149 Lines 16-24 ANY Employer with payroll $400k & above who does not provide public option pays 8% tax on all payroll.
Pg 150 Lines 9-13 Businesses with payroll between $251k & $400k who don’t provide public option will pay 2-6% tax on all payroll.
Pg 167 Lines 18-23 ANY individual who doesn’t have acceptable HC according to Government will be taxed 2.5% of income.
Pg 170 Lines 1-3 HC Bill Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay.)
Pg 195 HC Bill -officers & employees of HC Admin (the GOVERNMENT) will have access to ALL Americans’ finances and personal records. Big brother will be watching your every move.
Pg 203 Line 14-15 HC – "The tax imposed under this section shall not be treated as tax" Yes, it says that.
Pg 239 Line 14-24 HC Bill Government will reduce physician services for Medicaid. Seniors, low income, poor affected. Kill off the poor and elderly.
Pg 241 Line 6-8 HC Bill – Doctors – doesn’t matter what specialty – will all be paid the same.
Pg 253 Line 10-18 Government sets value of Doctor’s time, professional judgment, etc. Literally, value of humans.
Pg 265 Sec 1131Government mandates & controls productivity for private HC industries.
Pg 268 Sec 1141 Federal Government regulates rental & purchase of power driven wheelchairs.
Pg 272 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS – Cancer patients – welcome to rationing!
Pg 280 Sec 1151 The Government will penalize hospitals for what Government deems preventable readmissions.
Pg 298 Lines 9-11 Doctors who treat a patient during initial admission that results in a readmission – Government will penalize you.
Pg 317 L 13-20 OMG!! PROHIBITION on ownership/investment. Government tells Doctors what/how much they can own.
Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion – Government will mandate hospitals cannot expand.
Pg 321 2-13 Hospitals have opportunity to apply for exception BUT community input required. Can you say ACORN?!
Pg 335 L 16-25 Pg 336-339 – Government mandates establishment of outcome-based measures which of course forces health care rationing.
Pg 341 Lines 3-9 Government has authority to disqualify Medicare Adv Plans, HMOs, etc., forcing people into Government plan.
Pg 354 Sec 1177 – Government will RESTRICT enrollment of Special needs people!
Pg 379 Sec 1191 Government creates more bureaucracy – Telehealth Advisory Committee. Healthcare by phone.
Pg 425 Lines 4-12 Government mandates Advance Care Planning Consultations. Think Senior Citizens end of life prodding.
Pg 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of attorney. Mandatory!
Pg 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in how to die. EVERYONE on Social Security, (will include all Senior Citizens and SSI people) will go to MANDATORY counseling every 5 years to learn and to choose from ways to end your suffering (and your life). Health care will be denied based on age. 500 Billion will be cut from Seniors healthcare. The only way for that to happen is to drastically cut health care, the oldest and the sickest will be cut first. Paying for your own care will not be an option.
Pg 427 Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.
Pg 429 Lines 1-9 An "advanced care planning consultant" will be used frequently as patients’ health deteriorates.
Pg 429 Lines 10-12 "advanced care consultation" may include an ORDER for end of life plans. AN ORDER from the Government to end a life!
Pg 429 Lines 13-25 – The Government will specify which Doctors can write an end of life order.
Pg 430 Lines 11-15 The Government will decide what level of treatment you will have at end of life.
Pg 469 – Community Based Home Medical Services/Non profit orgs. (ACORN Medical Services here?)
Pg 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORGANIZATION. 1 monthly payment to a community-based organization. (Like ACORN)
Pg 489 Sec 1308 The Government will cover Marriage & Family therapy. Which means they will insert Government into our marriages.
Pg 494-498 Government will cover Mental Health Services including defining, creating, rationing those services. You’d better speak up now before you are on the "advanced care consultation" list.
It gets worse: the Health Care Reform bill that is now about to come up for a vote will absolutely eliminate private health care options. Do not kid yourself: They are going to say that they aren't going to interfere with your right to go to your "own doctor" or have your own "private health insurance." But there won't be non-government doctors or private health insurance if the government mandates them out of existence.
Even still, I hear people who want to "get past all this partisanship." Sorry, but GROW UP.
Our system from the beginning has pitted one group against another out of fear of the very giant government that is metastasizing before our eyes. James Madison didn't like "parties" or "factions," but he finally admitted that they were absolutely necessary to fragment power.
For our system to work there has to be a clear choice, not a mushy middle, because the mushy middle always, always, always gravitates left. There is a "presumption of power" on the left –conservatives, by nature, do not like government, don't trust it, and do not want to use it to advance their ends, which they see as advanced through liberty, individual achievement, and entrepreneurship.
It is hard to read H3200 and comprehend its implications. However, a careful reading leads me to similar conclusions to those of Mr. Schweikart.
Do you think your representatives have studied the bill? If they have and vote for it they should lose your vote. If they have not read it and vote on party lines they should lose your vote.
This bill is not going to Repair the Healthcare System. It will make the healthcare system more complex, restrict access to care, restrict the delivery of care, ration care, limit freedom of choice, and increase the deficit.
Let your Senators and Representatives know the proposals are unacceptable. Write, fax, call, email, twitter. Tell them:
“We do not want the government to control our lives. We want affordable, universal healthcare coverage that does not limit access to care. We want control over our healthcare dollars. We do not want government to control our lives and our money.”
We all agree the healthcare system is dysfunctional. As Obamacare works its way toward full implementation the dysfunction has intensified and healthcare costs have increased. It is important for all of us to recognize why Obamacare is a disaster.
Obamacare will not only destroy our healthcare system. More importantly It will destroy our freedoms.
On October 19th 2011, President Obama said his administration has done everything correctly. It just hasn’t worked out yet.
Does anyone believe him?
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
This mutual distrust must be overcome and price transparency achieved before any progress can occur in Repairing The Healthcare System.
In order to achieve Pareto efficiency in the healthcare system all the stakeholders must agree to price transparency. The advantage of Pareto efficiency is that all the stakeholders will be better off in the long term while some might have to yield to some issues in the short term.
Lodi Hurwicz introduced the idea of incentive compatibility. His point is the way to get as close to the most efficient economic outcomes is to design mechanism in which everyone does best for himself or herself. He says this can be achieved by sharing information truthfully (Price Transparency). It is easy to understand that some people can do better than others by not sharing information or lying.
The lack of interest in price transparency by the healthcare insurance industry was demonstrated in New York State in the last few weeks.
Benjamin M. Lawsky, the state superintendent of financial services, whose new agency oversees the state insurance division said,
“How these companies are setting these rates is vital for the public to know, and should not be treated like a state secret,” “Transparency will promote healthy competition and enable the public to rigorously comment on proposed rates, two goals that all of us should favor.”
The state insurance division issues permits to healthcare insurance companies to sell insurance in the state. If a healthcare insurance company does not want the state to publish the reasons for its insurance premium increases they should not be issued a permit to sell healthcare insurance in that state.
Mr. Lawsky has ordered that the memos be made public. His decision will go into effect by the end of November unless the companies obtain a court injunction.
The healthcare insurance industry has held the advantage over consumers in the past under the long-standing “trade secret” exemption. The state legislature should have the courage to eliminate that exemption.
State Insurance Department has received hundreds of consumer protests over proposed premium increases, many of them double-digit percentages without justification except that it must be done. The State Insurance Department now has the power to reject proposed rate increases. The question remains as to whether they have the courage to reject the increases.
United Health/Oxford wrote, “This matter is of critical importance to us.” It called the information “proprietary.”
Aetna wrote, “Public disclosure in this format will provide ready and easy access to comprehensive pricing, product and marketing strategies,” and warned of “substantial and irreparable injury to Aetna.”
Independent Health said, “It had spent “well over $700,000 developing the trade secret documents” and estimated that the value of keeping them confidential was much higher.
It sounds as if both Aetna and Independent Health are threating the state with legal action. If they do not like the state rule they should move on and not sell insurance in that state.
The state’s obligation is to protect its consumers from abuse. The state should simply deny permits to the healthcare insurance company to sell healthcare insurance in the state.
Moreover, other companies argued, the filings are too technical to be understood by consumers.
“Several of the exhibits to the rate application as well as the actuarial memorandum contain not only trade secrets as noted above, but esoteric actuarial pricing precepts best understood by fellow actuaries and health plan competitors,” Sean M. Doolan, a lawyer representing Excellus, Empire, Connecticut General, and Capital District Physicians’ Health Plan wrote to state officials.
“These documents, often speaking of concepts such as morbidity and anti-selection, could cause not only confusion, but also unnecessary alarm to the layman policyholder.”
These are excuses. They are lame and patronizing. Consumers are not as dumb as the insurance industry thinks.
Elisabeth Benjamin is vice president for health initiatives at the Community Service Society of New York and a founder of Health Care for All New York, a coalition of 100 groups working for more affordable medical care. She said the group has hired its own actuaries.
“The only way the public will find out whether these outlandish price hikes are justified is if we can see the underpinnings,” she said. “They would like to have us ignorant. What they are saying to us, by opposing the disclosure of why they think their rate increases are justified, is that they want to keep us uninformed consumers.”
They sure do want to keep consumers ignorant. I hope the state officials are not intimidated by the healthcare insurance companies. I hope the state officials are supported by New York’s governor. Consumers are starting to understand their power. They need to drive the healthcare system. This issue is a good place to start.
Mechanism Design has demonstrated that the most efficient systems are created when everyone’s vested interests are aligned.
“An example is defense contracting. If you agree to pay on a cost plus basis you have created incentive for the contractor to be inefficient.
The defense contractor will build enough extra into a fixed price system to account for cost overruns. The cost overrun would be permitted in the rules if the price was transparent. If there were no cost overruns the contractor’s profit would be increased. It would provide incentive to be efficient.
“If you agree to pay a fixed price, you can come close to an efficient price if you have all the truthful information.”
A reader wrote’
Stanley:
History has proven over and over again that only the market mechanism of willing sellers and willing buyers is the optimal way to allocate economic resources. This presumes an informed buyer, and a willingness of sellers to compete for buyers. Adam Smith was clear on this in the Wealth of Nations.
If incentives are aligned and truthful price information is available an efficient system is created. Most stakeholders think they can do better by not sharing truthful information. If the rules of the game require truthful information the system can become an efficient market driven solution.
The healthcare system must become market driven. At present the healthcare system is an artificially distorted free market system. Government intervention has distorted and made the free market inefficient.
The distorted free market has led to higher prices.
The concept of Pareto efficiency implies one stakeholder has to yield something which makes another stakeholder better off. The reality is in an efficient system the first stakeholder is worse off than he/she theoretically could be.
The first stakeholder yielding makes him/her better off than he/she is but still worse than he/she could theoretically be. The temptation is to not be truthful in order to maintain dominance at the expense of others.
The free market mechanism was far less afflicted than central planning bureaucracy by such incentive problems. The free market economy was by no mean immune to this defect.
He observed that the free market economy can get us closer than central planning to incentive compatibility because the end consumer can drive the discovery of truthful information.
Consumers creating rules of engagement in a market driven economy can get closest to ideal Pareto efficiency.Since customers determine success of an enterprise by creating demand in a transparent environment, they can get closer to an efficient system.
Consumers can create the rules of the game for compatible incentives. Consumers must have the appropriate financial incentives to maintain their health. They must also own their healthcare dollars.
The government should help consumers design the rules of the game and then get out of the way. The rules should be designed so the patient is first.
At present the insurance industry is taking advantage of the patients, doctors and hospital systems. The hospital systems are taking advantage of the patients, doctors and insurance companies. Doctors are taking advantage of the insurance companies, hospital systems, patients and the government. The government is taking advantage of the hospital systems, the doctors and the patients. Everyone is pursuing his or her own vested interest at the expense of other stakeholders.
The insurance companies take advantage of employers. The drug companies are taking advantage of patients and unduly influencing physicians.
In our healthcare system everyone is pursuing his vested interest in a game that has rules that do not lead to “incentive compatibility.”
Some politicians think central planning can result in producing effective rules and appropriate controls.
Historically, central planning has not worked.
Before effective healthcare reform can take place, rules acceptable to all the stakeholders must be in place. Stakeholders must create price transparency and understand the value of compromise.
It must be understood why it is important that consumers drive the healthcare system and not the central government. Only consumers can create an undistorted efficient market driven system.
Consumers have to have be empowered and given incentives to align all the stakeholders’ incentives. The best and easiet program to achieve this goal is my ideal medical saving account.
The pharmaceutical companies are marketing kings. The large increase in generic sales has affected their bottom line. When they are up against the wall marketing gets innovative.
The drug benefits costs for this healthcare insurance company increased as it did for others because the drug company was innovative. It started giving out coupons to cover the patients’ co-pay. It did not cost the patient to pay for this new expensive medication. It cost the insurance company dearly because patients stopped using the generics since their co-pay was covered by the drug company. The effectiveness difference between the generic and the new antibiotic was questionable.
This is not the first time drug companies have given patients co-payment coupons. The coupons paid the branded drugs’ co-pay. This is another example of consumer driven power. Consumers will seek the best price and highest quality.
Consumers are smart. They know when they are getting a good deal. Pfizer, the maker of Lipitor, introduced a new coupon card that reduces the co-pay for Lipitor to $4 a month. The co-pay for Lipitor is about $50 for a month’s supply. The coupon card saves consumers as much as $50 a month. The coupon gives Pfizer a chance to have Lipitor compete with generic Zocor at Wal-Mart and other chains.
The healthcare insurance industry pays much more for Lipitor than it does for generic Zocor. The clinical evidence for a difference in the medications is small. The marketing of the clinical evidence is a gimmick. The both work the same. Lipitor is twice as potent therefore, you need half the dose to achieve the same effect.
The health insurance companies say the coupons are a marketing gimmick. In reality they are. The healthcare insurance industry is just going to pass the cost to its bottom line to consumers by raising the price of insurance premiums.
“The member is somewhat insulated from the cost of the prescription,” said Kevin Slavik, senior director of pharmacy at the Health Care Service Corporation, which runs Blue Cross and Blue Shield plans in Illinois and three other states. “In essence, it drives up the total cost of providing the prescription benefit.”
President Obama, where are you when the public needs you? The Food and Drug Administration has been ineffective.
“The Food and Drug Administration, meanwhile, is studying the effect of the discounts on consumer perceptions, concerned that the coupons will make consumers believe that a drug is safer or better than it really is.”
The differences in costs are astounding.
Once a day Minocycline is $700 per month. The price of a twice a day generic Minocycline $40 per month
In New York City in a union representing public employees, 59 percent of claims were brand-name statins whose co-pay was coupon supported. The claims cost the union $17.3 million. The other 41 percent of claims were for generic statins. It cost the union only $179,000. The union has eliminated the co-pay on generic statins to encourage their use.
Jazz Pharmaceuticals has quadrupled the price of its narcolepsy drug Xyrem, to about $30,000 a year, over the last five years. In order to cushion patients’ out of pocket cost, the company recently increased its co-pay assistance to as much as $1,200 a month.
Co-payment coupons are distributed by drug company sales representatives to physicians. Physicians are made to believe they are helping their patients. The coupons are also available directly to patients over the Internet. Patients present them at the drugstore when paying for their prescriptions and receive the discount.
Medicis, the company that sells Solodyn(Minocycline extended tablet), have told investors that the co-payment card is used by an “overwhelming majority” of patients, and is largely responsible for doubling use of the drug, to 26,000 prescriptions a week.
The use of once a day Minocycline vs. twice a day generic Minocycline results in a difference in cost of $2.6 billion dollars a year for this one drug.
There is something wrong. Physicians are not aware of the drug companies’ gimmicks. They think they are helping their patients. The pharmaceutical industry is indeed the king of marketing.
Pharmaceutical Companies Shafting Healthcare Insurance Companies. Healthcare Insurance Companies in turn will shaft patients by increasing their premiums.
President Obama’s healthcare reform act should be doing something about this if it wants to keep the cost of healthcare down. It is not doing anything about this problem.
