Stanley Feld M.D., FACP, MACE Menu

Results found: 441

Permalink:

The Healthcare Insurance Industry Abandons Selling The Individual Insurance Policies In Health Insurance Exchanges

July 28, 2013
inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

   
Stanley Feld M.D.,FACP,MACE

 

 
 

http://youtu.be/Kyv8ZRkXnfU?t=58s

President Obama is on the campaign trail. He is selling the
virtues of Obamacare to the young uninsured.

He wants the healthy young to buy the health insurance exchange
insurance policies in order to pay for the sick. He wants to prevent
Obamacare’s failure.

His speeches are political. They have little substance and are
loaded with disinformation and hyperbole.

The campaign is a political ploy to blame the Republican Party
for Obamacare’s impending failure.

Last week Harry Reid said he has to increase taxes by another
trillion dollars. This increase will make the economy worse, not better.

When is the public going to learn that socialism doesn’t work?
Taxing and spending does not improve economic growth. Socialism and increased
taxes stifle innovation and productivity.

I think it is time for a
couple of Ayn Rand’s truisms as they apply to Obamacare. Men pursue their
vested interests. They resist being forced to follow orders that contradict
their vested interests. The key in any system success is to align all the
stakeholders’ vested interests. Obamacare does not achieve this goal.

“It only
stands to reason that where there's sacrifice, there's someone collecting the
sacrificial offerings.”

Where
there's service, there is someone being served. The man who speaks to you of
sacrifice is speaking of slaves and masters, and intends to be the master.

Ayn
Rand

America is going through a period of
time where it is evident that something is wrong.  Americans and the traditional media are keeping
our eyes wide closed.

“The hardest thing to
explain is the glaringly evident which everybody had decided not to see.”

Ayn Rand

Peggy Noonan said it in a paragraph
in this weekend's blog.

"One irony here
is that the Obama White House, always keen to increase the reach and power of
government, also seems profoundly disinterested in good governing. It is
strange. The long-term project of liberalism involves encouraging the idea of
faith in government as a bringer or guarantor of greater justice. But who needs
more government if government works so very badly, and is in its operations
unjust?"

"This White
House is careless with the reputation of government. They are a campaigning
organization, not a governing one."

Ayn
Rand goes on to say,

 “You
can avoid reality, but you cannot avoid the consequences of avoiding reality.”

― Ayn
Rand

 A problem occurs when
constituents finally realize government is not defending its vested interests.
Change is demanded.

Americans are finally
waking up.  

We have seen this phenomenon
in my last two articles when I wrote that unions and hospitals finally realized
that Obamacare does not serve their vested interests.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2013/07/obamacares-games-for-stakeholders-and-the-unintended-consequences.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2013/07/hospital-systems-are-finally-realizing-there-are-problems-with-obamacare.html

This is also the reason
Aetna decided to not sell healthcare insurance policies in the California’s
health insurance exchange.

 

 “Aetna Inc.  will stop selling
health insurance to individual consumers in California at the end of the year,
withdrawing as the federal health law is expected to reshape the market in
2014.”

Aetna did not comment on
the reasons it is dropping out of the individual market in California.

“A company spokeswoman declined
to comment about the reasons for Aetna's individual-business withdrawal.”

The dominos are starting
to fall as more healthcare insurers realize what is going on.

“Aetna isn't one of the 13
insurers participating in the California state's new consumer insurance
marketplace set to launch this fall under the federal law.”

“Like several other major
national carriers, it has said it would join only a limited number of these
exchanges. A carrier can still offer consumer plans without being in the
exchange.”

President Obama and other supporters argue that the health
insurance exchange is a success because it is encouraging competition and
pushing down prices. It is not true.

 “Insurance-industry experts say
similar moves by other carriers in other states may emerge in coming months, as
companies with limited market share decide to avoid the uncertainty tied to the
law's changes.”

The Obama administration’s concept of competition and price
reduction is tenuous. President Obama and other CMS official keep saying that
healthcare insurance prices will decrease.

The healthcare insurance industry originally calculated it would
make a killing by selling insurance through the healthcare insurance exchanges.

As the rules and regulations for health insurance exchanges are
slowly rolled out by the administration is it clear to the health insurance
industry they could get killed by selling insurance in the health insurance
exchanges.

The addition of a 3.5% tax on each policy sold is enough for the
insurance industry to realize the health insurance exchanges will cause them to
lose money.

These surprises do not serve the vested interests of the
healthcare insurance industry.

The Obama administration keeps announcing that health insurance
exchanges are decreasing healthcare premiums.

The public and businesses are experiencing double-digit
increases in healthcare insurance premiums since Obamacare was passed.

 The reason is clear. The increases are the result of all the additional
benefits President Obama brags about in his public relations campaign.

Obamacare contains community ratings for pre existing illness
and parental insurance for young adults under twenty-six.

These are important policies. The problem is it leads to an
increase in premiums for everyone.

Healthcare premiums have already increased 20- 30% since the
passage of Obamacare. BlueCross Blue Shield of Tennessee just announced,

  “BlueCross BlueShield of Tennessee expects a 20 to 30 percent
increase in rates in the individual market starting next year and a 10 percent
increase in the small group market.”


“BlueCross BlueShield exec warns of
health care cost ‘explosion.’ 

A healthcare Insurance CE0 told a business group at the Nashville Area Chamber
of Commerce that health care reform will cause “a lot of disruption in the
marketplace.”

The premium hikes will
be needed to offset new taxes on insurance payers such as his, he said.

“We are getting
ready to have a health care cost explosion,”  

“Details on the plans being offered on the exchanges, including
affordability, aren't yet known, but John
Maki, vice president of regional sales at BlueCross
BlueShield of Tennessee, said the company is looking at
offering traditional PPO plans, HSA-compatible plans and several other
"unique plan designs."

Only two commercial carriers have
applied to sell health insurance on Tennessee's new federally run insurance
exchange. They do not know if their submissions will be accepted. The deadline
for submission by other companies has passed.

Meanwhile, a New York Times editorial is conditioning Obamacare
fans as to who is to blame for the failure of the health insurance exchanges. The
Times is putting the blame squarely on the shoulders of the Republican Party.

“To their shame and discredit, Republicans are trying to block
efforts to inform people about the law and are using scare tactics to keep them
from enrolling.”

This is a typical Obama
administration tactic to blame the other guy for the impending failure of its
policy.

Obamacare is failing under
its own weight and the administration’s inability to implement the law.

The New York Times goes on,

“The Republican mantra is that the nation will face economic and
medical catastrophe — a “train wreck,” they say — unless health care reform is
stopped in its tracks.”

Obamacare is a train wreck. Max
Baucus Senator Democrat from Montana and author of Obamacare and head of the
finance committee said it.

“Top officials in Ohio
and Indiana who oppose the law have issued dire, misleading forecasts — roundly
debunked by analysts — that the law will raise premiums to astronomical levels.”

“roundly debunked by analysts”  This is not true. The Obama
administration’s analysis is biased and selective. By stating the analysis as a
fact the New York Times’ editorial board is expressing their bias without facts.

The New
York Times is once again acting as a shill for the Obama administration.  The New York Times is misleading the public.

Obamacare
is a bad law. It does not align any of the stakeholders’ vested interests. All the stakeholders are starting to realize it.

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

Please have a friend subscribe

 

 

 

 

 

 

Permalink:

The Anatomy of Healthcare Billing

June 9, 2013
inConsumer Driven Health Care, Disinformation and the healthcare system, Healthcare Insurance Industry, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley
Feld M.D.,FACP,MACE

The start of exposing the real cause of healthcare inflation has begun.  The billing and reimbursement system is
finally being questioned.

I hope the debate creates an uproar among consumers who are the most
important and most disadvantaged stakeholders in the debate. My hope is consumers will realize they
are pawns in the complex billing and reimbursement system created.

Consumers must also realize they have the power to demand control over their
healthcare dollars and not hope the government will protect them.

Steven
Brill’s article in TIME magazine started the debate. The demand for transparent
pricing has started.  Steve Brill’s
numbers are far from accurate.  However,the
pricing information is close enough to get consumers mad as hell.

The Centers for Medicare and Medicaid
Services finally released its massive database containing what 3,000 hospitals
charge for 100 of the most common medical procedures.

The database compares the hospital
“chargemaster” to the prices Medicare actually paid.

The reimbursement to hospitals is based
on the hospital system’s estimates of the actual hospital costs plus hospital
administrative overhead. These estimates are an error. The calculation should be the actual costs
and not an estimate of the actual cost.

The database only covers 100 of the
most common illnesses.

I have written about hospital
administrators’ salaries being in excess of 1 million dollars a year with many
being up to 15 million dollars a year. These salaries are included in the
overhead covered by Medicare payment.

I have questioned the appropriateness
of these massive salaries. In Boston there seems to be a contest between hospital
systems for which CEO gets a bigger salary.

Another important question is how many
hospital administrators in a hospital system get an excessive salary for the
value they add to medical treatment.

Who is worth more, a physician or a
hospital administrator?

 In many cases the
reimbursement by Medicare to some hospitals is 10% of the hospital’s billing.  In other hospitals the difference is 20-40%.

The payment gap between hospital charges
for procedures and Medicare payments is also stunning. The average difference
between hospital charges for the 100 procedures tracked and what Medicare’s
average actually payment is a difference of 72%.

A good metric is to beware of the man
that quotes average percentages if you want to understand the actual
difference.

The best example I have seen to visualize the variation of these prices
in simple terms is as follows.

 

“Imagine a banana in a supermarket. It costs $1 for those paying
with Visa, $3 for those paying with MasterCard, and $32 for those paying with
cash.

You can't sign up for Visa until you're 65, and you can only get
a MasterCard if you have a nice employer or a decent income.


Worse, customers have no
idea that such price discrepancy exists. They don't even know how much they'll
pay for the banana until long after they've eaten it.”


“That would be absurd. No
one would put up with it.


But it's how our health
care system works.”


Why should healthcare consumers in
America put up with it? Isn’t it the government’s job to protect us from this
abuse and not have a system that encourages it? Obamacare claims to stop the
abuse as it has been going on its merry way to encourage it.

This is not the entire grizzly story.

The average prices by states shows
massive discrepancies. In California, the average hospital charges $101,844 to
treat respiratory infections. In Maryland the average price for the same respiratory
infection is $18,144. The difference is 82% for the same disease in two
different states. The government is the same payer for both states.

 New Jersey hospitals bill an average for
$72,084 for "simple pneumonia," while Massachusetts’ hospitals charges
an average of $20,722. Neither of the state’s hospitals receives that much
reimbursement for treating these infections from Medicare. However, New Jersey
hospitals receive more.

Uninsured patients and the indigent
without insurance are getting the shaft. These people will have to pay retail
hospital prices or get sued by the hospital system.

None of the hospital prices are
transparent. A patient cannot even beg the hospital system to get a price.

Many treatments can be administered as
an outpatient. The government pays at least three times more for chemotherapy
in a hospital setting or a hospital outpatient clinic as it would to a freestanding
private outpatient oncology clinic.

 What’s the deal? The government doesn’t
trust physicians. It is afraid physicians will overcharge.

What does the government think the
hospital systems are doing?

I have also written about primary care
physicians’ salary being about $100,000- $120,000 a year. Surveys of physician
salaries have shown salaries varying between $100,000 to $600,000 per year. Surgical
subspecialists receive more than primary care physicians.

Let us assume the average physician’s salary
is $300,000 per year. There are approximately 600,000 practicing physicians in
the U.S.

The total physician reimbursement is $180
billion dollars a year in a $2.7 trillion dollar industry. This is less than
10% of the total dollars spent. Even if you doubled physicians’ salaries to
include an overhead of 50% physicians receive 13.2% of the healthcare dollars
spent.

A major question is where is the
remaining 2.5 trillion dollars going?

The healthcare insurance companies take
40% off the top of all care delivered including Medicare and Medicaid and other
government programs. They do all the government administrative services and
hide the fees through deductions that should go to expenses but with the
government’s permission go to direct patient care.

The most important metrics are never
discussed and inaccurately measured. 
They are clinical outcomes and quality of procedures performed with
respect to financial outcomes.

The reason this measurement is not done
is because there is no accurate definition or measurement of these metrics.
Clinical outcomes as it relates to cost of care has to be included in the
measurement of quality of care.  No one
knows how to do this.

How does all this get fixed?

Consumers must drive the healthcare
system. My ideal medical saving account would go a long way in
dis-intermediating the healthcare insurance industry.

An easy to use web site should be constructed
using the Travelocity, Expedia or the Orbitz formula.

All hospital and physicians’ prices
should be online. All insurance and government reimbursement should be
published on this web site, plus
insurance premiums and their justifications. The real government overhead
should also be available to consumers. 

A government web based educational
program to make consumers smart medical consumers would decrease healthcare
costs immediately.

All of the above would be a good start.

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

Please have a friend subscribe

 

 

 

 

Permalink:

Surprises For Physicians Coming With In Health Insurance Exchanges

May 8, 2013
inHealthcare Insurance Industry, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP, MACE

 Two
important components of Obamacare are Accountable Care Organizations (ACOs) and
Health Insurance Exchanges (HIEs).


The
adoption of both by medical communities and the states has been slow for good
reason.

I have
discussed the difficulties of setting up and the executing effective Accountable
Care Organizations.

Some hospital systems are trying to set up ACO’s. These hospital systems
are buying up physicians’ practices and trying to develop integrated care
organizations.

The hospital systems are buying the physicians’ intellectual property and
surgical skills sets. It will not work once physicians realize what happened.

The relationship between community hospital systems and practicing
physicians had always been tense. Physicians do not trust hospitals and hospitals
do not trust physicians.

Some physician groups are trying to develop their own ACOs. They are trying
to convert hospital systems from being providers of patient care to vendors for
their physician ACO.

If there are two hospitals in a community or town the hospital systems
might become competitive.

The huge problem for physicians is the assuming of risk. If healthcare
insurance companies cannot manage risk, why would physicians think they can
manage risk?

 A variable that cannot be controlled
in managing risk are patients. With all the obesity and the increase in
diabetes mellitus it seems patients do not have the incentives to manage their
own risks.

 Patients and physicians must be provided with appropriate financial
incentives if there is the slightest chance of managing risk and decreasing the
cost of healthcare.

 The adoption of ACOs has been slower than the Obama administration has anticipated.
  

 Adoption
of the Health Insurance Exchanges has been slow by states. Some states
recognize the financial risk the Obama administration is trying to force on
them.

This
risk is ever present even if the federal government is going to pay the entire
bill for the first three years.

As soon as physicians realize
the risk the Health Insurance Exchanges are going to impose on them, they will
not be willing participate.

These risks become more
apparent will each succeeding release of regulation.

Kathleen Sebelius said it two
weeks ago when she said there would be plenty of surprises ahead for physicians.

“Health
and Human Services Secretary Kathleen Sebelius, who told a gathering a few
weeks ago at the Harvard School of Public Health that she has been
"surprised" by the political wrangling caused so far by Obamacare,
there are likely to be plenty of surprises ahead.”

Physicians could face dramatic
financial challenges for treating patients who receive health coverage through
the Affordable Care Act's (ACA) Health Insurance Exchanges starting next year.

“ Insurance companies will not
process claims on patients who haven't paid their premiums in 3 months, leaving
doctors on the hook to recoup payment directly from the patients.”

Obamacare provides a 3-month grace
period to individuals who haven't paid their premiums for insurance purchased
through the Health Insurance Exchanges.

This provision will prove to be a
problem for physicians.

In Obamacare patients who fail to
pay their premium are free to sign up for another plan provided by the Health Insurance
Exchange.  

They can also start seeing another
physician without the insurance company or new physicians being aware of the
patient’s delinquent premium record.

"Why would a doctor sign up to treat these patients] if
they're going to be completely at risk and have to collect from the patient
directly for their care?"  "This
is a really bad provision in the bill, and we've got to get it fixed."


Under traditional insurance provided
by employers, the plan is still liable for paying doctors even if the patient
or employer hasn't paid their premiums,

Under the health insurance exchange
the individual is responsible for their monthly premium. If the patients
discontinue payment of their premium the healthcare insurer is not obligated to
pay the physician for the care provided.

Most of the time patients have stopped
paying premiums because they cannot afford them. Patients buying healthcare
insurance from the Health Insurance Exchanges are lower income producing
patients. 

 The
expected annual, out-of-pocket cost for an individual is estimated to be around
$6,400 and $12,800 for a family. This is not an insignificant expense for low
wage earners.

Recent premium estimates indicate
that the premium will be higher. This could be one of the surprises Kathleen
Sibelius is referring to.

Another potential shortcoming of the
Health Insurance Exchange is the reimbursement rates provided to physicians.
The Obama administration believes Medicaid rates are sufficient.

I wonder if any of President Obama’s
healthcare policy wonks ever questioned why so many physicians do not accept
Medicaid.

The answer is simple. The
reimbursement rate is less than the physicians fixed overhead to see the patient.

Medicaid physicians are driven to
see many patients a day to try to make a living.

It would be difficult maintaining a
physician patient relationship and a high quality of care seeing over 100
patients a day.

When their overproduction is
discovered these physicians are investigated for fraudulent practices.

 The rates the healthcare insurance industry
will pay physicians will not be set until late summer.

The big provider groups are negotiating with plans on their
payments. Small groups will only get a "take it or leave it" contract
from the health plans.

It seems obvious that fewer
physicians will sign up to accept patients receiving coverage through the
Health Insurance Exchanges once physicians understand what Obamacare is doing.

 This will result in a further physician
shortage.

 The simple question is what is Obamacare
trying to do to the healthcare system?

 Is Obamacare trying to destroy the
healthcare system?

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

Please have a friend subscribe

 

Permalink:

Hospital Systems’ Abuses Of The Healthcare System

February 28, 2013
inConsumer Driven Health Care, Disinformation and the healthcare system, Medicine: Healthcare System
• Leave a comment

Stanley
Feld M.D.,FACP, MACE

In my very first blogs in
2006 I made the point that all the stakeholders are to blame for the dysfunctional
healthcare system.

Most of the incentives that
created a technology driven healthcare system have been perverse. All the major
stakeholders’ incentives are misaligned.

The major stakeholders are
consumers, physicians, government, healthcare insurance companies,
pharmaceutical companies and employers.

The primary stakeholders
are consumers and physicians. The government, healthcare insurance companies,
pharmaceutical companies and employers are secondary stakeholders. Some
secondary stakeholders provide administrative services and some reimbursement.
None provide medical care.

None of the actions of any
of the stakeholders are transparent. All the stakeholders are trying to take
advantage of the payers (consumers, employers and the government).

The government should be
the neutralizing force. It should level the paying field for all the stakeholders.
Government should not permit one stakeholder take advantage another
stakeholder.

Everyone except the
primary stakeholders “patients and physicians” figured out the money game in
the healthcare system early on.

Government and employers
were next to last in figuring out the game of money gouging.  This happened in the early 1980’s when both
said they cannot pay any higher price for healthcare services.

At that point the hospital
systems and the healthcare insurance industry figured out another way to continue
the money gouging. The result was HMOs and managed care. They did not work.

The opacity of pricing
continued, cost shifting flourished, and the price of medical care continued to
rise.

Physicians are not
blameless. However, they are the easiest to blame. Physicians are the least
organized and least aggressive stakeholders in the healthcare system.

In the past, I have
pointed out the real problems that have resulted in the dysfunctions of the
healthcare system. Health policy wonks seem to ignore the real problems.

Consumers and physicians
are mere pawns in this money game.

Without consumers or
physicians there would be no healthcare system. They generate the engine that
provides the need for medical care and administrative services.

I have covered much of the
abuse of the healthcare system by most of the stakeholders.

I have been relatively
easy on hospital systems and pharmaceutical companies until now.

However, the basic problems
in the healthcare system must be to be recognized and then fixed. All of the
problems have to be recognized at the same time and fixed simultaneously.

A patch on one problem
simply intensifies the overall problems.

Obamacare does not solve
any of the real problems. It is an attempt at patching a problem. It will only
make the problems worse and will not reduce the cost of care.

On February 20,2013 TIME
Magazine published an article by Steven Brill. The article is an excellent article
pointing out the abuses of the hospital systems.

“Bitter Pill Why Medical Bills are Killing Us” presents
examples of the abuses of large and small hospital systems.

The basic philosophy that
hospital systems should operate by should be “Patients First.”  It is not. It is how much money can I make
from each patient.

Steven Brill asked the
major question. “ Why are hospital bills so high?”

He presented the answer:


 

http://www.time.com/time/video/player/0,32068,2178453595001_2136781,00.html

The answer is obvious to
all physicians.

One fellow physician
wrote.

Stan

Although
we know much of this, this is an excellent overview of healthcare costs.

 Steve

All Americans ought to
understand the distortions hospital system pricing creates. The government
ought to make hospital pricing transparent to everyone..

The government should include
the hospital system’s retail price, wholesale price and actual cost for an item
or service.

Then, consumers can choose
the hospital system to go to.

Policy makers continually criticize
this ideal saying that illnesses are sudden and patients are not in a position
to choose a hospital system or negotiate price.

If the hospital system is
compelled to compete on price the price will be the same as the competitive
price when the patient gets sick. If one hospital is much higher than the next
hospital the patient will know this before hand.

Hospital system charges
are actually higher than they appear. Most hospital systems are non-profit
organizations. The hospital systems do not pay taxes.

Hospital charges are
opaque to everyone, including physicians. Physicians generate the services
hospitals charge for.

As seen in Steven Brill’s
article oncology charges are extremely high.

One oncologist wrote to me
and said he could administer the same therapy in his office for one-tenth the hospital
cost.

However, neither the government nor the healthcare insurance industry
would reimburse him for the office procedure. It is the same procedure he performs
in the hospital.

Doesn’t that seem strange? What is going on?

Steven Brill discovered
that it is almost impossible to find out what hospital systems are charging.

The same opacity is true
for pharmaceutical charges.  The
pharmaceutical charges are further inflated by multiple middlemen involved in
drug distribution.

This has been less true
for drugs since Internet Drug stores publish drug prices.

However, since the patients’
physicians prescribed the drug patients are hesitate to use substitute drugs.
The patients’ attitude is that the healthcare insurance company will pay for
the drug less the copay.

Therefore the patients are not interested in looking
up the difference in price or the options for substitution.

This is the reason consumers need skin in the game.

The result of consumer apathy is an increase
in healthcare insurance premiums.

Steven Brill covers the
grotesqueness of retail hospital system charges. He also points out the amount
Medicare reimburses for the grossly inflated charge.

The consumers without
insurance are the consumers that get stuck with the retail charges. Insurer consumers recieve a large discount.  The uninsured
consumers are least likely to be able to afford these charges.

In some cases Medicare
reimbursement is less than 20% of the hospital retail charge. Steven Brill
points out that at this time Medicare reimbursement to hospitals is still 10
times its actual costs.

The article “Bitter Pill” is
excellent. It covers many categories of hospital system abuse by the use of
case studies.

The facts are
overwhelming.  I am going to try to
categorize these facts in my next blogs. The abuses will be easier to remember.

Consumers must be educated.
The hope is consumers can be activated by education. Only a consumer driven
healthcare system can drive the abuse out of the healthcare system. 

Then,
Americans will have an affordable healthcare system.

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



If you have enjoyyed it please have a friend subscribe

 

Permalink:

The Destruction of Private Healthcare Insurance

January 9, 2013
inHealthcare Insurance Industry, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D., FACP, MACE

One of these days Americans
are going to pay attention to how President Obama is destroying private
healthcare in America.

Many people will fine this
hard to believe because he is such a nice guy and many people like him.

He is making the healthcare
insurance industry destroy itself by forcing them to increase healthcare
insurance rates.

The destruction is so well
designed that the public cannot take notice. The healthcare system will not be
more affordable or accessible to anyone in the nation.

The changes will provide
President Obama with another tool to redistribute wealth and increase the individual’s
dependence on the federal government. This defines President Obama’s goal in affecting
all areas of our life.

Americans are on the Road To
Serfdom.

I remember Barney Frank and
John Kerry saying that healthcare reform would not work without a “Public Option.”
I also remember President Obama saying we can make it work without a “Public Option.”

President
Obama’s original plan was to eliminate private insurance. Americans would have
no choice but a “Public Option.”  (National Health Plan)

 

 Kathleen
Sebelius, the secretary of health and human services
said, she “retains authority to make the
final decision” on insurance rates if she finds that a state acted in an
arbitrary or capricious way in denying a rate increase sought by a nationwide
health plan.

 

This is the first time I
have seen President Obama’s administration use the words “National Health
Plan.”

It was obvious President
Obama was not truthful when he said “if
you like your physician you can keep him” and “if you like your healthcare insurance you can keep it.”

Congress made a gigantic while
passing Obamacare and transferring all healthcare policy decision making power
to the executive branch of government.

President Obama’s goal is to
have complete control over the healthcare system. He wants to force the private
healthcare insurance industry out of business. He wants to socialize the entire
medical care industry into a single party payer system.  The government will be the single party payer.

Healthcare will then be a
ubiquitous entitlement program that the government cannot afford unless it increases
taxes entire population according to the taxpayers means.

This is the pattern behind many
of the articles written in isolation by the traditional media.

The unintended consequences
resulting from each policy change will be overwhelming.

I have been fascinated by President
Obama’s negotiating strategy.  

Americans are going to wake
up to the fact that President Obama has increased taxes for the funding of
Obamacare by $1 trillion dollars over the next ten years aside from the tax
hikes effective January 1st.

Americans are going to wake
up and feel deceived by President Obama when they realize they are getting
little for their increased taxes except government control over their freedoms.

I predict President Obama’s
plans will blow up in his face.

Consumers will protest when
they recognize the impact these multiple new taxes will have on their
discretionary income. President Obama will not get the funding he needs from
congress.  

His physician workforce will
not cooperate. Hospitals are starting to wake up and are seeing they were
deceived. They thought they would do better because they have bought physician
practices.

Recently they automatically
received cuts in reimbursement while the doctor fix was extended for another
year. Physician reimbursement will be cut and the physician workforce will
dwindle.

On Friday afternoon November
30th 2012 the Obama administration pulled a stunt on the healthcare
insurance industry.

“The Obama administration
said Friday that it would charge insurance companies for the privilege of
selling health insurance to millions of Americans in new online
markets run by the federal government.”

The cost of these “user
fees” can be passed on to consumers. The proposed fees could add 3.5 percent to
premiums for private health plans sold in insurance exchanges operated by the
federal government.

The "user fees" are another tax to consumers.

The government is
disregarding the fact that healthcare insurance premiums are too high for
employers to provide healthcare insurance for employees now.

Employers are opting to drop
healthcare insurance coverage and pay the government penalty. Some are dropping
healthcare insurance and avoiding the penalty by decreasing the number of
employees to under 50 employees or decreasing employees work hours to under 30
hours per week.

This will increase, not
decrease the tax burden on the consumer.

The exact effect of the
health insurance exchange on the healthcare industry is muddled.

It looks as if President
Obama is rapidly moving toward a “Public Option.”

Consumer advocates, insurers,
and some state officials had expressed concern about delays in publication of
the rules for this new proposal.

President Obama has used
this is the same tactic before. Consumers and agencies must accept the changes
before the rules are published.

Consumers and state
governments do not trust President Obama. They are afraid to say yes when they
do not know what they are saying yes to. In the end it  looks like the state governments and the
consumers will get stuck with the bill and the federal government will have
complete control over the healthcare system.

CMS said. “These plans will
be offered by private insurance companies under contract with the United States Office of Personnel Management. The agency already provides insurance to eight
million federal employees, retirees and dependents.”

The scary part is the administration said,
“It (the government) retains
authority to make the final decision” on rates if it finds that a state acted
in an arbitrary or capricious way in denying a rate increase sought by a
nationwide health plan.”

The term “Nationwide Health Plan” and “final authority” sounds as if the
government is taking over.

The federal government will
also have control over physicians and hospital fees.  It will also control access to care and the
rationing of care.

It is almost too late for
consumers to wake up.

No one can say President
Obama didn’t tell us.

It can only be said the plan
was so obfuscated, final rules so delayed and unsubstantiated promises made and
not publicized on a Friday afternoon the week after Thanksgiving that the
public did not understand what was going on and could not express an opinion.

The games President Obama
and his administration play are dizzying. The irresponsibility of our elected
congressional officials who are supposed to be our surrogates is
unconscionable.

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



Please have a friend subscribe

 

 

Permalink:

What Is The Insurance Value Of Medicare?

November 19, 2012
inHealthcare Insurance Industry, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests
• Leave a comment

Stanley Feld M.D.,FACP,MACE

 

Healthcare insurance is
great if you do not need it.

The wonderful thing
about Medicare is private insurance is not available to seniors.  

Healthcare insurance companies
are not interested in covering consumers with health risks or preexisting
illnesses.

In fact private
individual healthcare insurance policies are not available to an unemployed 55
year old person with mild obesity and hypertension.

If you are employed and
over 65 years old with mild obesity and hypertension the healthcare insurance
industry is required to insure you under your employer healthcare plan.

The employed person
receives healthcare coverage with pre-tax dollars.

 A person who might be
eligible to purchase individual healthcare insurance must pay with after-tax
dollars.

This is unfair but
easily corrected.

The pre-tax/post tax
issue could be solved if the state insurance boards required the healthcare
insurance companies, wanting to sell private insurance in that state, cover
everyone applying for insurance. The insurance company should be required to
set the premiums based on community rating.

Everyone should pay
premiums with pre-tax dollars.

Medicare, through
government inefficiency, has become very expensive. If it were efficient
insurance it would be less expensive to both consumers and the government.

Most working people have
no idea of Medicare’s cost to them during their working years.

Medicare’s yearly tax
withholding is 1.45% of salary. A worker earning
$100,000 a year pays $1450 yearly to the Medicare Trust Fund. In 40 years that
person would pay $58,000 into the Trust Fund.

When they became eligible
for;

 Medicare Part B the yearly premium in 2012 was
means tested.

 

If your yearly income in 2010 was

You pay (in 2012)

File individual tax return

File joint tax return

$85,000
or less

$170,000
or less

$99.90

above
$85,000 up to $107,000

above
$170,000 up to $214,000

$139.90

above
$107,000 up to $160,000

above
$214,000 up to $320,000

$199.80

above
$160,000 up to $214,000

above
$320,000 up to $428,000

$259.70

 

 

 

In
2013 the Medicare Part B premiums are going to increase.

 

 

 

 

 

 

 

 

 

 

 

 

 
   

 

 

 

 

 

If your yearly income in 2011 was

You pay (in 2013)

File individual tax return

File joint tax return

$85,000
or less

$170,000
or less

$104.90

above
$85,000 up to $107,000

above
$170,000 up to $214,000

$146.90

above
$107,000 up to $160,000

above
$214,000 up to $320,000

$209.80

above
$160,000 up to $214,000

above
$320,000 up to $428,000

$272.70

above
$214,000

above
$428,000

$335.70

 

Income is defined as
income from all sources such as capital gains, interest, pension annuities,
social security and all earned income.

Further premium increases have been announced for 2014 but
have not been published.

Medicare premiums are
taken out of each Social Security check.

The Medicare Part B
insurance has deductible and co-pay rules. Medicare Part B deductibles apply
for each hospital stay, ER visits and physician office visits.

For each benefit period
you pay:

  • A total of $1,156 for each hospital admission of
    1-60 days.
  • $289 per day for days 61-90 of a hospital stay.
  • $578 per day for days 91-150 of a hospital stay
    (Lifetime Reserve Days).
  • All costs for each day beyond 150 days.
  •  

Skilled Nursing Facility
Coinsurance

  • $144.50 per day for days 21 through 100 each
    benefit period. Days 1-20 are free.
  •  

Part B: (covers Medicare eligible physician services, outpatient
hospital services, certain home health services, durable medical equipment)

  • $140.00 per year. (Note: You pay 20% of the
    Medicare-approved amount for services after you meet the $140.00 deductible.)

 

The deductible for the
first $140 dollars worth of services plus 20% of any physicians and hospital
bill can add up as one gets older. It becomes unaffordable for many seniors.

 

Medicare Part B’s deductibles
and copays’ costs makes Medicare gap coverage   essential.

Premiums For Medicare Part
F   

Policy Summary

Monthly Premium:
$84 – $302  depending on age and benefits

Estimated Annual
Cost: $6,050.00

Benefits

  • Basic Benefits Medigap
    Basic Benefits definition[?] – Opens in a
    new window
  • Skilled Nursing Facilities Skilled
    Nursing Facility definition[?] – Opens in a
    new window
  • Part A Deductible Part
    A (Hospital Insurance) definition[?] – Opens
    in a new window
  • Part B Deductible Part
    B (Medical Insurance) definition[?] – Opens
    in a new window
  • Part B Excess Charges (100%)
  • Foreign Travel Emergency
  • Preventive Services

 Medicare
Part D is the drug benefit plan. Medicare Part D helps reduce the cost of
medications.

Medicare
Part D is also means tested. There are multiple plans to pick. Some include
complete payment for brand named drugs and some cover the donut. The price can
range from $40 to $120 per month per senior depending on the coverage a senior
picks. The additional means tested fees are below.

The
brand named drugs are expensive. Most drug chains have followed Wal-Mart’s lead
and charge $4.00 for generic drugs. This forces seniors to purchase generic
drugs

Medicare
Part D is expensive and unfair for seniors needing brand named drugs.

The Means Testing Formula For Medicare
Part D 2012

 If your yearly income in 2010 was

You pay

File individual tax return

File joint tax return

$85,000
or less

$170,000
or less

Your
plan premium

above
$85,000 up to $107,000

above
$170,000 up to $214,000

$11.60
+ your plan premium

above
$107,000 up to $160,000

above
$214,000 up to $320,000

$29.90
+ your plan premium

above
$160,000 up to $214,000

above
$320,000 up to $428,000

$48.10+
your plan premium

above
$214,000

above
$428,000

$66.40
+ your plan premium

 http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

 Medigap
fees and Medicare Part D fees are paid with post tax dollars.

These
costs are in addition to seniors having contributed $58,000 to the Medicare
Trust Fund during their working years.

“The reason we have
health insurance at all is not that health care is expensive, but rather that
there is great uncertainty about who will need very expensive and potentially
lifesaving care and when they will need it. Medicare should give beneficiaries
not just access to medical care, but also protection from the risk of
catastrophic spending.” 

Medicare
coverage is not cheap. President Obama’s Obamacare is going to make it more
expensive with less access to care.

 Why
is Medicare Part B,F,D  so expensive when
the average person on Medicare spends only $6,600 dollar per year?

This
is the major question. The government should focus on the answer. It should not
be spending time and money on a system that is punitive to patients and
physicians and has little chance of being successful.

The
money creating the Medicare deficit is going somewhere. Where?

The cost to Medicare beneficiaries is high.
The protection against economic ruin is limited. The basic benefit lacks a cap
on out-of-pocket spending, so beneficiaries are exposed to the risk of
open-ended cost sharing that can generate substantial financial strain (or
deplete assets for surviving spouses).1 

Moreover,
the odds of facing a catastrophic expense mount over time. Almost 50% of
beneficiaries are hospitalized at least once over a 4-year period.2 

If
we are going protect our seniors from financial strain or ruin Medicare must
reassess it premises and reduce its administrative waste. It must be completely
transparent. If the government did it correctly it would provide an affordable
healthcare insurance plan for seniors.

“Everyone knows the dice is loaded.”
Leonard Cohen.

  

http://youtu.be/GUfS8LyeUyM

 

At
the moment seniors do not have another choice. It is the only game in town.

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

Please have a friend subscribe

 

 

 

 

 

Permalink:

Evidence For Impending Healthcare System Failure

October 17, 2012
inMedicine: Healthcare System
• Leave a comment

Stanley Feld M.D.,FACP,MACE

The following are the links that is the evidence for the impending failure of the healthcare system in its present form and in the form that Obamacare is adopting.

Obamacare is piling on more regulations and restrictions to the present healthcare system. The present system is a failed system.The regulation will be impossible to comply with and impossible to enforce. They will create more opportunity for secondary stakeholder to extract more funds from monies needed for direct patient care creating a greater decrease in access to care for all .

The links follow the slides I presented in my last blog. Those links could not be opened because they were jpegs.

My hope is the links serve as an excellent reference to Repair The Healthcare System presently or when it collapses under it unsubstainable costs and the present system's inability to be executed.

The Etiology of Accelerated
Collapse

Slide03

Medicare 1965-1980 Fee for
service

Nixon
authorized HMO’s

Medicare Price Fixing Begins In 1980

Cost shifting Penalizes Private
insurance

HMO Fail Because Of Faulty Assumptions In 1990.

 Reasons for Hillarycare’s
Failure To Pass.

Distrust of Government
Increases.

Healthcare Insurance Companies
Raise Premiums.

Birth of Managed  Care: Another Compicated Mistake  

Managed Cares Fails. 

Managed Care Pricing And
Premiums Remain  High

2009 Obamacare And The Threat
Of Government Takeover To Freedom, Liberty and Choice.

Rationing Of Healthcare

ACOs Are HMO's On Steroids Combined With Managed Care Is Obamacare's Complicated Mistake. 

ACOs Will Fail At Great Costs To Everyone.

 Tort Reform And Defensive Medicine Are Ignored By Obamacare.

Medical Cost Escalate Out Of
Control And Then The Healthcare System Will Collapse.

The other major slide in the last blog was the barriers to the
Physician/Patient Relationship. This relationship is critical to the
theraputic index. It is almost destroyed and will be totally dstroyed in
Obamacare. Both physicians and patients will become commodities in a
bureaucratic healthcare system. Patients will not win.

 

Physician/ Patient Barriers to the Physicians/Patient Relationship

Slide08

 

The Physician/Patient
Relationship.

 The
physician/patient relationship.

 The Magic  of the Patient Physician Relationship  

 Patient and
Physician responsibility contract

 Patient should be the leader of the team

 Barriers for physicians in the Physician/Patient
Relationship

 

1. Tort
Reform/Defensive Medicine.

2. Restriction
of Physicians Clinical Judgment.

3. Medicine
is a calling not a business 

  4.  Constant
lowering physicians’ reimbursement.

 5. Physicians
are driven to decrease time spent with patients.

6. Government
rations care through panel of experts

7. Physician’s
treatments are driven by government regulations.

8. The
traditional media undermining physician credibility

9. Government
is attempting to commoditize medical treatment.

 

Patient Barriers To the Patient/Physicians Relationship

1. Patients are not in control of their own medical decisions.

2. Patients are not in control of their own healthcare
dollars.

3. Patients
do not have to be responsible for their treatment because they

receive
first dollar coverage.

4.  Education about chronic disease must be extension of
physician’s care  

5.  Internet can undermine the Physician/Patient
relationship..

6. Method of choosing a physician is random and must be
made clearer.

7. Portability of information about previous treatment
is difficult.

8. Patient must be responsible and in control of their
medical record.

9. Patient must endure poor communication by their
physician.

10.
Government and the healthcare insurance industry limit choice with

network
restrictions.

11. Patients should be responsible for their treatment
Management

America's healthcare system is at a critical turn in 2012.

Obamacare must be repeal.

Effective healthcare reform is essential. Both the primary and secondary stakeholders have abused a system. A system that is punitive.

Consumers must drive the system by being responsible to themselve and their healthcare dollars.

Obamacare is building a system of government dependency by all stakeholders (patients,physicians,hospital and healthcare insurance companies).

The healthcare system should be developed to create innovation and competions among stakeholders for the benefit of consumers and their indepent choice.

The government's inefficiency will create a healthcare system destined to doom at the expense of all of us taxpayers.

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

Please have a friend subscribe

Permalink:

The Healthcare System in Switzerland Works

September 28, 2012
inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld
M.D.,FACP,MACE

Paul
Krugman is starting to drive me crazy with all his fact free declarations about
the healthcare system.

He recently declared that consumer driven healthcare has
been a bust everywhere it has been tried. Paul Krugman as an “expert” has once
again made a declaration that contradicts the facts. He is clearly not
interested in being confused by facts.

Paul Krugman is against putting consumers in
control of the healthcare system. He feels,
as President Obama feels, that a central committee (IPAB) should be in charge
of deciding what to do with limited health care resources. 

He has said,

 "Consumer-based" medicine has been a
bust everywhere it has been tried. Medicare Advantage was supposed to save
money; it ended up costing substantially more than traditional Medicare.

Medicare Advantage costs the government more
money because the government gave the private insurance companies a $3,000 bonus
per senior to get Medicare out of the government’s hands.

This is one of the principle reasons I am not a fan of
Medicare Advantage.

In reality Medicare Advantage provides more
services at lower premiums and deductibles for seniors. Seniors with Medicare Advantage use
fewer services resulting in a lower cost of total services and more profit for the
healthcare insurance industry.

“America has the most "consumer-driven" health care
system in the advanced world. It also has by far the highest costs yet provides
a quality of care no better than far cheaper systems in other countries.”

Paul
Krugman is wrong.  Switzerland has the
most consumer driven healthcare system in the world and the Swiss government
pays far less than most countries while the Swiss get a high quality of care.

His ideology
blinds his mind. The healthcare system in Switzerland is a consumer driven
healthcare system that works for the Swiss. The Swiss government makes the
rules and then gets out of the way.

The
Swiss healthcare system can be used to start a constructive conversation about
healthcare reform in America that can satisfy both conservatives and liberals
and save the U.S. from bankruptcy resulting from expanding entitlements.

The
healthcare system in Switzerland is a consumer driven healthcare system in
which consumers have choice. It has resulted in a low income tax rate,
universal healthcare, and satisfied stakeholders

The
Swiss system could not be totally transformed into an American system because
of America’s embedded ideology and prejudices as well as stakeholder vested interests.
However it outlines the government’s role in a healthcare system and highlights
the power of a consumer driven system.

America’s
healthcare system must undergo significant changes. Most of these significant
changes have been ignored by President Obama in Obamacare. It empowers
government and not the consumer.

Paul Krugman has stated flatly, "Patients
are not consumers"

“Patients get illness that others (government) should decide on
whether it is cost effective to treat.”

This
attitude toward patients points out the disrespect for the intelligence and
judgment of consumers.

The elements
critical to meaningful reform of America’s healthcare system must include the
following changes.

1.
There must be significant and meaningful Tort Reform to decrease the practice
of defensive medicine.

2.
There must be significant reform of the healthcare insurance industry’s
financial rules to stop the industry from listing non-direct care expenses as
direct patient care.

3.
There must be regulations to cause the healthcare industry to be competitive
for consumers’ business. Government should not be the consumer of healthcare.

4.
There must be legislation to change the healthcare insurance industry’s incentives
for profitability in order to create innovative healthcare insurance products
that will reduce healthcare costs.

5.
There must be significant financial incentives for consumers to be motivated to
save healthcare dollars.

6.
Consumer must responsible for their health and healthcare dollars. The
entitlement mentality must be eliminated.

7.
Hospital systems should be competing for patients’ healthcare dollars and not
government healthcare dollars.

8.
Physicians must be responsible to consumers and not hospital systems or the
government.

9.
Insurance costs must be community rated.

The
healthcare system must be a consumer driven system just as purchasing
groceries, automobiles, computers and televisions are. If the product is poor
the company will go out of business.

America’s goals should be universal healthcare
coverage with freedom of choice, and reduction of healthcare costs.

It is worth understanding the Swiss healthcare
system as a starting point to meaningful reform of the American healthcare
system. 

These are the major features
of the Swiss Healthcare System:

1.Swiss citizens
buy insurance for themselves.

2.There are no
employer-sponsored or government-run insurance programs.

3.Insurance
prices are transparent to the beneficiary and community rated.

4. The
government defines the minimum insurance benefit packages that must be offered.
 Everyone must have the minimum
healthcare insurance coverage.

5. All
packages require beneficiaries to pick up a portion of the costs of their care
(deductibles and coinsurance) in order to incentivize citizens to be
responsible for their health and the control of healthcare dollars spent.

6. My ideal
medical savings account would provide a positive incentive by rewarding
citizens who did not spend the first $6,000 dollar to keep that money in a
retirement account.

7. Patient
incentive is a critical element in healthcare reform because incentives provide
consumers with a reason to take care of their health and healthcare
dollars 

8.The Swiss government
subsidizes health care for the poor on a graduated basis, with the goal of
preventing individuals from spending more than 10 percent of their income on healthcare
insurance.

9. Citizens
can be responsible for a significant component of healthcare costs in Switzerland.

10. Consumers
often opt for the cheaper healthcare insurance packages. They have freedom of
choice.  Many Swiss consumers choice chose
minimal insurance plans combined with high-deductible insurance plans.

11. Citizens
are free to choose comprehensive insurance coverage or some form of
supplemental coverage. It is not a one size fits all system.

12. Ninety-nine
percent (99.5%) of Swiss citizens have health insurance.

13.There are
about 100 different private insurance companies in Switzerland with multiple
healthcare insurance plans.

14. It is clear
that the government has made the rules and then has gotten out of the way. The
rules have set up a market driven competitive healthcare system.

15. The result
has been that healthcare insurers are competing for consumers’ business on
price and service. Consumers gravitate to the best price and service that fits
their needs.

16. The Swiss
healthcare system not only helps to curb health care inflation but most
beneficiaries have complete freedom to choose their doctor.

17. The setup
of the system has resulted is low waiting times for physician and hospital
services with a minimum of bureaucratic slow downs. 

18. The Swiss healthcare
system aligns all the stakeholder incentives by empowering the consumer while
helping less fortunate consumers.

19. Government
spending on health care in Switzerland is only 2.7 percent of GDP, by far the
lowest in the developed world.

U.S.
government spending on health care was 7.4 percent of GDP in 2008 and will
exponentially grow under Obamacare.

 “ If the U.S. could move its state health spending to Swiss
levels, it would save more than $700 billion a year.”

Dr. Regina Hertzlinger has an excellent description of the
Swiss healthcare system in the following You Tube.


 

http://youtu.be/E5bsz_oewDA

Switzerland’s
healthcare system cannot be superimposed on the U.S. healthcare system. It can
be used as a starting point to empower consumers to drive the healthcare system
and be part of the solution. 

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

Please have a friend subscribe

 

 

 

 

Permalink:

Supreme Court and Healthcare

June 24, 2012
inMedicine: Healthcare System
• Leave a comment

Stanley Feld M.D.,FACP,MACE

This week the Supreme Court is going to rule on whether President Obama’s Healthcare Reform Act is constitutional or not.

The traditional media and blogosphere has spent many hours speculating on the Supreme Court’s decision.

The Supreme Court probably recognizes the many strange issues involved in the passage of Obamacare and the many tricks President Obama played in its passage. It also recognizes than only 32% of the population approves of the plan.

The Supreme Court has cleverly picked the two most important issues dealing with the constitutionality of President Obama’s Healthcare Reform Act. These two issues are intermingled with the multitude of issues that are wrong with the law.

There are two key issues.

One key issue is whether it is constitutional for the central government to mandate that Americans and American companies must purchase healthcare insurance from a private healthcare insurance company. If Americans do not purchase the healthcare insurance, can the federal government fine them?

The second key issue is whether it is constitutional for the federal government to force states to increase the number of people eligible for Medicaid or do the states have the right to determine who they can and should cover at their expense.

 The two core issues are freedom of individual choice and central government control over states rights. Does the federal government have the power under the constitution to limit these constitutional rights?

Once the constitutionality of these two issues are decided by the Supreme Court, Obamacare still has the healthcare system’s original dysfunctional problems.

Obamacare institutes none of the necessary rules or regulations to repair the healthcare system. It adds a patch onto a dysfunction healthcare system.

Effective repair of the healthcare system must be incentive driven with alignment of all of the stakeholders. The primary stakeholders are the patients and physicians.  It must not be a system that is punitive to stakeholders.

The healthcare system must not be an entitlement program. It can be a subsidized program that is consumer owned and driven. Consumers must have financial incentive to be responsible for their health and healthcare dollars.

Any system that promotes government dependency will fail.

The list of initiatives that could repair the healthcare system is large. Obamacare does not include any of them.  

Obamacare omits the need for patients’ responsibility, expands entitlements and promotes government dependency.

These are the initiatives that must be included in a healthcare system that will work:

  1. Eliminate defensive medicine by effective Tort Reform.
  2. Individual patients’ responsibility for their healthcare dollars using the Medical Saving Accounts.
  3. Individual patients must become responsible for their health.  Obesity and the avoidance and control of chronic diseases and complications are in large measure the patient’s responsibility. Financial incentives for effective health along with educational programs to avoid chronic diseases and the complications of chronic diseases should be available.
  4. Dis-intermediate the healthcare insurance industry’s ability to extract 40% of every healthcare dollar for both public and private healthcare insurance sectors: Medical Savings Accounts.
  5. Eliminate the vague regulations and confusing regulations restricting innovative direct medical care programs.
  6. Make all healthcare insurance programs, corporate, small business and individual programs, tax deductible. 
  7. Administrative waste is expanded in Obamacare. Over 250 new agencies have been created already.  
  8. Effective system to implement Electronic Medical Records. The present stimulus is inadequate and will not achieve its goal. It can be done much less expensively.
  9. The hospital reimbursement system must be revised.  The government should institute regulations that monitor transparent real costs of a service and transparent negotiated charges. This should be available to patients and physicians in order to make educated choices.
  10. The government should provide on-line information to patients and physicians about reimbursement for services and need for services based on evidence based medicine recommendations.
  11. The government should help patients save their own money by helping patients decide what are necessary diagnostic tests and treatment.
  12. It should be the patient’s decision and not the government’s decision on necessary treatment.  
  13. Patient should be a Pro-sumer ( Productive Consumer). Patients must learn to be responsible for their care and healthcare decisions.
  14. The central government should stop trying to control the healthcare system and forcing consumers to be dependent on government. This is the Road To Serfdom.  
  15. The government should streamline regulations, eliminate paperwork, and make the healthcare system interaction a pleasant one.
  16. The government should eliminate bureaucracy. The government must approach healthcare reform from the patients’ and physicians’ point of view.

 

 There are many more initiatives I could list that are needed to the repair of the healthcare system. All the initiatives are based on maintaining individual freedoms and promoting individual responsibilities. The initiatives are not based on forcing everyone to be dependent on government.

These are exactly the problems the Supreme Court is considering.

As a society we have been acculturated to accept an entitlement society and central government dependency.

We are also noticing that entitlement societies do not work as witnessed by European socialism.  

America is in a Catch 22 situation. If you want to be fiscally responsible you cannot live beyond your means. America cannot maintain the entitlements any longer because the central government cannot afford them.  

After a finite time a nation runs out of other peoples’ money.

 

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

Please have a friend subscribe