Stanley Feld M.D., FACP, MACE Menu

Results found: 182

Permalink:

Obamacare’s Solyndras

January 14, 2015
inDisinformation and the healthcare system, Healthcare Insurance Industry, Medicine: Healthcare System
• Leave a comment

Stanley Feld M.D.,FACP, MACE

Peter Orszag was previously President Obama’s director of Office of Management and Budget. He was wrong about Obamacare’s economic impact, improvements in the healthcare system and efficiency in 2009.  He is wrong about it in 2015 in his critique of Steven Brill’s book “A Bitter Pill”.

http://www.bloombergview.com/articles/2015-01-12/what-brills-bitter-pill-gets-wrong-on-obamacare

The problem is Peter Orzag still believes in the Obama administration’s fiction. He quotes the Obama administration’s spin of the results as proof of Obamacare’s success. There is little valid data to back up the spin.

Obamacare has had its share of Solyndras. Solyndra was destined to fail. It had a lot of built in organizational waste.

I fear the few Obamacare experiments that we are aware of that have failed are only the tip of the Obamacare failure iceberg. There will be many more debacles that the Obama administration is probably hiding. 

CLASS

Community Living Assistance Services and Supports, or CLASS, was designed to provide cash benefits for those patients needing long-term services and support. CLASS was a part of Obamacare (Affordable Care Act). Many Republican and moderate Democrats objected to CLASS and considered it fiscally unsustainable. It would only waste money.

Senate Budget Committee Chairman at the time Kent Conrad D-N.D. called CLASS “a Ponzi scheme of the first order”. In any event the $68 billion dollar program was rammed through as part of Obamacare.  

Two years later the Department of Health and Human Services determined CLASS could not be implemented in a fiscally solvent manner, and in January 2013 Congress repealed CLASS.

In 2015 the American public still does not know how much of the $68 million dollars was wasted.

Just how much did HealthCare.gov cost?

 The American public will never know. We will never know what we should have paid for the website or what we finally paid.

In October 2013 as soon as it was apparent that www.healthcare.gov was a train wreck the Obama administration denied all the published prices contracted for building the website.

Prices to build the website varied from $91 million dollars to $634 million dollars to over 1 trillion dollars ($1,000,000,000.00).

Americans did not know what the website should have cost. They never found out what the cost was to rebuild the website after the initial disaster.

It was never clear whether the contract to CGI was won by competitive bid. The Obama administration never answered the question of Michelle Obama’s influence in choosing CGI.

The history is clear. CGI has failed to deliver for other projects they have done in other parts of the world.

What is the truth? Why would the Obama administration pick this company? What can we do about this waste of taxpayers’ money?

I guess Americans can remain passive and pay more taxes.

Americans have given up on the truth about the www.healthcare.gov

 debacle. The attitude of many is that it is what it is. We must go on.

All Americans are hearing or want to hear is the current website is easy to use and is working well.The important question is, Is it?

It is easy to understand why Jonathan Gruber would say Americans are stupid and the lack of transparency is a powerful tool. The implication of that statement indicates an Obama administration attitude. It is the reason the administration says they hardly knew the guy.

CoOportunity Health falters, taken over by state

This Obamacare debacle almost got away from recognition by the American public.

 CoOportunity Health is a fledgling Iowa health insurance cooperative set up under  Obamacare with Obamacare money.  It is going bankrupt.

CoOportunity Health was set up by the Obama administration. The Obama administration granted the company $146 million dollars in funding from Obamacare funds. The idea was to provide consumers and small businesses alternative insurance in healthcare markets with limited insurance choices. It could also be thought of as a disguised “Public Option”.

The healthcare insurance industry had refused to participate in the federal and state insurance exchanges in many states. The healthcare insurance companies thought the risk was too great. They would lose money.

Just before this year’s open enrollment period President Obama activated the reinsurance provisions in Obamacare guaranteeing insurance companies that they can only make money and not lose money on providing insurance through the government health insurance exchanges.

The Healthcare insurance companies are falling all over themselves to provide healthcare insurance in high risk states now.

 Where else can you sell insurance to more people at no risk?

“As of December 12,2013 Cooportunity has only $17 million of the $146 million dollars left.  CoOportunity has been taken over by state regulators and could soon go under, officials said Wednesday.”

The Obama administration knows they can now throw government funded insurance companies like CoOportunity under the bus because they have guaranteed backup companies from the healthcare industry that want to sell no risk insurance.

 The CoOportunity hasn't reached insolvency yet but it doesn’t have  enough money on hand to continue to run the company.  It will leave 96,350 consumers uninsured with unresolved claims healthcare insurance claims. These consumers will also lose their un-used premiums.

The 96,350 should be able to get insurance through the federal health insurance exchange in their state.

The federal government as banker has simply cut CoOportunity’s credit and took a $146 million dollar loss.

I wonder how many other Obamacare funded insurance companies are out there?

I wonder how many other Solyndra like experiments Obamacare has. I can think of at least 4 or 5.

I wonder how much money Obamacare is losing on experiments and bureaucratic waste?

It is making medical care more expensive for taxpayers and for patients with increased out of pocket expenses.

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

Please have a friend subscribe

 

 

 

 

 

 

Permalink:

When Will We Ever Learn

September 10, 2014
inDefective scientific studies, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests
• Leave a comment

Stanley Feld M.D.,FACP,MACE

When will President Obama ever learn?

His ideology blinds him to the facts. I vividly remember him telling John Kerry and Barney Frank not to worry about not having a Public Option.

Barney Frank said we need a Public Option for the Affordable Care Act to work. The only way Obamacare could work is by ending up with a single-payer system.

 

 

President Obama had a clandestine “Public Option” built into Obamacare.  

Progressives believe deeply in their ideology. They do not consider past history, present reality or facts. 

All progressives have to do is look at what is happening to socialized medicine all over the developed western world.

It is failing even as some people believe it is succeeding.

 The Commonwealth Fund (a private progressive foundation) with a focus on healthcare is certain that a single party payer system is the only viable healthcare system.

The report ranked healthcare systems throughout the developed western world.  In its published ranking the National Health Service of Great Britain was considered the best medical system among the 11 of the world's mostadvanced nations, including Canada, France, Germany, Switzerland and Sweden.

 The United States came in last.

 Few have the time or patience to read the complete report or pick out the defects in the study.

Most people reads the summary. The summary in this study is not close to the evidence presented.

 

The Commonwealth Fund’s rankings of countries are contradicted by objective data about access and medical-care quality in these countries in peer-reviewed academic journals.

The Commonwealth Fund’s methodology is defective. Its conclusions relied heavily on subjective surveys about "perceptions and experiences of patients and physicians."

Kenneth Thorpe made an important point by examining differences in disease prevalence and treatment rates for ten of the most costly diseases between the United States and the ten European countries with a single payer system.

He used surveys of the non-institutionalized population age fifty and older. Disease prevalence and rates of medication and treatment are much higher in the United States than in these European countries.

Why would that be?

There are many reasons for this finding. The main one is the availability of care in the United States compared to the ten socialized western countries.

Another is lifestyle and incidence of obesity in the United States. Both lead to the onset of chronic disease and increased treatment.

 “Efforts to reduce the U.S. prevalence of chronic illness should remain a key policy goal.”

“Americans are diagnosed with and treated for several chronic illnesses more often than their European counterparts are.”

Americans diagnosed with heart disease receive treatment with medications and procedures more frequently than patients in Western Europe.

In the past local peer review was all that was needed along with confidence in the treating physician’s judgment. This confidence in physicians’ judgment has been destroyed by excessive media sensationalism. The real percentage of abuse is small and easily discoverable by peers and the use of the new social media.

Cancer treatment survival rates in America are far greater than the survival rates in Britain, and countries in western Europe.

The reasons for the higher cure rates are the availability of early detection and treatment.

Cancer treatment costs are high. The government should look into the reasons for this high cost and try to lower the cost.

The Commonwealth Fund’s report does not consider any of these factors.

The NHS has a waiting list of 3.2 million people for admission to the hospital. In London alone over 500,000 patients are on a waiting list for diagnosis and treatment.

A large percentage of patients triaged as urgent after being diagnosed with suspected cancer have a 62-day wait time to receive therapy.

The British Health and Social Care Act 2012 authorized the use of the small private sector of healthcare to help the NHS with its problems.

The share of NHS-funded hip and knee replacementsby private doctors increased to 19% in 2011-12, from a negligible amount in 2003-04. Each year there is an increase in NHS funded care by the private sector.

It sounds like the VA Healthcare System’s solution to its problems.

Englishmen who can afford private care and private healthcare insurance to avoid the NHS are switching to private insurance even though they have to pay $3,500 for each man, woman and child in a family into the NHS.

The single party payer system (NHS) is struggling with unsustainable costs even though we hear from progressives how great socialized medicine is in England.

The key ingredient missing in all these systems is patient responsibility for their health and their healthcare dollars. Both are powerful motivators to healthy living and detecting disease early.

There are big problems in Canada that have been undisclosed in the United States.

There were two articles in American newspapers in 2011 that applaud the Canadian system.

 Article 1. Debunking Canadian health care myths – The Denver Post                                                                                                                         

Article 2. Everything you ever wanted to know about Canadian health care in one post. Washington Post

Both articles are opinion articles and lack concrete evidence. The articles contain both misinformation and disinformation.  

The Fraser Institute is a well-respected Canadian think tank. Its research is considered accurate with a libertarian slant.

Its 2011 report contradicts the statistics in these articles on the Canadian government healthcare costs.

 Article 1. “Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's.”

Article 2.  “In 2009, Canada spent 11.4 percent of its Gross Domestic Product on health care, which puts it on the slightly higher end of OECD countries.”

This is not true according to the Fraser report. Six of ten Canadian provinces are on track to spend half of their revenues on health care, according to the Frazer Institute. To be specific, in 2011, health care spending consumed 50% GDP in Canada’s two largest provinces, Ontario and Quebec.

“Total federal, provincial and territorial government health spending has grown by 8.1 percent annually, while the national GDP in Canada rose by only 6.7 percent during the same period.”

 The provincial governments have raised taxes and rationed care, while increasing patient wait times.  

“Provincial drug plans have also more often refused to pay for most of the drugs that are certified as “safe and effective” by Health Canada.”

“Unsustainable rates of growth in health care spending crowd out the resources available for other purposes including education, public safety, and economic growth-enhancing tax relief,”

One has only to think about the Obama administration’s initial propaganda and the stunning reality we are facing presently.

The VA is now asking for additional funding to clear up the disaster.

The problem is entitlements are too expensive for a government.  Entitlements do not work because governments cannot legislate behavior by directives. Individuals must be responsible for their health and healthcare dollars.

The other problem is government entitlement programs generate a large bureaucracy. The bureaucracy stimulates the development of inefficiencies and corruption. The new bureaucracy practically guarantees failure of the entitlement.

The Government can help people be responsible for their health with incentive programs.

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

 

 

 

Permalink:

Another Trap From Ezekiel Emanuel and President Obama

April 9, 2014
inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP,MACE

President Obama and Ezekiel Emanuel set a trap in the Affordable Care Act (Obamacare) for all Americans including middle class and upper class wage earners. 

The administration has claimed that 7.1 million people have signed up on the exchanges as of March 31, 2014. It is now 10 days after his April 1st claim.

I doubt that we are going to have a breakdown of the enrollees. I doubt that we are going to hear anything about the Rand Corp survey showing that only 875,000 people actually signed up for insurance that did not have insurance previously.

I have not heard any demands for those numbers from the traditional media or congress. It looks like President Obama got away with another one to the American people.

Ezekiel Emanuel M.D. is one of the main architects of Obamacare.

President Obama’s promised the American people that you can keep your doctor if you like your doctor and if you like your plan you can keep your plan. President Obama knew it was a lie before Obamacare was passed. Dr. Emanuel admitted as much in his multiple television interviews

Americans are starting to see another lie beginning to unfold. President Obama promised that his health insurance exchanges are a free market solution to promote competition.  It looks like he knew that this was not true before Obamacare was passed.

If you recall both John Kerry and Barney Frank said the Affordable Care Act would not work unless we have a single party payer system. They said the bill must contain a “Public Option.” 

 

 

http://youtu.be/-522hcm3woA

President Obama said, “don’t worry. We don’t have the votes. Also, we don’t need a “Public Option.”

He should have added, “We don’t need a “Public Option” the way the bill is written.”

The truth is a “Public Option” and a single party payer will happen by default as implementation of Obamacare proceeds.

In his recently published book, “Reinventing American Health Care” Ezekiel Emanuel predicted; by 2025, “fewer than 20 percent of workers in the private sector will receive traditional employer-sponsored health insurance.”  

With all the changes President Obama has made without congressional approval, it is obvious that each change will help Obamacare get to a single party payer system more quickly.

There must be a public outcry by the public to stop its loss of freedoms especially freedom of choice of physicians and choice of care.

All the stakeholders are confused about Obamacare at this point.

Many patients have lost insurance. If President Obama did not waive the corporate mandate and the small business mandate many more would be uninsured right now.

Many who think they are insured are not insured. Many physicians do not know if they are going to get paid. Insurance companies do not know if they are going to make money.

If the mandate were in place for all those that received waivers, there would have been a gigantic public outcry that would have sunk Obamacare immediately.

The mandate’s delay decreases the number of people directly affected all at once.

If a person is not directly affected by Obamacare, the long-term implications of the law are ignored. It is difficult to have a public outcry.

Dr. Emanuel’s book is subtitled; “How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System.”

All of the above are true. The healthcare system has been driven to this level of dysfunction because one action by one stakeholder leads to an unintended consequence which in turn leads to another untended consequence and another stakeholder’s reaction.

It is clear that government must set up concise rules that level the playing field for all the stakeholders.

All President Obama has to do is to discontinue the mandate for large corporations year after year. The large employers will drop its employer sponsored healthcare insurance for its employees. Having no other choice these employees will go to the health insurance exchanges to get the cheapest insurance.

“Dr. Emanuel argues that in the next two or three years, “a few big, blue-chip companies will announce their intention to stop providing health insurance.”

I believe this was the plan before the law was passed. It forces people into the “Public Option” without there being a “Public Option” in the law.

“Dr. Emanuel says that few small businesses will join the SHOP exchanges set up for them and that most of those that offer coverage now are even more likely than big companies to drop the coverage since those who employ fewer than 50 workers face no mandate.”

Enrollment in the health insurance exchanges to non-covered employees will increase if the price is right. The price has been right for the government subsidized people. The premiums are much higher for the employees that do not qualify for government subsidy.

“Dr. Emanuel thinks is fine.”

Many employees previously covered by the employer-sponsored plans will receive government subsidies.

The healthcare insurance furnished by the health insurance industry for both private insurance plans and government plans will still be price at non-subsidy prices for the government.

The government subsidy will result cause greater government deficits and/or an additional tax increase.

Employees who previous received healthcare coverage from employers received those benefits with pre-tax dollars.

Now they are going to pay for healthcare insurance with post tax dollars.

Employers received a tax deduction for the employer sponsored healthcare plan’s insurance payments.

Both employees and employers will be losing In Dr. Emanuel and President Obama’s system.

The winner is the government by collecting more taxes. The biggest loser is the consumer earning over $50,000 a year.

The next step is for government to stop calling the subsidized private insurance healthcare coverage.

“President Obama should call it something like it “Medicare G.” Obamacare will have achieved another entitlement without calling it a “Public Option.”

Why doesn’t the Obama administration concentrate on eliminating fraud, abuse, and waste in the healthcare system?

Why doesn’t it concentrate on making the healthcare system more efficient?

Why doesn’t it promote the patient/physician relationship?

Why doesn’t it concentrate on making the healthcare system more patient friendly?

Why doesn’t it put the patients in control of their healthcare dollars and promote patient responsibility for their health and healthcare?

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

Please have a friend subscribe

 

 

 

 

 

Permalink:

Obamacare is Right On Schedule

January 26, 2014
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP, MACE

Is President Obama trying to destroy the healthcare system in America?

Yes he is!

 Actually he is right on schedule to have Obamacare implode on itself.

 I remember when he told Barney Frank and John Kerry not to worry about not including the Public Option in the Affordable Care Act.  We will get to a single party payer system.

  

http://youtu.be/f3BS4C9el98

  

http://youtu.be/-522hcm3woA

They did not understand how President Obama could make such a compromise. They thought the Public Option was the only way in the Affordable Care Act Obamacare) to get to their goal.

The goal was a single party payer system.

They did not have the votes then and they do not have the votes now.

President Obama has used a lot of trick plays to get his way in passing and implementing Obamacare. I have pointed out these trick plays along the way. They should be reviewed.

As hard as it is to believe, it seems that President Obama wants his legacy legislation Obamacare to fail.

Otherwise he would not have had Obamacare constructed with so many perverse incentives for stakeholders.

The only route to success is to align both primary and secondary stakeholders incentives. Obamacare is misaligning all of the stakeholders' incentives.

The incentives are more misaligned now than they were in the dysfunctional healthcare systems days before Obamacare.

The stated goal of Obamacare was to provide affordable healthcare insurance to all, with access to quality care to all without rationing of care.

The effect of Obamacare has been just the opposite. The healthcare insurance coverage will not be universal. It is unaffordable to many in the middle class. It is also unaffordable to many of the subsidized poor that do not qualify for Medicaid. There is limited access to care. There is an increase in the rationing of care.

President Obama claimed Obamacare’s health insurance exchanges would create a competitive free market insurance system.

The health insurance exchanges would force the healthcare insurance companies to be competitive. Healthcare insurance competition would lead to a decrease in healthcare costs.

Health insurance exchanges have not worked as advertised. President Obama’s health insurance exchanges have not resulted in a competitive free market system.

Healthcare premiums have skyrocketed.

Healthcare insurance deductibles and copays are higher.

Hospitals and doctor networks are skimping for two reasons. Doctors and hospitals are choosing not to participate in Obamacare. Healthcare insurance companies are not electing to include many well known  doctor and hospital networks.

Many excellent drugs are not on the insurers' formularies because of the cost. When newer brand name medications are on the formulary the co-pays are unaffordable to patients who need them. Patients therefore do not fill the prescription.

The healthcare insurance premiums are often higher than what consumers previously paid for their private insurance pre Obamacare even after some consumers receive government subsides.

The Obama administration will conclude soon that the free market healthcare system does not work. 

The administration will claim that only healthcare system that will work is a government single party payer system.

However, President Obama has not created a free market healthcare system with his health insurance exchanges. It is a highly regulated market.

In his over regulated marketplace he has created incentives that have further misaligned stakeholders vested interests than they were pre Obamacare.

In the Obamacare system the healthcare insurance companies are led to believe they remain the king of the healthcare industry. They believe they can continue to control healthcare costs.

The government remains totally dependent on the healthcare insurance industry. The healthcare insurance industry performs all the administrative services for government healthcare programs.

In performing these services the government has permitted the healthcare insurance industry to pad direct patient care costs with items that are insurance companies expenses and should not be counted as direct patient care.

The increased distortion is magnified when the government dictates the benefits the insurers must offer patients in the health insurance exchanges and the private insurance markets.

This causes the premium prices to skyrocket .

Consumers might not need these added government benefits. Consumers have no choice. They have to pay for unneeded benefits. These benefits are added to the cost of insurance as well as the net profit of the healthcare insurance companies.

The healthcare insurance industry is also permitted to choose their own networks of physicians and hospitals.

The insurance companies try to maximize their net profit at their lowest cost. Therefore they have kept the best hospital and physicians out of their networks. This affects the quality of care.

It must be realized that quality of care has not been adequately defined or accurately measured.

 In some cities and states consumers only have one insurance carrier. Other carriers have opted out. There is not even a pretense of competition.  This insurance carrier usually picks the hospitals and physicians that will accept the lowest reimbursement. The healthcare insurance industry is offering low fees to providers. They will take only those providers into their networks that accept those low fees.

An additional incentive distortion is the Obamacare requirement for the healthcare insurance companies to charge the same premium for anyone who signs up for Obamacare.  There is no risk weighting permitted.

The hope is all consumers will sign up and enable the industry to keep premiums down.This rule generates two negative incentives. The healthcare insurance industry must overcharge the healthy and undercharge the sick. Therefore the healthcare insurance companies try to attract the healthy and avoid the sick.

This has backfired on Obamacare. The healthy young have realized the trap. They are not signing up in the heath insurance exchanges.

Previously when they were employed the employer didn’t mind covering the young. The young help lowered the overall premium because they were young healthy.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           &#
0160;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 &#0
160;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 &#01
60;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 &#016
0;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 &#0160
;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  &
#0160;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 &#
0160;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      

There are only two options left to the government. Obamacare can bail out the insurance industry and bully the healthy and low risk young into buying healthcare insurance from the government health insurance exchanges.

Many cities, towns and stats have underfunded healthcare coverage commitments. These local commitments include retirees. These cities, towns and states can now dump these consumers into Medicare and the health insurances exchanges.

In addition, there are many people who have chronic illnesses who have been afraid to leave their jobs because they could not get healthcare insurance in the individual market in the past.

These patients can now obtain insurance in the health exchanges at the same cost as everyone else. This will further contaminate the risk pool and increase the health insurance exchange premiums.

The Obama administration figures all taxpayers will cover the added costs. Taxpayers will bail out insurance companies for the poor risk pools that are decreasing their profits.

It looks like the real purpose of Obamacare is to destroy the relationship between the employer and his employee by driving employees into the health insurance exchanges just as it has destroyed the relationship between the consumers and their physicians.

President Obama understood this as the bill was written.  

Small employers are dumping employees from their healthcare insurance plans into the individual market and the health insurance exchanges.

In 2015 group employer insurance will affect an estimated 80 million people. They will loss their insurance and be forced into the health insurance exchanges.

The insurance industry will quit providing insurance and President Obama’s plan  to have a single party payer will occur by default. 

Taxpayer will pay the difference through higher taxes. In the meanwhile nothing has been done in making healthcare premiums more affordable, access to care more available, quality of care better or preventing the rationing of care by a government body.

Consumers will not stand for government control over their healthcare decisions.

There is a better and cheaper way. It is to put the consumer in charge, not the government.

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

Please have a friend subscribe

 

 

 

 

 

Permalink:

What Is Going On With Obamacare?

November 17, 2013
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D.,FACP,MACE

President Obama’s implementation of Obamacare is right on course to destroy the healthcare system and replace it with the federal government being the single party payer.

He is out to prove that the free market system does not work.

President Obama uses the strategies of Cloward and Pivan as well as Saul Alinsky to overwhelm the healthcare system. The goal is to create chaos in the system.

At the same time he attacks his enemies personally.

Cloward and Pivan said full enrollment of those eligible for welfare (entitlement/Obamacare) “would produce bureaucratic disruption in welfare agencies and fiscal disruption in local and state governments” that would “deepen existing divisions among elements in the big-city political parties and party coalitions.

The remaining white middle class, the working-class ethnic groups and the growing minority poor would be polarized. This would further weaken democratic institutions and existing political parties.

"In order to avoid the continuation of the chaos the federal government would step in and be obligated to advance a federal solution to poverty that would override local welfare failures, local class and racial conflicts and local revenue dilemmas.”[3]

Doesn’t this sound familiar? This week President Obama presented a non-fix to fix the problem of over five million people losing their insurance coverage. His move will only accelerate the chaos in the healthcare system he has already created.

Saul Alinsky said “do not let the enemy attack with a constructive solution. The enemy must be neutralized before its solution takes hold.”

The way to neutralize the enemy is by focusing on an individual you are going to attack. “Do not attack the constructive solution or the institution.”

Freeze the criticism on the individual; personalize the individual criticism and then polarize the populous against the individual and the constructive solution that individual represents. 

This is exactly what President Obama and the Democrats did to Mitt Romney and Paul Ryan. President Obama ignores the opposition’s constructive solutions.

An unidentified source sent me this comment. I am in total agreement

“Obamacare was designed to fail so that the unwashed masses, at the mercy of a cumbersome and unworkable system would look to Obama and the Feds for salvation in the form of single-payer medical care”. 

The only "incompetent and unknowledgeable" aspect of the situation is that Obama never, ever considered that the sycophantic Mainstream Media would ever call him out on this.

President Obama has never considered the wisdom of the American people.

In reality, government interference with the free market and its bureaucratic structure, inefficiencies and ill informed advisors have been the major cause of all the chaos.

Ben Carson quote

Barney Frank and John Kerry told President Obama that the only way Obamacare would work is with a strong public option and a single party payer system. President Obama’s response was don’t worry just pass the Affordable Care Act.

The creation of chaos in the healthcare system is the first step. Obamacare has succeed is creating chaos for people having their healthcare insurance coverage cancelled.

President Obama promised them that they could keep their insurance if they like their insurance. They could also keep their doctor if they liked their doctor.

He knew that this was not true in 2010. Nevertheless he promised it 23 more times since.

The New York Times reported,” A Contrite Obama Unveils a Health Fix

President Obama announced a fix to his signature health care law that will allow existing customers to keep their insurance plans.”

President Obama was far from contrite in my view. His non-fix fix will serve to accelerate the chaos in the marketplace.

His pronouncement is unconstitutional.

The insurance industry is not inclined to do things obviously against the “law of the land”. The main reason is the insurance industry has already purged the old insurance policies from their systems.

It will be impossible to reactivate them again in four weeks.

Increasing chaos is an important step in accelerating President Obama’s endgame to collapse the entire healthcare system.

Let us look at what he said during his “contrite” press conference.

"His announced fix is aimed at remedying the mass cancellation of individually purchased insurance plans by letting insurance companies re-offer non-compliant policies."

President Obama let slip that this is one big blame-shifting exercise. He announced that no one would be able to say Obamacare caused him or her to lose insurance.  

This is a Saul Alinsky tactic. The insurance industry has no inclination or ability to change its policies this late in the game. The industry can only lose money doing this.

President Obama has thus set up the healthcare insurance industry to take the blame for the before and after crisis in the healthcare system.

The fix undermines the essential premise of Obamacare. The young healthy people need to be forced into buying insurance through the health insurance exchanges. Insurance they do not want or need.

The President’s new fix will explicitly encourage many people to stay out of the exchange. The signal is clear that no one should sign up now because the entire program is in flux.  Young people do not trust President Obama anymore.

There were a series of incredible statements and lies made at the fix press conference.  Those paying close attention could hear them.

“We fumbled the rollout on this health-care law.”

No kidding. Where is the lie about the promise you made after you knew this would happen with both the web site and the ability to keep your insurance.

“I completely get how upsetting this can be for a lot of Americans.”

Thank you Mr. President.

“It is a complex process.”

Therefore, no one in the administration is to be blamed for anything that went wrong because it is a complex process.

“I was not informed directly [How about indirectly?], that the Web site would not be working. . . .

I don’t think I’m stupid enough to go around saying this is going to be like shopping on Amazon or Travelocity, a week before the Web site opens, if I thought that it wasn’t going to work.”

This is either an intentional lie or he did not listen to people who were telling him the web site was not ready.

People were telling him for months that the web site was not ready, not secure and not tested.

It is time for President Obama take some personal responsibility.

“With respect to the pledge I made that if you like your plan you can keep it. . . that there is no doubt that the way I put that forward unequivocally ended up not being accurate.”

President Obama didn’t lie. He was just inaccurate. Hah!

“The Affordable Care Act is not going to be the reason why insurers have to cancel your plans.”

President Obama must be kidding. His administration’s regulations made the old insurance policies against the law of the land.

“The federal government does a lot of things really well. One of those things it does not do well is information technology procurement.”

Is it the federal government’s fault when President Obama awarded the non-bid contract to build the web site to Michelle Obama’s girlfriend?

“In terms of what happens on Nov. 30th or Dec. 1st, I think it’s fair to say that the improvement will be marked and noticeable.”

I thought we were promised that the web site would be fixed by November 30.

“What we are also discovering is insurance is complicated to buy.”

 Why make it more complicated with Obamacare? The process could and should be simplified.

“There is no doubt that our failure to roll out the ACA smoothly has put a burden on Democrats, whether they’re running or not.”

The burden is on the Democrats. They were fools to pass this un-executable law without reading it or understanding it.

Didn’t Nancy Pelosi tell fellow Democrats that they have to pass the bill in order to see what is in it?

Democrats were the only ones that voted yes for the bill. They are responsible for what is in it.

They all deserve to be kicked out of office in 2014.

“There have been times where I thought we were … slapped around a little bit unjustly. This one’s deserved, all right?”

Again Saul Alinsky comes up. In the last few days I have once again seen the race card come up in the traditional media and among celebrities. Alinsky said attack your enemy personally.

There is beginning to be outrage and fear among the people of all socioeconomic groups. Everyone is now getting President Obama number. No one trusts him anymore.

 Obamacare must be repealed. America must start all over again to reform the healthcare system.

A good place to start is with My Ideal Medical Savings Accounts and Tort Reform.

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

Please have a friend subscribe 

  

 

 

 

 

 .[3]

Permalink:

The Devil Is In The Details

October 30, 2013
inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust
• Leave a comment

Stanley Feld M.D., FACP,MACE

 

The devil
is in the details. Many of the Obama administrations sound bites are lies.

The Megyn
Kelly interview of Ezekial Emanual on the Kelly File October 25th
2013 is a must watch video. It is worth 9 minutes of every American’s time.

The Obama
administration rolled out one of the chief architects of Obamacare to provide
disinformation about the pending success of Obamacare.

 

  

 http://youtu.be/cwfk3vOvzvE

I have
written about Ezekial Emanuel’s disinformation campaigns. His misinformation is
based on incorrect facts leading to misguided conclusions.

This Megyn
Kelly interview is a perfect example of President Obama’s disinformation
campaign.

The
interview starts with President Obama’s promise that Obamacare will let you
save up to $2500 on insurance premiums and be able to keep your doctor and your
insurance plan if you like them.  Obamacare
will bend the cost curve. It looks like Obamacare is going to bend the cost
curve up not down.

Dr. Emanuel
says it is not President Obama’s fault that people cannot keep the same doctor or
healthcare plan. Corporations and the healthcare insurance industry changed their
insurance rules for business reasons. Obamacare did not change the rules.

Obamacare
forced the healthcare insurance industry to change its rules.

Is Dr.
Emanual in denial or is he lying?   

Dr. Emanuel
contradicts himself immediately by saying it is unethical and immoral to sell
healthcare insurance plans that do not cover bare minimum care coverage such as
maternity care, preventive care (not defined), pregnancy, pediatric dental care
and drug coverage.

It should
be obvious that everyone does not need maternity care or pediatric dental care.

Ezekial
Emanuel then continues with a rant about McDonald’s Minimed insurance coverage
plans being immoral and unethical.

This is a
point at which reality and being disingenuous gets buried in the weeds.

President
Obama has allowed corporations to avoid penalties by using “minimal essential coverage” criteria. 
Dr. Emanuel certainly knows about and understands this nuance. The Obama
administration has certainly not explained it to the public.

Dr. Emanuel
also ignores the fact the President Obama’s gave waivers to 13,000 companies permitting
them to continue to provide Minimed coverage until January 2014. It has now
been extended until January 2015.

President
Obama has modified minimal essential coverage
criteria through CMS administrative regulations bypassing congress.

In August
2013 The Kaiser Foundation News published an article called “Why Health
Law's 'Essential' Coverage Might Mean 'Bare Bones' “

 “It came as a surprise
to some that the Affordable Care Act seems to allow large employers to offer
health insurance that pays for preventive care and not much else.” 

“How can Ezekial Emanual
brag about a law he praises for expanding coverage — one that includes an
"employer mandate" to offer "minimum essential coverage" —
allow companies to offer insurance that might not even cover hospitalization?

I will
spend the rest of this blog explaining this nuance.

Dr. Emanuel
misinforms the audience throughout the interview.  

There has
been no outright ban on these skinny plans — even after the employer mandate
kicks in in 2015.

Instead,
large employers — those with 50 or more full-time employees — run the risk of
fines (penalty) only if the coverage
doesn't conform to ACA (Obamacare) rules.

 “ The
regulations published so far, however, seem to allow skinny plans with a
penalty that many employers may choose to pay because it is less costly than
offering fuller coverage.”

There are two fines in the health law for
large employers.   There is a $2,000 per
employee fine for any company that does not offer "minimum essential coverage."

Most people
do not know that the fine is only triggered when at least one employee enrolls
in the health insurance exchange and receives subsidized coverage.

If none of
the employees enroll and get subsidized coverage from the government, the
corporation is not liable for the $2,000 per employee fine.

What
is the definition of “minimum essential
coverage”? It is not the same as  "essential health benefits," that
include maternity benefits and prescription drugs. Those essential health benefits vs. minimum essential coverage are
benefits that must be included in plans sold to individuals or small employers.

Who
suffers? The small businessman, and the individual buyer in the health
insurance exchange will suffer the most.

Most
large corporations are self- insured. A self-insured company provides dollar
coverage for their employees’ illness. The company pays the bills minus the
deductibles for each employee. The corporation is assuming the risk rather than
the healthcare insurance company.

The
insurance company does the administrative services just as they do for the
federal government for Medicare, Medicaid and government worker insurance
(Medicare Part C). 

The
self-insured corporation is the sponsor for the health insurance. A
self-insured corporation passes one test necessary for “minimum essential coverage.” This avoids the $2,000 per employee
penalty (fine).

If
the company goes over the amount the company paid the previous year to cover
employees’ illnesses, the corporations pays the difference in the following
years administrative services fee to the healthcare insurance carrier.  

 The regulations are
obscure, defining minimum essential coverage largely in terms of what it is not.
Therein lies the loophole.

“As a result, many
experts believe large employers can shield themselves from the $2,000 penalty
by offering a plan that covers the health law's required preventive care, but
still leaves workers vulnerable to thousands in bills if they're hospitalized.”

The young people working for
minimum wage at McDonald don’t want to spend their money on full healthcare
insurance. They believe they will not get sick. They cannot to buy insurance
through the health insurance exchange.

They do not want to go on Medicaid.
Many physicians view Medicaid as unacceptable insurance.

Government reimbursement is for
Medicaid is extremely low. In some cases it is lower than the physician’s
overhead to provide the care.

Many physicians do not take
Medicaid patients. This results in long waits for appointments, a lack of
access to timely care and in many cases rationing of care.

Medicaid is free to the
needy. Nonetheless the government must pay the insurance industry for their
administrative services.

According
to Alden Bianchi, a Boston-based benefits and compensation lawyer. “

“Skinny coverage flunks the
test, based on regulations that
measure minimum value against "benchmark plans" in each state.”

The trick
is the employer penalty is only $3,000 for each worker enrolling in subsidized
exchange coverage. The fine is not imposed on the employer for all workers.  

The fine
will be much less than the fine for not offering a minimum essential coverage
plan of $2,000 per employee if one employee buys subsidized coverage through
the health insurance exchange.

Bianchi,
who represents large employers said in an industry
brief.

 “The people who wrote the law intended to give
companies a bare-bones option.”

"The ability to
offer such plans is a result of conscious policy decisions by Congress, as
implemented by the regulators."

I
think he is wrong.

I
think the Cato Institute’s Michael Cannon is right.

Cannon
suspects the administration "had no idea what they were doing," as he wrote
on the libertarian think tank's blog.

I
think President Obama’s goal is to drive everyone into the health insurance
exchanges and use the “public option.” 

The
health insurance exchanges’ non-subsidized options are in some cases double the
previous price for healthcare insurance despite the claims of the Obama
administration.

Obamacare
is now backfiring on the President and his administration.

I
apologize for not exposing the misinformation of each point Ezekial Emanual was
sent out by the Obama administration to make on the Kelly File.

It
is all disinformation and spin.

I felt
it was important to explain the confusion created about the $2,000 and $3,000
dollar penalties attached to the mandates.

The
corporate self-insured have figured out a way to get around the mandate and
penalty. They also get around the mandate by hiring only part-time new
employees who work less than 30 hours per week.

President
Obama has bragged that new job creation is slowly improving. However, 77% of
the new job creation is for part time employment.

If
one puts it all together it spells hard times for economic growth and
Obamacare.

I
implore you to watch the video and hear disinformation one of President Obama’s
architects is peddling.

 The issue is becoming clear. Can the American
people trust President Obama to tell them the real story?

My
impression is that it is doubtful.

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

Please have a friend subscribe

 

 

 

Permalink:

The Method Of Operation

October 27, 2013
inDisinformation and the healthcare system, Medicine: Healthcare System
• Leave a comment

Stanley Feld M.D.,FACP,MACE

It’s clear. President Obama
has used the same techniques to neutralize the scandals and mishaps during his
administration.

In has been the same for Benghazi,
NSA, IRS, and Fast and Furious scandals.

President Obama makes his
characteristic statement, “This is unacceptable
and we will get to the bottom of this.”

After this statement there is
never any follow-up. What has been done? Has President Obama gotten to the
bottom of it?

The public never learns who
was responsible for the debacle. No one ever gets fired and the traditional
media carries on. The public soon forgets about a non-resolved scandal.   

President Obama always leads the
public to believe he had nothing to do with the scandals or the decision-making
leading to the scandals.

He is the President. He should
know. If congress investigates the scandal it gets stonewalled by the administration. The investigationg committee then is accused
of muckraking.

Somehow the traditional media
buys this story and sells it to the public. It is the journalist’s obligation to
dig into a scandal and find out the real story. It is not done.

Nothing this administration
does has been transparent. The traditional media ignores the scandals and so
does the public.

The devil is always in the
details.  

The real story is the attack on individual
freedoms and choices. They are being impinged upon by the bureaucratic regulations of
big government. The traditional media should make this clear.

America does have a freedom
of information act and constitutional rights that have to be protected and not
ignored.

All the participants in the
various scandals finger point to others being responsible for the actions that
would not be approved by the people.

No one ever questions whether President Obama is
responsible for the scandals.  

The same method of operation
is being put in place to explain the colossal disaster of www.healthcare.gov’s rollout.

The Obamacare web site has
many problems. It is not a simple fix as the President and his administration
has declared it to be.

President Obama claims he did
not know anything about the problems before the launch. He has promised to get
to the bottom of this.

He is finger pointing to
everyone except himself and his administration. 

If the Obama administration
did not know about the impending failure it is either stupid, or irresponsible
or both.

President Obama is not stupid. He is cunning.

These are President Obama’s remarks in the
Rose Garden of the White House last week.

 “Shortly
before the president’s appearance, White House officials let it be known that the “president will directly address the technical
problems with HealthCare.gov – troubles he and his team find unacceptable.” But
in that Rose Garden appearance, the president did not explain what the
technical problems with HealthCare.gov were, though he did acknowledge their existence and stated “there is no excuse” for them.

He then promised he would recruit the best
information technology talent in the country to come to the rescue and fix the
problems.

President Obama happened to hire one of Michelle
Obama classmates at Princeton in a no-bid contract to build the web site. The
administration paid $634 million taxpayer dollars to Michelle Obama’s friend’s
company and got a disaster.

"Toni
Townes-Whitley, Princeton class of ’85, is senior vice president
at CGI Federal, which earned the no-bid contract to
build the $678 million Obamacare enrollment website at Healthcare.gov. CGI
Federal is the U.S. arm of a Canadian company.

"Townes-Whitley
and her Princeton classmate Michelle Obama are both members of the Association of Black Princeton Alumni."

The Obama administration also awarded CGI
another no-bid contract for 2 billion dollars to clean up from the Sandy
Hurricane.

 Mr.
Nelson chair
of Housing Trust Fund Corporation presented that the State
received a $1.7 billion allocation in CDBG Disaster Recovery aid from HUD to
aid impacted businesses and residences.



 The
corporation requires immediate access to consultant services to assist in policy and
procedure development, training, surge capacity, and call center assistance,
and stated that CGI Federal Inc. could provide such services.

The
resolution was passed and scheduled to “take effect immediately.”

Nearly a
year after the devastating storm, a majority of the 24,000 families that have
requested monetary assistance have yet to receive a penny from the federal aid
package.”

Does anyone think something funny going on at
taxpayers’ expense?

Shouldn’t President Obama have hired the best
minds in the country to build the web site to begin with?

Do you
remember this famous statement?


 
 

http://nyti.ms/18ThbbJ

Ezra Pound
is a big fan of President Obama and Obamacare. What happened? Did he change his
mind?

  

http://www.youtube.com/watch?v=AQxYY2dyChY&feature=player_detailpage

 Uwe Reinhardt is an economics professor
Princeton. He gave
President Obama an F on his mid-term grade on Obamacare.

 “With proper management and more energetic work earlier
on, and untainted by the political desiderata reported to have affected the architecture of
HealthCare.gov, that Web site’s management team should have been able to
achieve the same success. It did not, hence the midterm grade F.”


 

A key discussion being avoided in the
mainstream media is whether President knew about the impending disaster. I suspect
he did.

It was one of the reasons he gave the group
healthcare insurance holders a one-year waiver. Parenthetically, he is not
seeking the advice or consent of the congress. This is probably
unconstitutional.

The group healthcare insurance market represents
the largest percentage of people insured. The individual insurance market represents
a relatively small percentage of the total insured population. The number of
people affected cannot make a big enough stink to be noticed by the traditional
media.

If the group insurance market were included in
the rollout, the community uproar would be too great for the Obama administration
to ignore or pivot from.

The public is already hearing the pivot from
President Obama and Kathleen Sibelius. They claim the past is the past. We must
ignore the past and go forward to fix the problem.

It sounds like the same story Hillary Clinton
told congress about Benghazi when she scolded a congressman during her Benghazi
testimony about Ambassador Stevens death. “He
is dead. Let us go on and deal with the problem.”

This method of operation is going to back fire
on President Obama for two reasons.

1. Americans are finally recognizing the Obama
administration’s methods of operation. It is to deflect with half-truths,
deceive and pivot. The public is getting angry.

2. There are an increasing number of people
who have lost their job, their healthcare insurance and the doctors. In the last
week 650,000 people lost healthcare insurance coverage they liked.

This is because of the exclusive regulatory
control the Democrats gave Kathleen Sibelius in passing Obamacare.

Not one single Republican voted for the
Affordable Care Act (Obamacare). 

The preparations for the implementation of
Obamacare for the group healthcare insurance market through health insurance
exchanges and www.healthcare.gov have unleashed gigantic outcries from both the
young and the middle-aged middle class.

The outrage is not over yet.

President Obama said he did not anticipate
that so many corporations would reduce insuring so many of their workers.

President Obama has discovered an obviously
scapegoat.

The “glitch” is not
Obamacare fault. It is the big bad corporations that are trying to make a
profit.

Wait a minute! Isn’t that the American way?
You build a business to try to make a profit within the rules.

The 40,000 new Kathleen Sibelius healthcare
regulations are preventing them from making a profit while providing healthcare
insurance. They want to provide affordable healthcare coverage.

The only way corporations can make a profit is
by dropping healthcare insurance of their employees.

Maybe driving people into the health insurance
exchange was President Obama’s goal in the first place. Remember Barney Frank
and John Kerry’s dismay about passing a bill without a public option. President
Obama response was don’t worry.

Well, we have an expensive public option that
doesn’t work. Who is going to pay for it?

 The
middle class is going to pay for it with increased healthcare insurance
payments and increased taxes. 

 The
cost of insurance on the health insurance exchange is high unless one qualifies
for a government subsidy. I have previously explained the dynamics involved in the
cost of healthcare insurance when a person receives a government subsidy.

Young healthy people will not buy insurance.
With the present computer programs the government will not know who qualifies
for a subsidy or be able to identify people will should be penalized.

A key to a business’ survival is to adjust to
adverse circumstance as long as the business has the freedom to adjust.

Watch out for the freedom to adjust to
anything.

Watch out seniors. Medicare is next.

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

Please have a friend subscribe

Permalink:

Speaking Of Chaos And Uncertainty

October 6, 2013
inDisinformation and the healthcare system, Medicine: Healthcare System
• Leave a comment

Stanley Feld M.D., FACP, MACE

I ended my last blog with,

“President Obama’s goal is to create more chaos
and dysfunction in the healthcare system. “


“Only then can the government really step in and
say let me help you.”


It is the only
reason President Obama told the then Senator Kerry and Congressman Frank not to
worry if the final bill does not have a public option.

Kerry and Frank said
Obamacare would not work without a public option. The only thing that would
work is a single party payer system.

  

 

 

With limited benefit
plan, employers would avoid the broader $2,000 per-worker penalty.

It is not
clear is whether employers could face a $3,000 penalty per individual for any
employee who opts out of the limited benefit plan.

Four
problems are being discovered with the health insurance exchanges.

1.
If the employee is a low wage employee that refused employer provided insurance
he is not eligible for a government subsidy.

2.
If the federal government runs the health insurance exchange, the federal
government by law is not permitted to provide a subsidy. Only state run
healthcare insurance plans can provide subsidies.

Over
50% of the states have refused to run health insurance plans. Therefore people
who need subsidies are not eligible in over 50% of the states.

3.
The law calls for tax credits and not subsidies. All of a sudden the words “tax
credits” have been dropped in discussion. Only taxpayers who earn over $38,000
per year pay taxes. The only way a person can utilize a tax credit is by
deducting the tax credit from taxable income.

The
government has gotten around this problem by giving the healthcare insurance companies a tax credit in advance and calling it a subsidy for qualified
persons.

Those
workers who opt out of the employer provider plan for a health insurance
exchange plan would not be eligible for a government subsidy. 

A full-time worker earning $9 an hour would
have to pay as much as $70 a month for a mid level exchange plan from a health
insurance exchange, even with the subsidies, according to the Kaiser Foundation.

At $12 an
hour, the workers' share of the premium would rise to as much as $140 a month.

 A $12 an hour worker cannot afford to pay $1680
a year for healthcare insurance.

Mid
level coverage is limited coverage. A patient might need a higher-level plan that costs $200
a month or $2400 per year. This plan is out of reach for most patients making $40,000/year.

 "There are going to be many people who will
be ill and need a more robust plan,” a health benefit
advisor proclaimed.

Currently, only one-quarter of workers eligible
for the mini-med plan take it. Ms. Newman said, "We
really feel like the people who are not taking it now will not take it
then."

There
is a huge glitch in the health insurance exchanges’ individual healthcare
market. This glitch will make the health insurance exchanges more costly and
less attractive to all stakeholders. It will decrease the number of people
insured and increase the federal deficit.

The
majority of the individual market is comprised of low wage earners with
irregular work histories.

These people may be
self-employed or seasonal workers with surges of income. They could be
part-time workers with several part time jobs. 

Obamacare does not permit cancellation of the health insurance exchange
policy because it will mean that people will be in violation of the federal mandate
if they do not have insurance. 

The Obamacare bureaucrats realize that people receiving subsidies might
have a hard time paying the premiums even if they receive a subsidy.

These people live from month to month. Some have surges in income. Some
collect commissions one month and nothing the next month. Most have old cars.
They might suddenly need new brakes or new tires. Some might get the flu and have
to stay home without pay for a week. There are many reasons low wage earners
suddenly have a hard time paying healthcare premiums even if they are subsidized.

Many do not have bank accounts or credit cards. There is no such thing
as auto pay in their world.

The Obamacare bureaucrats writing the health insurance exchange
regulations are people with nice bureaucratic jobs with steady paychecks. They
have no idea how difficult it is to make ends meet for these people each month.

The healthcare insurance industry
does not care about these problems. It may provide for a grace period of a week or two. If a healthcare
policyholder fails to pay their healthcare policy premium the policy is
cancelled in the real world.

In the bureaucratic world of Obamacare the healthcare insurer cannot
cancel the insurance in the usual way.

HHS has created through multiple regulations a whole new and very
restrictive method of discontinuing healthcare policies that must be followed
to a “T” by the healthcare insurance industry.

This method will lead to even more dysfunction in the healthcare system.

HSS has instituted a 90-day grace period for paying premiums only for those
receiving federal subsidies from the health insurance exchanges.  

At the end of the 90-day grace period the policyholders must pay the
entire three months due. If they could not pay the premium monthly how are
they going to pay the three month fee?

Aetna was not so dumb in dropping out of the health insurance exchange
system after all.

During the three-month grace period if a policyholder get sick and
needs care they will be entitled to care.

Who will bear the financial responsibility for the care? Not the
patient.

HHS has decided to split the financial responsibility between the
insurance companies and the providers. The insurance company will cover the
first month and the hospitals and physicians will cover the next two months.

After three months the insurance company can cancel the insurance.  However people can re-enroll again during the
next signup period without penalty.

If one is clever enough a patient can receive 12 months of care and
coverage for nine months of premiums without penalty.  

“Along with paying for services during the first month of
the delinquency, the insurer must:

1) notify HHS of the non-payment;

2) notify
providers of the possibility of denied claims during the second and third
months;

3) notify the insured that he/she is delinquent;

4) continue to collect
the advanced tax credit on behalf of the policyholder;

5) return the tax credit
for the second and third month to the Treasury;

6) issue a termination notice
to the insured at the end of the grace period.”

This procedure is a
very large administrative burden and potential financial loss because of the
federal government's decreases in funding. Most providers and insurance companies will quit
participating in the health insurance exchange program.

Rather than increasing affordability and access to care it will decrease
access to care and affordability of care. It will create a more dysfunctional
healthcare system.

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

Please have a friend subscribe

 

 

 

Permalink:

Significance Of IBM Retiree Decision

September 18, 2013
inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System
• Leave a comment

Stanley
Feld M.D.,FACP,MACE

 IBM’s dropping of retirees’ healthcare plans will be the cause of a
continuing avalanche of companies dropping healthcare insurance for its non-retired
employees.  These companies are doing it
in two ways. They are decreasing work hours from 40 to 30 hours per week. They
are hiring part time employees. The are also outsourcing work to avoid paying
an “Obamacare penalty.”

Companies are contracting with “Private Health Exchanges” to service the
rest of their employees. The companies provide a stipend for healthcare
coverage and send employees to the “Private Health Exchange” to buy coverage.
If employees cannot afford the coverage, employees would be able to buy
insurance from the government health insurance exchange.

 

In February 2011 I wrote about the McKinsey study that estimated the
percent of employers that would stop providing healthcare insurance for their
employees in 2014.

None of the Obamacare fans wanted to believe this study.

Senator John Kerry and Representative Barney Frank said a public option was
essential in order for Obamacare to work.

President Obama told them not to worry. Obamacare will work without a
public option.

I called Obamacare’s health insurance exchanges essentially Obamacare’s Public
Option. Consumers will be forced into the health insurance exchanges in 2014.

The Congressional Budget Office provides congress estimates of the effects
of legislation. The CBO is not required to think.

 The CBO crunches numbers provided
to it by the administration. The administration has been less than candid with
everyone including the American public

“The
Congressional Budget Office estimated that only 7 percent of employees
currently covered by employer-sponsored insurance (ESI) will have to switch to
government subsidized-exchange policies (Public Option) in 2014.”

The McKinsey study concluded; Feb 2011

 

  • Overall, 30 percent of employers will definitely
    or probably stop offering ESI in the years after 2014.
  • Many
    Human Resources officers and CFOs do not know the implications of Obama care.
  • Among employers having a high understanding of
    President Obama’s Healthcare Reform Act more than 50% will stop offering
    employee healthcare benefit and more than 60% will make some kind of change.
  • At least 30 percent of employers feel they would
    gain economically from dropping coverage and paying the penalty. They would
    even gain if they increase their employees’ salary or other benefits.
  •  The
    insurance coverage is in excess of $15,000 per year per employee. The
    government penalty is $2,000 per employee.
  • The
    difference in cost will force employers to drop ESI and force employees into
    the Public Option.  This was President Obama’s plan all along.
  • The survey also showed that more than 85 percent
    of employees would remain at their jobs even if their employer stopped offering
    ESI.
  • Sixty (60) percent of employees would expect an
    increase in compensation from their employers    . 
  • Who
    are these rules in favor of? They are not in favor of the employee.”

 

“Health care reform fundamentally alters the
social contract inherent in employer-sponsored medical benefits and how
employees value health insurance as a form of compensation.”

 “Obamacare” guarantees the right to health
insurance regardless of an individual’s medical status or ability to pay. In
doing so, it minimizes the moral obligation employers may feel to cover the
sickest employees, who would otherwise be denied coverage in today’s individual
health insurance market.

The logical result is healthcare insurance
premiums would increase for the individual and benefits would decrease to keep
the premium cost down.

In 2014, people who are not offered affordable
health insurance coverage by their employers will receive income-indexed
premium and out-of-pocket cost-sharing subsidies from the government through public
health insurance exchanges.

The highest subsidies will be offered to the
lowest-income workers. It enables these low paid workers to obtain coverage
they could not afford in today’s individual healthcare insurance market.

It will force people into the dysfunctional
individual insurance market under public supervision of public health insurance
exchange.

The government will pay the subsidies for the resulting
increased premiums that will result from expanded coverage in this “Public
Option.” The government would then pass the increased premium cost on to the
taxpayer on a means tested basis and with higher taxes.

This is what Don Berwick and President Obama meant by
redistributing wealth. 

The next step is government’s complete control of
a single party healthcare system. 

Employers will no longer be able to offer better
healthcare insurance benefits to their highly compensated executives either.
Companies will be forced to discontinue employee healthcare coverage. We see
that happening in the Fall of 2013.

The penalty is set low to further encourage
companies to discontinue coverage. President Obama’s goal is to have most people
in the “Public Option.”


This will lead to government control of the
healthcare system and all the inefficiencies that will result. These
inefficiencies will increase the cost of care and result in a decrease in
access to care as well as rationing of care.

 State insurance exchanges will be paid for
by the states with a federal subsidy. These exchanges will offer individual and
family policies of set benefit levels (bronze, silver, gold, and platinum) from
a variety of insurance companies.

The effect on the federal deficit will be much
greater than the original CBO’s estimated. The number of people who will loss
their company insurance was estimated by the CBO at 10 million, or about 7
percent of employees, currently covered by ESI.

Seventy (70) million people was McKinsey’s estimate in 2011.

“ A July study by Craig Garthwaite of Northwestern
University’s Kellogg School of Management predicts as many as 940,000. That
number is an estimate of how many adults without children are working because
of what the researchers call “employment lock.”

This
increased number of participants will add to the federal deficit. The increased
federal deficit will result in higher taxes for everyone, including the middle
class.

“The taxpayers are going to get
hammered,” says Douglas Holtz-Eakin, a former Congressional Budget Office
director who is now president of American Action Forum, a Washington-based
advocacy group that opposes the health law. “It’s going to be extraordinarily
expensive.”

President Obama wins his ideological goal.
Consumers will have less control over their own healthcare decisions and
choices. 

The healthcare insurance industry will gain more
control over pricing. This will increase profits because they will administer
government health insurance exchange services. President Obama will continue to
outsource the administrative services to the healthcare insurance industry.

 The losers will be consumers and
physicians.

The impending results are all totally
predictable. Obamacare fans refuse to listen.

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

Please have a friend subscribe