Stanley Feld M.D., FACP, MACE Menu

Results found: 36

Permalink:

Election Time! Obamacare Is Not Working

Stanley Feld M.D.,FACP,MACE

Despite the proclamations of President Obama and Paul Krugman Obamacare is not working.

However, if you tell a lie enough times it becomes the truth. This is especially true if you have enough traditional media coverage of the lie.

The reality is consumers cannot keep their own doctor, access to care is decreasing, and you cannot keep your healthcare insurance plan if you liked your  plan because of Obamacare’s imposed rules and regulations.

Healthcare insurance premiums are increasing despite President Obama’s proclamation that healthcare insurance premiums are affordable. Consumers’ out of pocket costs are increasing despite President Obama’s claims.

The narrow and ultra-narrow new networks on the federal health insurance exchanges are decreasing consumer choice of physicians. The access to quality healthcare at a reasonable price is vanishing.

Consumers are feeling these negative affects on their quality of life already. They will not forget it at the polls on Tuesday despite the efforts of the Democrats to keep Obamacare a non-issue.

President Obama wishing that Obamacare is working does not make it so. He cannot simply decree lower prices. He cannot simply say I want better quality. Neither happens out of thin air. Obamacare’s rules and regulations are disastrous.

The reality is government cannot do a thing about the negative affects Obamacare is having on consumers except repeal it.

Neither federal nor state government can tweak Obamacare and fix the negative affects. These affects are here already. Federal and state government cannot hide the avalanche of negative affects that are coming.

Consumers don’t believe President Obama or the government’s spin anymore.   

The mid-term elections are two days away and the progressives Democrats are trying to make Obamacare better with propositions on the mid-term ballot.

They are trying to improve Obamacare in their states and disguise its goal of increasing government control of healthcare. Increasing the rules and regulations in order to control the healthcare system does not work.  

In the process, progressive in various states are contradicting each other. The bottom line is none of the propositions will work.

Progressives have become prisoners of Obamacare as well as prisoners of their own thinking.

California liberals (progressives) are always the leaders in progressive propositions that make no sense. On Tuesday November 4th California’s propositions 45 and 46 stand out.

Prop. 45 would give the healthcare insurance commissioner the power to reject rates he deems “unreasonable,” with no reference to actuarial or solvency standards.

Anthem Blue Cross is raising small healthcare insurance group premiums 9.8% in 2015.  This is happening even though Obamacare guarantees the healthcare insurance industry an adequate profit through the federal government’s reinsurance plan for healthcare insurance carriers.

 Who is paying for this guarantee and this rate increase? Consumers are through higher taxes. The California commissioner is going to try to reduce the increase to 2.1% through added power given to him by Prop. 45. 

What is the commissioner going to do about it?  Nothing! If he does not permit the raise the exchange will not have healthcare insurance companies providing administrative services for its healthcare coverage. The government cannot provide administrative services.  Any attempt at price control has not worked in the past and will not work in the future.

The healthcare insurance industry’s alternative is to have narrower networks and less coverage. The consumer will have to cover the cost of better coverage.

Proposition 45 also gives trial lawyers the right to challenge rates in court. It is a good deal for trial lawyers on both sides of the price control issue. It is a terrible   deal for taxpayers on both sides of the issue. It will increase the cost of healthcare resulting in higher taxes.

A logical proposition would be to develop a competitive system for consumers and insurance companies so that insurance companies fight for consumers’ business rather than impose the bureaucratic practice of selective contracting. The bureaucracy provides a list of demands and then picks a few compliant winners. The losers are excluded from the federally subsidized exchange.

Government would dictate what products consumers are allowed to buy and use its clairvoyance to decide what businesses can charge.”

Why wouldn’t you let consumers decide what they want rather than bureaucrats telling consumers what healthcare policy they can have?

Proposition 46 is another disastrous proposition.

In 1975 the then Governor Jerry Brown limited medical malpractice awards to $250,000 for non-economic injury. It decreased the medical malpractice business for lawyers in California.  Lawyers would not take cases that did not make them enough money.

Proposition 46 is proposing to lift the $250,000 restrictions for non-economic damages on medical malpractice awards to $1.1 million dollars. The affect will be more medical malpractice lawsuits because lawyers once again can make some serious money from frivolous malpractice suits with minimal effort.

Physicians’ malpractice premiums will rise once again, and once again doctors will be forced to raise their fees or leave the state. The availability of physicians will decrease. Consumers will suffer again suffer from a proposition that was not thought out.

It does not make sense. I hope the citizens of California are paying attention to the implications of these two propositions.

The common denominator is the propositions are great for trial lawyers and terrible for consumers. The propositions will not be effective in making Obamacare better for consumers.

The goal should be to lower the cost of healthcare for consumers not increase it.  

South Dakota has a proposition (Prop IM-17) which, rather than limiting networks expands networks.

Prop IM-17 is trying to regulate back into existence the access to medical providers that ObamaCare destroyed.

Patients expecting to keep the doctor they liked continue to discover that the narrow networks offered on the exchanges resemble the standard of care in Medicaid.

“Measure-17 would force insurers to accept “any willing provider.” All doctors and hospitals licensed by the state that met certain de minimis conditions must be covered by all plans, regardless of cost or quality.

“IM-17’s cure is worse than the Obamacare disease.”

Healthcare prices will increase. Healthcare insurance premiums will increase. The conflicts among providers will intensify. Consumers’ access to care will be diminished.

The California and South Dakota referenda reflect liberal health-care confusion.”

America is supposed to be a government by the people for the people. The government should not be a government dictating what can have.

Progressives are prisoners of their ideology.

I hope the American people understand this on November 4,2014 and vote to stop progressives“stinkin thinkin.”  

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

Please have a friend subscribe

 

 

Permalink:

Caving In

Stanley Feld M.D.,FACP,MACE

As time goes by the implementation of Obamacare (ACA) becomes more bizarre.

The start of the 2015 enrollment period in Obamacare’s health insurance exchange program was delayed from October 1, 2014 until November 15, 2014.

The reason for the delay is obvious. The Obama administration fears another disastrous enrollment rollout just before the midterm elections.

President Obama is protectingDemocratic candidates who voted for Obamacare from the political fallout.

The enrollment period is supposed to end December 31, 2014 in order for insurance coverage to start January 1, 2015.

This enrollment period is very short. The Thanksgiving and Christmas holidays will make it even shorter.

President Obama will probably delay the end of the enrollment period once again by executive order.

The Obama administration must also deal with people who lied about their enrollment qualification. Hundreds of thousands could not show proof of income or eligibility for government subsidies for their insurance for 2014.

The government has not published any data about the number of people who have been disqualified for providing false information.

These people owe the government money. They cannot afford to pay the amount owed. Is the government going to let these underpayments disappear?

The Obama administration also announced that anyone who was enrolled last year does not have to do anything. They will be enrolled automatically in 2015.

At what price?  Premiums will be higher than last year. Enrollees might not be able to pay the higher or unsubsidized premiums.

Insurance premiums in the health insurance exchanges are going to increase at least 10% in 2015 despite the Obama administrations guarantee, through its reinsurance plan, that it will cover any of the healthcare insurance industry’s claimed losses.

Problems were compounded this week by a CMS announcement that they will not publish the health insurance exchange premiums until November 15,2014.

Medicare premiums are also going to increase dramatically in 2015. Many seniors will not be able to afford to pay them. Senior might not notice the increase until they receive their first social security check.

On January 1, 2015 Obamacare’s “employer shared responsibility reporting requirement”  goes into effect.

“Starting in 2015, applicable large employers will need to identify whether eligible employees have been offered employer-sponsored health care coverage and whether that coverage meets the standard for minimum essential coverage, among other requirements.

Employers will also be required to track employee eligibility for health care coverage, including number of hours worked, etc.”

There is no way employers can track this information manually anymore. They will have to hire a benefits manager to keep track of something that is so fluid as to will be impossible to keep track of.

Employers’ overhead will rise. The large employers will decide it is cheaper to pay the Obamacare’s penalty and force their employees to buy insurance on the federal health insurance exchanges.

How can all these people buy insurance wisely between November 15, 2014 and December 31, 2014 to be insured in 2015.

This will create havoc in the healthcare system.

Creating havoc is the goal of President Obama’s plan to transform America. It follows Saul Alinsky’s game plan precisely. It will lead to population fear. Population fear will lead to a government controlled single payer healthcare system.

The public is presently experiencing a great deal of fear with the potential for an Ebola epidemic. The resulting hospitalizations and deaths that might occur from an epidemic will intensify this fear.

This CDC and the Obama administration keep giving us illogical reason for why they refuse to stop flights from West Africa to the U.S.  

The airport screenings’ protocols are illogical. The training protocols have been unsuccessful.

Havoc will intensify if the United States experiences an influenza outbreak this winter. People will not know whether they have the flu or Ebola. People will overrun the nation’s hospital ERs.

Public and private health insurance policies might not cover the care needed to diagnose and treat these patients.

People will be put in isolation in the hospitals. The patient’s contacts will have to be quarantined. The economy will come to a standstill.

The only option remaining is for the people to beg the government to take over the healthcare system.

I do not know if President Obama and his administration are brilliant or incompetent.

I suspect he is brilliant.

 In either case his goal of socializing medicine will be achieved

Are President Obama and his administration competent enough to control and run the healthcare system?

What is your guess?

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

Please have a friend subscribe

 

 

Permalink:

Government Is The Problem Not The Solution

Stanley Feld M.D.,FACP,MACE

 

The government has been attempting to take over the healthcare system since 1935 at the time of the Roosevelt administration.

The government took over the healthcare system 30 years later during the Lyndon Johnson administration. LBJ passed Medicare and Medicaid. It turned out that financial projections were faulty and the business model was defective.

Medicare and Medicaid provided medical care for the elderly and the poor at an affordable price at that time. Everyone loved it. At the time it was also affordable for the government.

I do not think anyone contemplated the healthcare inflation that occurred as a result of the government’s business model.

Inflationary pressure increased rapidly.

Finally, President Reagan said the government could not afford the increasing prices any more. He said enough is enough. He decreased provider (hospital, doctors, pharmaceutical company, and insurance company) reimbursement for Medicare and Medicaid services.

The reduction in reimbursement for services resulted in price shifting increases in reimbursement in the private sector.

Both the private sector and the public sector experienced increased inflationary pressure as a result of this maneuver.

It was clear by 1984 that Medicare and Medicaid were unsustainable long term.  

America did not have a free market healthcare system before Obamacare. It was a hybrid system.

The country already had 90 million Americans in a single-payer system. Ninety million Americans get coverage from Medicare, Medicaid, and the Veterans Health Administration systems.

The problem is these government controlled single-payer systems did not work efficiently. They were financially unsustainable.

Obamacare expands the single party payer system to eventually cover all Americans. Obamacare simply adds on to an existing unsustainable healthcare.   Raising taxes is not going to make it more sustainable.

The expanded bureaucracy will only make the system more inefficient and more prone to fraud and abuse.

President Obama is already modifying the law without congressional approval. He is trying to hide elements of this unsustainability from the American public.

The federal government’s Obamacare enrollment system www.Healthcare.gov alone has already cost taxpayers about $2.1 billion dollars according to a Bloomberg government analysis of contracts related to the project.”

The website is still not working perfectly at the backend after spending $2.1 billion dollars.

Americans will experience more of the www.healthcare.gov dysfunction after the mid term elections.  

Navigator companies hired to help people enroll cost $48 a session. These companies are increasing their prices for the 2015 enrollees.

 

These same companies have had their fraud and abuse exposed. Nevertheless they have been rehired at the increased price by the Obama administration.

President Obama announced to Democrats last spring that Obamacare would not be an issue at the time of the midterms.

This week the administration also announced that the cost of healthcare insurance through the health insurance exchanges is decreasing next year.

It was also announced that there is an increase in the choice of insurance carriers in most states resulting in competitive premium pricing and lower premiums.

President Obama announced that Obamacare is working. He said Obamacare is a non issue in the 2014 mid term elections.

Nothing could be further from the truth.

If our elected officials cannot see President Obama’s trick play how can the public expect to understand the deception?

This is another of the manipulations of Obamacare designed to hide its impending failure from the public.  

The Obama administration set up a reinsurance company funded by taxpayers that eliminates any insurance risk the healthcare insurance companies might incur in insuring enrollees.

Healthcare insurance companies are signing up and competing for market share to gain profit from this no risk insurance. They can easily afford to lower the premiums because the government will cover their supposed loses.

None of this has anything to do with patient care or the quality of patient care.

It has little to do with providing low cost insurance. The cost of insurance keeps increasing. The government pays the difference between the cost of insurance and what patients who receive subsidies pay for their premiums.

Obamacare misses the main problems in the healthcare system. Obamacare creates more dysfunction in the healthcare system.

 Obamacare will result in greater unfunded future liabilities.

White House spin pretends otherwise, but the unfunded liabilities may exceed $100 trillion.”

 The Congressional Budget Office said,

 “Looking indefinitely into the future, the unfunded liability, with optimistic assumptions, is $43 trillion—almost three times the size of today's economy.”

Based on more plausible assumptions, such as those reflected in the "alternative" scenario for Medicare produced by the Congressional Budget Office in June 2012, the long-term shortfall is more than $100 trillion.

It is the responsibility of our elected officials control America’s expenditures.

Unfortunately, for American’s, this is not how a government controlled system works.

Voters must decide how long they are going to tolerate this abuse of power.

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



Please have a friend subscribe

 

 

http://online.wsj.com/news/articles/SB10001424127887323393804578555461959256572

 

Permalink:

Obamacare: Its Failure Increases

Stanley Feld M.D.,FACP,MACE

 

C-Span has provided the public with important lessons on how our government is really run by televising various congressional committee meetings.

The traditional mainstream media provides us with little of the important information that comes out of these committee meetings.

C-Span’s coverage has revealed how inefficient, political and bureaucratic our government is.

Americans should elect representatives to be our spokesmen. Our representatives should do what is right for us and not for the vested interests of various special interest groups.

The latest information about Obamacare has not been reported in the media but came out in committee.

The Obama administration had announced publicly to a subcommittee in April 2014 that its "risk corridor" plan would be revenue neutral.

In English, it means that there would be no extra taxpayer dollars available to cover the losses of the healthcare insurance companies. Those healthcare insurance companies insure enrollees through the government’s healthcare insurance exchanges.

Chet Burrell, head of Maryland insurer CareFirst told Valarie Jarrett this plan would result in premium increases of 20% or more later this year as Obamacare policies come up for renewal. 

He warned it would be "an unwelcome surprise" to the Democratic Party and Democrats running for reelection in November.

The Obama administration was very concerned about a 20% premium increase for enrollees in Obamacare. After a while, Ms. Jarrett assured Mr. Burrell the insurance industry would get 80% of the subsidy (bailout) they sought.

The 80% was granted by executive order without congressional approval. A few weeks later the healthcare insurance industry bailout was changed to almost 100% of the request with little notice from anyone.

The government guarantee affects all of the enrollees in Obamacare. It also permits the increase in private insurance plans.

There are 50 million people on Medicare, 65 million people on Medicaid, 9 million in the VA system, 7.3 million in Obamacare and an additional 149 million for employer-provided healthcare insurance.

It turns out that Obamacare is just another government subsidy program with the government throwing more money at the health care insurance industry while the healthcare insurance industry raises the premiums.

President Obama, by executive order, has created an unlimited Obamacare reinsurance program covering the healthcare insurance industry’s supposed losses.

According to some, the total subsidy to the healthcare insurance industry is $1.3 trillion dollars.

It’s no surprise that many more healthcare insurance companies are planning to participate in President Obama’s health insurance exchanges.

If a healthcare insurance company sells insurance without risk it is a great deal. Taxpayers are assuming the risk for the insurance companies. Some insurance companies are decreasing their rate to capture a larger market share. They will  cash in on the Obamacare subsidy.

This subsidy is a mistake. It adds little value in improving the nation’s health. President Obama does not seem to care about how much money he is wasting.

It is all about politics. 

The subsidy adds much political value to Obamacare because it postpones the 20% premium increase at this midterm election.

Bob Laszewski, a policy wonk and former insurance executive said,

 “The administration has succeeded in temporarily suppressing incipient Obamacare price hikes, contributing to an illusion of Obamacare sustainability.”

However, the healthcare insurance industry is finding it necessary to increase premiums an additional twenty percent despite the tremendous subsidies. This is the result of the enrollees who acquired insurance but did not pay the premiums and used the services and the terrible demographic distribution of enrollees who paid their premium.  Eighty-five percent of the people who paid premiums were high risk patients with pre-existing illnesses. 

The rules of Obamacare have turned out to be totally improvised. The Obama administration changes the contents of the law in order to keep it afloat without the approval of congress.

The plot thickens. A challenge is in the courts right now on whether the government health insurance exchanges are allowed to provide subsidies to enrollees.

The law specifically states that tax credits are only available through the state health insurance exchanges and not the federal health exchange.

Funny things are going on in the courts. One panel said yes, the subsidies may be provided by the federal health insurance exchanges. The D.C. panel of three judges said no.

Attorney General Holder appealed to the D.C. court of appeals. He wanted the judgment determined by the entire panel of 9 judges not a subpanel of 3 judges.  The 3 judges’ decision was overruled by the 9 judge panel.

I still do not understand how tax credits are given to people who do not earn enough to apply a tax credit to their income tax. Why do they receive a subsidy? They pay no federal income tax.

I hope Americans wake up soon to the fact that Obamacare is deeply flawed and cannot work. The only thing that will overturn it will be an overwhelming taxpayer protest.

This midterm election cycle is a good place for voters to start. A Republican majority of the senate might be able to stop Obamacare in its tracks.   

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



Please have a friend subscribe

 

 

 

 

 

Permalink:

What President Obama Forgot To Tell US

 Stanley Feld M.D.,FACP, MACE

Nancy Pelosi was correct. The only way we are going to know what is in the Affordable Care Act is to pass the bill.

The weeks before January 1st when the web site was going so poorly we heard a lot about the healthcare insurance companies taking a bath on Obamacare because of the skewed enrollment.

Only the sick and elderly were buying healthcare insurance from the health insurance exchanges. Young people were needed to buy insurance in order to keep Obamacare from the “death spiral.”

The sick and elderly were more likely to be hospitalized and run up a big hospital bill. The high bills would eat into the insurance companies profits. Young people were needed to stabilize the risk pool or insurance premiums would sky rocket because insurance company profits would fall. Insurance companies could go bankrupt.

The government’s expressed fear is the healthcare insurance industry would not participate in the health insurance exchanges.

President Obama offered to bail out the healthcare insurance companies if this was to occur.

This was another of President Obama’s deception.

It is similar to the deception “If you like your insurance you can keep it. If you like you doctor you can keep him/her.”

Last week we learned that the insurance company bailout was built into the original bill passed in 2010. The President knew about this bailout before Obamacare was passed.

Did the congressional members who passed the bill know about the built in bailout?

If they did they should all be voted out of office. If the Democrats needed to pass Obamacare did not know about the bailout they should have and they should all be voted out.

It should be recalled that this was a Democrat controlled House and Senate. There was not a single Republican vote included in the passage of Obamacare.

The American people did not know about the built in bailout at taxpayers’ expense.

Obamacare contains a "Reinsurance Program that caps big claim costs for insurers (individual plans only)." Robert Laszewski, a prominent consultant to health insurance companies, writes that in 2014, 80% of individual costs between $45,000 and $250,000 are paid by the government [read: by taxpayers], for example." 

Private insurance plans bought through the health insurance exchanges are not private health insurance plans. They are plans that are subsidized by the government if the insurance bill goes over $45,000.

Who pays this government subsidy?

The taxpayers, by having their taxes increased.

 Who makes the profit from this subsidy?

 The healthcare insurance industry makes the profit because the insurance policies have been priced at high risk (Increased deductibles, and increased premiums for consumers not eligible for government subsidies).

 "The reinsurance program has done and will continue to do what it was intended to do; help attract and keep more carriers in Obamacare than might have otherwise come."  Thus, Obamacare is being aided by having taxpayers subsidize big insurance companies' business expenses.”

Obamacare also provides the healthcare industry a greater subsidy. It is called the Risk Corridor Program”. The “Risk Corridor Program” limits the overall losses of the healthcare insurance industry to 2.4%.

This is the way the “Risk Corridor Program” works. The healthcare insurance company submits its expected costs to the government for a particular year.

If the expected costs of the insurance exceed 102%, the government will pay the healthcare insurance company 80% of the difference above 102% at taxpayers’ expense.

 Taxpayers' are unwitting generosity toward these "participating health plans" (plans sold through Obamacare's government-run exchanges):

 "[I]f the health plan has costs at 110% of the medical cost target [the costs that the insurer expects to accrue], it will be responsible for only 102.4% of the target (a 2.4% shortfall)-only about a quarter of its losses.”

There is little risk to the healthcare insurance company for being involved in the healthcare insurance exchanges.

The key point is President Obama had this written into Obamacare without telling taxpayers about it. I wonder if the CBO knew about it and calculated it into the original cost estimates of Obamacare.

“In this way, and so many others, Obamacare takes a major step toward the government monopoly over American medicine ("single payer") that liberals drool about in their sleep.”

The problems with a government controlled single party payer system are multiple. I have enumerated them in the passed.

I will summarize the problems:

1.Consumers are dependent on the government to make their healthcare and medical care decisions.

 2. A single party payer system does not encourage consumers to be responsible for their health, healthcare dollars or medical care.

3. The inevitable cost overruns will result from government bureaucracy, regulations and inefficiencies.

4. The occurrence of fraud and abuse is inevitable. We have seen some fraud and abuse already.

Navigators are paid $48 an hour to help the poor enroll in Obamacare. One reader told me about a case were the navigator had to apply four times before the application was accepted without any errors.

This is only the first step in obtaining healthcare eligibility and then healthcare insurance.

4.  Government will be forced to limit access to care and ration care in order to keep the direct medical care costs down.

 5. All the secondary stakeholder costs are escalating as physician reimbursement is decreasing.

 6. Most importantly freedoms to choose your physician, your insurance and your treatment are being compromised at the expense of all taxpayers.

Something is very wrong with this plan.

This is all going to be done slowly so we do not notice.

America has been deceived. We are already feeling the effects of the deceptions.

There is more to come.

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

Please have a friend subscribe.

 

 

 

 

 

 

 

 

 

 

Permalink:

Twisting the Facts About Health Care

Stanley Feld M.D.,FACP,MACE

I have been a New York Times reader since 7th grade. At
that time I delivered the New York Times to all the classrooms in my Junior
High School.

The New York Times has become pretty shabby in recent
years. It has stopped printing unbiased news. It does not print,  “All
The News Fit To Print.”

It has been publishing biased news, news leaks as well as
opinions that have contained innuendo and not based on facts.

A glaring example is the healthcare editorial on Sunday October
21,2012.

The New York Times is trying very hard to help defeat
Mitt Romney and push President Obama over the finish line.

I hope intelligent readers can see through the Times’
smokescreen of no facts and evaluate the candidates objectively.

The editorial’s first sentence is absolutely correct.

“The outcome of the presidential election will determine which of
two opposing paths the nation will follow on health care for all Americans.”

One
path represented by Obamacare is a path of government takeover of healthcare.
It will convert the healthcare system totally to an entitlement system.  The government will make the rules and create regulations.
Many will be difficult to follow and impossible to enforce.

This
path leads to restriction of freedom of choice, rationing and a decrease in
access to healthcare.

Americans
did not expect this option when they elected President Obama.

It
is easy to remember the sound-bite, “ If you like your present
insurance you can keep it. If you like your physicians you can keep them.”

His
campaign principles were vague. His promises were broad brushstrokes of
policies and not a specific outline of policies. At the end of these vague
promises was the appealing promise of affordable healthcare insurance coverage
for all.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/09/is-medicare-an-effective-bureaucracy-part-1.html

It
turns out that after four years healthcare insurance coverage has become more
expensive. There is no relief in sight. All Americans are subjected to 10
hidden taxes that in effect increases the cost of healthcare insurance
coverage.

America
has passed a 2400 page bill that few read and fewer understand. The bill has
generated over 44,000 new regulations so far and massive new government
bureaucracies.

The
bill was supposed to decrease the cost of healthcare by over $125 billion
dollars during the next ten years.

It
is now estimated to cost taxpayers an additional $1 trillion dollars over ten
years.

The
New York Times editorial goes on to say:

“If voters re-elect President Obama, he will
protect the health care reforms that are his signature domestic achievement.”

It
sounds like the New York Times believes this is a good thing. My guess is the
Times is not a very good judge of sound business practices because it is itself
on the verge of bankruptcy.  Obamacare is
unsustainable and destined to drive America into bankruptcy.

So
far President Obama has done nothing to decrease the number of uninsured and
nothing to decrease the cost of care. In fact the cost of care has escalated as
patient deductibles have increased, premiums have increased and the quality of
employer coverage has decreased. Employer sponsored healthcare insurance
coverage is expected to decrease further in the next two years.

The
New York Times editorial goes on to state:

“If they elect Mitt
Romney, they will be choosing a man who has pledged to repeal the reform law
and replace it with — who knows what?”

The biggest defects in today’s healthcare system are ;

1. It does not encourage individuals to be responsible for the
maintenance for their own health

2, it does not give consumers control of their healthcare dollars
or incentives to preserve those dollars.

3. It does not discourage the practice of defensive medicine with
effective tort reform.

4. It does not create a competitive healthcare market that must
become consumer driven in order to control costs.

The New York Times invites us to visit Mitt Romney’s web site
after this biased preamble:

“The competing visions are often difficult to evaluate because the
Republican candidates — Mr. Romney and his running mate, Paul Ryan — have
become so artful about obfuscating their plans for Medicare, Medicaid and what
they will do to reform the whole system.”

I went to the web site to see what Mitt Romney’s plan is. He has
very specific proposals in his healthcare plan. The proposals could Repair the
Healthcare System if implemented correctly.

I imagine the New York Times did not pay attention to any of the
words in the plan because they are drinking President Obama/Mr. David Axelrod’s
"Kool Aid."

The Times tells us in the very next sentence;

“Almost nothing the Republican candidates say on these or other
health care issues can be taken at face value.”

I would say this is not objective reporting.

What is Mitt Romney’s healthcare plan? I would like readers to
read it carefully and judge for themselves.

He first explains the Obamacare failures. The failures are
important to keep in mind because Obamacare has been shoved down the mouth of
Americans.

OBAMA'S FAILURE

Unfortunately,
the transformation in American health care set in motion by Obamacare will take
us in precisely the wrong direction. The bill, itself more than 2,400 pages
long, relies on a dense web of regulations, fees, subsidies, excise taxes,
exchanges, and rule-setting boards to give the federal government extraordinary
control over every corner of the health care system. The costs are
commensurate: Obamacare added a trillion dollars in new health care spending.
To pay for it, the law raised taxes by $500 billion on everyone from
middle-class families to innovative medical device makers, and then slashed
$500 billion from Medicare.

Obamacare
was unpopular when passed, and remains unpopular today, because the American
people recognize that a government takeover is the wrong approach. While
Obamacare may create a new health insurance entitlement, it will only worsen
the system’s existing problems. When was the last time a massive government
program lowered cost, improved efficiency, or raised the consistency of
service? Obamacare will violate that crucial first principle of medicine: “do
no harm.” It will make America a less attractive place to practice medicine,
discourage innovators from investing in life-saving technology, and restrict
consumer choice.

In short,
President Obama’s trillion dollar federal takeover of the U.S. health care
system is a disaster for the federal budget, a disaster for the constitutional
principles of federalism, and a disaster for the American people.

MITT'S PLAN

On his
first day in office, Mitt Romney will issue an executive order that paves the
way for the federal government to issue Obamacare waivers to all fifty states.
He will then work with Congress to repeal the full legislation as quickly as
possible.

In place
of Obamacare, Mitt will pursue policies that give each state the power to craft
a health care reform plan that is best for its own citizens. The federal
government’s role will be to help markets work by creating a level playing
field for competition. 

Restore
State Leadership and Flexibility

Mitt will
begin by returning states to their proper place in charge of regulating local
insurance markets and caring for the poor, uninsured, and chronically ill.
States will have both the incentive and the flexibility to experiment, learn
from one another, and craft the approaches best suited to their own citizens.

  • Block grant Medicaid and other payments to
    states
  • Limit federal standards and requirements on
    both private insurance and Medicaid coverage
  • Ensure flexibility to help the uninsured,
    including public-private partnerships, exchanges, and subsidies
  • Ensure flexibility to help the chronically
    ill, including high-risk pools, reinsurance, and risk adjustment
  • Offer innovation grants to explore
    non-litigation alternatives to dispute resolution

Promote
Free Markets and Fair Competition

Competition
drives improvements in efficiency and effectiveness, offering consumers’ higher
quality goods and services at lower cost.  It can have the same effect in
the health care system, if given the chance to work.

  • Cap non-economic damages in medical
    malpractice lawsuits
  • Empower individuals and small businesses to
    form purchasing pools
  • Prevent discrimination against individuals
    with pre-existing conditions who maintain continuous coverage
  • Facilitate IT interoperability

Empower
Consumer Choice

For
markets to work, consumers must have the information and the power to make
decisions about their own care.  Placing the patient at the center of the
process will drive quality up and cost down while ensuring that services are
designed to provide what Americans actually want.

  • End tax discrimination against the individual
    purchase of insurance
  • Allow consumers to purchase insurance across
    state lines
  • Unshackle HSAs by allowing funds to be used
    for insurance premiums
  • Promote "co-insurance" products
  • Promote alternatives to "fee for
    service"
  • Encourage "Consumer Reports"-type
    ratings of alternative insurance plans

 

Mitt Romney’s plan is an outline of his healthcare plan that
corrects all of the defects in our healthcare system. Obamacare has amplified
the healthcare system’s defects.

By giving states the opportunity to select a waiver from Obamacare,
Governor Romney is eradicating all the new taxes, regulations, bureaucracy, and
impingement on individual choice, individual freedoms and access to care
issues. He is also opening the door for subsidized healthcare coverage for
those in need.

It is much more specific than the plan President Obama presented before
his election in 2008. I have reviewed my articles on his proposals. President
Obama disguised his real intentions. He made it sound much better than he
intended. If one reads between the lines it is clear President Obama wanted the
federal government to control the healthcare system.

The blog post from 2008 make interest reading. Please click on
them.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-1.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-2.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-3.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-4.html

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2008/08/is-barack-obama-any-different-than-other-politicians-part-5.html

President Obama is the pot calling the kettle black.

Government Romney puts the consumer first, not the government. His
plan also strengthens states rights which have been severely discounted during
his term in office. The states can be a little more efficient that the central
government.

President Obama has presented nothing about his healthcare plan
during his reelection cycle,

Many of the regulations have not been written yet. President Obama
is waiting until after the election when “he
will have more flexibility. ”

Please remember I voted for him in 2008. President Obama has been a
tremendous disappointment to me. He does not understand the American psyche and
is ignoring Americans’ wishes.

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

Please have a friend subscribe

 

Permalink:

How Could A Social Networking Company Make Money In Healthcare?

Stanley Feld M.D.,FACP, MACE

My last blog about individual healthcare insurance policies generated a lot of comments from young people starting up a business and individuals operating their own business at home. I also received several from entrepreneurs looking to start a business.

One person wrote,

"Dear Dr. Feld

So we have now learned that high deductible plans are what people should be purchasing. We also learned that they should be self insuring for $10,000 which is the highest deductible insurance at the lowest price.

 Over $10,000 is where are at the greatest financial risk. True insurance should cover our greatest risk.

I would like to know where is the business opportunity is for an Internet company that runs social networks?

 

 

 Sincerely

Z"

I said the world belongs to young people 20-50 years old. They also understand the power and mechanics of social networking.

If there was a social network dedicated to describing the advantages and disadvantages of the healthcare insurance options available to the unemployed, self- employed and under insured there would be many members. If those members had the ability to have input it would grow even larger with appropriate marketing.

I have not figured out how social networking sites make money except through advertising. I imagine many companies would like to get the attention of these consumers who are seeking healthcare insurance advice.

It has been reported that people change their job up to 8 times during their career. More and more people are in start-up businesses and need healthcare insurance for their employees. Many people are becoming consultants and are self-employed. They all need healthcare insurance for their family.

President Obama’s answer to the problem is the government will provide the healthcare insurance for you. Healthcare insurance is a right as an American.

There are several problems with this statement. The government cannot afford to provide adequate healthcare insurance for the entire population.

Britain has proved it. They are reverting back to a pay for service system. The socialist democrats in Europe have proved that. Each country is going bankrupt.

The business opportunity would be to teach the people who are self-insured or uninsured about the rip off of the healthcare insurance industry and to teach them how to save money.

How many start up companies do you guess are uninsured or under insured or not insured for catastrophic illness because they cannot afford the healthcare insurance premiums?

The chances are many start up employees will not get sick. True healthcare insurance should be a hedge against catastrophic illness.

If someone gets sick in a company, the company could pay the employee for the amount he spent before they reached the full deduction.

The high deductible individual policy is not tax deductible. If it were made tax deductible by citizen demand to congress through social networking the voice of the individual could be heard. Congress might be forced to act.

Start up companies and other companies would save money. These companies would be placed on the same playing field as companies who pay for employee insurance with pre tax dollars. The social network could even form an association of self-employed companies and enjoy the tax benefits and purchasing power of large corporations.

This would represent a threat to the healthcare insurance industry. They would do everything to stop. So would the government.

If you do the math for the government, the government would be saving much more money than it would collecting taxes. 

An appropriate social network could stop the healthcare insurance industry's grotesque business model in its tracks.

It could save billions of dollars. It could create incentive for people to take better care of themselves. 

Many large and small companies are self-insured. The law lets these companies deduct their healthcare insurance with pre tax dollars. These companies could offer my ideal medical saving account with a $7,500 trust account. They could then reinsure employees for over $7,500 with a reinsurance company. 

Employees would obtain first dollar coverage after the deductible is reached.

In the worst case the company would save $6,000 per employee. In the best case it would save $13,000 per employee.

http://www.lijit.com/search?uri=http%3A%2F%2Fwww.lijit.com%2Fusers%2Fstanleyfeld&start_time=&p=g&blog_uri=http%3A%2F%2Fstanleyfeldmdmace.typepad.com%2F&blog_platform=&view_id=&link_id=7386&flavor=&q=ideal+medical+savings+accounts&x=0&y=0 

I suspect even the traditional insurance companies would provide the re-insurance.  These healthcare companies have already negotiated fees with physicians, hospitals and drug companies. 

If the healthcare insurance industry did not provide re-insurance its negotiated fees could be obtained easily.

A bank or a mutual fund could adjudicate the claims instantly.

The large corporations, who are self-insured, all have HR officers. The HR officers I have met either do not seem to have the bandwidth to investigate the possibility of the ideal medical saving account structure or they are trapped into outsourcing the details of the corporation’s self-insured healthcare plans to middlemen. I have a feeling the commitments of some with middlemen are long term.  

If all this could happen it would be an important first step in the development of social networking in healthcare and medical care.

Consumers need education for the care of their chronic disease such as diabetes, asthma, chronic lung disease, heart disease and chronic gastrointestinal diseases. Many of these diseases are a result of obesity.

If social networking could discourage the ever-increasing incidence of obesity, society would decrease healthcare costs dramatically. 

If patients learned how to manage their own disease the cost of medical care would decrease precipitously.  

Why?

Because 80% of the healthcare dollars spent on direct patient care are spent on the complications of chronic diseases that are not well managed by patients.

Many drug companies and medical device companies would advertise on these social networking sites.  

Consumers must drive the healthcare system in order for the healthcare system to be repaired. Not government or the healthcare insurance industry.

Consumers feel powerless at present. Empowering consumers through social networking will disrupt the entire healthcare systems supply chain for the better.

Consumers are up against a government that wants to tell them what they have to do. They are up against healthcare insurance companies that charge obscene premiums. They are up against hospitals, physicians and emergency rooms that have exorbitant charges.

Consumers are up against diseases such as obesity which precipitates many chronic diseases.

Consumers are frustrated and need leadership and guidance.

The phenomenal growth in social networking can give consumers the tool they need to control their health and drive the healthcare system.

Social networking is the only way to start a consumer driven healthcare movement. It has to happen before the medical care system is destroyed.

The young people expert (20-50 years old) in social networking have to become engaged. 

Those young people have to understand physician mentality and the importance of the patient physician relationship.

I will be happy to help in any way I can.

 

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

Please send the blog to a friend

 

 

 

 

 

 

 

Permalink:

Infringement On Privacy Keeps Popping Up With Obamacare

Stanley Feld M.D.,FACP,MACE

 I suggest those of you who enjoy reading the Federal Register to read the proposed rule: “ Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment, Volume 76, page 41930. Proposed rule docket ID is HHS-OS-2011-0022”

http://www.gpo.gov/fdsys/pkg/FR-2011-07-15/pdf/2011-17609.pdf)

  President Obama’s healthcare reform act is proposing to collect healthcare claims data on all Americans. The federal government already owns the claims data on Medicare and Medicaid recipients.

Now President Obama wants the claims data on all private insured and non-insured consumers. His reason is to stratify risk for the healthcare insurance industry.

Every consumer would pay the same healthcare insurance premium through the state exchanges whether he was a high risk or low risk patient.

If patients incurred high healthcare costs because they were a high-risk patients, the government would subsidize the healthcare insurance company if the cost was greater than the fixed premium.

 Presumably the government would subsidize the healthcare insurance company so it would not lose money. It would also tighten the government’s control over the healthcare insurance industry and its profits. These regulations have not been written yet.

What is wrong with that? Consumers are again left out of the loop. An unelected bureaucrat is making our healthcare decisions. If the potential consequences were followed to the end, private insurance and a freedom of choice to have no insurance coverage would be eliminated.

 Everyone would be required to have to have healthcare insurance through the state healthcare insurance exchanges.  In reality it is a backdoor mandate.

“In a proposed rule from Secretary Kathleen Sebelius and the Department of Health and Human Services (HHS), the federal government is demanding insurance companies submit detailed health care information about their patients.”

The healthcare insurance industry is being asked to provide proprietary information to government. The healthcare industry claims that providing this information will undermine its competitiveness.

It forces the healthcare insurance industry to become more transparent while the proposal claims to protect the healthcare insurance industry from risk.

Obama and Sebelius made such a big deal about Americans being able to keep the coverage they have under ObamaCare; with these provisions, such private insurance may cease to exist if insurers are required to divulge their business models.”

There are several obvious dangers of this action. The first danger is from the healthcare insurance industry’s point of view. Another danger is from the healthcare system’s point of view. The third danger is from the consumer’s point of view.

The federal government is not capable of providing the administrative services necessary for healthcare coverage. The government outsources the administrative services for Medicare and Medicaid.

Those administrative service fees are in the 20-30% range to the federal government presently. Those hidden fees are creating unsustainable healthcare costs for the federal government.   

If the government tried to lower those fees, the healthcare insurance industry would walk away from the healthcare system. The healthcare system would collapse.

 The Federal Register includes three proposals for collecting the claims data on every American.

  1. A “centralized approach” wherein insurers’ data go directly to Washington.
  2. An “intermediate state-level approach” in which insurers give the information to the 50 states.
  3. A “distributed approach” in which health insurance companies crunch the numbers according to federal bureaucrat edict.

 “ There are major problems with any one of these three “options.” First is the obvious breach of patient confidentiality. The federal government does not exactly have a stellar track record when it comes to managing private information about its citizens.”

“Why should we trust that the federal government would somehow keep all patient records confidential?”

Each option provides government bureaucrats access to the health records of every American. 

President Obama’s trap for consumers is obvious. If a business loses or gives up or sells confidential data a victim can fire or sue a health insurance company. The power of the market can also punish a private sector provider.

If a government bureaucrat losses or gives up your confidential information to another federal agency or other private individuals, the individuals affected could not get the unionized bureaucrat fired even if they could find out who was responsible bureaucrat providing the information.

Imagine a Wikileaks-sized disclosure of every American’s health histories. The results could be devastating – embarrassing – even Orwellian.

With its extensive rule-making decrees, ObamaCare has been an exercise in creating authority out of thin air at the expense of individuals’ rights, freedoms, and liberties.

Providing the federal government the ability to spy on, review, and approve individuals’ private patient-doctor interactions is an abuse of power and a challenge to every American’s liberty Where is the ACLU on this issue?

In an attempt to do the right thing, President Obama and HHS ends up restricting our freedoms, individual rights and liberty.

I hate to be cynical. Perhaps President Obama’s goal is the have centralized control over Americans and restrict our freedoms, individual rights and liberty. .

Obamacare is looking more and more like this is the goal.

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

Permalink:

Republican Healthcare Proposal Executive Summary : Part 1

 

Stanley Feld M.D.,FACE,MACE

It is not fair to criticize the Republican Party’s healthcare proposal without providing the reader with the source material. The source material comes from Senator Tom Coburn’s web site. My negative comments should be judged in light of the original proposal. The executive summary follows.

Preventing Disease and Promoting Healthier Lifestyles

· Critical investments in public health and disease prevention will go a long way in restraining

health care costs and improving the quality of Americans’ lives. The Patient’s Choice Act of 2009 would:

Encourage increased coordination of federal prevention efforts and bring long‐overdue accountability to these programs

Require CDC to undertake a national campaign highlighting science‐based health promotion strategies

Equip recipients of Supplemental Nutritional Benefits with easily understandable information about nutritious food options and target the use of food stamps to healthy food choices

Invest $50 million annually for increased vaccine availability and bonus grants to states that achieve 90 percent or greater coverage of CDC‐recommended vaccines

Provide incentives for states to reduce rates of chronic disease like heart disease and diabetes

All of the above proposals should be executed. How will they be implemented? The Republicans do not have a plan but not having a plan does not make the Democrat’s plan a good one.

Creating Affordable and Accessible Health Insurance Options

Our health care system should be easier to navigate and provide integrated care in a more equitable manner. A vibrant market for health insurance that is consistent and fair will allow all Americans access to health coverage.

How will Republicans make a vibrant market for healthcare insurance? How will people who cannot afford healthcare insurance pay for it? The tax credits might help a little. However, if you do not have the cash you cannot pay for the insurance.

The Patient’s Choice Act of 2009 would encourage states to establish rational and reasonable consumer protections, including the following:

Creates State Health Insurance Exchanges to give Americans a one‐stop marketplace to compare different health insurance policies and select the one that meets their unique needs

Gives Americans the same standard health benefits as Members of Congress, so all Americans have a wide range of choices

Protects the most vulnerable Americans to ensure that no individual would be turned down by a participating Exchange insurers based on age or health

What will the premium be for those with preexisting illnesses? Will the premiums be higher for patients with preexisting illnesses? The high risk pool premiums have been very expensive.

Creates a non‐profit, independent board to risk adjust among participating insurance companies to penalize companies that “cherry pick” health patients and reward insurers that encourage prevention/wellness and cover patients with pre‐existing conditions.

Expands coverage through auto‐enrollment at state and medical points of service, for individuals who do not select a plan at the beginning of the year

This is an empty statement. How will this be administered? The devil is in the details and there are no details presented.

Gives states the ability to band together in regional pooling arrangements, as well as the creation of robust high risk pools, reinsurance markets, or risk adjustment mechanisms to cover those deemed ‘uninsurable’

Risk pooling has been tried and has been unsuccessful. It has been an excuse to allow the insurance industry to spread the risk. The proposal also implies variable premiums.

Equalizes the Tax Treatment of Health Care, Empowering All Americans with Real Access to Coverage

Economic analysts across the political divide agree that the tax code is stacked in favor of the wealthy and those who get their health coverage through their employers, discriminating against the self‐employed, the unemployed, and small businesses. The Patients’ Choice Act of 2009 would restore fairness in the tax code and give every American, regardless of employment status, the ability to purchase health insurance by:

Providing an advanceable and refundable tax credit of $2,300 per individual or $5,700 per family

Improving the operation of Health Savings Accounts [HSAs] by allowing health insurance premiums to be paid with HSAs without a tax penalty

Allowing preventative services to be covered by High Deductible Health Plans

Increasing the amount of money an HSA owner may annually contribute to their account

Healthcare insurance premiums are $14,000.00 a year for a family. A $5,700.00 tax credit does not cover it. It also assumes the consumer has enough income to have a $5,700.00 be tax liability. Citizens are not subject to income tax if they make up to $38,000.00 year. HSA’s retain the healthcare dollar to be used for future spending on healthcare. The healthcare insurance industry retains control over the premium and the healthcare dollars. It is not a pro consumer proposal. It does not offer financial incentives to consumers .

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