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The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
Copywrite 2006-2018
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I am coming to the conclusion that the Republican establishment does not want to Repair the Healthcare System.
The Republican establishment has the same goal as the Democratic establishment.
Recently the mainstream media is saying that a single party payer system is looking good.
Neither party has any interest is having consumers control their healthcare dollars. It looks as if both parties want the government to control the consumer’s healthcare dollars.
All the politicians ignore the fact that government control is unaffordable. It also ends up not working.
The best example is the bureaucratic VA Hospital System and its system wide corruption.
A reader wrote:
“I have read your last blog post carefully and agree with many of the points put forward but there is a glaring omission.”
“How are patients supposed to be responsible for their healthcare dollars when there is absolutely no transparency and no consistency in pricing.”
The lack of transparency is a major defect in our present healthcare system.
Only 20% of consumers use the healthcare system at any one time. Eighty percent of the consumers have not run into the lack of transparency problem in the healthcare system.
Most consumers do not care about transparency because they have first dollar coverage provided by their employer. They think their medical care is free. They believe they have excellent healthcare insurance.
President Obama took care of that notion with Obamacare. The defective structure of Obamacare caused healthcare insurance premiums and deductibles to skyrocket. First dollar healthcare insurance became too expensive for most employers.
Employers stopped providing first dollar coverage. Middle class employees are now noticing that out of pocket expenses have made their healthcare insurance unaffordable. Consumers have tried to compare prices of competitive providers. They have discovered that it is impossible!
Consumers are becoming aware of the lack of transparency. They have been astonished by this lack of transparency.
There is nothing in the new Republican bill that addresses Republican politicians’ awareness that the lack of transparency is a major defect in the healthcare system.
The lack of transparency is only one of the major defects in our healthcare system.
There is nothing in the Republican bill that speaks to the consumers’ responsibility for their health and healthcare dollars. Consumer driven healthcare is completely ignored.
There is nothing in the bill that addresses effective tort reform. The Massachusetts Medical Society survey showed that defensive testing to avoid lawsuits costs the healthcare system between $250 billion to $700 billion dollars a year.
The lack of the development of systems of care for chronic diseases cost another $700 billion dollars a year that our healthcare system does not address. There is nothing in the bill that emphasizes this very important defect in the healthcare system.
The Republican establishment thinks consumers are too stupid to take care of themselves.
The mainstream media likes to tell us that people love entitlements. The public does not want to give up these entitlements.
My question is how come less than 9 million people signed up for Obamacare’s individual healthcare plans last year if they love entitlements?
It is because they cannot afford to buy the health exchange insurance even though 85% of the premiums of those 9 million consumers are subsided by the government. Their high deductibles are not subsidized.
The Republicans are going claim they are promoting health savings accounts. The public is not told the amount of money they can put into a health savings account or whether it will provide first dollar coverage over that amount if they get sick.
There is no financial incentive for consumers to be responsible for their healthcare or their healthcare dollars.
My Ideal Medical Saving Account is a much better idea.
These are only a few of the major defects in the Republican establishment’s concept to fix the healthcare system.
President Obama did some of the awful things to Obamacare through rules and regulations after certain vested interests complained about the law. Obamacare’s rules and regulations have to be eliminated
There were crony waivers that would make one’s blood boil. In fact, elected congressional members got the best exemptions.
It is becoming apparent that congress doesn’t want to fix the healthcare system for the majority of Americans. The congressional establishment wants to control consumers.
Socialism does not work!
Our political establishment does not tell us about the economic result in other countrys’ single party payer universal healthcare systems.
We don’t have to go to other countries. We only have to go to the indigent areas in California were everyone is covered by Medicaid.
The Republican establishment needs to get off the stick before all of them are kicked out of congress.
Just imagine the healthcare systems savings if every consumer were empowered to shop for the best healthcare at the best price.
The result would be a free market healthcare system in which competition would cleanse the system and make it affordable to everyone.
The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.
All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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I think the Republican establishment in the senate is trying to undermine President Trump’s agenda.
It would be easy to repeal and replace Obamacare if the reasons for its failure where publicized. The main reason is that it does not align the initiatives of most of the stakeholders. The cost of administration is a close second.
Obamacare is about redistribution of wealth and control over the healthcare system. It ends up penalizing the middle class the most because of premium increases.
People like entitlements because they are free. Someone else is paying for them.
Politicians want to keep their jobs. They do not want to upset people who receive these entitlements.
“But the revisions may well alienate the Senate’s most conservative members, who are eager to rein in the growth of Medicaid and are unlikely to support a bill that does not roll back large components of the current law.
Even with more moderate Republicans on board, party leaders would have a very narrow margin for passage on the Senate floor.”
The healthcare insurance companies do not want to lose money selling healthcare insurance. They are getting out of the healthcare market because, by their calculations, they are losing money.
The Republicans establishment in the Senate want to continue to provide subsidies to the healthcare insurance industry.
Congress needs the healthcare insurance industry’s ability to provide administrative services whether it is for Medicare, Medicaid, health insurance exchange coverage (Obamacare) or private insurance.
The government’s goal is to provide enough financial incentives for the healthcare insurance industry to provide affordable healthcare insurance coverage while saving money.
President Obama subsidized the healthcare insurance industry for any perceived losses through the Obamacare reinsurance program. Then President Obama reneged on the agreement. He only paid 12% of what was owed according to the insurance industry’s calculations..
Democrats want a single party payer system. They want everyone on Medicare or Medicaid. It is simple. The result is the government provides healthcare insurance for everyone. Everyone receives first dollar coverage. This would be the mother of all entitlements.
The single party payer system would also provide the government with tremendous power over the people. It would control consumers’ freedom of choice.
Along with this simple single party system comes a complex bureaucracy with all the inefficiencies that I have described previously.
Consumers would be chained to the inefficient healthcare system. The inefficiencies in the system have been graphically demonstrated by the VA Healthcare System and its ever increasing costs.
It would be nice if a single party payer system were efficient and affordable. Canada has a universal healthcare system. Canadians who are not sick and do not need their healthcare system believe the Canadian system is great.
They ignore the fact that the Canadian provinces are paying 50% of their GNP to provide free healthcare to all Canadians.
The fact is single party payer systems do not work for all the stakeholders.Both Democrats and Republicans are missing the essential point about what would work to provide an affordable healthcare system that aligns the incentives of all stakeholders.An essential element is to develop a system that encourages consumers of healthcare to be responsible for their health and have control over their healthcare dollars.
The Senate’s present revision does not consider this. The Senate is considering the needs of the healthcare insurance industry and not the needs of consumers.
The Senate should be considering the following in order to repeal and replace Obamacare.
Self-management of chronic disease is essential for a healthcare system to become affordable. My Ideal Medical Saving Account provides that financial incentive.
1. The Ideal Medical Saving Account will provide instant adjudication of medical care claims.
http://stanfeld.com/chronic-disease-management-and-education-as-an-extension-of-physicians-care/
http://stanfeld.com/social-networks-patient-education-and-the-healthcare-system/
The networks could be physicians to patients networks, patients to patients networks, patients to their physicians’ healthcare team networks. These networks need to be an extension of the physician’s care. All encounters should be imported to the patient’s chart with certain restrictions.
The goal of effective healthcare reform should be to align all the stakeholders’ incentives. Patient incentives should be at the center of this alignment.
Obamacare did not bother to try to align any of the primary stakeholders’ (patients and physicians) incentives. In fact Obamacare destroyed the patient/physician relationship.
The house bill to repeal and replace Obamacare touches on some alignment.
The senate is fighting about issues that are not significant in aligning all stakeholders’ incentives.
The healthcare system will not be repaired until all the stakeholders’ incentives are aligned. Healthcare policies must be put in place to align those incentives.
The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.
All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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In my last blog I continued my War on Obesity. I started this war in 2007.
There has been little progress in this war because of cultural conditioning and a lack of emphasis on personal responsibility.
Every New Year’s Day millions of Americans make New Year resolutions to lose weight. They are initially successful. They then regain the weight they have lost.
If America is going to solve the healthcare systems unsustainable cost, it is going to have to solve the increasing Obesity problem.
The National Institute of Diabetes (niddk.nih} recently published Overweight and Obesity statistics:
“More than two-thirds (68.8 percent) of adults are considered to be overweight or obese.”
“ More than one-third (35.7 percent) of adults are considered to be obese.”
“ More than 1 in 20 (6.3 percent) have extreme obesity.”
“ Almost 3 in 4 men (74 percent) are considered to be overweight or obese.”
Each year the obesity problem gets worse. Companies have sprung up selling weight loss formulas. These companies advertise their great success.
However, most of the iconic personalities used in their advertising have regained their weight after experiencing mild or significant weight loss.
The Prevalence Ratio of Obesity and Type 2 Diabetes is 18.1 for men and 12.9 for women.
Therefore Type 2 Diabetes is very prevalent in both Obese and Overweight men and women.
Eighty percent of the treatment costs for diabetes and hypertension to the healthcare system is the result of the treatment of the complications of hypertension and diabetes.
In order for a healthcare system to be sustainable diabetes and hypertension must be cured. It is essential that each must be recognized early and treated aggressively.
This takes a lot of personal responsibility and personal discipline.
Equally important is the morbidity resulting from the complications of diabetes and hypertension, two diseases that result from obesity.
Complications from the onset of both hypertension and diabetes take about eight years to develop. This is the reason to diagnose and discover Pre-Diabetes at the onset.
Lifestyle intervention is remarkably effective in the primary prevention of diabetes and hypertension. These principles also are pertinent to the prevention of downstream macrovascular complications of the two disorders.
This is the where my story of the importance of personal responsibility comes in.
A restaurateur, in his early 50’s, who runs a large restaurant in Dallas, that I frequent, was slowly gaining weight. At 269 lbs. he had difficulty standing on his feet all day long. He was being treated for hypertension and hyperlipidemia (high cholesterol).
His physician told him he must lose weight. He informed him of his risk factors for the complications of these diseases.
This was all he needed hear. The thought of having to quit the job he loved and the possibility of dying from the complications of his diseases was enough to make him decide to loss the weight.
He was told he would be fine if he lost the weight.
He has lost 70 lbs.so far without assistence. He has decided to be personally responsible for his weight loss.
He now gets up at 5 am each morning and exercises for one hour each day before work.
He has stopped eating his wonderful pasta dishes. He eats nothing that is white.
Every time I meet a friend at the restaurant, the restaurateur sits down at our table for a chat. We usually talk about how great he is doing in the weight loss department.
I had initiated an obesity program at Endocrine Associates of Dallas P.A. in the mid 1980s. A California clinical endocrinologist, with whom I did my endocrine fellowship with, had a very successful obesity program. He convinced me to start one at EAD.
Patients on large doses of insulin were totally off insulin after two weeks. It was successful until the patients graduated from the program.
Unfortunately the recidivism rate (regaining weight) was around 80%. This rate was not dissimilar to the national overage at the time.
EAD stopped the program.
In my view there were not enough patients who turned the corner and stuck to the program.
I believe the restaurateur has turned the corner. This fellow has turned the personal responsibility corner to control his food intake and exercise output. I do not believe he will regain his weight.
He has exhibited personal responsibility for his health and well-being.
If only physicians could solve the obesity problem so easily, the cost of healthcare would plummet to sustainable levels.
The development of Type 2 Diabetes Mellitus would also plummet and the cost of the treatment of its complications would vanish.
Social change is necessary in restaurants and fast food chains.
People have to be taught to eat wisely in restaurants and at home.
People have to be provided with education about the perils of obesity.
People have to understand the natural history of obesity.
People have to be motivated to not only maintain their health. They have to be given financial incentives to control their health.
This can only be achieved with a consumer driven healthcare system in which people are provided with incentives to control their healthcare dollars.
The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.
All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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The New York Times editorial “The Republican Healthcare Con” should really be entitled “The New York Times Con of The Republican Health Care Con”
In my opinion The New York Times has become a biased newspaper. Instead of publishing “all the news fit to print”, it is printing articles and editorials that are biased opinions with incomplete facts.
The Republicans have not introduced their replacement of Obamacare yet this editorial is critiquing the replacements effect on the healthcare system..
Everyone is entitled to his or her own opinion. No one is entitled to his or her made up facts.
This is true. Most of the population seems to agree with this statement.
The only people buying insurance from the health insurance exchanges are people with pre-existing illnesses. These people have no other insurance available.
“Whatever the flaws of these policies (Obamacare), the new Trump administration is trying to pull off a con by offering Americans coverage that is likely to be so much worse that it would barely deserve the name insurance.
It would also leave many millions without the medical care they need.”
How does the New York Times editorial board know this when the Trump administration’s healthcare plan has not been introduced?
The liberal media keeps saying the Republicans have no plan. If Republicans do not have a plan how can the NYT criticize it?
How can a non-existent healthcare plan leave many millions without the medical care they need”?
There is no evidence for the statement above.
This reality became increasingly clear when President Trump’s choice to run the Department of Health and Human Services, Tom Price, testified before a Senate committee last week.
He looked pained as he described the terrible predicament of people who earned around $30,000 to $50,000 a year and had to deny “themselves the kind of care that they need” because they had Obamacare policies with deductibles of $6,000 to $12,000.
Tom Price M.D. is correct in saying the Obamacare deductibles are $6,000-$12,000. The NYT left out that the Obamacare networks available are restrictive and the access to proper healthcare is difficult.
The NYT editorial board also left out the fact that 85% of people buying healthcare insurance from the health insurance exchanges are subsidized by the government and have a pre-existing illness.
“ Yet, earlier in the same hearing, Mr. Price extolled the virtues of policies that would be woefully inadequate — policies that cover medical treatment only in catastrophic cases.”
This is a misrepresentation of Dr. Price’s testimony.
Perhaps the NYT editorial Board does not understand Health Savings Accounts?
Dr. Price was talking about the virtues of health saving accounts without being specific.
The goal of health savings accounts are to put consumers in control of their medical care and healthcare dollars while providing them with financial incentives to save retirement dollars and not waste medical care dollars.
Consumers could have control of what they spend for their own healthcare.
The employer or government would pay for the deductible and the reinsurance above the deductible.
The money would be put in a healthcare trust. The money in the trust would pay for medical care.
If consumers did not spend the money on medical care that year, it would go into a personal saving trust for those consumers retirement.
“ Such policies often have deductibles of around $14,000 for family coverage.”
Health Savings Accounts are the fastest growing healthcare insurance vehicle.
The government has put so many restrictions on health savings account that employees are hesitant to offer it. The government must remove these restrictions. www.unitedheath.com
“ This is simple hypocrisy. Condemn the policy you don’t like, propose something far worse as a replacement and claim that it is much better”
This paragraph is written to condemn Dr. Price and rile up the anti-Trump forces with false information.
The editorial completely disregards the fact that a proposal has not yet been announced by the Trump administration.
There were 2000 plus pages published about President Obama’s Obamacare proposal. There were glaring defects in he proposal.
The NYT did not comment on these defects at the time. Others did. I turned out that the defects were the source of Obamacare’s failure.
In reality the NYT has no idea of what the Trump administration’s proposal will be.
The NYT editorial also ignores the fact that Obamacare is unsustainable, unaffordable and is restricting access to care while rationing care for the very citizens that need the care.
“Mr. Price and Mr. Trump have recently said that their goal is to offer health care to many more people than are covered by the current health care law, which has driven the uninsured rate to historic lows.”
I believe historic lows are a counting error just as the unemployment rate and the inflation rate are counting errors in order to provide the Obama administration acceptable numbers.
Average people know exactly what is happening.
Mr. Price’s testimony and the legislation he introduced in the House (a few years ago), where until recently he was the Budget Committee chairman, show that the new administration will make decent health care less affordable and less accessible for most people.
The underlined portion is a NYT editorial opinion. It is an opinion without facts or evidence. It could also be a lack of understanding of the bill Dr. Price’s introduced.
The Trump administration’s upcoming proposal might be completely different.
How would the NYT know the Trump administration’s healthcare plan would make decent health care less affordable and less accessible for most people?
This is an unsubstantiated bias that would qualify as fake news.
“Those Health Savings Accounts would not help families earning the median household income of $56,000 a year because these families would never be able to sock away enough money.”
The NYT editorial either missed the concept of Health Savings Account totally or is reporting the concept to fit its bias.
The best description of what Mr. Price stands for can be found in a bill he introduced in 2015, the Empowering Patients First Act. It would “empower” Americans by eliminating the health care law’s expansion of Medicaid that has helped more than 10.7 million newly eligible people enroll in that government-run insurance program.
Many of these Medicaid patients cannot find a physician or hospital that accepts Medicaid.
Therefore they have very limited access to care.
A potential proposal could expand Medicaid patients’ access to care using health savings accounts.
It would also drastically cut subsidies that have helped 11.5 million people purchase private insurance on federal and state health exchanges.
There is no evidence for this wild statement.
Under his bill, people buying insurance for themselves would get between $1,200 and $3,000 a year in subsidies, down from an average of $4,600 that people get now on HealthCare.gov.
The amount of tax benefits or tax credits for Health Savings Accounts have been restricted by Obamacare in order to discourage its use.
The Obama administration wanted to control medical care and eliminate consumer choice and power.
President Obama wanted healthcare decisions to be in the hands of the central government.
The Trump administration plans to modify these restrictions. President Trump has stated he wants to put healthcare decision making back into consumers’ hands and not the government’s hands.
The bill would even get rid of the requirement that allows young people to stay on their parents’ insurance policy until age 26, a provision that is widely popular.
This is totally false and once again fake news.
And it would hurt people who get insurance through their employers by setting a cap on how much of that expense businesses can claim as a deduction on their taxes. Experts say that over time this would encourage companies to stop offering health benefits to workers.
The independent insurance market has not had tax deduction. It should be on a level playing field with group insurance. There is no evidence that the group market will lose its tax deduction.
“When it comes to health care, Mr. Price and other Republicans say their goal is to give people more choices. It is hard to argue against choice. But in the ideological world inhabited by Mr. Price, House Speaker Paul Ryan and many other Republicans, choice is often a euphemism for scrapping sensible regulations that protect people.”
This claim also has no basis in fact. It is pure opinion by the NYT editorial board.
“Some Americans might well be tempted by this far-right approach. They would have to pay less up front for these skeletal policies than they do now for comprehensive coverage.”
Has Obamacare provided comprehensive care? It is unaffordable and inaccessible to all.
But over time, when people need health care to recover from accidents, treat diabetes, have a baby or battle addiction, they will be hit by overwhelming bills.
Where did this come from? It came from a negative bias toward Donald Trump and his administration without facts or evidence.
The Trump administration seems perfectly willing to sell those people down the river with false promises.
People are not stupid. They do not need government to rule their life and make healthcare decisions for them.
People need incentive to control their health and healthcare dollars.
The opinions expressed in the blog “Repairing The Healthcare System” is, mine and mine alone.
All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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In 2008 I thought President Obama was the real deal.
I thought he cared about Americans and cared about repairing the healthcare system. I wrote six letters to him giving him suggestions on how to repair the healthcare system.
Then, I realized he was not interested in the improved delivery of healthcare to all Americans. He was interested in the central government controlling the healthcare system in order to control the people and limit their freedoms.
Obamacare was the answer to his goal. Most physicians did not agree with his plan. Many felt powerless to object. Many felt they should go along to get along.
Many in the healthcare industry figured that greater government involvement in healthcare financing would lead to its economic benefit.
Everyone has been deceived. Everyone is starting to believe that government managed healthcare leading to a better healthcare for all and a better healthcare system is a myth.
In my letters I tried to explain this to President-elect Obama. My explanation fell on deaf ears.
Dear President Obama Part 1
Dear President Obama Part 2
Dear President Obama Part 3
Dear President Obama Part 4
Dear President Obama Part 5
Dear President Obama Part 6
Over the last seven and a half years I have developed a simple but effective consumer driven healthcare system that should replace Obamacare after it is repealed.
Obamacare is missing the major ingredient necessary to create creating a successful healthcare system.
The healthcare system must be market driven, with consumers being responsible for their healthcare and healthcare dollars. The tool that will accomplish this is my Ideal Medical Saving Account. Please include reading the article My Ideal Medical Savings Account Is Democratic! among all the articles in the group explaining My Ideal Medical Savings Accounts.
The Republicans in the House got many things right in its legislation to replace Obamacare. However they have left out the three most important elements necessary to Repair the Healthcare System.
The first is the revival of the physician/patients relationship.
Consumers must control their health and their healthcare dollars. America must have a consumer driven healthcare system.
Consumers can be taught to drive the healthcare system though public service education.
Consumers must be taught through public service education to change their eating and exercising habits. The emphasis must be on the health dangers of obesity and its development.
Secondly, consumers must be given financial incentives as outlined by my Ideal Medical Savings Accounts to control their own health and have access to available care available in necessary.
Third, there must be significant tort reform included in the replacement of Obamacare.
If the Republicans simply send you the bill they have passed in the house and you sign it you will have an impending disaster as large as Obamacare.
If you include my suggestions in your bill, you would excite consumers and physicians. All the people who have been hurt by the failures of Obamacare will cheer you.
The repeal of Obamacare is vital. It should only be replaced with a consumer driven healthcare system that I have outlined. It will be economically sustainable. It would win over all conservatives and independents. It would even make progressives rethink their ideology.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
The following is Part 3 of my review of your healthcare reform platform. You have a viable alternative to Obamacare. Your alternative needs some vital additions.
In my last blog I omitted the link proving that only 1 million people signed up for Obamacare health insurance exchanges.
I apologize for the oversight. Today enrollment is only 2.3 million. I also noticed that the enrollment date was extended to January 30 from December 31 without fanfare. The site I omitted that follows daily enrollment is acasignups.net.
Obamacare is still a long way from the 20 million claimed and the actual 10 million enrolled for 12 months.
The Obama “experts” still believe that Obamacare is viable. They refuse to believe it has been a healthcare disaster as well as a disaster for America’s economy.
Your next proposal is;
Health Savings Accounts (HSAs) should be changed to Medical Savings Accounts (MSAs) to provide better financial incentives for people who choose this form of insurance. The Medical Savings Accounts can easily be customized so that consumers can choose the level of insurance they desire.
The cost of first dollar reinsurance for coverage after the deductible is met plus the MSA contribution is much cheaper than the first dollar coverage Medicaid coverage. The insurance vendor will still make a sizable profit by providing first dollar coverage reinsurance.
The contribution to the MSA should be flexible to provide an adequate amount of money to be put into the savings accounts to provide financial incentivizes to consumers to maintain their health.
Obesity is a huge problem to health maintenance of health. Obesity can be effectively cured behavioral change of consumers.
The incidence of chronic diseases in obese people is five times that of normal weight people. Financial incentives must be provided. The is also the area that social engineering might be helpful.
Obese children are becoming diabetic and hypertensive at a young age. This must be prevented because of the potential explosive cost effect of complications of both diabetes and hypertension on individuals. The overall costs to patients, Medicaid and society will be devastating.
Medicaid must be converted to a system where the recipients are responsible for their health with financial incentives. Only then Medicaid patients will not be treated as a commodity. Service will improve. .
Price transparency is an essential provision for individuals, businesses and groups in order to produce smart consumers of healthcare.
It is also necessary to require insurance companies to provide verifiable price transparency for their administrative costs and their direct patient care costs.
Consumers must be empowered to be responsible and shop for the best healthcare service value. They must look for the best prices for procedures, exams or any other medical related procedure.
The only way to decrease the cost of healthcare services is to produce smart and motivated consumers of healthcare.
The Healthcare System must be converted to a Consumer Driven Healthcare System.
Social networking should be used as the backbone for the establishment of consumer empowerment.
The success of Angie’s list, Trip Advisor and Open Table are a result of social networking.
All medical care is local. Local communities have their individual social networks that empower people in their neighborhood to know which vendors provide the best value in their community.
Healthcare consumers can use this simple procedure to decrease the cost of healthcare and medical care.
This could also be a place where government can lead the way in establishing accurate educational resources.
These block grants can be used by the states to fund MSAs without a threat of increasing state budget deficits or giving up states’ rights to the federal government.
Block grants for social networking should be used to provide incentives to help individual Medicaid patients seek out and eliminate fraud, waste and abuse of some of its local providers.
It would eliminate expensive big data collections that often times are inaccurate for policy making by central federal control.
Federal and state governments should help their citizens choose safe, reliable and cheaper products for the treatment of their diseases.
This would help with compliance and adherence to recommended treatment and also decrease the cost of care.
It would provide consumers with information to take responsibility for their own health and healthcare dollars.
One example is allowing consumers access to imported, safe and dependable drugs from overseas. It will stimulate competition for consumer dollars in the U.S. and lower the cost of brand and generic drugs sold here. Drug prices are artificially high in the U.S.
This is only one example of many ways to decrease the cost of drugs in this country.
You have made many proposals to make a lot of important changes to the healthcare system.
Some are good proposals. Some are not very well thought out by your advisors.
It is absurd to let Obamacare “experts” like Ezekiel Emanuel and Jonathan Gruber heckle your “non viable” healthcare reform plan.
However, you are missing the other important elements in reforming the healthcare system. Those elements are the elements of the use of consumer power, consumer initiatives, and consumer incentives.
By utilizing these elements you will begin to “Drain the Healthcare Swamp.”
Your healthcare changes must include a consumer driven system with an ideal medical saving account. Otherwise, the healthcare system will remain an unmanageable, expensive and abused mess.
You have admitted these proposals are simply a start. You can easily fall into the trap of listening to academicians who have never practiced medicine in a private setting. You need people who understand patients’ needs.
Obamacare has been a disaster that is unsustainable. It is increasing the cost of care week by week, while rationing care and decreasing access to care.
You must repeal and replace Obamacare. No one wants it. You have outlined a viable proposal even if the progressives don’t like it.
It is a good start.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
The following is Part 3 of my review of your healthcare reform platform. You have a viable alternative to Obamacare. Your alternative needs some vital additions.
In my last blog I omitted the link proving that only 1 million people signed up for Obamacare health insurance exchanges.
I apologize for the oversight. Today enrollment is only 2.3 million. I also noticed that the enrollment date was extended to January 30 from December 31 without fanfare. The site I omitted that follows daily enrollment is acasignups.net.
Obamacare is still a long way from the 20 million claimed and the actual 10 million enrolled for 12 months.
The Obama “experts” still believe that Obamacare is viable. They refuse to believe it has been a healthcare disaster as well as a disaster for America’s economy.
Your next proposal is;
Health Savings Accounts (HSAs) should be changed to Medical Savings Accounts (MSAs) to provide better financial incentives for people who choose this form of insurance. The Medical Savings Accounts can easily be customized so that consumers can choose the level of insurance they desire.
The cost of first dollar reinsurance for coverage after the deductible is met plus the MSA contribution is much cheaper than the first dollar coverage Medicaid coverage. The insurance vendor will still make a sizable profit by providing first dollar coverage reinsurance.
The contribution to the MSA should be flexible to provide an adequate amount of money to be put into the savings accounts to provide financial incentivizes to consumers to maintain their health.
Obesity is a huge problem to health maintenance of health. Obesity can be effectively cured behavioral change of consumers.
The incidence of chronic diseases in obese people is five times that of normal weight people. Financial incentives must be provided. The is also the area that social engineering might be helpful.
Obese children are becoming diabetic and hypertensive at a young age. This must be prevented because of the potential explosive cost effect of complications of both diabetes and hypertension on individuals. The overall costs to patients, Medicaid and society will be devastating.
Medicaid must be converted to a system where the recipients are responsible for their health with financial incentives. Only then Medicaid patients will not be treated as a commodity. Service will improve. .
Price transparency is an essential provision for individuals, businesses and groups in order to produce smart consumers of healthcare.
It is also necessary to require insurance companies to provide verifiable price transparency for their administrative costs and their direct patient care costs.
Consumers must be empowered to be responsible and shop for the best healthcare service value. They must look for the best prices for procedures, exams or any other medical related procedure.
The only way to decrease the cost of healthcare services is to produce smart and motivated consumers of healthcare.
The Healthcare System must be converted to a Consumer Driven Healthcare System.
Social networking should be used as the backbone for the establishment of consumer empowerment.
The success of Angie’s list, Trip Advisor and Open Table are a result of social networking.
All medical care is local. Local communities have their individual social networks that empower people in their neighborhood to know which vendors provide the best value in their community.
Healthcare consumers can use this simple procedure to decrease the cost of healthcare and medical care.
This could also be a place where government can lead the way in establishing accurate educational resources.
These block grants can be used by the states to fund MSAs without a threat of increasing state budget deficits or giving up states’ rights to the federal government.
Block grants for social networking should be used to provide incentives to help individual Medicaid patients seek out and eliminate fraud, waste and abuse of some of its local providers.
It would eliminate expensive big data collections that often times are inaccurate for policy making by central federal control.
Federal and state governments should help their citizens choose safe, reliable and cheaper products for the treatment of their diseases.
This would help with compliance and adherence to recommended treatment and also decrease the cost of care.
It would provide consumers with information to take responsibility for their own health and healthcare dollars.
One example is allowing consumers access to imported, safe and dependable drugs from overseas. It will stimulate competition for consumer dollars in the U.S. and lower the cost of brand and generic drugs sold here. Drug prices are artificially high in the U.S.
This is only one example of many ways to decrease the cost of drugs in this country.
You have made many proposals to make a lot of important changes to the healthcare system.
Some are good proposals. Some are not very well thought out by your advisors.
It is absurd to let Obamacare “experts” like Ezekiel Emanuel and Jonathan Gruber heckle your “non viable” healthcare reform plan.
However, you are missing the other important elements in reforming the healthcare system. Those elements are the elements of the use of consumer power, consumer initiatives, and consumer incentives.
By utilizing these elements you will begin to “Drain the Healthcare Swamp.”
Your healthcare changes must include a consumer driven system with an ideal medical saving account. Otherwise, the healthcare system will remain an unmanageable, expensive and abused mess.
You have admitted these proposals are simply a start. You can easily fall into the trap of listening to academicians who have never practiced medicine in a private setting. You need people who understand patients’ needs.
Obamacare has been a disaster that is unsustainable. It is increasing the cost of care week by week, while rationing care and decreasing access to care.
You must repeal and replace Obamacare. No one wants it. You have outlined a viable proposal even if the progressives don’t like it.
It is a good start.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
If you tell a lie enough times it becomes the truth. President Obama and Hillary and Bill Clinton keep telling the American public that there are 20 million new Obamacare enrollees.
Obamacare advocates believe that Obamacare provided healthcare insurance for 20 million people who did not have healthcare insurance before Obamacare.
These Obamacare advocates have little understanding of the details of this lie. They usually react negatively when I tell them the 20 million new enrollee figure is a lie.
Republicans do not pick this up and call Democrats out about this lie. Perhaps they have no understanding of what is going on.
The lie then becomes the truth.
I follow Charles Gabbe at http://acasignups.net. Charles Gabbe is pro Obamacare. He publishes daily and weekly statistics as well as news in general about Obamacare’s progress and enrollment.
His numbers come from government sources. His numbers are very different than the numbers President Obama, Hillary and Bill Clinton are announcing.
The Obama administration continually manipulates the enrollment figures in order to give the impression that Obamacare has been successful.
President Obama continuously lies about the enrollment figures.
Obamacare has been a total failure because of its structure.
On December 9, 2015 ACAsignups.net published these enrollment numbers for 2016.
Confirmed 2016 Exchange QHPs: 3,260,356 as of 12/09/15
Estimated 2016 Exchange QHPs: 4.73M as of 12/09/15 (3.60M via HCgov)
Projected Exchange QHPs: 5.76M by 12/12/15 (4.34M via HC.Gov)
Projected #OE3 QHP Selections: 14.70M nationally (11.23M via HC.gov)
Projected #OE3 QHP Selections by State
Maybe 9 million signed up for Obamacare last year. (2015)
What were the 12/09/14 enrollee numbers with 3 weeks to go until January 1, 2015?
Christmas to New Years consumes one week of enrollment. Holiday shopping will consume the other two weeks.
Why did the government reduce the expected enrollment to 5 million when enrollment was 9 million last year (2016)?
Does the Obama administration expect 4 million people to drop out of Obamacare because it is too expensive?
How did the Obama administration’s data given to the CBO cause the CBO to predict an enrollment of 21 million enrollees for 2016?
The 2016 Obamacare enrollment figures barely touch 10 million, not 20 million.
What is enrollment going to be when most of the major insurance companies have dropped out of the health insurance exchanges?
What is enrollment going to be when 18 of the 22 Obama administration created State Co-Ops have gone bankrupt?
President Obama and his administration have mislead Americans about the exact number of enrollees since the very beginning of the first enrollment period starting October 1, 2013. The first enrollment was delayed until November 1, 2013 and extended 6 months.
The American public has been mislead about:
Along the way I got the feeling that none of the enrollment numbers could be trusted. HHS and CMS kept modifying and lowering them.
The Obama administration keeps telling American how great the enrollment is and that Obamacare is a success.
However, we are told only ten million enrollees had Obamacare insurance in 2016.
Eighty five percent of those on Obamacare are receiving subsidies so the premiums are affordable. These subsidized recipients still cannot afford the deductibles.
The remaining 15% enrollees have a pre-existing illness. They cannot find private insurance to buy.
What about the 330 million people who might have subpar healthcare insurance? How many employers might discontinue employee insurance?
After five years with all the new Obamacare taxes, I would not call Obamacare a successful healthcare reform program.
All of these enrollees are in the individual insurance market. These numbers do not include the group insurance market.
14 million people in the individual market lost their healthcare insurance pre Obamacare.
10 million gained insurance on the healthcare insurance exchanges in 2016. There is a net decrease of 4 million individuals that is not discussed by the Obama administration or the traditional mass media.
Many of the state healthcare insurance exchanges have failed.
Eighteen of the 22 state insurance co-ops have failed so far.
An unknown number of enrollees in 2014 did not re-enroll in 2015 because of the loss of the subsidy.
Other enrollees did not sign up again because they could not afford the high deductible.
At the end of 2015 enrollment the Obama administration announced that 11.5 million people were enrolled.
On March 16, 2015 the administration said about 16.4 million people have gained health insurance coverage since the Affordable Care Act became law nearly five years ago.
Please notice the tricky wording. The Obama administration is counting children under 26 that now can be included in their parents’ group insurance plans and the additional Medicaid recipients added by some states.
The count is not only the people who enrolled in Obamacare through the healthcare insurance exchanges.
The discussion should be about the success of the healthcare insurance exchanges not the increase in Medicaid coverage.
The 2014 enrollment figures as of March 18, 2015 were also inflated. It is noteworthy than the Medicaid/CHIP estimate was 14.1 M. It is down to 10 million in 2016.
Confirmed Exchange QHPs: 11,699,473 as of 3/18/15
Estimated: 11.95M (9.06M via HCgov) as of 3/18/15
Estimated ACA Policy Enrollment: 33.1M (10.46M Exchange QHPs, 8.20M OFF-Exchange QHPs, 330K SHOP, 14.1M Medicaid/CHIP)
Written into the law is that only state healthcare exchanges can provide subsidies not the federal health exchanges.
President Obama has not asked congress to rewrite the law’s provision.
This was another example of executive overreach of power by President Obama.
It looks as if President Obama cannot help himself from trying to manipulate the American public.
Republicans have not pointed out all this manipulation to the voting public.
I believe the public has figured out the manipulation.
Hillary Clinton has promised she will expand Obamacare. Why expand a failed program?
Her unspoken goal is to institute a single party payer system. A single party payer system will also be unsustainable.
There is a better way!
It is a consumer driven healthcare system with my ideal medical saving account.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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