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Dear President-elect Trump Part 3

December 1, 2016

inHealth Savings Accounts vs Medical Savings Accounts, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests

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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;

Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate.

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. .

Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals.

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.

Block-grant Medicaid to the states.

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.

Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products.

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.

Encourage Congress to step away from the special interests and do what is right for America.

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.

You left out Tort Reform, which is one of the most important proposals. Effective Tort Reform will result in a precipitous decrease in the cost of medical care.

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.

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When Its Not Your Money

October 25, 2016

inMedicaid, Medicine: Healthcare System

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Stanley Feld M.D.,FACP,MACE

No one should be surprised at the money wasted by federal government programs. President Obama has been the biggest offender of wasting taxpayers’ money in my lifetime.

He increased the national debt from 10 trillion to 20 trillion dollars.

The volume of regulations, the creation of bureaucratic agencies, bureaucratic czars and the lack of enforcement of existing laws have served to create much of this waste.

However the public is unaware of the amount of taxpayers’ dollars spent because of the lack of government transparency. Congress ought to be standing on every mountain screaming about the waste.

I have observed the opposite. All we have to do is remember how congress marginalized Tom Coburn’s efforts to eliminate waste by eliminating duplication.

Obamacare is no exception to immeasurable waste while it destroys the healthcare system.

Improper payments for Obamacare are soaring because of a defective law and government inefficiency and incompetence.

A study by HHS shows that the improper payment rate for Medicaid will be 11.5% for 2016. It means that more than one out of every 10 dollars spent is wasted on either fraud, errors in payment or accounting inaccuracy.

The pre-Obamacare improper payment rate was 5.8% or one in 20 dollars spent. In 2015 it was reported that the improper payment rate was 9.7%.

This is the waste rate for only 10 million people added to the Medicaid roles.

I would suspect all three reports are an underestimate of the real improper payment rates.

The actual dollar amounts of improper payment rates are increasing because Obamacare has expanded Medicaid enrollment.

As the number of Medicaid recipients increase the wasted dollars will increase.

With President Obama’s new executive order to expand the eligibility of illegal immigrants for Medicaid coverage, the rate and amount of dollars improperly deployed will skyrocket.

To my amazement a lot of intelligent people are ignoring this simple arithmetic.

Medicaid eligibility is increasing rapidly. In 2015 Medicaid enrollment increased by 13.8%. One in five Americans as well as all illegal immigrants are entitled to Medicaid coverage.

I guessed that HHS would blame physicians for the waste. I was correct.

Medicaid reimbursement is so low that physicians have figured out ways to see more patients per day. They are using physician extenders extensively.

These physicians are accused of running Medicaid mills. They are accused of Medicaid fraud.

Then these physicians are put through a costly audit and are penalized. Many get fined for fraud and abuse due to overbilling.

There are many other reasons for this waste. Most important is HHS’ lack of proper diligence in administering the program. It smacks of reasons similar to the VA Healthcare System scandals.

“There’s no particular reason the error rate should be spiraling upward other than overwhelming incompetence.”

On closer look, home health agencies are probably the biggest abuser along with an ineffective bureaucracy that becomes more ineffective as the program grows.

“In recent audits of Medicaid in Arizona, Florida, Michigan and New Jersey, the GAO uncovered 50 dead people who recouped at least $9.6 million in benefits after they died; 47 providers who registered foreign addresses as their location of service in places such as Saudi Arabia; and $448 million bestowed on 199,000 beneficiaries with fake Social Security numbers—12,500 of which had never been issued by the Social Security Administration.”

The problem is not discussed by the traditional mass media. The public has no idea this is occurring.

Medicaid is a single party payer system completely controlled by the government. Patients have no control over which doctors they will see for an illness.

Medicaid is another clear example of the lack of concern or incompetence by government agencies for spending other peoples’ money.

Even worse, the system does not work for patients or physicians. Patients are the most important stakeholders in the healthcare system. They are treated like a commodity.

Medicaid is inefficient and costly.

Twenty percent of our population is now in this system. There is limited access to care and rationing of care.

There is a better way. It is a consumer driven healthcare system using my ideal medical saving account.

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

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Bill Clinton Is Crazy As A Fox

October 9, 2016

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP, MACE

Many Republicans and Democrats thought Bill Clinton had lost his mind when he made his Obamacare statement earlier this week.

Most of the conservative traditional and alternative media also thought he lost his mind. They repeated Bill Clinton’s statement over and over again. The media’s goal on both sides of the aisle simply wanted to make sure it sunk into the head of the American people.

Notable & Quotable: Bill Clinton on ObamaCare

“Former President Bill Clinton speaking about ObamaCare at a rally Monday in Flint, Mich.:”

“The people that are getting killed in this deal (Obamacare) are small business people and individuals who make just a little too much to get any of these (Obamacare’s) subsidies.”

“ Why? Because they’re not organized.”

“ They don’t have any bargaining power with insurance companies. And they’re getting whacked.”

“ So you’ve got this crazy (healthcare) system where all of a sudden 25 million more people have health care, and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half.

It’s the craziest thing in the world.”

Clinton

https://youtu.be/ETVcsPRTSHM

Trump

https://youtu.be/jziTLD0Gc7Y

Bill Clinton knew exactly what he was doing. Hillary Clinton’s position on Obamacare has been clearly stated. She is for Obamacare and for the public option. She has stated that she is going to expand Obamacare.

Bill Clinton’s position sounds totally opposite his wife’s position.

Hillary Clinton’s website explains her position on healthcare clearly.

She wants to : “Defend and expand the Affordable Care Act, which covers 20 million people.”

Hillary Clinton stating that 20 million people were covered by Obamacare is untrue. In 2016 the health insurance exchanges only cover 10 million people. Obamacare has expanded Medicaid coverage by 10 million people. Medicaid coverage is less than ideal.

The comments in the WSJ about Bill Clinton’s comments are more entertaining than Bill’s comments about Obamacare.

One comment suggested that Bill Clinton is jealous of his wife.

“This is called a “Bill bomb”, designed to passive aggressively tank Hillary’s campaign so he doesn’t have to go back on the leash.”

“She was lagging in the polls, Bill had nothing, but she is surging again and Bill can’t have that.”

Some of the comments applaud Bill Clinton for finally speaking the truth.

1.” You gotta love it when Bill sounds like a Republican.”

“It is so refreshing to hear a Democrat politician speak the truth. And oh, so rare. Perhaps Bill forgot to take his medication.”

“Give the Democrats credit whenever they do something intelligent, and non-ideological, even if they do it for a confounding reason.”

4. “Leave it to Bill to hit the nail on the head. Pure genius.”

5.”Perhaps there is one Clinton who tells the truth.”

This commentator forgot all of the lies Bill Clinton’s told us (the public) when he was president such as his most famous lie, “I did not have sex with that woman.”

6.” I don’t know what’s more shocking: Bill slamming Obama’s signature law or a Clinton telling the truth.”

7.” He must have been off his meds at the time he made the comment, the next day he was back on track. I guess Hillary had to break another lamp over his head.”

I believe Bill Clinton did a brilliant thing for his wife. Obamacare is going to fail. He and Hillary do not want to have anything to do with Obamacare’s failure.

Consumers have discovered that their premiums and deductibles for 2017 are rising to unaffordable level. These increases are because of Obamacare. The private sector has also experienced tremendous increases in premiums and deductible because of Obamacare.

Open enrollment for the health insurance exchanges are supposed to start November 1, 2016, seven days before the Presidential election. If Hillary Clinton does not separate herself from Obamacare it will sink her chances to be elected.

I think the Obama administration will delay open enrollment until after the Presidential election.

President Obama might be able to pull Obamacare’s failure out of the dirt if he is able to illegally obtain the “Judgement Fund” money to pay the healthcare insurance industry the money he owes them.

The Republican establishment in congress should make a stink about the release of this money. The Republican establishment should not sell out to President Obama.

President Obama is pulling another illegal fast play on congress and the American taxpayer by getting this money.

President Clinton’s statement is his effort to distance his wife from the Obamacare impending failure.

His statement demonstrates the Clintons’ character. After President Obama and Michelle Obama went all out to endorse Hillary Clinton for President, Bill Clinton stabs President Obama’s legacy legislation in the back.

“Now that the Obamas have given Hillary their full-throated endorsement, Bill can take policy positions more in line with suffering middle class voters. In Clintonworld expedience supersedes truth.”

Hillary Clinton’s goal is to usurp credit for healthcare reform from President Obama.

She wants to be able to say that healthcare insurance plans do not work.

America needs a single party payer system and it needs it now.

Bill Clinton’s assessment is correct on the issue of Obamacare. All Obamacare is doing is merely shifting costs from those who cannot pay to those who can pay.

It is truly a healthcare system that redistributes wealth as Dr. Don Berwick said a long time ago.

The Clintons want a single party payer system real fast so that they look like they are coming to the rescue of the American people.

Democrats running for congress have rapidly gotten on the Clinton bandwagon.

Clinton’s proposal is simply bait and switch.

The problem is a single party payer system detrimentally affects the middle class taxpayer the most as I have explained.

They are trying to make Obamacare’s failure into an election issue asset for Hillary Clinton who will come to the rescue with her single party payer system.

A single party payer system is unsustainable and has huge defects.

I also know the majority of the middle class does not trust Hillary or Bill Clinton.

The Clintons will not fooled the majority of the middle class again.

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

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What Exactly Is A Public Option?

September 28, 2016

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

Obamacare is failing. The impending disaster is coming November 1^st when the insurance vendors publish their premium prices for Obamacare’s Health Insurance Plans.

Consumers will be shocked by the 20% increase in premiums, the sparse selection of insurance vendors and the higher deductible.

As a distraction from the failure of Obamacare, the progressive Democrats are now trying to sell the “Public Option” as the savior of Obamacare.

I have received several questions asking what exactly is the “Public Option.” The “Public Option” was turned down in 2009 when Democrats were in control of both houses of congress.

How could a “Public Option” be passed in a Republican controlled congress? It can’t be passed.

The Democratic push to sell the “Public Option” is political theater. It is meant to provide hope for President Obama’s progressive base and blame Obamacare’s failure on the Republicans.

It is also meant to distract the traditional mainstream media from the impending Obamacare failure and upcoming disasterous enrollment before the Presidential election.

Here is the answer to the question “What exactly is the Public Option ? ”

It is another defective program that will fail. If passed by congress it will result in the deepening distruction of the healthcare system.

The “Public Option” was first introduced into Obamacare at the onset of the passage of the act. It was eliminated from the bill in a Democratic dominated congress because as Barney Frank said, “We don’t have the votes”.

Barney Frank and John Kerry were convinenced that the only way to get to a single party payer system in the United States was though a “Public Option.”

The “Public Option” is the creation of a federal government-run health insurance agency. The goal of this new insurance company would be to compete with private health insurance companies on price within the United States.

The original published purpose of the “Public Option” was to provide more affordable health insurance rates to uninsured citizens who are either unable to afford the rates of or are rejected by private health insurers.

Now it will be providing cheaper insurance than the private insurance companies are offering to force the private insurance companies to reduce their premiums.

The private insurance companies will not show up to compete.

Obamacare was supposed to be doing creating competition through its Health Insurance Exchanges and State Co-Ops for the people with pre-existing illness and the poor.

The result was premiums went through the roof for both the Health Insurance Exchange policies and private insurance policies.

The government is ended up providing subsidies for 85% of only 10 million people who have bought insurance through the Health Insurance Exchange. It is economically unsustainable for the government and tax payers if the entire population would buy insurance through the Public Option.

It is obvious that the government would try to undercut the private insurance companies and force the private insurance compaies to lower their prices. The result would be bankruptcy as the State Co-Ops experienced.

“Supporters argued that a government insurance company could successfully lower its rates by using greater leverage than private industry when negotiating with hospitals and doctors,^[18] as well as paying the employees of the public option insurance company salaries as opposed to paying based on individual medical procedures.^[19]”

However, the federal government is dependent of the healthcare insurance industry for the administrative services necessary in adjudicating healthcare insurance claims.

Federal government dependence is true of all government healthcare programs except the VA Healthcare System.

Does anyone think the federal government bureacracy can run a healthcare system effectively and efficiently?

The healthcare insurance industry builds profit into its administrative services contracts. The federal government’s bureacracy cannot control those prices.

The reduced premium pricing would result in government subsidizing the “Public Option” further resulting in an increase in the federal deficit. This has happened in Medicare. Premiums have gone up, covered care has gone down. Medicare is unsustainable.

The recipients of Medicare think it is a wonderful program. The trustees of Medicare feel it is unsustainable simply because of the massive hidden subsidies and cost overruns.

There is no question that premiums are increased, reimbursement to providers has decreased, care is rationed and access to care has decreased.

No one in government is thinking of a more efficient way to format Medicare.

Neither Barak Obama, Hillary Clinton, or Bernie Sanders are thinking about the consumer and the consumers’ needs at this point.

Neither are they thinking about a healthcare system that is affordable to the federal government or the consumers of healthcare.

No one is thinking about consumers driving the healthcare system and being responsible for their health and healthcare dollars.

These politicians are only thinking about power and central control by the federal government over the healthcare system no matter the cost to the federal government, the tax payer, the quality of care delivered to consumers, or the system’s effect on economic growth.

“The real sign of how Bernie Sanders changed the Democratic Party can be seen not just in shifts in the Democratic Party platform, but in how the party’s current leader, Barack Obama, has altered his own posture. “

“And this week, in a special communication to the Journal of the American Medical Association, Obama endorsed a public health insurance option to enhance the Affordable Care Act, his signature legislative achievement.”

“This puts Obama in line with his preferred successor, Hillary Clinton, who recently reiterated her support for a public option and for allowing Americans between 55-65 to buy into Medicare. Both policies tilt toward Sanders’s vision of universal coverage.”

Philosophically it is called Socialism.

Big government controlling society does not work. There are countless examples of socialism’s failures in Europe, bankruptcies, unemployment and stagnation, both economically. and politically.

America must learn now. We ought to adopt a healthcare system that is consumer driven.

Big government and its bureaucracies cannot do it for us. It has led from one disaster to the next. It will destroy our healthcare sytem.

America should try a system that provides financial incentive to the public so people are responsible for their health and healthcare dollars.

The government should adopt a healthcare system that I have outlined.

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

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The Deception and Disinformation Continues

September 2, 2016

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

When Co-Op Health Insurers close, what happens to customers’ all ready paid in deductibles?

The new insurer will not credit the already paid deductibles in 2016. Consumers will have to start all over again with new deductibles. This is despite President Obama’s implied promise that consumers will get credit for the deductibles paid.

President Obama’s goal was to make Obamacare as complicated as possible so no one could understand it.

I believe neither he nor his administration understand all the interwoven parts and the unintended consequences.

Obamacare was built to fail.

Obamacare was built so that whatever part of the component policy failed, that policy would ultimately default to a single party payer system. The original goal was to have complete government control of the healthcare system.

The federal government would control choice and restrict access to medical care.

Americans’ free choice would be disappear.

Obamacare’s healthcare exchanges have only been attractive to people who could not obtain healthcare insurance because they had pre-existing illnesses.

That was a good thing. However, premiums were too high for the healthy uninsured.

The healthy uninsured would pay for the consumers with preexisting illnesses and spread the risk. The thought was that it would lower the cost of insurance.

The Obama administration lent $2.5 billion dollars to only 22 states that opted to set up Co-Ops to compete with the healthcare care insurance companies offering insurance through the health insurance exchange in those states.

These Co-Ops were destined to fail. The Obama administration’s plan was to low ball the insurance premiums and force the healthcare insurance companies to compete and lower their premiums.

President Obama’s reinsurance program to subsidize and protect insurers from loss fell apart because of budget restraints that he signed into law.

High-risk people with pre-existing illnesses flocked to sign up for the Co-Op’s healthcare insurance. The Co-Op insurance plans were poorly advertised and constructed. Few healthy people bought the plans.

We are constantly told how many people lost their insurance and their deductible.

In reality the Co-Ops was the “public option” without the approval of congress.

So far, seventeen of the twenty-two have declared bankruptcy so far. The remaining five Co-Ops are on the way. The federal government will never get paid back for the $2.5 billion dollars in loans.

Illinois’ Co-Op “ Land of Lincoln” declared bankruptcy and closed out over 49,000 patrons. The have to get new insurance to cover them for October, November and December.

“A large insurer (Blue Cross and Blue Shield of Illinois) on the Illinois’ Obamacare exchange has decided not to credit former Land of Lincoln members for money they’ve already paid toward their deductibles despite a request from the state to consider doing so.”

“They will likely have to start from zero again on their deductibles and out-of-pocket max payments — in some cases costing them thousands of additional dollars.”

The other large insurers have not commented yet. President Obama has not come through with his promise to cover these deductibles.

President Obama and his press secretary deny Obamacare is in trouble. The casual observer who reads are Paul Krugman’s articles in the New York Times and believes he personally has adequate healthcare insurance would also believe the lie.

Paul Krugman is President Obama and Hillary Clinton’s hatchet man. When something goes wrong in any area of the economy Mr. Krugman blames it on the Republicans without evidence or data.

The New York Times and his readers believe him without critically evaluating his statements.

Paul Krugman: “Most of the news about health reform has been good, defying the dire predictions of right-wing doomsayers.”

This is lie. He has no positive evidence for this statement except that Obamacare has added 10 million people to the Medicaid program.

This could have been accomplished without Obamacare by simply raising the definition of poverty from its obsolete 1955 level.

Paul Krugman :“But this week has brought some genuine bad news: The giant insurer Aetna announced that it would be pulling out of many of the “exchanges,” the special insurance markets the law established.”

Others have pulled out in addition to Aetna.

UnitedHealth, Cigna, Blue Cross and Blue Shield and other smaller insurance companies such as Baylor/ Scott and White have pulled out because they have lost huge amounts of money. Their losses are unsustainable for their business.

Seventeen of the 22 federally funded Co-Ops have gone bankrupt and closed down. They were supposed to create competition like the public option to keep premium prices and deductibles down.

Paul Krugman says: “This doesn’t mean that the reform is about to collapse.”

What does it mean? He does not say.

Then he goes on to attack the Republican Party and Donald Trump.

“They’re problems that would be relatively easy to fix in a normal political system, one in which parties can compromise to make government work. “

Maybe the Republicans cannot compromise because Obamacare was so poorly conceived and constructed.

Obamacare has been a waste of government money and taxpayers’ money. It is destroying the delivery of medical care. I would call this a failure.

Maybe the Republicans are correct in opposing a law that is increasing the federal deficit while claiming is that it is budget neutral.

It is unbelievable that Hillary Clinton wants to expand Obamacare. Isn’t it because Obamacare is failing and unsustainable?

Then Mr. Krugman goes on to take an inappropriate swing at Donald Trump.

“But they (the problems) won’t get resolved if we elect a clueless president (although he’d turn to terrific people, the best people, for advice, believe me. Not.).”

Paul Krugman then goes on to tell lie after lie about the success of Obamacare and how unfairly Republicans view Obamacare.

“Paul Krugman says:” The economy of race prevents Medicare and Obamacare expansion.”

“White voters “don’t like the idea of helping neighbors who don’t look like them”

“New York Times columnist Paul Krugman argued Monday that the opposition of red states like Texas to accepting federal money to fund Medicaid expansion isn’t based, as claimed, on a commitment to smaller government and the superiority of the free market so much as it is the politics of race, and who would receive those funds.

Medicaid expansion, Krugman noted, disproportionately benefits nonwhite Americas, and voters in red states — particular the white ones — “don’t like the idea of helping neighbors who don’t look like them.”

Paul Krugman is an economics professor. Can’t he figure out that the system has failed economically? American needs a better system with responsible consumers driving the system.

Who is stimulating race wars without facts or evidence?

Paul Krugman is stimulating race wars with unfounded statement like this in order to defend Obamacare and President Obama’s legislation. Legislation that has failed.

“Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law.”

Higher than expected costs have led UnitedHealth, Aetna, Humana and many smaller companies such as Baylor/Scott and White to pull out of Obamacare’s federal health insurance plan.

With the demise of the state Co-Ops the competition is even slimmer.

“The Kaiser Family Foundation, in a study commissioned by the Wall Street Journal, estimates that 19% of Obamacare enrollees seeking coverage in 2017 will be in a market with just one insurer, up from just 2% in 2016. Another 19% will have access to just two carriers, up from 12%.

Forty percent of 10 million people is 4 million people who are going to be affected by a decrease in competition. The total enrollment in Obamacare has been stagnant the last 3 years.”

We must repeal this debacle called Obamacare and start a new system that could work. A consumer driven healthcare system for all as described in my article “My Ideal Medical Saving Account is Democratic.”

It includes everyone. It provides financial incentives to everyone to be responsible for their own health and healthcare dollars.

“What do we have to lose?”

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

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We Never Learn: Watch Out Colorado

August 10, 2016

inDisinformation and the healthcare system, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP, MACE

“You can always count on Americans to do the right thing – after they’ve tried everything else.”

Winston Churchill

There are many smart people in America.

Americans form opinions from the information presented to them. When the information presented in incorrect or incomplete it is easy to form the wrong opinion.

The art of presenting misinformation and disinformation has been perfected.

The people of Colorado are now being bombarded with the need to pass Amendment 69 or ColoradoCare.

Most Coloradans have not paid sufficient attention to the amendment. Their opinions are being influenced by misinformation or inadequate information concerning the unintended consequence that are inevitable.

Many might look at ColoradoCare’s official website. http://www.coloradocare.org/know-the-facts/increases-savings/ and read the following.

“With Amendment 69, ColoradoCare, every Colorado resident can contribute their best, knowing ColoradoCare has everyone covered with universal health care.” Sounds wonderful.
“ Imagine life with ColoradoCare. If you’re a resident and you need any kind of health care (including mental health), you just go to see your provider, and ColoradoCare pays the bill.”Free is great.
“Without the layers of hassles, businesses, providers, and everyone in the state can go about their important work of contributing to their families and communities knowing ColoradoCare has everyone covered.” The problem is nothing is free.
In a statement to the Colorado Independent October 2016, Bernie Sanders lent his support to the single-payer measure.
“Colorado could lead the nation in moving toward a system to ensure better healthcare for more people at less cost. In the richest nation on earth, we should make healthcare a right for all citizens.”

Hillary Clinton has not yet supported ColoradoCare. I believe she is afraid it will steal her thunder by having large increases in government healthcare expenditures she has planned. She plans to increase taxes and get healthcare governance firmly in the hands of the federal government.

The ColoradoCare website goes an to say,

“An economic analysis of health care spending in Colorado has calculated that comprehensive health coverage for every resident could be paid for with pre-tax payroll premiums of 3.33% for employees and 6.67% for employers.”

There has been no effort to prove these numbers are correct.

In fact, all of the Republican establishment politicians in Colorado are against ColoradoCare as well as many high ranking members of the Democratic establishment.

The Democratic establishment includes Governor John Hickenlooper and former governor Bill Ritter. They are opposed to Amendment 69’s passage because they understand the financial burden ColoradoCare would put on the state’s budget and growth.

The size of the current state budget is $25 billion dollars. The tax increase for ColoradoCare would be an additional $25 billion dollars. Everyone can assume the state would need more to implement the program.

“ColoradoCare would be far and away the largest tax increase in state history, and would give Colorado the highest tax rate in the nation.”

“ This would be implemented as a payroll tax that would be split into 3.33% for employees, and 6.67% by employers.

An additional $18billion dollars would be asked of the federal government, as well as a waiver to let the state opt out of the Affordable Care Act in order to fund Colorado care.

If voters approve ColoradoCare, it would be written into the state constitution, making it very difficult to dismantle and impossible to amend.

The president of the Denver chamber of commerce is opposed to ColoradoCare because the chamber knows this will drive businesses out of the state and inhibit businesses from coming into the state. The Denver chamber of commerce has worked very hard and very successfully to bring business into the state.

Most of all these politicians know that Obamacare has failed. Oregon’s attempt at the state being the single party payer has failed.

Most recently, Vermont’s attempt at a single party payer system has failed.

Both Oregon’s and Vermont’s governance realized the great fiscal burden to the state budget as well as its businesses and residents.

These states quit before the taxpayers realized the extraordinary tax burden the single party payer system would have on their state.

However, most progressive thinking people cling to the ideology that a single party payer system is the way to universal coverage.

Why did Vermont fail to institute a single party payer system after the state legislature passed the bill?

I will describe the reasons for failure in my next blog.

Walker Stapleton, the Colorado state treasurer said, “a major part of his responsibilities is attention to the fiscal and economic condition of the state.”

He goes on to say,

“If passed by the voters, the provisions of Amendment 69 will have a great negative impact on the state’s fiscal and economic health, as well as impacting individual residents fiscally.”

“If passed, Amendment 69 — creating a governmental entity called ColoradoCare to administer the health care payment system — would amend the Colorado Constitution. It would not be a legislative issue to which the Colorado Legislature could make amendments as needed.”

Walker Stapleton said the state health exchange was supposed be self-sustaining. However, the state health exchange has blown through federal dollars provided.

The State has no way to fix the state exchange or has a way to pay back the federal loan. Walker Stapleton acknowledged the problems with Colorado Health Benefit Exchange, saying, “The exchange was intended to be self-sustaining, and it is anything but, and we have blown through federal dollars.”

United Health and others are leaving the exchange. The exchange has one-fifth of the enrollment anticipated because of cost, network size and service.

“The exchange is in a hole and we have not yet come up with a way to fix it,” he said.

He added that Amendment 69 would assume the state health exchange burden in addition to its debt.

This burden is not good for the single party payer financial burden.

ColoradoCare (Amendment 69) was proposed by a Boulder State Senator, a progressive M.D., with support of the other progressive M.D.s in the Boulder, Colorado community.

Most of the M.D. practices in the Boulder community are owned by Boulder Community Hospital.

I wonder if the M.Ds understand the unintended consequences to the state’s fiscal health, the unintended consequence to the business environment as a result of the increase in tax rate and the unintended consequence to residents experiencing increases in taxes.

I wonder if these physicians are aware of the unintended consequences to their ability to practice medicine.

I suspect the author of the amendment and her followers have not thought about the unintended consequences.

Consequences.

1. Amendment 69 authorizes state taxes be increased $25 billion annually in the first full fiscal year and by such amounts that are raised thereafter.

2. ColoradoCare would be exempt from Taxpayer’s Bill of Rights (TABOR).

3. “A 10 percent payroll tax for every employer in Colorado,” Stapleton said.

The employer would pay 6.7 percent and the employee 3.3 percent. If a taxpayer were self-employed, he/she would pay both, for a total 10 percent.

4. Investment income is subject to this tax. 5. If the employer is outside the state, the tax does not apply for the employer’s 6.7 percent so the employee pays the full 10 percent. Walker Stapelton said, “It is possible retirement income would be taxed,”

Also of great concern to Stapleton are these additional provisions in Amendment 69:

• Transferring administration of the Medicaid and children’s basic health programs and all other state and federal health care funds for Colorado to ColaradoCare;

• Transferring responsibility to ColoradoCare for medical care that would otherwise be paid for by workers’ compensation insurance;

• Requiring ColoradoCare to apply for a waiver from the Affordable Care Act to establish a Colorado health care system;

• And suspending the operation of the Colorado health benefit exchange and transferring its resources to Colorado Care.

I hope the people of Colorado understand what this dangerous amendment represents to the fiscal health of the state.

The population will only understand its negative connotations if it starts paying attention to the consequences.

If it only believes that free medical care is good they do not understand that nothing is free.

A system in which the state offers free medical care will fail at the expense of all the taxpayers.

It has already been proven in Oregon and Vermont.

There is a more effective and less expensive way!

If you are interested please read the following links.

My ideal medical savings account is democratic and provides universal coverage with the consumers being responsible for their choice of medical care while being in control of their healthcare dollars.

Consumers’ responsibility for their health is always left out of models of healthcare reform.

If the federal government or a state government wants a business model to be successful, it should adapt my future state business model.

It is a consumer driven model with consumer responsibility built in so that consumers control their healthcare dollars.

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

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President Obama Continues to Deceive i.e. The Public Option

July 27, 2016

inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D., FACP,MACE

President Obama continues to deceive the American people about Obamacare’s success as his term in office is winding down.

He is trying to use his charming personality to erase the fact tat Obamacare is failing.

The public must keep their eyes and ears open.

Obamacare is falling apart as the months continue. President Obama and the liberals are queuing up to pour more money into a failing healthcare reform model by reintroducing the need for a public option.

On June 30, 2016“CMS division of the HHS Dept. released the HHS Dept. released the actual Q1 effectuation report,

Each year the Obama administration has lied to Americans about enrollment in the health insurance exchange program.

As of June 30,2016, only 11.1 million people have signed up and continued to pay their premiums for Obamacare coverage in the 38 federal health exchanges as opposed to over 13 million that were published. State exchanges are closing monthly.

The latest prediction is that only 10.2 million will have insurance through Obamacare for the entire year. Eighty-seven percent of those insured through the federal health insurance exchanges have government subsidies in the government’s attempt to make health insurance purchased through the exchanges affordable.

If President Obama is correct about Obamacare providing insurance for 20 million people who did not have healthcare insurance previously then 9 million new people have signed up for Medicaid coverage.

Medicaid coverage is completely free to the recipients and is a single party payer system. The federal government presently pays for Medicaid coverage. The increased enrollment is also increasing the federal deficit.

Soon the federal government is going to dump some of the financial responsibility on participating states that are already running budget deficits.

It is only a matter of time before all the 23 state Co-Ops will go out of business and the federal health insurance exchange will take over.

Illinois is the 16^th state to close its Co-Op doors. It followed one week after Oregon Health Co-Op closed its doors.

Land of Lincoln Health received $160.1 million in loans from the Centers for Medicare and Medicaid Services. More than 54,000 enrolled in coverage from the co-op through March 31.

Where are these 54,000 people going to go for healthcare insurance?

“It’s a bad day for the marketplace in Illinois and our consumers,” Jason Montrie, Land of Lincoln Health’s CEO said. “This is the end.”

Who is going to pay CMS back for these federal loans? The state of Illinois cannot afford to pay CMS back. The American taxpayers will re-pay the loan.

So far the total number of federal loans given to the failed nonprofit insurers is more that $1.5 billion for an experiment that was destined to fail from the start.

When are the liberals and progressives going to learn? You cannot keep spending other peoples’ money. You will eventually run out.

These last two weeks have been a big distraction because of party conventions.

Hillary Clinton announced her healthcare proposals. She has proposed an increase of $40 billion dollars in mandatory federal spending insulated from annual budget fights over the next 10 years to develop community health centers.

Hillary Clinton also wants to expand Medicare by letting people age 55 years old or older to opt into Medicare.

In addition she wants a public option.

“Bernie Sanders tweeted. “Together these steps will get us closer to the day when everyone in America has access to quality, affordable health care.”

Who is paying? The middle class taxpayer will pay the burden of the increase in taxes. It will not be paid by the 50% of the entitled citizens who do not pay taxes.

This is an attempt by Hillary Clinton to expand coverage for middle-aged adults. It also gives us a glimpse at how she wants to make Obamacare her own.

President Obama was not taking this lying down. He published an article in the Journal Of the American Medical Association, a “scientific journal.” This article is complete progressive propaganda. Why the AMA permitted this publication is beyond my understanding?

In his “special communication” President Obama once more presents another Trojan Horse (A destructive program that masquerades as a benign application.) to the physicians of America and the consumers of healthcare.

“Some parts of the country have struggled with limited insurance market competition for many years, which is one reason that, in the original debate over health reform, Congress considered and I supported including a Medicare-like public plan.

Public programs like Medicare often deliver care more cost-effectively by curtailing administrative overhead and securing better prices from providers.⁵⁹^,⁶⁰

The public plan did not make it into the final legislation. Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited.

Adding a public plan in such areas would strengthen the Marketplace approach, giving consumers more affordable options while also creating savings for the federal government.⁶¹^”

In 2009 Barney Frank and John Kerry insisted that a public option was essential for Obamacare to evolve into a single party payer system.

President Obama told them they would get to a single party payer system without a public option.

He has now changed his mind.

https://youtu.be/f3BS4C9el98

I have written extensively about the defects in a public option. http://stanfeld.com/?s=public+option

The New York Times writers did not describe the meaning or consequences of the public option in articles about both Hillary Clinton’s and President Obama’s call for a public option.

The American people should be told the real reason for the public option.

The combination of a “public option” within a health insurance exchange system was originally developed by liberal health policy analysts as a dual action mechanism to secure a “single payer” system. It presents the facade of a free market system but the end game is a full-scale government monopoly.

“If a public option became part of government-run health, the Health and Human Services secretary would establish such a plan, set its benefits, and fix its payment rates.

While private plans must negotiate market rates with doctors and hospitals, a Medicare-like “public option” would fix payment rates by fiat, well below the rates that would otherwise prevail in a real market.”

The “public option” would be a better deal for consumers rather than private healthcare coverage. The government would artificially force premiums down with subsidies. It could indiscriminately lower non-negotiated reimbursement to physicians and hospitals and force insurance companies out of the healthcare market.

It would result in an increase in federal taxes.

Additionally, the result will be a defacto single party payer system with less choice and access to care.

President Obama continues to ignore the fact that the government is dependent on the healthcare insurance industry to perform the administrative services for this government program. He ignores the fact that he needs doctors and hospitals to treat and care for sick patients.

He is only interested in financing the healthcare system and controlling the consumer’s ability to choose.

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

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April 20, 2016

inDisinformation and the healthcare system, Medicare, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System

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We Don’t Need A Public Option

Stanley Feld M.D.,FACP.MACE

When President Obama told Barry Frank and John Kerry “We don’t need a Public Option in the Affordable Care Act legislation” he was right.

https://youtu.be/SHPsEVQ9dGQ

https://youtu.be/4iR_iKRKewQhttps://youtu.be/4iR_iKRKewQ

Senator Chuck Grassley know all along what President Obama’s scheme was. His problem was none of his Republican friend would listen to him or do anything about it.

https://youtu.be/-522hcm3woA

President Obama’s goal all along was to sneak in a Public Option in through the expansion of Medicaid. He wanted the local states to be administratively and financially responsible for Medicaid while the Federal government controlled the system through regulations.

President Obama had figured out the way to get to a single party payer without a Public Option. However, he and his advisors misjudged the defects in Medicaid.

Republicans have been opposed to a single party payer system and government control of the healthcare system. Republicans felt government control would increase the cost of healthcare, increase inefficiency in the administration of healthcare care, ration healthcare and decrease access to healthcare.

President Obama thought he could use a myriad of regulations to help Obamacare back into a single party payer system. The State and Federal Health Exchanges (“so called Obamacare competitive model”) has resulted in both the health exchange and the private insurance industry increasing the cost of healthcare to unaffordable levels, decreasing access to care, rationing of care and destroying the healthcare system.

The politicians, in a state like California, by following the federal money, ignored the will of the people. The people hate Obamacare because it is restrictive. They are angry about the lie President Obama told them to get their support. “If you like your doctor you can keep your doctor. If you like your insurance you can keep your insurance.”

President Obama has created a healthcare system infrastructure that played on states’ greed. Many states have tremendously high budget deficits. They have over taxed state residents.

State citizens and businesses are leaving for more tax friendly states. The migration has created larger state budget deficits. State politicians say a way of getting more federal money into the states and perhaps attracting people back to the state will be by expanding Medicaid. The federal government promised to pay 100% for the first three years of the Medicaid expansion program

Twenty-two states fell into President Obama’s trap. These states are on their way to a single party payer system without even knowing it.

I predict his scheme will fail.

California was the first state to jump into this pot of boiling water.

The federal government is going to pay 100% of newly qualified enrollees to Medicaid until 2017. Medicaid is under state control.

A record number of people have signed up for Medi-Cal in California. This has led to huge cost increases in Medi-Cal. Its price tag has jumped from $59 billion to $91 billion.

Where does President Obama get the money to pay for it? He increased the federal deficit. I guess $32 billion dollars would be considered a rounding error to most Democrats in congress.

States will have to start paying 5% of the bill for the newly eligible and enrolled enrollees in 2017. In 2020 the states will start paying 10% of the bill.

Medi-Cal is the state’s Medicaid plan for low-income Californians. Nearly one in three Californians now receive coverage in Medi-Cal. With its continued Medi-Cal expansion it is predicted to expand to 20 million by 2020.

The people of California are going to be the first victims of the increased costs and decreased services.

Every government program creates a complex bureaucracy along with money wasting inefficiencies and abuses.

California politicians were bragging about the great deal the government had given them.

“That’s a really great deal for California,” said Scott Graves, research director at the California Budget & Policy Center. “You don’t find that anywhere else.”

“Advocates say the expansion, with the huge infusion of federal money, should in fact eventually yield savings for states, possibly enough to make up for the costs.”

“UC researchers calculated that each new federal dollar brought to California by Medi-Cal will generate 5.4 cents in tax revenue for the state, which would mean several billion dollars. That’s because the money creates jobs in healthcare, which creates income and sales tax.”

Over the years because of the cost overages, Medi-Cal has been forced to decrease reimbursement to physicians and ration both care and access to care. Physicians have opted out of Medi-Cal participation. As Medicaid has grown as a result of Obamacare, Medi-Cal patients cannot find a physician to care for them.

I suppose President Obama could force physicians to accept Medicaid payment in order to retain their license to practice medicine. This executive action would attack freedom of choice and propelling the United States further down the road to serfdom.

As predicted, a group of Californians filed a civil rights complaint against Medi-Cal, alleging that failures in the program have prevented Latinos from accessing their healthcare they needs.

“But the complaint filed with the U.S. Department of Health and Human Services claims that because Medi-Cal administrators don’t pay doctors enough to see patients, they “effectively deny the full benefits of the Medi-Cal program to more than seven million Latino enrollees.”

Many complain that Medi-Cal’s reimbursement rates, among the lowest in the nation, create a shortage of doctors willing to see Medi-Cal patients.

“The audit confirmed our long-standing concerns about access for Medi-Cal patients,” said Anthony Wright, executive director of the advocacy group Health Access California. “The findings of the audit cry out for more oversight.”

Gov. Jerry Brown’s budget for the 2014-15 fiscal year accommodates an influx of uninsured residents into Medi-Cal.

“However, at Governor Brown’s request, the Legislature left in place a 10 percent recession-era cut in reimbursement to most doctors, dentists and other health care providers who treat Medi-Cal patients.”

Health providers predicted this harmful contradiction. The contradiction is that Medi-Cal expansion will provide more of the poor with adequate healthcare coverage. It is, in fact, reducing poor persons ability to get into clinics, practices and even hospitals.

The California HealthCare Foundation reported that 76 percent of primary physicians accept new patients through private insurance. Only 57 percent accept new Medi-Cal patients.

The optimism of politicians for the expansion of Medi-Cal improve state revenue has vanished. California’s deficit is increasing rapidly as a result of Obamacare’s largess.

In California, state officials are discussing how they’ll afford the program next year (2017). Gov. Jerry Brown called a special legislative session this year to address funding for Medi-Cal.

“It’s a strained system,” said Hernandez, “and I really believe we need to figure out how to resolve. ”

The 20 states that have not accepted President Obama’s offer to expand Medicaid were correct. These states wanted to make their own decision in the name of states’ rights. Many of the states could not afford expansion in the way President Obama was dictating it. Their budget deficits and taxes would have to increase.

California has just proven these states fears. In 2017 California will start paying 5% into the Medi-Cal expansion. It will make the budget deficit worse.

California will, once again, start begging the federal government to bale it out.

President Obama’s plan was to dump the financial burden on the states while controlling the system and creating a single party payer by default.

There is a much better way to provide healthcare to all people at an affordable cost.

The better way is to put consumers in control of their healthcare dollars.

They will control their health to avoid costly complications of chronic diseases. The people will be given financial incentive to be responsible for their health to try to avoid the onset of chronic disease.

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

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President Obama Somehow Finds The Money

February 26, 2016

inMedicine: Healthcare System, Politicians,Healthcare and Vested Interests, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

It is almost impossible to follow the tricks President Obama and his administration use to ignore congress and avoid the law. Few media outlets even try to understand the tricks. No one cares.

The media simply republishes the press releases of the Obama administration. The information is usually out of context.

ObamaCare was sold to the public and congress with a bunch of lies:

1.You can keep your healthcare insurance plan if you like it.

You can keep your doctor if you like your doctor.
Anyone making less that $250,000 per year will not pay a dime more in taxes.

President Obama’s promises were then followed by a long string of lawless executive actions to keep an unworkable scheme (Obamacare) going despite the damage being done to employers, doctors, consumers and the economy.

Statutory deadlines were routinely ignored.
Government funds were shifted from one program to another ignoring the law.
The employer and employee mandate built into the law was illegally delayed, repeatedly
Individual mandates were illegally delayed.
Free Obamacare healthcare plans were illegally granted to illegal immigrants.
Granting waivers to special favored groups.
And many more.

Now, it looks like President Obama is diverting public funds to bail out the health insurance-companies in defiance of the law passed by congress one year ago. President Obama signed it into law.

I am also surprised that Marco Rubio has not been screaming about it because he claimed to initiate that law passage of the law to prevent overspending for reinsurance.

President Obama desperately needs healthcare insurance industry to participation in Obamacare in order to prevent its collapse. He somehow had to come up with the bailout money.

Not only is he in the process of destroying our healthcare system as well as our economy, he is destroying America’s most important asset, the rule of law.

The mainstream media ignores the facts. One reason could be because the Obama administration keeps confusing the facts presented to the media. Another reason is the media bias toward President Obama.

These are probably the facts;

Last fall UnitedHealth said they were considering dropping out of the Federal Health Exchanges in 2017. The company said they were losing money on Obamacare. Aethna followed shortly thereafter

“The latest jolt is the $475 million loss UnitedHealth Group booked on the insurance exchanges in 2015, which the largest U.S. mega-insurer by membership expects to rise this year to another $500 million.”

Only three months ago the company projected losses of $400 million to $425 million. Every other line of UnitedHealth’s business is thriving.

In my last blog I published the outrageous healthcare insurance company executive salaries. The insurance industry cannot be losing money.

The real reason for UnitedHealth’s threat to quit was because the Obama administration underpaid the healthcare insurance industry $2.8 billion dollars for its 2014 obligated reinsurance payment.

When the reinsurance programs were activated congress passed the “Rubio” addendum stating that CMS could not pay out to the insurance industry more than they took in from insurance premiums.

The Obama administration had promised the healthcare insurance industry the reinsurance money for health risk overruns for participating in Federal Health Exchange.

The reinsurance programs were activated in 2014 for 3 years in an attempt to stabilize the insurance market (i.e. guarantee the healthcare insurance industry would not lose any money).

After he realized he could not pay more than 12% of what was owed he promised the healthcare industry he would make good on his commitment and pay as soon as he found the money.

This headline appeared, out of the blue, late on Friday afternoon February 12 at the start of Valentine Day Weekend.

“CMS readies $7.7 billion for ACA reinsurance payouts”

Some how President Obama found the money. The low enrollment in Obamacare resulted in high-risk patients with pre-existing illnesses. The few low risk young patients could not cover the cost overruns.

The shortfall was $2.8 billion for 2014. Somehow in the flurry of numbers thrown at the American public late that Friday afternoon it looked like the 2014 $2.8 billion shortfall was settled with the healthcare insurance industry for $1 billion by the government.

The 2015 reinsurance bill looks like it is $7.9 billion.

The reinsurance program was high in 2015 because the Obamacare health exchanges sold droves of healthcare insurance on the exchanges in 2015 to high risk people with preexisting illnesses.

So far the Obama administration has only found $5.5 billion of that $7.9 billion owed to the healthcare insurance industry.

“Just three California insurers—Anthem, Blue Shield of California and Kaiser Permanente—raked in more than $1 billion of reinsurance payments combined.”

Something is fishy about all of this, especially in the face of the Rubio amendment.

Where are you Marco Rubio?

Are you letting President Obama pull another trick on the American people at tax-payers’ expense?
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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Stanley Feld M.D.,FACP, MACE

Stanley Feld M.D.,FACP, MACE

Stanley Feld M.D.,FACP,MACE

Obamacare is failing. The impending disaster is coming November 1st when the insurance vendors publish their premium prices for Obamacare’s Health Insurance Plans.

Consumers will be shocked by the 20% increase in premiums, the sparse selection of insurance vendors and the higher deductible.

As a distraction from the failure of Obamacare, the progressive Democrats are now trying to sell the “Public Option” as the savior of Obamacare.

I have received several questions asking what exactly is the “Public Option.” The “Public Option” was turned down in 2009 when Democrats were in control of both houses of congress.

How could a “Public Option” be passed in a Republican controlled congress? It can’t be passed.

The Democratic push to sell the “Public Option” is political theater. It is meant to provide hope for President Obama’s progressive base and blame Obamacare’s failure on the Republicans.

It is also meant to distract the traditional mainstream media from the impending Obamacare failure and upcoming disasterous enrollment before the Presidential election.

Here is the answer to the question “What exactly is the Public Option ? ”

It is another defective program that will fail. If passed by congress it will result in the deepening distruction of the healthcare system.

The “Public Option” was first introduced into Obamacare at the onset of the passage of the act. It was eliminated from the bill in a Democratic dominated congress because as Barney Frank said, “We don’t have the votes”.

Barney Frank and John Kerry were convinenced that the only way to get to a single party payer system in the United States was though a “Public Option.”

The “Public Option” is the creation of a federal government-run health insurance agency. The goal of this new insurance company would be to compete with private health insurance companies on price within the United States.

The original published purpose of the “Public Option” was to provide more affordable health insurance rates to uninsured citizens who are either unable to afford the rates of or are rejected by private health insurers.

Now it will be providing cheaper insurance than the private insurance companies are offering to force the private insurance companies to reduce their premiums.

The private insurance companies will not show up to compete.

Obamacare was supposed to be doing creating competition through its Health Insurance Exchanges and State Co-Ops for the people with pre-existing illness and the poor.

The result was premiums went through the roof for both the Health Insurance Exchange policies and private insurance policies.

The government is ended up providing subsidies for 85% of only 10 million people who have bought insurance through the Health Insurance Exchange. It is economically unsustainable for the government and tax payers if the entire population would buy insurance through the Public Option.

It is obvious that the government would try to undercut the private insurance companies and force the private insurance compaies to lower their prices. The result would be bankruptcy as the State Co-Ops experienced.

However, the federal government is dependent of the healthcare insurance industry for the administrative services necessary in adjudicating healthcare insurance claims.

Federal government dependence is true of all government healthcare programs except the VA Healthcare System.

Does anyone think the federal government bureacracy can run a healthcare system effectively and efficiently?

The healthcare insurance industry builds profit into its administrative services contracts. The federal government’s bureacracy cannot control those prices.

The reduced premium pricing would result in government subsidizing the “Public Option” further resulting in an increase in the federal deficit. This has happened in Medicare. Premiums have gone up, covered care has gone down. Medicare is unsustainable.

The recipients of Medicare think it is a wonderful program. The trustees of Medicare feel it is unsustainable simply because of the massive hidden subsidies and cost overruns.

There is no question that premiums are increased, reimbursement to providers has decreased, care is rationed and access to care has decreased.

No one in government is thinking of a more efficient way to format Medicare.

Neither Barak Obama, Hillary Clinton, or Bernie Sanders are thinking about the consumer and the consumers’ needs at this point.

Neither are they thinking about a healthcare system that is affordable to the federal government or the consumers of healthcare.

No one is thinking about consumers driving the healthcare system and being responsible for their health and healthcare dollars.

These politicians are only thinking about power and central control by the federal government over the healthcare system no matter the cost to the federal government, the tax payer, the quality of care delivered to consumers, or the system’s effect on economic growth.

“And this week, in a special communication to the Journal of the American Medical Association, Obama endorsed a public health insurance option to enhance the Affordable Care Act, his signature legislative achievement.”

“This puts Obama in line with his preferred successor, Hillary Clinton, who recently reiterated her support for a public option and for allowing Americans between 55-65 to buy into Medicare. Both policies tilt toward Sanders’s vision of universal coverage.”

Philosophically it is called Socialism.

Big government controlling society does not work. There are countless examples of socialism’s failures in Europe, bankruptcies, unemployment and stagnation, both economically. and politically.

America must learn now. We ought to adopt a healthcare system that is consumer driven.

Big government and its bureaucracies cannot do it for us. It has led from one disaster to the next. It will destroy our healthcare sytem.

America should try a system that provides financial incentive to the public so people are responsible for their health and healthcare dollars.

Stanley Feld M.D.,FACP,MACE

“White voters “don’t like the idea of helping neighbors who don’t look like them”

Forty percent of 10 million people is 4 million people who are going to be affected by a decrease in competition. The total enrollment in Obamacare has been stagnant the last 3 years.”

Stanley Feld M.D.,FACP, MACE

Stanley Feld M.D., FACP,MACE

Stanley Feld M.D.,FACP,MACE

Obamacare is failing. The impending disaster is coming November 1^st when the insurance vendors publish their premium prices for Obamacare’s Health Insurance Plans.