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All items for June, 2015


The New Medicaid

Stanley Feld M.D.,FACP, MACE

President Obama let the regulation to increase Medicaid reimbursements to the level of Medicare reimbursement expire because it failed to accomplish its goal. The goal was to get more physicians to accept Medicaid.

The Obama administration has proposed new federal regulations for Medicaid managed-care plans.

These regulations pledge the program's beneficiaries will have adequate access to a doctor. The pilot programs for these new regulations have been completed.

Two years ago six states made a deal with the Obama administration. Arkansas, Indiana, Iowa, Michigan, New Hampshire and Pennsylvania were willing to cover families earning up to 138% of the federal poverty level as long as it was on the states' terms.

Each state relies on private insurers, which are required to come up with qualified health plansthat meet the standards of Obamacare.

While Medicaid plan “purchasers” are almost totally subsidized, five of six states require some of these very low-income beneficiaries to make financial contributions that range as high as 2% of their income.

The idea is that everyone has some skin in the game. The plans also focus on setting up health savings accounts for beneficiaries and establishing wellness programs.

“While these are common features in many of today's corporate-sponsored plans (with only limited evidence to support claims that “more skin in the game” and wellness incentives hold down costs), these elements discourage enrollment by people who are scrambling to keep food on the table and a roof over their heads.”

I think the Obama administration is making another complicated mistake. There is not enough incentive in the program for Medicaid patients to try to save money for the government.

There is not enough incentive for physicians to sign up to accept Medicaid.

The Obama administration is using surveys of Medicaid beneficiaries.

Their response is not much different from the perceptions of Medicare beneficiaries and the privately insured.”

“But closer examination, experts say, reveals that beneficiaries' satisfaction is boosted by the additional access that comes from visiting hospital emergency departments and government-subsidized community health centers.”

 The Obama administration now proposes to hold Medicaid managed-care plans to the network adequacy of Medicare Advantage and Exchange Plans.

The six states, Arkansas, Indiana, Iowa, Michigan, New Hampshire and Pennsylvania, have been doing this along with offering higher-than-Medicaid rates to primary-care physicians to attract more of them to their networks.

A reduction in cost starts by managing patients in ways that encourage them to visit the doctor's office instead of the Emergency Department.

It does not have an element of encouraging patient responsibility or providing indigent patients with financial incentives to be financially responsible for their health or health care.

The same mistake is made over and over again. It is focused on providing patients healthcare coverage. The Medicaid Advantage healthcare coverage plans make Medicaid patients dependent on the government. It does not provide incentives for Medicaid patients to be responsible for themselves.

The healthcare insurance companies are planning to have a field day at the expense of the Obama administration. It seems like the Obama administration does not care how much the new plan costs.

The Obama administration is overlooking the important point. Healthcare coverage cannot work as long as patients are dependent on the government. Patients must be given financial incentives to be responsible for themselves.

All of the healthcare insurance companies that participate in the government supported medical insurance plans are aware of the impending changes in Medicaid.

These insurance companies bid for the administrative services contracts in each state.

The government makes the rules for engagement but the individual healthcare insurance companies bid for the contract.

It is totally logical for all the healthcare insurance companies attempted to merge. If these insurance companies were permitted to merge it would make Medicaid, Medicare and private insurance unaffordable to all.

The healthcare insurance industry sets the prices for administrative services.

The price increases would lead to citizen protest. It would lead to total government takeover of the healthcare system and a single party payer system.

Insurance merge


The CMS has released a sweeping proposed rule (PDF) intended to modernize the regulation of Medicaid managed-care plans.

 CMS plans call for health plans to dedicate a minimum portion of the rates they receive toward medical services, a threshold known as a medical loss ratio.

At the very last minute the Obama administration is proposing an 85% threshold for Medicaid managed-care plans, the same as the government’s regulations for large group plans in the private market. 

The formula is MLR= incurred expenses /premiums earned.

Private insurance and Medicare are subject to an 85% MLR. It means that 85% of the premiums earned must go to direct medical care. Seventy five percent means only 75% must go to direct medical care and 25% can go to expenses as opposed to 15%.


The healthcare insurance industry also defines direct medial care expenses such as network formation, insurance salesmen’s commissions and other into the direct medical care column. 
As of 2015, plans doing business with Medicaid and the Children's Health Insurance Program are the only health plans that aren't subject to an MLR.

The Medical/Loss ratio is one large source of profit to the healthcare insurance industry for two reasons.

Each expense allowed goes into the incurred claims column. The insurance industry builds a cost plus profit into each expense.

  1. The more required services (Obamacare requirements) rendered by that insurance company the more fee for those services which include profit goes into the incurred claims column.
  2. Each expense allowed goes into the incurred claims column. The insurance industry builds a cost plus profit into each expense.
  3. The more premiums collected the more goes into expenses in the incurred claims column.
  4. The lower the percentage (85% to 75%) of the Medical/ Loss Ratio profit to the healthcare insurance company.

 An arbitrary cap on health plans' administrative costs could undermine many of the critical services—beyond medical care—that make a difference in improving health outcomes for beneficiaries, such as transportation to and from appointments, social services, and more,” interim AHIP CEO Dan Durham said in a statement."

The MLR that the CMS has proposed for Medicaid plans is a suggestion rather than an enforceable mandate.

Medicaid managed-care enrollment has soared by 48% to 46 million beneficiaries over the past four years, according to consulting firm Avalere Health. By the end of this year, Avalere estimates that 73% of Medicaid beneficiaries will receive services through managed-care plans.

"This proposal will better align regulations and best practices to other health insurance programs, including the private market and Medicare Advantage plans, to strengthen federal and state efforts at providing quality, coordinated care to millions of Americans with Medicaid or CHIP insurance coverage.”

America's Health Insurance Plans immediately said applying an MLR to Medicaid managed care fails to reflect much of what these managed care plans do to hold down costs.

 In essence the new Medicaid proposal will also fail if the healthcare insurance industry merges and the impending fight over the MLR continues.

 The cost of healthcare insurance will increase for the private sector, Medicare and Medicaid.

The fault lies in President Obama's lack of understanding in who should drive the healthcare system. Consumers should drive the healthcare system not the government.

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

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Medicaid’s Reimbursement Problems Increase As It Expands

Stanley Feld M.D., FACP,MACE

In order to attract more physician participation in Medicaid the Obama administration increased the level of Medicaid reimbursement to Medicare levels in 2013.

The Obama administration anticipated an increase in Medicaid recipients once Obamacare started in 2014.

In 2012 there was not enough physician participation in Medicaid to service the number of patients enrolled at that time. Appointment wait time was long. Access to care was rationed.

To prepare the primary care workforce for the influx of new Medicaid eligible patients established through the Affordable Care Act (ACA, Obamacare), this provision increases payment rates for certain primary care services to at least the level of Medicare in 2013 and 2014.

 At that time CMS (2012) promised states it would pay 100% of Medicaid reimbursement. Therefore the increase did not threaten individual state budgets because the federal government was paying 100% of the bill until 2015.

Many but not all Primary Care Physicians fell for this Obamacare ploy. Many physicians still did not sign up to accept Medicaid patients.

 “According to a survey conducted by The Physician’s Foundation in 2012, declining reimbursement rates are the most “significant impediment to patient care delivery in today’s practice environment by a large margin.

In 2012 a major administrative service provider for Medicaid said,

 “Enhanced payment rates may induce more physicians to participate in Medicaid. According to a survey conducted by United Healthcare, half of primary care physicians would increase their Medicaid case load if Medicaid payment rates were increased to the level of Medicare pay rates.”

There were long waiting times for appointments and decreased access to care in 2012. The Obama administration figured these issues would be cured with the change in reimbursement.

The new increase Medicaid enrollment figures have been an intentional mystery to the public. 

The Obama administration has provided convoluted enrollment figures to the public. These figures have confused everyone including those who are interested in them. I believe it has even confused the Obama administration itself. The non-transparency has prevented everyone from facing the reality of the Obamacare mess.

This analysis of the numbers must be read carefully. Physicians have been faked out once more.

“In the third quarter 2014 health insurance enrollment data show continuation of two trends during the first and second quarters—increasing Medicaid enrollment and declining enrollment in employer plans.

" However, while individual-market enrollment increased substantially in both the first and second quarters, it declined by 357,000 during the third quarter. The net result was 160,000 fewer Americans with health insurance."

These numbers are nowhere near the numbers the Obama administration reported to the traditional media and in turn to the public.

 All the traditional media did was celebrate President Obama’s victory lap. The public was deceived by the victory lap.

  “For the first nine months of 2014, individual-market enrollment grew by 5.83 million, but 4.93 million individuals lost employer coverage—offsetting 85 percent of the individual-market gain.”


 This was not been made clear by the Obama administration. The uninsured number still remains unclear. This analysis points to Obamacare being a total failure.

 Thus, the net increase in private health insurance for 2014 is so far 893,000 individuals. During the same period, Medicaid enrollment grew by almost 7.49 million. Taken together, the number of Americans with health insurance increased by 8.38 million during the first nine months of 2014, but growth in Medicaid accounted for 89 percent of that gain.

The situation has not gotten better now that the Affordable Care Act's bump in Medicaid pay to Medicare levels has expired.

Just seven states kept the higher rates in place for 2015, while the rest reverted to the previous low rates.

 Medicaid rates in virtually every state are a fraction of what will be paid by Medicare and private insurance companies.

 There are only so many hours in a day. How many physician practices could afford to devote their time to serving its lowest-paying patients?

A 2013 physician survey found 33% of physicians refused to see new Medicaid patients while 17% refused to see new Medicare patients. The obvious reason is Medicare pays better than Medicaid.

 With the expiration of higher primary care physician reimbursement it can be expected there will be less physician participation and decreased access to care for the expanding Medicaid enrollment.

The Obama administration anticipates this problem. It has introduced new regulations that it thinks will solve the problem.

It might, or at least help a little, except for the fact that it is going to cost the government more and help make healthcare insurance companies richer.

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

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The Defects In Obamacare

Stanley Feld M.D., FACP, MACE

We live in an era of sound bites driving opinions rather than details driving opinions. The devil is always in the details.

The defects in Obamacare are too numerous to count. President Obama provides the traditional mass media with sounds bites leading to false conclusions.

The sound bites are misleading. Many of the sound bites are lies. One such sound bite is Obamacare is working and therefore does not need changing.

He and the Democrats keep the discussion on the sound bites level and do not dig into the real issue. President Obama even keeps the details away from congress the very people he is dependent on to pass the bill.

President Obama kept the facts and details about Obamacare away from the congress and the people. He is now doing it with the Trans-Pacific Partnership (TPP).

The Trans-Pacific Partnership (TPP) is a proposed regional regulatory and investment pact. Just as with Obamacare, President Obama expects congress to vote in favor of a pact they have not debated and have not had an opportunity to read the details in the final bill.

It is another one of those bills where the administration is telling the congress and the American people you have to pass the bill in order to see what is in it.

Americans are tired of his lack of transparency and lies. They do not trust President Obama anymore.

Congress should never make the same mistake they made with Obamacare. If they do all Americans should rally to throw all the bums out.

The devil is always in the details.

United States Senator Ron Wyden (D-OR) said,

   “Congress is being kept in the dark as to the substance of the TPP negotiations, while representatives of U.S. corporations—like Halliburton, Chevron, PHRMA, Comcast, and the Motion Picture Association of America—are being consulted and made privy to details of the agreement. […]

More than two months after receiving the proper security credentials, my staff is still barred from viewing the details of the proposals that USTR is advancing. We hear that the process by which TPP is being negotiated has been a model of transparency. I disagree with that statement.[98]

President Obama and the speaker have told us it is good pact for the country’s economy. Senator Cruz is right. “Don’t vote for something whose details you do not know.”

There are many defects in Obamacare. One major defect is that it is not affordable to consumers, the federal government or state governments. When fully implemented the cost of healthcare to the federal government will be at least 50% of our GNP not the 23% of GNP predicted. Twenty three percent is bad enough.

Federal and State taxes will have to be increased to cover all medical care entitlement costs.

President Obama keeps telling us that Obamacare is working. He says it is here to stay.

The reality is Obamacare is an unworkable and costly failure in multiple areas including the health insurance exchanges,, insurance premiums and deductible costs, the development of Accountable Care Organizations, maintenance of employer insurance and more.

Americans deserve a better system than Obamacare.

It is impossible to cover all of the harmful details of every category in one blog. 

It is disingenuous for President Obama to claim, in his repeated sound bites, that there is no need to change anything in Obamacare because Obamacare is working fine.

The real cost of Obamacare to consumers (especially taxpayers), the federal and state governments and the economy have not been disclosed nor are they transparent.

The real costs start to leak out with stories about how the costs affect consumers and their lifestyle.

This usually leads to the sound bites that it will be better to have a government single party payer system.

The underlying defect is that this system leads to consumers being dependent on government and not responsible for themselves. Government changes rules on a whim. Consumers do not have options. This is a road to serfdom.

After the Affordable Care Act kicked in, a 52-year-old sales and marketing entrepreneur reported his monthly health-insurance premium to cover himself and his family grew to $848 from $513. Like others, he wasn’t happy about it. “It’s taking a lot out of pocket,” he said.”

He is one of millions of Americans who earn too much to qualify for government subsidies on policies purchased through the federal insurance exchange. He was in favor of Obamacare before he realized Obamacare’s effect on reality.

 Obamacare requires insurance companies to offer insurance policies with broad coverage and greater protection against catastrophic medical costs. It also requires coverage on illnesses and conditions such as pregnancy and birth control coverage for people who do not need this coverage.

Obamacare was supposed to save every family $2,500 a year. It costs families more than $2,500 dollars a year. It was not supposed to affect anyone making less than $250,000 per year.

It is true that many of the above a not taxes. However it is a cost burden on consumers making less than $250,000 a year.

Others, making less than $50,000 a year, receive complete or partial government subsidies. This is what is meant by redistribution of wealth. It is a significant cost burden on consumers making $50,000 to $250,000 dollars a year.

Everyone remembers President Obama promising that Obamacare will not cost families making less that $250,000 one dime.

Obamacare premiums have become unaffordable to people earning less than $50,000 per year as well.

Obamacare’s goal was to cover everyone with broad insurance coverage and greater protection against catastrophic medical costs.

Yet, only 10 million out of 330 million are covered by the exchanges. Each enrollee in the exchanges also has high deductibles. These deductibles can be as high as $6,000 a year.

Many of the insurance companies claim they will be losing money after the government’s health insurance industry subsidies disappear in 2016.

These companies will leave the Obamacare federal health exchanges reducing competition. This in turn will increase premiums further and make premiums more unaffordable.

Another detail overlooked is enrollees are poorer, sicker and older. The pool is not diluted by younger, healthier and richer. The result is more expensive insurance rates.

“ HHS was saying that it needed about 40 percent of the exchange policies to be purchased by people age 18-35 to keep the exchanges financially stable. It was 28 percent in both 2014 and 2015, according to HHS data. The CBO had projected about 85 percent of exchange enrollees to be subsidized, falling toward 80 percent as enrollment grew; instead, that number is 87 percent and actually rose slightly from 2014.”

According to a study last year by the National Bureau of Economic Research, people who bought silver and bronze plans on the federal and state health insurance exchanges saw total premiums and out-of-pocket payments rise an estimated 14% to 28% higher than pre- Obamacare premiums and out of pocket expenses.

Obamacare is not fulfilling any of President Obama’s sound-bite promises.

His claim that Obamacare is working well and does not have to change makes absolutely no sense.

If one tells a lie enough times it becomes eventually becomes the truth.

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

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President Obama Tries To Bully The Supreme Court

Stanley Feld M.D.,FACP,MACE

President Obama attacks his opponents, marginalizes them, throws them under a bus, lies, ignores reality, or bullies them.

The reality about Obamacare is that none of the stakeholders like it.

It is causing states with State Health Insurance Exchanges to go deeper in debt.

The government has been forced to create 37 Federal Health Insurance Exchanges. Premiums are skyrocketing because of poor enrollment and demographic distribution. Only people with pre-existing illnesses or those receiving subsidies are joining.

Premiums are now unaffordable even applicants receiving subsidies.

Obamacare is driving corporations providing healthcare insurance for their employees to figure out how to avoid providing healthcare insurance and penalties.

The government has provided waivers for companies such as McDonalds, Burger King and 1300 other companies to not participate in Obamacare.

 Obamacare has tried to take away Medicaid subsidies from states that did not start a State Health Insurance Exchange and would not expand Medicaid. The Supreme Court stopped that two years ago.

Obamacare has driven physicians into hospital employment. Many physicians are unhappy and less productive working for hospitals themselves.

Many physicians have retired early because of Obamacare. This is a bad sign in light of our present physician shortage.

Obamacare has created incentives for hospitals to create Accountable Care Organizations (ACOs).

Logically ACOs cannot work because they shift financial risk for patients on to physicians and hospitals and away rom the healthcare insurance industry.

Hospitals and physicians are finally starting to realize the risk and are dropping out of the ACO programs.

Obamacare has spent over one billion dollars for a web site that is still not fully functional.

The promise of universal healthcare coverage has resulted in more people being uninsured than before Obamacare was passed. Only 9 million people are signed up and 6.4 million receive subsidies.

The original prediction in 2009 for 2015 was 17 million participants.

The expanded Medicaid program in 14 states is  experiencing severe physician shortages and financial problems.

Obamacare patients and Medicaid and Medicare patients are starting to experience limitations on access to care and rationing of care.

I am only naming a few of the many problems Obamacare has created.

Yet with all these defects and failures President Obama has the gall to say,

 There's something deeply cynical about the ceaseless partisan attempts to roll back progress.”  

"I understand people being skeptical or worried before the law was passed and there was no reality to examine. But now that we can see millions of people having health care—and all the bad things that were predicted didn't happen—you'd think it was time to move on."

Obamacare is not working despite President Obama’s claims.

I think it is time to move away from Obamacare and in another direction.

This week President Obama did another astonishing thing. It reveals   his consistent disrespect for the constitution and the separation of powers.

He has tried to intimidate the Supreme Court to rule in favor of Obamacare with his personal attack on the court and its upcoming decision in King vs. Burwell.

 “The law provides for subsidies only for policies purchased on exchanges "established by the state", inserted in the law as an inducement to states to set up exchanges.”

Congress limited the subsidies to State Health Insurance Exchanges to encourage the states to set up their own exchanges. Thirty-seven states saw the trap that President Obama was setting for them and refused to cooperate.  

The IRS, operating under the direction of President Obama, tried to “fix” the law by permitting federal exchange to provide subsidies.

The infamous Dr. Jonathan Gruber, a principle framer of Obamacare, who was paid by the Obama administration $375,000 for his consultations with the White House staff, said the exclusivity of state exchanges rewarding subsidies was put into the law to induce states to set up exchanges.

Dr. Gruber, a healthcare economist, also said the law would have not passed if the public was not so stupid and could recognize the lack of transparency of the law.

President Obama said at the time of the scandal that he did not know Dr. Gruber. President Obama said Jonathan Gruber played a minor role in the construction of Obamacare.

During the last month President Obama has used the traditional media to try to convince the Supreme Court and the American people that congress really meant to give the State Exchanges and the Federal Exchanges to ability to provide insurance subsidies.

Article after article was published confirming that what the law meant to say was both State and Federal Exchanges had the ability to provide subsidies. This was morally the right thing to do.

President Obama said this week. “That we have an obligation to put ourselves in our neighbor’s shoes, and to see the common humanity in each other.”

First of all congress didn’t write the law. It should have and it should have been bipartisan. Most Democratic congressmen who voted for Obamacare didn’t even read the law.

The IRS has no authority to change the letter of the law with a regulation.

The law as written should be the law. The Obama administration overstepped its constitutional limits. If the law is wrong, congress should amend the words to include subsidies for federal exchanges also.

Obamacare is a terrible law. It is distorting and destroying our already dysfunctional healthcare system. The Republican dominated House and Senate are not going to change a law that is self destructing, if the Supreme Court favors King and the letter of the law.

Since President Obama’s traditional media campaign has been a flop, he has personally gone after the Supreme Court. He tried to intimate it by challenging its integrity.

President Obama said, Frankly, the Supreme Court should not have taken up the lawsuit challenging Obamacare subsidies.” 

Who is he to decide which cases the Supreme Court should take up?

 President Obama continued,“There is no reason why the existing Federal Health Insurance Exchanges should be overturned through a Supreme Court case,”

 President Obama is preparing the country to be angry at the Supreme Court if the Supreme Court rules in favor of King.

President Obama is disregarding the notion that the Supreme Court is interpreting and upholding the constitution, a concept he frequently ignores.

I think it’s important for us to go ahead and assume that the Supreme Court is going to do what most legal scholars who've looked at this would expect them to do.”

 This statement is both a lie and a veiled threat to the court.

“Elena Kagan  recently wrote in another case that, "This Court has no roving license, in even ordinary cases of statutory interpretation, to disregard clear language simply on the view that (in [the IRS’s] words) Congress 'must have intended' something broader."

During oral arguments in March, Justice Antonin Scalia suggested Congress could step in and fix the problem.

“Congress just adjusts, enacts a statute. It would take care of the problem. It happens all the time,” he said. “Why is that not going to happen here?”

President Obama did say there was one way to resolve the dispute over the law: “Congress could fix this whole thing with a one-sentence provision.”

President Obama said, “He is puzzled by the legal challenges against his signature healthcare law, arguing there is ample evidence that the system is working.

“Fortunately, there's no reason to have to do it. It doesn't need fixing,”

President Obama keeps harping on the same lies. He believes if you tell a lie enough times it becomes the truth.

President Obama said, “Part of what's bizarre about this whole thing is, we haven't had a lot of conversation about the horrors of ObamaCare because none of them have come to pass.”

There has been limited conversation about the horrors of Obamacare in the media because President Obama and the traditional media have limited the conversation

President Obama cannot bully the Supreme Court into not of upholding the constitution and it obligation to interpret the constitution accurately.

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

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Chaos Continues At


Stanley Feld M.D.,FACP,MACE

Chaos continues at with the sudden departure of QSSI. QSSI was a minor hub manger of in early 2014 when the site was failing. It became the major integrator and senior advisor.

CGI was the major integrator at first.  Michelle Obama’s college friend was a principle in CGI. The friend obtained the non-bid CGI contract. CGI was dismissed as the web site disaster unveiled itself. The contract was for more than $600 million dollars.

QSSI was hired as the senior advisor and the web site’s prime integrator.

QSSI is a subsidiary of Optum the IT healthcare arm of healthcare insurance company United Healthcare. 

 Andy Slavitt, a senior executive at Optum, joined CMS in June 2014. He had subsequently been heralded by CMS as the savior of

He received a rare waiver from federal ethics rules at the time which allowed him to be involved in contracting issues involving Optum and the United Healthcare Group.

When Slavitt joined CMS, a little known loophole in government hiring practices permitted him to pocket $4.8 million in tax-free money when he joined the government agency.”

Andy Slavitt was initially hired as deputy administrator of CMS. He was promoted to acting administrator when Marilyn Tavenenner left.

There has always been a question of conflict of interest between Slavitt , Optum and United Healthcare. It is not clear if Andy Slavitt is still at CMS.

Republican Sens. Chuck Grassley of Iowa, and Orrin Hatch of Utah, asked CMS and United Health Group in June 2014 about Slavitt’s potential conflicts of interest.

The answer to Senator Grassly and Hatch’s questions were never made public.

A scandal occurred recently when 800,000 Obamacare enrollees received incorrect subsidy information on the 1095-A tax forms sent by the federal exchange

Some enrollees were mistakenly told they received too large a subsidy, while others were told their subsidy was too small.

Publicity of this error was buried in the news that the Obamacare enrollment period for 2015 healthcare insurance was being extended until April 30th, after initially being extended to February 15th.

 The real reason for the extension appears to be poor enrollment in despite the administration bragging that the enrollment was great.

 One month later Optum suddenly quit.

An Optum spokesman said,

 “Having achieved the goal of making a stable, reliable platform for people seeking health coverage, Optum will not seek to continue our role as senior adviser to,”

This isn’t the first time this has happened. Jeff Zients took over when was launch in October 2013.

In December 2013 Zients, who Obama had turned to in the past to fix sticky issues, had “made it clear that he was not going to stay on the job past December.”

Kathleen Sebelius said in a blog post,

Today, the site is night and day from what it was when it launched on October 1. I am very grateful for his service and leadership," Secretary of Health and Human Services.”

The Obama administration then announced that former Microsoft executive Kurt DelBene took over the operation of in December 2013 in consultation with Marilyn Traverner and QSSI.

Somewhere in 2014 CGI was rehired and DelBene left. QSSI remained.

CGI was then relieved in December 2014.

Accenture was hired. In December 2014 Accenture was rehired with a $563 million dollar contract to run

“The Centers for Medicare and Medicaid Services (CMS) in January dropped a key contractor on the project, CGI Federal, and selected Accenture Federal Services to rehabilitate and build out the portal.”

Suddenly, in May 2015, QSSI quit.

This all seems fishy to me. The price tag of more than $1.1 billion dollar for seems very high. The web site is still incomplete. The healthcare insurance premiums are unaffordable and rising.

Consumers and physicians do not approve of Obamacare.

State exchanges are losing money they cannot afford. There is little evidence that the electronic medical records program is increasing the quality of medical care.

The individual health insurance market through is a mess.

The public does not know how many people are uninsured, have become uninsured and do not have access to medical care.

Obamacare has been delayed in the group market. Private insurance has increased in price. Large corporations are increasing part-time employment to avoid paying for employees’ healthcare insurance and to avoid federal government penalties.

Yet, the Obama spin machine is trying to influence the public and the Supreme Court through the media saying the subsidy should be extended to the Federal Health Exchanges.

It all seems crazy to me. There is a better, more efficient way to help Americans purchase insurance and be protected in case of serious illness.

It is not a government run single party payer system. The government cannot even build an efficient website.

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

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