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Where Is The Missing Money?

Stanley Feld M.D.,FACP,MACE

Does anyone know how much Obamacare cost each year? Does anyone know if Obamacare is the cause of America’s more than one trillion-dollar deficit each year despite the Obamacare tax increases that are supposed to pay for it ?

If someone knows they sure are not telling taxpayers. A good friend who is a liberal and a big fan of President Obama said to me he is not worried about the federal deficit. Neither is President Obama. President Obama has convinced his base that the budget deficit and America’s escalating debt is an insignificant problem.

It follows that he can spend money as he wishes and waste money with impunity. I was taught that is not the way to run a business. Especially when the waste fullness gets negative results that leads to more deficit spending.

The problem is the waste of money is reported in dribs and drabs and usually on a Friday afternoon.

We have seen that happen in the VA system. After one year and billions of dollars spent the waiting times have decreased slightly. The medical service to veterans has not improved. No one in the bureaucracy has been held responsible. Veterans have been complaining more loudly since nothing has improved.

Missing Money

The federal government awarded over $5 billion to help states set up Obamacare exchanges, with the vast majority – $4.6 billion – going to 16 states and Washington, D.C.” 

The Government Accountability Office (GAO) recently reported that most of the money has not been accounted for. Several of those State Health Insurance exchanges have gone out of business this year.

$1.4 billion of that has been spent on IT projects. This sounds very high for 16 different web sites. Why couldn’t everyone use the same website?

Three ($3 billion) has been “spent or drawn down.” Only some of the drawn down spending has been detailed.

At least $1.6 billion is unaccounted for. Only three states returned any portion of the money. The federal government has only received back $1 million.

It sounds like government bureaucracy inefficiency at best and fraud and abuse at worst with no one being held accountable.

Can Americans trust the government to run our healthcare system?

Where did those taxpayer dollars go?

More Missing Money

Obamacare created the co-ops to encourage State Health Insurance Exchanges to increase competition in state insurance markets.

The intent was to offer consumers choices with the hope of holding down premiums.

Co-ops were snuck into Obamacare to replace the public option. No one has spoken about this being a substitute for the “public option.” The public option is an obvious ploy to convert the healthcare system quickly to a single party payer system.

The public option was designed to compete with private insurers on the state level by offering lower premiums in order to force the insurance industry to lower its premiums. The co-ops were designed to do the same thing.

President Obama offered state co-ops $6 billion dollars for start-up costs. Since there were only 23 states co-op formed instead of 50 Congress decreased the total payment to $2.4 billion to the 23 start-up co-ops.

All 23 co-ops received their proportional federal loans to meet solvency requirements as well as start-up costs.

President Obama now claims the Republican house denied Obamacare enough money for the co-op to be successful.

Twelve (12) of the 23 nonprofit insurance co-ops announced they will not offer coverage to consumers who bought healthcare coverage in 2015 in 2016. They are bankrupt. Where did the money go?

Somewhere between 300,000 and 600,000 people will be shopping for more expensive healthcare coverage for 2016.

The remaining 11 standing co-ops are $500 million dollar in the hole.

There is no accounting available to explain why these co-ops have failed

Does anyone think these $2.4 billion dollar loans will be paid back to the federal government? I do not. It will simply be added to the federal deficit.

  • “CMS said the government would “use every tool available to recover taxpayer dollars” from the co-ops going out of business, but it declined to say how much she expected to recoup.”

There are many reasons these co-ops have failed. Republicans not giving the co-ops more money, as progressives and Democrats have claimed, is not one of the reasons.

Another area of missing taxpayers’ dollars.

The Senate Finance Committee is looking into the millions of taxpayer dollars being spent on ads to promote Obamacare enrollment.

The total federal government budget for ads and PR was nearly $1 billion in fiscal 2013. How much was spent on Obamacare?

The Health and Human Services budget for “paid media” is about $35 million for the current enrollment period. The $35 million dollars will be spent in the 38 states using HealthCare.gov in the 2016 enrollment period.

Chairman Orrin Hatch, R-Utah, raised concerns about agency ad spending and sent a letter to the acting head of the Centers for Medicare and Medicaid Services (CMS) asking for a full accounting of agency ad spending.

“Increased transparency on government spending on advertising will improve accountability and help ensure that the taxes from hardworking Americans are not squandered and wasted on ineffective or misguided government programs,” he wrote to Acting Administrator Andrew M. Slavitt.

Senator Hatch demanded the accounting by November 25th. Does anyone think he received it?

In 2010, the nonpartisan Government Accountability Office (GAO) reported the Obama administration spent nearly $20 million on a Medicare brochure that contained “instances in which HHS presented abbreviated information and a positive view of Patient Protection and Affordable Care Act (PPACA) that is not universally shared.”

The GAO papered over the ridiculous expenditure.

GAO concluded that “nothing in the brochure constitutes communications that are purely partisan, self-aggrandizing, or covert.” 

CRS reported HHS was second only to the Department of Defense, spending $197.4 million on advertising in fiscal 2013.

“The total federal government budget for ads and PR was nearly $1 billion in fiscal 2013.”

Would healthcare be so expensive if the government was transparent and congress was really on top of everything?

Physicians only receive 20% of the healthcare dollars spent.

President Obama and his administration spend taxpayer’s money at will.

Americans have to demand “more efficiency and much more transparency.”

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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Lie. Why Not?

Stanley Feld M.D.,FACP,MACE

President Obama and his administration continue to lie to the American people. One of the major criticisms of letting Syrian refugees into this country is that our vetting process is not robust enough to determine if some of the young strong men might be ISIS operatives.

Ben Rhodes, Deputy National Security Adviser, repeated President Obama’s lie about the U.S. intelligence agencies having a robust vetting procedure. The agencies contradicted President Obama.

How can President Obama have the nerve to tell the American people that Obamacare is working when few enrollees are signing up on www.healthcare.gov so far during this open enrollment period.

On Thursday UnitedHealthcare said it is losing too much money on servicing www.healthcare.gov enrollees to continue. It is threatening drop out of servicing the Health Insurance Exchanges.

The traditional mainstream media did not cover this important news release on its important evening cycle.

In the latest piece of ObamaCare news (Failure) that the liberal media has chosen to ignore, ABC, NBC, and Spanish networks Telemundo and Univision skipped on Thursday night and Friday morning word from United HealthCare from Thursday that it may withdraw from ObamaCare exchanges in the future after reporting losses of around $700 million for the year.”

While ABC and NBC were joined by CBS in censoring this story from their Thursday evening newscasts, Friday’s CBS This Morning stepped forward with a measly 18-second, 46-word brief from co-host Charlie Rose that alluded to a Wall Street Journal piece on United HealthCare.

Charlie Rose said with little emotion, editorial comment or explanation of its meaning, “The Wall Street Journal reports on one of the nation’s biggest health insurance company considering pulling out of ObamaCare. United Health Group said it suffered major losses on the policies sold on the Affordable Care Act exchanges. Operating losses this year will total about $700 million.

The CEO of UnitedHelath’s actual statement was, “in recent weeks growth expectations for individual exchange participation have tempered industrywide, Obama”s co-operatives have failed and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated, so we are taking this proactive step.” 

These are the reasons for the UnitedHealthcare pull out. Fox News covered the story in full on Thursday evening in primetime and Friday morning.

Special Report to devote a full story to the matter from correspondent Rich Edson.” 

“Host Bret Baier declared in a short lead-in that “a major setback” is possibly “in the works tonight for ObamaCare” as “[t]he President’s health care law could be losing a huge source of the coverage provided.”

“Edson also made sure to mention that such a story has given “ObamaCare critics” additional reasons to argue that “with rising premiums, fewer health provider choices, is another sign of the unsustainability of the health care law.”

How can anyone expect the public to be informed about Obamacare’s failures when the major networks who these important stories?

But the public is catching on. The major networks are acting as a shill for the Obama administration. The major networks should not be surprised that their viewership is declining.

 As opposed to covering the major healthcare story Thursday’s CBS Evening News and NBC Nightly News each found time to tout the Food and Drug Administration’s approval of a genetically-modified salmon for human consumption that won’t actually become widely available for at least a few years.

How can President Obama think the American people have confidence in him?

The lies continue daily. The majority of the information sources have become a super pac for President Obama. What is the public recourse to stop this madness?

Most of the people in the country have never heard of Saul Alinsky or his book “Rules for Radicals.”

Saul Alinsky’s recommendations are exactly what President Obama is using.

You lie to the people and restrict information so that the critics of your policies seem unreasonable. Opponents cannot mount an effective offensive and therefore get enough public support to demand change.

I suggest Republicans hire an effective and innovative public relations firm to counteract President Obama’s attacks on the freedoms of the American people.

President Obama’s response to his critics has been that Republicans are fear mongers and should be ignored. He presents no evidence just accusations.

I am republishing the following 2014 blog’s You Tubes because viewing these amazing You Tube compilations of President Obama’s lies are essential to understanding President Obama’s method of operation.

http://youtu.be/4puS-yjwsiE

This You Tube is worse than the Words Matter You Tube

 

http://youtu.be/1YqXCFCXXL8

The American people must do their own research, get involved and not let President Obama manipulate us into a socialist state.

Socialism does work as we are seeing in Europe. France cannot afford to fight ISIS because entitlements consume 54% of the GDP and taxes are close to 70% of personal income.

The wealthy people with large incomes who paid high taxes in the past are fleeing the France.

As corporate taxes and individual taxes have gone up in the United States on President Obama’s watch we have not only had a tax inversion occur with corporations moving over 3 trillion dollars overseas, we are now seeing a tax inversion movement by rich individuals.

President Obama’s lies and manipulations cannot be ignored anymore. These lies are a clear and present danger to America’s economy and way of life.

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



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Obamacare Is In Big Trouble!

Stanley Feld M.D.,FACP,MACE

There are so many parts of Obamacare that are failing it would be impossible to describe each failure in a single blog..

President Obama and his administration keeps telling the American people that Obamacare is working great. It is here to stay.

I cannot believe Americans believe him. I cannot believe he thinks Obamacare is doing great.

It could be true that everything is going great for him if he wants Obamacare to fail and cause hardship for millions of Americans.

At that point Americans would beg President Obama or another progressive president loke Hillary Clinton to institute a single party payer system.

A single party payer system has been Hillary’s dream since Hillarycare 1993. Now she is saying she wants a private insurance based system. The purpose of this statement is to neutralize (freeze) her free market system critics.

Once more America is being exposed to Hillary Clinton’s use of a typical Saul Alinsky tactic. The tactic in his “Rules for Radicals” is to freeze your opponent by stating his position as yours even if it is a lie.

Hillary wrote her senior Wellesley College thesis on Saul Alinsky and “Rules for Radicals”. She also became a big fan and good friend of his.

Hillary Clinton and President Obama know Obamacare is failing. They are just waiting for the tipping point. The tipping point will be when the American people say please help us and give us a single party payer system.

At that point we will hear the typical gee shucks, I guess we will have to try a single party payer system.

A single party payer system will be a bigger financial and patient care disaster than what we have now.

The data on the first week of applications for Obamacare’s healthcare.gov was announced to the rave reviews by the Obama administration.

Since few pay attention to the actual numbers President Obama can get away with the lie.

The CBO predicts 19 to 21 million will sign up for Obamacare for 2016. The administration estimates they are going to have 9.1 to 11 million enrollees for 2016.

The Obama administrations estimate is 30% lower than the announce 13 million enrollees in 2015. In reality only 9.7 million enrollee paid for healthcare insurance through healthcare.gov 2015. Of those 9 million only 6.5 million kept their insurance premiums current for the entire year.

The www.acasignup.net quoted the Obama administrations claim that 595,590 filled out applications to get price insurance quotes. Only 8% of the reported applicants or 47,243 paid their first month’s premium for 2016.

These numbers are not a cause for celebration unless you want to misinform the public by claiming a successful first week enrollment.

Let’s do the math. The enrollment period for 2016 is from November 1st until December 31st 2015 or eight and one have weeks with four major holidays, Veterans Day, Thanksgiving, Christmas and New Years.

Let us the assume all 600,000 that filled out applications will pass the application requirements and pay their assigned premium for each month. Let us also assume the average weekly application rate is 600,000 per week for the 81/2 weeks. The grand total enrollees would be 5.1 million enrollees for 2016. This is 4.5 million less paid enrollees than in 2015.

There was an attrition rate 2% a month in 2015. President Obama extended the enrollment period several times to get more people to sign up.

2015 FULL YEAR ENROLLMENT/ATTRITION RATE TABLE PROJECTION:

2015_full_year_projection_effectuated

2014 FULL YEAR ENROLLMENT/ATTRITION RATE TABLE (FINAL):

  Microsoft ExcelScreenSnapz 2014 458

It is clear that President Obama’s victory laps celebrating the success of Obamacare is unwarranted.

However the media is the message. He controls and manipulates the media. It would have been much easier to provide Medicaid and CHIP coverage to the poor outright than destroying the healthcare system with changes that are not working.

The final enrollment for 2014 was 6,338,622 not over 13 million. The final enrollment for 2015 was 9,736,350 and not over 13 million. This is a net gain of 3.5 million new paying enrollees in 2015.

This year the Obama administration estimates that 9 million will purchase insurance through the health insurance exchanges. At the present rate only 5.1 million will purchase insurance for 2016 at the end of the enrollment period December 31, 2015.

The CBO’s estimate was 19-21 million paid enrollees.

It does not represent a very successful net gain when the government publishes that there are 34 million uninsured Americans. No one knows if the 90 million unemployed Americans are counted in the number uninsured.

Unaffordable care act

All anyone hears is the Obama administration’s reasons our taxes, and insurance premiums are going up, while our insurance coverage is going down. The Obama administration is blaming the healthcare insurance industry and Republicans.

President Obama has used, with the help of the mainstream media, the Saul Alinsky tactic to freeze opponents by shocking them with unsustainable factoids.

 The Avalere Health consultancy’s analysis of 2015 signup data showed surprisingly weak ObamaCare enrollment at modest income levels. At between 150% and 200% of the poverty level, just 41% of those eligible signed up for coverage. The number falls to 30% among those between 200% and 250% of the poverty level.

 In 2016 President Obama is going to penalize people that do not have healthcare insurance.

It’s now clear that the actual impact of ObamaCare’s individual mandate tax penalty will be far worse than the benign intent that the Obama administration claimed.

“What we’re talking about is a penalty for the few people who will refuse to buy health insurance — even though they can afford it — and who expect the rest of us to pick up the tab for their care,” a September 2009 White House defense of the individual mandate states.”

Reality should be coming into focus by now for the average American taxpayer and the poor. Obamacare is ripping everyone off.

The mandate’s primary impact will be to compel low-income households to buy bronze coverage with deductibles of up to $6,850 per adult that are well beyond their capacity to afford.

Even after these poor people pay the $6,850 deductible they have a 40% deductible on the rest of the billing.

Who said poor people are too stupid to handle their own money and be responsible for their healthcare dollars?

They are smart enough to know the government is ripping them off.

George  Shore101  3 months ago

If the Obama administration and Democrats love the poor why did they force the poor to purchase something they can not afford and then penalize them for not being able to afford it?

It is a horrible thought to think President Obama is working to make the poor poorer and make the healthcare system fail the American people.

It looks like he is. His plan to replace it with a single party payer system will result in a bigger failure.

Why are Republicans just standing around doing nothing? Why don’t they publicize my Ideal Medical Saving Accounts?

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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My Two TechStars Sons

Stanley Feld M.D., FACP,MACE

A few Mondays ago I flew to Boulder on the first American Airlines flight from Dallas to Denver get to TechStars FounderCon before 9.30 a.m. and the first morning session.

I wanted to see what FounderCon was all about and how my son, Daniel Feld, put it together.

Daniel and his staff put on FounderCon in Boulder. It attracted over 800 TechStars founders. I wanted to be there to celebrate Daniel’s success.

Also I wanted to spend time with all these young people observing how their powerful social network works.

I love spending time hanging out and learning from my sons. I try to take every opportunity I can to learn from them

Daniel Feld is Vice President of Operations for Techstars. He leads its powered by TechStars expansion efforts with corporate partners including Nike, Kaplan, R/GA, Sprint, Disney, Barclays, Ford, MetroAG and others.

FounderCon is a TechStars annual event for all Techstars graduate founders. The conference is two full days of keynote speakers and breakout sessions in addition to social and business opportunity networking.

The primary purpose is to learn and network with almost 800 Techstars founders across the 36 TechStars programs in the U.S. and around the world.

My conclusion at the end of the conference was that Daniel is an excellent organizer and administrator. His staff is dedicated to his leadership.

His father (me) is very proud of him. I also learned a ton from all these young entrepreneurs about their corner of the world.

What is TechStars?

TechStars is a startup accelerator founded by David Cohen, David Brown, Brad Feld and Jared Polis in 2006.

In Las Vegas in 2006 on one of our father-son weekends Brad told me the two David’s idea to see how I would react. I knew he had already made up his mind that he was going to go for it.

I thought it was great. There is nothing like a young startup entrepreneur learning how to start and run a business from mentors who have already started up a business. It is much better and more efficient than learning from scratch.

TechStars has grown into a fabulous franchise in the last nine years. There are founders who have learned how to startup a company from all over the world. It is growing rapidly.

FounderCon provides an opportunity for graduates of TechStars to grow and help each other.

The TechStars mantra is give first. Do not worry about the return. The concept is expressed eloquently in Brad seminal book for start ups Startup Communities Building An Entrepreneurial Ecosystem In Your City. “ The book has been published in many languages.

The book is the foundation of his Startup Revolution.

The startup energy results from his Boulder Hypothesis. This hypothesis has led to the formation of many very successful startup companies.

TechStars has expanded geometrically in the pursuit of developing Startup communities.

The magic of TechStars and the development of a successful Startup Community are expressed in the following You Tube.

 

My sons Daniel and Brad teach me more that I teach them these days.

I am all ears and try to learn all I can.

We also have a great time hanging out and enjoying chocolate ice cream.

 

Daniel and I at foundercon

Daniel and Stan. Which One is Stan?

Brad and I Boulder founderCon

Brad and Stan at our tradition.

Thanks guys. I love you both very much.

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE





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A Message That Needs Repeating

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I Told You What To Do 8 Years Ago: Part 4

Stanley Feld M.D.,FACP,MACE

This is the last of the series of blogs I wrote in 2007 explaining what should be done in repairing the healthcare system.

The issues causing the dysfunction in the healthcare system have been explained, expended and simplified by detail throughout the succeeding eight years.

The result was the business plan for an alternative future state of medicine in 2020.

If one follows the logic of this plan carefully understand that Obamacare has escalated the pre Obamacare problems in the healthcare system one will visual this potential alternative future state business plan not only achievable but successful..

When reading Part 4 it must be remembered that 2007 was pre Obamacare.

Nothing has changed since 2007 except consumers are more aware that they are continuing to be shafted by the government, the healthcare insurance industry and hospital systems.

Many consumers believe physicians are shafting them. The reason for this belief is physicians are the stakeholder that consumers make initial contact with in the healthcare system.

Physicians have not made the rules or issued the regulations.

Physicians have been trying to adjust to many of the insane and impractical rules and regulations that have been written.

Consumers are starting to recognize that government says it is there to help and all it accomplices is making the healthcare system worse.

Obamacare, along with its special interest group, the traditional mainstream media, is trying to keep consumers stupid before it is too late for consumers to use their immense power.

Leadership, creativity and vision are missing from the Republicans, Independents, Libertarians and Democrats. The problems in the healthcare system are not a partisan problems.

Americans have been conditioned to go along to get along while many elected officials and officials running for election lie to us and cheat.

Many consumers blindly forgive politicians they elect not realizing that their condition will get worse and their freedom will be compromised.

Please keep in mind that the following comments where written in 2007.

 

What I Said So Far? Spring 2007 Part 4

Stanley Feld M.D., FACP, MACE

Many people have made the following comments about the healthcare system;

  • “It is hopeless!”
  • “There will be no solution in our lifetime.”
  • “Good luck.”
  • “You are wasting your time.”
  • “We are too far down the road to be able to save this puppy.”
  • “The politics and economics are out of the control of physicians and patients.”

Only 20% of the people are sick at any one time. Therefore only 20% of the people think about the healthcare system and their healthcare insurance policy at any one time.

The uninsured think about the potential cost of getting sick and fear not having health insurance.

When insured people get sick and navigate through the healthcare system is a nightmare for only about 40% of them.

At any one point in time only 8 out of 100 people who have health insurance are having difficulty with the healthcare system. When all the people with healthcare insurance are forced to think about the healthcare system only 40% has experienced a horror of the situation.

The other 60% that did not have a problem think the problems with the healthcare system are over exaggerated.

In August 2006 I received this comment from Cleve:

“Great post and keep it up. After 44 years of perfect health, my 45th was spent with doctors, labs and hospitals …the system is beyond Kafka. I’m no expert but I have a feeling that doctors will have to be the spearhead of change (with patients the driving force maybe?). So keep at it…please!!
Cleve”

Last week I spoke to a friend who had neck surgery two years ago. He was hospitalized for 2 days. He had the opposite comment. He has health insurance with UnitedHealthcare. He thought my comments about UnitedHealthcare were exaggerated.

His hospital bill was $17,500. The surgeon charged him $17,000. I remembered his complaining about how atrocious these two bills were.

I assured him the adjudication of the bill would look nothing like the retail charges.

UnitedHealthcare paid both the hospital and the surgeon $3,500 each. He was responsible for nothing. He was relieved and pleased with the system. He said the hospital and surgeon seemed satisfied.

What about Denise?

Remember her. She did not have health insurance. She was self- employed with a preexisting condition. She did not qualify for health insurance.

If she needed emergency neck surgery she would have been responsible for the entire $34,500. Both the hospital and doctor would have been unrelenting in the pursuit of payment.

If the hospital and doctor would settle for $3,500 with the insurance company they should settle for the same with Denise. However, she would probably go to the collection agency and if she did not pay, her credit would be destroyed.

Denise could not get information for the price of a simple x-ray from the hospital. This precipitated her frustration and letter to then Texas gubernatorial candidate Kinky Friedman, the comedian cowboy, running for governor.

My goal is to help people who are not sick understand the problem with the healthcare system. I believe the only thing that will repair the healthcare system is people and their purchasing power.

Matthew Huebert wrote:

“There is something meaningful about blogs and RSS that I’ve only begun to understand recently, and this post describes and exemplifies it well: you are a thinking person, putting yourself ‘out there’, introducing outsiders into your own world and adding depth to a discussion that matters to you and matters to society.

For me, it is writing like this that is an antidote to the superficial sound bytes that obscure possibilities for change by avoiding the “Why?” questions.

I think what’s finally hitting me is the fact that these conversations simply wouldn’t be happening if RSS did not exist! What you’re doing is inspiring. Thanks for the great post.
Matthew Huebert”

A huge barrier to real repair is the lack of awareness of 60% of the insured population.

The 46.7 million uninsured are a mere abstraction to these people. The horror of the 40% insured is also an abstraction. If the trend continues the system will cave in all at once and everyone will be affected.

People have to be stimulated to action now and demand the solutions.

I outlined in the last three blogs.


We are approaching a Presidential election year. We will hear all sorts of noise from “leaders” who in my opinion have little serious knowledge of the problem or the solution as seen in recent initiatives in California
and Massachusetts.

Our leaders are not stupid. The problem is the input of information is coming from the facilitator vested interest groups and not the people in the street.

Perhaps I can capture the imagination of all of the stakeholders. If we could all focus on the higher goal of excellent medical care at an affordable price rather than improving the financial results of facilitator vested interests, all of the stakeholders could all flourish with the minimum of pain and maximum creativity.

Nothing has changed because we the people have not made the correct demands.

All that has happened is that Obamacare has made the healthcare system worse. Obamacare Is going down in tubes.

It is time for Consumer Power to act.

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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I Told You What To Do 8 Years Ago: Part 3

Stanley Feld M.D.,FACP,MACE

I told you about all my ideas necessary to repair the healthcare system 8 years ago. None of the ideas have changed

Politicians and their healthcare policy wonks have not implement or supported any of theses ideas. The adoption of Obamacare has made the healthcare system worse.

“The hardest thing to explain is the glaringly evident, which everybody has decided not to see.”

Any Rand, The Fountainhead

It is a pity that the public votes for people who hold their vested interest and their quest for power above the needs of the people.

It is worse that the traditional media works as a special interest group to support the politicians’ quest for power over the people.

Our government is getting further from the solution to the problems of our healthcare system in order to force consumers to be more dependent on big government and less responsible for themselves.

The end game will be a disaster for Americans, our freedoms and our financial well-being.

My ideas do not support the vested interests of secondary stakeholders. I support consumers’ interest. Many of these secondary stakeholders are abusing the healthcare system. They take advantage of consumers.

The government is one of those secondary stakeholders that cause dysfunction in the healthcare system with its endless regulations.

The government regulations are written to control physicians and patients..

Consumers’ health and their healthcare dollars must be the responsibility of the consumers. A consumer driven healthcare system is the only way to stop the evolving medical care and financial disaster.

This week the progressives in Colorado blew my mind. They want to eliminate Obamacare because it has failed and replace it with a state run single party payer system.

This group has 200,000 signatures to petition that its proposal be put on the 2016 ballot.

In the small print they are proposing a $25 billion dollar tax increase to pay for the proposal.

Obamacare has resulted in increasing the cost and dysfunction of the healthcare care system. The adoption of this single party payer system will make it worse.

I am sure many people in Colorado are unaware of the progressives’ stinking thinking.

However, the petition is the first step in President Obama’s scheme to make thing so bad that the people beg the government to take over the entire healthcare system.

This tactic is right out of Saul Alinsky’s playbook and right up Hillary Clinton’s alley.

Meanwhile, “What Have I Said So Far? Spring 2007 Part 3 is republished below.

Maybe people will start paying attention to what is happening in our healthcare system before it is too late.

For more details on each proposal please click on the links.

“What Have I Said So Far? Spring 2007 Part 3

Stanley Feld M.D.,FACP, MACE

 

The following are additional solutions necessary for the Repair of the Healthcare System

Disease management systems can be developed in primary care physicians’ offices because there are not enough specialists to take care of all the patients with chronic disease.

 Treating chronic diseases this way should lower the complication rate for chronic diseases. The result should be a reduction in the cost of healthcare by at least 45%.

 

Measurement of quality should be all of the above. However, the key measurement of quality is the medical outcome as it relates to the financial outcome. If you prevent a $50,000 complication utilizing $1,000 of treatment you have a leveraged financial outcome as well as an excellent medical outcome.

The main question is, “was the complication of the chronic disease avoided?” We are misguided when we start believing that measuring the percentage of our patients we measure cholesterol on, or the percentage of patients on whom we do colonoscopies or bone densities is a measure of quality of care.

It is simply one element of quality medical care and it should not be rewarded as the Pay 4 Performance advocates are suggesting. This thinking makes us vulnerable to another false hope of reducing complications of chronic diseases.

 

  • Increasing obesity in our population is a huge health risk.The government should declare war on obesity. It should strive to eliminate the many stimuli we are exposed to. It should institute a gigantic public media campaign to explain the health risks and the stimuli in society to overeat.

    The most important need is to put the patient in charge of his disease management. The patient must be responsible for his care and in control of his health care dollar. We do not need more schemes destined to fail such as;

the California and Massachusetts mandates. We do not need the Pay 4 Performance scheme that will distort the healthcare system even further.

We need some common sense infused into the development of a healthcare system that is driven by the patients and not the facilitator stakeholder for the purpose of the facilitator stakeholders’ bottom line.

If patients do not want to take care of themselves they will suffer medically and financially.


These are some of the solutions I have proposed. We need the political will and leadership to institute and execute these solutions.

Responsibility for follow up care and compliance must be the patient. The physicians are the teachers educating patients to be experts in their disease self- management.

In the present system the penalty to the patient is bad health. The new system should have a clear message of good health and financial reward. It is much cheaper for all the stakeholders in the long run.

The patient has to;
• Be responsible for the purchase of care.
• Have ready access to care.
• Be responsible for the appropriate adherence to care and medication regime given by the physicians.
• Be rewarded for excellent lifestyle changes and avoidance of complications of disease.

If this is accomplished, and it can be with appropriate leadership and the demand by the consumer, we can repair the healthcare system.”

It is almost past time to start listening and demanding a “consumer driven healthcare system.”

Consumers have Patient Power and do not even know it.

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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I Told You What To Do 8 Years Ago: Part 2

Stanley Feld M.D. FACP,MACE

There are so many little changes that can have a big affect on repairing the healthcare system.

These changes would go a long way in putting consumers in control of their own health and healthcare dollars.

President Obama and the Democrats want to make consumers dependent on government. Most Republican politicians do not understand the healthcare system’s problems.

Republican senators and congressmen have not been able to come up with a viable solution because they are influenced by vested interests other than the consumers’ vested interests. .

Republicans cannot understand that consumers are smart. Most know how to spend their money wisely. Consumers can solve problems if they are given the right tools and incentives.

In last week’s Republican debate Mike Huckabee got close when he said we have to solve four chronic diseases and the costs to the healthcare system would plummet. He mentioned diabetes, heart disease, cancer and lung disease. He was almost correct.

The care of chronic diseases that are manageable consume 80% our healthcare dollars. Most of the 80% is spent on the complications of these chronic diseases.

Motivating patients to become the “Professor of Their Disease” can prevent at least 50% of the complications of these diseases.

Mike Huckabee missed that part. Patients must be provided with financial incentives to prevent a chronic disease from occurring in the first place and then learn how to prevent complications from occurring.

I am publishing the spring of 2007 blog summaries to demonstrate that none of the obvious fixes have been executed to put consumers in a position to make wise choices and be responsible for them.

What Have I Said So Far? Part 2 Spring 2007

April 3,2007

Stanley Feld M.D.,FACP,MACE

 

The solutions I have proposed are all directed to a patient centered, patient driven, and patient advantaged system. I will review the proposed solutions in the next two blogs.

 Price transparency is an essential beginningNot only must the retail price be published but all of the discounted prices must be transparent as well.

The government must enact legislation so that the providers and the insurance companies post their range of prices. The government has to empower the patient with negotiating power to get the best price.

There are many different prices paid for a service depending on the negotiating power of the purchaser. The net effect of this total price transparency will be lower the prices and decrease cost of health insurance.

Consumer must demand real price transparency. Aetna’s declaration of price transparency last year was a rouse. The hospital associations of Wisconsin and now Texas have developed web sites to provide hospital retail prices.

We have little idea how much the government or insurance companies pay for these services. I assure you the discount is very deep and the hospitals are satisfied with the payments. 

The automobile industry has figured out how to deal with total price transparency and the Internet publication of the MSRP, the invoice prices and the average prices paid for an individual automobile. 

We should demand that the healthcare system does the same. The system should be set up where patients can negotiate price pre or post treatment. Sometimes the patients need a care emergently and are not in a position to negotiate in an emergency room.

Yet an oncologist is not permitted to administer the drug in his office for one and one half times the cost of the drug. It is estimated that $150 billion dollars are wasted on administrative costs in the hospital and in the insurance industry. These costs add not value to the treatment of patients. Increased executive salaries and increasing construction of enlarging hospital facilities absorb the administrative waste. The brick and motor expansion of hospitals should be over since much can be done on an outpatient basis.

 These are some of the solutions necessary to repair the healthcare system. The solutions have to be instituted as a total plan and not introduced piecemeal. Each of the pieces of the solution is dependent on each other in order to have a positive effect on repairing the healthcare system. Next time I will review the other elements of my plan needed to Repair the Healthcare System.

April 03, 2007  

There are two more parts to go. If only our elected officials would listen. The only way that will occur is if consumers start making demands. If the politicians do not listen them kick them out of office.

The most profound thing said at the Republican debate last week was by Marco Rubio. He said the traditional media is the Democrats largest and most powerful special interest group.

I suggest people start reading between the lines of the New York Times articles for a start.

Wake up, America.

 

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

 All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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