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If Something Works, Destroy It!

Stanley Feld M.D.,FACP,MACE

If a program is working well the Obama administration starts regulating the program out of existence. In a very quiet and deceptive way the Obama administration is destroying Health Savings Accounts.

The fastest growing health insurance plan in the private healthcare market is Health Saving Accounts (HSAs). HSAs are also available in Health Insurance Exchanges.

Consumers love HSA’s because the money not spent for their yearly deductible expenses go into a personal trust fund, which goes to pay future medical expenses. Consumers, employers or government can fund the deductible. Healthcare coverage starts after the deductible is reached. The trust fund can grow tax-free until funds are withdrawn.

HSAs are not ideal but they do act to provide a mild financial incentive to consumers to be responsible for their health and healthcare dollars. Consumers decrease their overuse of the healthcare system.

Health Savings Accounts are not as powerful as my ideal Medical Savings Accounts. Medical Savings Accounts provide greater financial incentive for consumers to be responsible for their healthcare and healthcare dollars.

Consumers seem to lack the desire to prevent obesity, which is responsible for many chronic diseases and their complications. These diseases are responsible for 80% of the healthcare dollars spent.

With my ideal Medical Savings Account consumers or the consumer’s sponsors (government or employers) pay a high deductible. The sponsor then buys first dollar reinsurance for healthcare coverage. The unspent deductible goes into a Medical Saving Account tax-free retirement fund. It does not stay in the healthcare system.

The Medical Saving Account provides greater financial incentive for consumers to become more responsible for their health care and healthcare dollars.

Why and how does Obamacare want to regulate Health Savings Accounts out of existence?

In case you missed it, final regulations published on March 8 will make it impossible to offer HSA-qualified plans in the future.

 The health insurance industry has been opposed to HSAs and MSAs because the premiums the healthcare insurance industry receives is lower than regular healthcare insurance premiums.

Once the premiums are put into a trust it does not belong to the healthcare insurance industry to invest.

The healthcare industry has tried to influence HHS to dissuade consumers from buying HSAs through Health Insurance Exchanges since the exchanges began.

However HSS has done nothing (a) to help consumers identify HSA-qualified plans on the exchanges or (b) provide information to individuals that choose HSA-qualified plans about where to get more information about opening and contributing to an HSA.”

Last year’s proposed standardization of healthcare plan design rule gave no hint that the proposal would eliminate the possibility of HSAs surviving.

This year’s rule change made it clear that this was President Obama’s goal.

1)” Plans must apply specific deductibles and out-of-pocket limits that are outside the requirements for HSA-qualified plans.”

2) “Plans must cover services below the deductible that are not considered “preventive care.”

“ Regarding the deductibles and out-of-pocket limits, no Bronze, Silver, or Gold plans adhering to the standardized benefit designs will likely be HSA-qualified for 2017.”

The first step was for HHS to change the definition of a qualified plan. The next step was to force the plan design to be incompatible with HSAs.

HHS and CMS have given the healthcare insurance industry another gift. Maybe it is a payback for CMS short changing the insurance industry on its reinsurance payback promise.

In any event HSAs look doomed. The Obama administration has succeeded in destroying the development of a viable healthcare system that the free market, not the central government controls.

John Dunn M.D.,J.D. wrote a wonderful summary of Obamacare’s failed attempts to control the healthcare system to his chat group followers.

He has summarized all the policies that have failed in the Obama administration’s goal to destroy the private healthcare market and eliminate the free market system.

 “ Subject: HSAs being eliminated?

Yep, Obamacare strikes again to accomplish the real goal, elimination of private capitalist free market healthcare.

 Now let’s tally up the failures of Obamacare in its attempt to destroy the healthcare system—

  1. more expensive, less accessible,
  2. restrictions on hospitals and care givers,
  3. promotion of mid level practitioners, extraordinary inefficiencies created by computer mandates,
  4. penalties for hospitals and physicians that are created by apparatchiks,
  5. no decline in the uninsured,
  6. in fact there might be an increase in the uninsured because of the cost of premiums and deductible,
  7. more movement of people to Medicaid where coverage is free,
  8. bankruptcies of COOP insurance programs,
  9. exchanges failing with insurers leaving the market for taking big economic hits from adverse selection,
  10. and most of all—the death spiral of private market insurance—with the goal being to destroy the private market ????  
  11. Why of course, Medicaid for all. 

 The goal of government bureaucrats is control and power, achieved in this case by the growth of single payer government controlled medicine—Medicaid on steroids—

The result will be mediocrity as far as the eye can see, and destruction of innovative and creative health care,

but also the loss of the ethics and patient consideration that comes from physician guided health care,

 instead a trade for mandarins with frowns and red pencils,

 Checking the data banks that aren’t secure from hacking.

 It leaves one almost breathless, but it started a long time ago.

Good intentions and unanticipated results—Bastiat von Mises, Fredrick Hayek warned us about the fatal conceit and the problem of government actions to protect certain interests or promote a cause—ignorant of the realities of markets and the benefits of free markets. 

Socialism and statism will produce mediocre, expensive healthcare run by bureaucrats and apparatchiks who aren’t interested in good patient care,

They are only interested in control.

Looks like I am not the only one who has figured it out.

I do not understand why the political establishment cannot understand why Americans are getting ready to cast a protest vote against them.
 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




Biased Newspaper Reporting

Stanley Feld M.D.FACP, MACE

I used to read every word of the New York Times. After all it was “all the news fit to print.”

It took me a long time to figure out it was the same sensational journalism as the New York Daily News and the New York Post. Its sensationalism is subtler.

Both the News and the Post had better Sports sections than the Times. All three newspapers are biased. They all leave out important facts.

The New York Times leaves out important facts and does not connect related facts. The result is intelligent people reading and believing the New York Times can have one world view, while another group of intelligent people reading and connecting the facts can have an opposite world view.

The following headline appeared on the front page of the Sunday Times on Easter Sunday.

On Campaign Trail, Republicans Tone Down Criticism of Obamacare.

On its surface the headline infers that Obamacare is working and citizens like it.

The Times claim is, “Among the most embattled Senate Republican incumbents, the campaign websites of Kelly Ayotte of New Hampshire, Mark Kirk of Illinois and Ron Johnson of Wisconsin barely mention the health care law.

The article goes on to quotes Health and Human Services Secretary Sylvia Mathews Burwell.

“The explanation for (the lack of criticism of Obamacare) may be that for all its controversy and imperfections, the sweeping law has taken hold.”

 “This (Obamacare) is in the fabric of the nation,” said Burwell.

 “To be sure, the presidential election outcome will be a determinant of whether the health care law is reshaped, bolstered or downsized.”

Is reporting this Obama administration bias?  To me it certainly is. This conclusion is total nonsense. It is an attempt by the New York Times to help the Obama administration spin the truth and save President Obama’s legacy

The Times also points out that; President Obama took part in a celebration in Milwaukee this month after the city was given an award for increasing health insurance enrollment.”

Paul Krugman’s New York Times articles have been telling reders how successful Obamacare has been. The problem with his commentary is it does not fit the facts.

Meanwhile President Obama and the administration have been modifying the law almost monthly without the consent of congress.

It has also been spending money without congressional approval because the law has not worked out well for President Obama and his administration.

Obamacare has been a failure for all the stakeholders. It has had a negative impact on the economy and the delivery of medical care.

It cannot be fixed with a few modifications.

I hope the New York Times is just printing the Obama administration’s press releases. However, the Times editorials reflect the lies.

Anyone running for congress who believes the New York Times propaganda about the success of Obamacare should not be elected.

Many patients credit the President with giving them access to coverage even if they have a pre-existing condition and are not in a group plan. Meanwhile, the cost of the insurance has changed with higher premiums and deductibles, and the cost of coverage is increasing annually for both Obamacare and private insurance.

Remember President Obama’s promise, “If you like your insurance you can keep your insurance

 The cost of has been a debacle. It had been riddled with scandals, inefficiency, cronyism, and disrespect for consumers’ intelligence. I thought the original $800 million dollar cost estimate was ridiculously high. Its present estimate is $2.1 billion dollars. the web site is still not right.


How much did CMS really spent on Obamacare? No one really knows. It has not been cheap. Most of the expenditures have not been approved by congress.

For the last three years the Obama administration has lied about the enrollment numbers. At the same time they have bragged about the enrollment success. In 2014 the grand total enrollment in private insurance through the Obamacare exchange was 260,000 while 14 million privately insured lost coverage.

However the total number of consumers enrolled through Medicaid was 8.99 million. This occurred with only 23 states participating in the expansion of Medicaid


The enrollment figures had not improved at the end of 2015 even though the Obama administration extended the enrollment period constantly throughout the year.

“Earlier this month (2016), the Centers for Medicare and Medicaid Services announced that nearly 8.8 million Americans had “effectuated” coverage at the end of 2015, meaning they were paying their health insurance premiums.”

The agency praised this number as a sign of Obamacare’s success in expanding access to coverage.”

This is a perfect example of spinning the news. At the of the 2015 enrollment period before the enrollment extensions 11.69 million members signed up and paid. At the end of 2015 only 8.78 million people continued to pay their premiums.


This represents less than the Obama administration claimed enrollment of 2014.

 The New York Times is publishing fiction because of it’s bias toward President Obama and Obamacare. The truth about Obamacare’s lack of success is public record. Unfortunately the New York Times ignores the truth.

Obamacare enrollment decreased even further this year (2016). The insurance premiums and deductibles are too high for people making over 50,000 dollars a year. Only the fully subsidized people can afford to stay in Obamacare.

 Obamacare’s State Co-Ops were formed to have states run their own state insurance exchanges. Inefficiencies and faulty business model cause 13 of the 23 to fail so far.

The Obama administration provided 2.5 billion dollars in loans to these State Co-Ops. So far the federal government has lost 1.2 billion dollars of it 2.5 billion loaned to the state Co-Ops.

The Affordable Care Act allowed for the creation of consumer-operated and oriented plans, or co-ops, that were intended to inject competition into areas where consumers had few choices.

At present 8 more Co-Ops are on the verge and will probably close for enrollment for 2017.

The Centers for Medicare and Medicaid Services have little hope or collecting the money lent to the State Co-Ops. Information surrounding the liability of the failed state Co-Ops for the loans has not been transparent.

A total of $2.4 billion in loans was awarded to 23 Co Ops start-up and solvency loans to the 23 co-ops.

Now, 12 of the 23 co-ops that opened their doors in 2013 have closed and have left 900,000 consumers without insurance. No one can tell if these people were assimilated into the federal health exchanges. Republicans in Congress are questioning whether the taxpayers will ever get repaid $1.2 billion loaned to those failed Co-Op insurers.


Obamacare has made insurance available to millions of Americans with pre-existing conditions were denied coverage. This is true. However both the premiums and the $6000 deductibles are unaffordable.

A diabetic wrote to me, “Obamacare is great! Now I can buy insurance. My premium cost $12,000 a year. My deductible is $6,000 for a total of $18,000 a year. My medical bills were $100,000 last year.

I asked what was her HbA1c. She said it was 9.2% (normal 4.5% -5.5%).

The high HbA1c means she is a poorly controlled diabetic.

Shouldn’t this patient be responsible to lower the HA1c to 6% in order to reduce her diabetes complication rate?

Not everyone can afford $18,000 per year. Most of the diabetic patients who cannot afford the high insurance rates in the federal health exchanges have even higher HbA1c levels. They will ultimately cost the payer of last resort, the government, even more after the patient is bankrupt.

A better system needs to be developed to incentivized these people to be responsible for their own diabetes control.


Another feature of Obamacare that is publicized as one of the great successes is that children can stay on their parents’ plans until age 26.

The unintended consequence of this feature has given the healthcare insurance industry and excuse to raise insurance premiums by double digits increase each year.

President Obama has bragged, and the New York Times has applauded him for it, that health care inflation has been lowered since Obamacare was passed into law. He say that Obamacare has bent the healthcare cost curve.

This is false. Obamacare was collecting Obamacare imposed tax increases on every income bracket for three years prior to implementation of the healthcare coverage.

The cost curve was bent because there were no expenditures in the delivery of healthcare. In 2015 the healthcare cost curve is rising.

There are 20 hidden taxes in the law that effect citizens earning less than $250,000 dollars a year. .

These new taxes contradict President Obama’s promise that “anyone making under $250,000 a year will not pay a dime in new taxes.” Many of these taxes on businesses are being passed on to consumers in the form of higher prices.

Insurance companies are leaving the federal health exchanges in droves because they are not making as much money as promised by the Obama administration. Obamacare will disappear without insurance company participation.

When compared to 2015, 22 states and the District of Columbia have fewer insurers offering coverage on the exchanges in 2016.

 Just 10 states have more insurers offering coverage on Obamacare’s exchange.
The New York Times presents deceiving information about Obamacare. I cannot understand why readers believe these lies.

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


Wanting Something To Fail?

Stanley Feld M.D.,FACP,MACE

If someone wants something to fail, make it complicated enough so no one understands what is going on.

I am convinced that President Obama wants Obamacare, Medicaid and Medicare to fail.

President Obama wants a single payer health care system. He said it as far back as 2003. This You Tube was uploaded on Aug 12, 2009.

President Obama won’t tell the American people the truth about his plans for health care. Watch President Obama declaring his intention in his own words.

The result is everyone will receive the same healthcare under the government direction and control.

The ultimate goal is to make people dependent on the government.

The people will have no power to choose their physician or their treatment. It is true that every country in the western world has this system.

No country has proven that a single party payer system works for countries with the single party payer systems economy or their citizens. Surveys have shown that their citizens are satisfied.

The main reason people like it is because it relieves anxiety of being able to receive medical care even though they have relinquished their freedom to choose their physician or insurance company.

The biggest loss is independence from the government bureaucracy. People will be dependent on the decisions of unelected government bureaucrats.

The big questions that are never answered about medical costs are; who is spending most of the healthcare dollars and what are the healthcare dollars being spent on?

Do you want the government to decide if you are young enough to get an artificial hip or knee when you need it?

Do you want the government to decide about your treatment or do you want your doctor to help you decide on what your best treatment is?

President Obama is changing medical care in a methodical way. He is utilizing executive orders and rules and regulations written by non-elected bureaucrats, who are forced to follow his orders. Our elected officials should be in charge of government spending.

Many in congress know better and would not let President Obama do what he is doing. Most in congress are happy that he has exempted congress from Obamacare.

President Obama and his administration have been trying to do bad things very quietly to avoid political uproar. The mainstream media has been a great Obamacare ally.

The mainstream media has helped Obamacare keep these destructive regulations and their subsequent failures out of public view.

The media has also publicized President Obama’s lies about the success of Obamacare.

President Obama is adept at diverting blame for errors and failures in pursuit of his single party agenda.

At the same time he is trying to take power away from the states he is trying to persuade states to not permit big insurance premium rate increases requested by many health insurance companies for 2016.

President Obama’s Obamacare is the cause of the increases. He is positioned to blame the state regulators for the insurance companies not showing up to sell insurance for 2016.

If the states act to cut back rate increases the insurance companies will not participate in the federal and state exchanges for the 2016 enrollment period. The result will be the erosion of the possibility of competitive pricing.

The Obama spin machine started working at the beginning of the summer to shift the blame and/or force insurance companies out of the market.

Kevin J. Counihan, the chief executive of the federal insurance marketplace said in letter to state insurance commissioners, “Recent claims data show healthier consumers.

He also said, “The federal tax penalty for going without insurance will increase in 2016, he said, and this “should motivate a new segment of uninsured who may not have a high need for health care to enroll for coverage.”

This claim of costs data by Obamacare does not square with the healthcare insurance companies’ costs data. They are finding that new customers were sicker than expected. The insurance industry is also losing money because the Obama administration has paid them $2.5 billion dollars less than they were promised.

Health insurance plans sold through Obamacare’s Federal and State Health Insurance Exchanges are seeking 10 to 40 percent increases in premiums.

They are also seeking the same increase in the private sector as well as in Medicare and Medicaid.

The Obama administration is making up its own story to force state regulators to not allow the increased premiums.

The Obama agenda is choreographed to prove that insurance choices do not work. He is hoping that the public will conclude the only solution is a single party payer system.

The problem is the government cannot afford a single party payer system and the people will not tolerate it.

What is more bizarre is the Obama administration made loans to help start up state co-ops. These state co-ops were supposed to compete with the big insurance companies. They were supposed to sell insurance on the health insurance exchanges. The Obama administration invested $38 billion in startup costs and solvency loans to these co-ops.

Nevada Health Co-op received $66 million in federal loans. It is closing down on January 1,2016 because it ran out of money.

Louisiana Health Cooperative announced in July that it was voluntarily shutting down operations.

CoOportunity Health, which sold policies in Iowa and Nebraska, was liquidated and forced to close earlier this year.

Many state Co-op’s are on the way to bankruptcy. In Nevada alone one third of the health insurance exchange population will lose insurance coverage.

Nevada Health CO-OP’s departure will leave a big hole in Nevada’s exchange market. Open enrollment begins Nov. 1, and consumers will have to shop for plans with other carriers. The co-op had 21,300 members as of the first quarter this year. Nevada’s exchange population was about 63,000 at that time.

A.M. Best’s report shows a majority of the nation’s 22 co-ops have combined medical and administrative expense ratios above 100%.

All these failures and impending failures mean that either the Obama administration is stupid or things are going precisely as  President Obama had planned.

The healthcare system is on its way to destruction. The federal government as the payer of last resort will replace it.

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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President Obama’s “Noble Lie”

Stanley Feld M.D.,FACP,MACE

The Obama administration has been riddled with multiple scandals such as Fast and Furious, IRS, Benghazi, the red line on Syria, saying he is protecting Israel’s back, NSA and now the Obamacare roll out.

Bob Woodward on the Chris Wallace Show on November 18th said he was not impressed with President Obama’s lie about Americans keeping their own insurance and their doctor if they like him. 

To paraphrase Bob Woodward’s comment he said President Obama’s goal was to do something Noble for the American people. He wanted to provide insurance for the 30 million uninsured Americans.

My impression is Bob Woodward was forgiving President Obama’s  “Noble Lie.” He moved on to the disastrous rollout of the Obamacare  web site.

I was floored.

I thought about Bob Woodward’s statement for a long time. His statement reminded me of Plato’s Philosopher King.

My humanities teacher at Columbia College, Gilbert Highet ,was obsessed with Plato’s concept of the “Noble Lie.”

Gilbert Highet believed it is the duty of the intellectual to support freedom and defend pluralism.

He emphasized that the concept of the “Noble Lie” was exactly what the American founders rejected in the Declaration of Independence, the Constitution and the Bill of Rights.

The very next day one of my readers sent me an article by historian and author Arthur Herman ("The Cave and the Light: Plato Versus Aristotle, and the Struggle for the Soul of Western Civilization) concerning Plato’s “Noble Lie.”


He wrote,

Thomas Jefferson once confessed to John Adams that he had been rereading Plato’s "Republic" and “laid it down often to ask myself how it could have been that the world should have so long consented to give reputation to such nonsense as this,” including the notion of the Noble Lie.

They knew rulers, no matter how well educated or experienced, actually have no superior knowledge to ordinary people, because they all understand and judge reality at the same level.

That’s why Noble Lies aren’t just wrong. They also don’t work very long because citizens can see what’s real and true just as clearly as any of Plato’s Philosopher Kings, and sooner or later will catch them out.

President Obama has a knack of moving the traditional media quickly off one “Noble Lie” on to another before the first lie and its consequences can be fully appreciated by the people.

George Will had a wonderful statement about this ability. He called it

Clunker progressivism.

“Barack Obama’s presidency has become a feast of failures whose proliferation protects their author from close scrutiny of any one of them.

Now, however, we can revisit one of the first and see it as a harbinger of progressivism’s downward stumble to”

The following quote of Plato by Arthur Herman sounds a little bit like Bob Woodward’s statement last Sunday.

 It is the business of the rulers of the city,” Plato wrote in his "Republic," “to tell lies, deceiving both its enemies and its own citizens for the benefit of the city…”  

In fact, the wise ruler — Plato’s Philosopher King — must be prepared to “administer a great many liesand falsehoods,” Plato went on, for the benefit of the masses.  

Plato goes on to justify the “Noble Lie.”

 “The Philosopher King knows that they are too ignorant to ever see the truth about their city’s problems and how to fix them.”

“And at times it’s only through telling what Plato called “a noble lie” that he or she can get the people’s cooperation in achieving it.” 

Mr. Obama, you are not Plato!

The traditional media and the Democratic Party promote these Noble Lies.

Arthur Herman goes on to say,

And every lie is planted for a single end: to justify increasing the power of the federal government, and with it the clout of its Number One champion, the Democrat Party.”

The Democrats who voted for Obamacare either knew or understood its provisions. If they did not understand the provisions because they did not read the bill before they voted for Obamacare they were not doing their job.

It was predictable that Obamacare would be a disaster for ten of millions of Americans already holding health insurance policies. 

Above all, they knew their president had deceived the American public into accepting this financial and moral disaster, in order to clear the way for a single payer, completely government-run health system”

In either case they should all be thrown out of office.

Americans have not seen anything yet!

Wait until they try to see a doctor or receive access to needed medical care once Obamacare get further on down the implementation road.

It is going to get worse!

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

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Consensus: A Clever Way To Build One, Whether It Is Right Or Not: Part 2

Stanley Feld M.D.,FACP,MACE


Consensus is usually defined as a general agreement by groups of people. Consensus decision-making is the process of developing a consensus. A consensus is theoretically inclusive, participatory, cooperative, and egalitarian. Egalitarian means all stakeholders in a consensus decision making process should be afforded equal input into the process. All stakeholders should have the opportunity to table, amend or block proposals.

The consensus decision making process should be solution oriented. It should strive to be all inclusive, promote compromise and resolve positions of difference.

President-elect Obama issued an important challenge to forming a consensus.

"In order for us to reform our health care system, we must first begin reforming how government communicates with the American people," Obama said in a statement yesterday. "These Health Care Community Discussions are a great way for the American people to have a direct say in our health reform efforts."

The consensus decision making process has been contaminated by President-elect Obama’s healthcare transition team in order to arrive at Tom Daschle’s predetermined solution. The results of the consensus building will be molded to fit the ideas the Secretary designate of HHS has to repair the healthcare system.

Dr. Val Jones had a Healthcare Community Discussion in her home. It seems the healthcare transitions teams goal is accumulate as many horrible healthcare interface stories as they can to use as evidence of the need for the new bureaucracy to be imposed on the healthcare system.

“President-elect Obama and Secretary of HHS designate, Tom Daschle, invited concerned Americans to discuss healthcare reform in community groups across the country. My husband and I hosted one such group at our home in DC yesterday. Although we had been instructed to compile a list of compelling stories about system failures – instead we decided to be rebellious and discuss “what’s right with the healthcare system” and compile a list of best practices to submit to the website.

Even in Val’s attempt to be rebellious she had only one physician in her group.

“The event was attended by a wide range of healthcare stakeholders, including a government relations expert, FDA manager, US Marine, patient advocate, health IT specialist, transportation lobbyist, real estate lobbyist, health technology innovator, Kaiser-trained family physician, medical blogger, and EMR consultant. Here is what they thought was “right” with the healthcare system:”

The deck is intentionally being stacked against the private practice of medicine. It ignores the fact that eighty percent of the medical workforce is in private practice. Uwe Reinhardt said do not get your workforce mad. I would think private practicing physicians as a stakeholder should have significant input into forming a true consensus.

President-elect Obama has picked up a hardheaded political strategist in Tom Daschle for his push to overhaul the nation’s healthcare system.”

I believe President –elect Obama has a great chance of overhauling the healthcare system. The problem, in my opinion, is elements of Tom Daschle’s overhaul are wrong. The public opinion manipulation will probably get some legislation passed, but will it be the best?

“ Learning from Clinton’s mistakes, the nominee for Health and Human Services secretary favors going on the political offensive to bring about reform.”

A common denominator in this consensus building is everyone agrees something has to be done to fix the healthcare system. The next administration is close to developing this common denominator. They are not building a consensus on what should be done. This issue has already been decided by Mr. Daschle. It does not matter if what is done is wrong.

“Guided by lessons from President Clinton’s healthcare debacle 15 years ago, Daschle has put a premium on cooperation between the White House, Congress and major healthcare interest groups, many of whom agree that major action on healthcare is vital.”

Bertrand Russell said it perfectly.

What a man believes upon grossly insufficient evidence is an index into his desires — desires of which he himself is often unconscious. If a man is offered a fact which goes against his instincts, he will scrutinize it closely, and unless the evidence is overwhelming, he will refuse to believe it. If, on the other hand, he is offered something which affords a reason for acting in accordance to his instincts, he will accept it even on the slightest evidence. The origin of myths is explained in this way.”

Naomi Klein in the Shock Doctrine said in times of economic or political upheaval policies are enacted that could never have been passed in ordinary times. We are not living in ordinary times.

“Tom Daschle favors moving decisively to seize political momentum and, if necessary, cut off opposition, something he said Clinton failed to do in 1993.”

"This means going on the offensive," he wrote in "Critical," his recent book about healthcare,”

I do not believe Tom Daschle is going to repair the healthcare system. He does not fully comprehend the problems in the healthcare system. Brute force will not work. Aligning stakeholders’ incentives is the only thing that will work.