Stanley Feld M.D., FACP, MACE Menu


Wrong Is Wrong

Stanley Feld M.D.,FACP,MACE

When the Democrats were in power in one or both houses of congress, President Obama had Republicans tied up in knots. Now that Republicans are in charge of both houses of congress, President Obama still has Republicans tied up in knots. The reason is the administrations spin the story to the traditional media blaming the Republicans for everything and the media sends the spin to the American citizens.

Republicans don’t fight back effectively. As a recent example, Republicans are being afraid of being blamed for an impending Homeland Security non-funding.

Aren’t the Democrats holding up progress by filibustering? Why haven’t they made any positive suggestions to move the process along? Come on Republicans. Democrats and the traditional media would attack you for that    behavior. Get smart!

Scott Walker fought back when Howard Dean (a Democratic plant and hatchet man), told Morning Joe that Scott Walker did not graduate from college and he would be unknowledgeable. Unknowledgeable is a new word invented by Howard Dean on the spot.

Scott Walker immediately replied with names of people who have been very effective without a college degree like Steve Jobs, Bill Gates and Einstein, among many others.

Howard Dean’s attack is a typical Saul Alinsky tactic.

Obamacare is a bad law. It is having a negative effect on our economy and healthcare delivery in America.

I said Obamacare would fail. It has failed so far.

President Obama has pulled lots of tricks and caused lots of delays in the implementation of the law so as not to upset too many American at one time.

He has made a lot of promises and told lots of lies to all the stakeholders to get them to support Obamacare.

It is easy to remember President Obama’s promise, “If you like your doctor you can keep your doctor. If you like your insurance policy you can keep your insurance policy.”

Another lie was “Anyone making less that 250,000 a year will not pay a dime, not a dime more in taxes.”

He has promised the insurance industry it would have more customers buying healthcare insurance. The healthcare insurance industry has not seen an increase in subscribers yet. It is betting on future consumers buying insurance that is no risk to the healthcare industry because it has a government guaranteed no risk insurance subsidy attached to it.

So far the healthcare insurance industry has seen nothing but sick people who they would not sell insurance to before Obamacare.

It has not seen a balanced insurance population. President Obama had to subsidize the insurance industry by guaranteeing their profit in order to get the industry participation. I have warned the healthcare insurance industry that this is another President Obama trick play.

He promised that healthcare insurance premiums would decrease. Families would save $2500 dollars year. The premiums have gone up $2500 a year.

In addition, healthcare insurance has increased to unaffordable levels for both the unsubsidized and subsidized Americans buying insurance through the health insurance exchanges. The deductibles are out of reach of the middle class.

Why doesn’t the Republicans expose this issue?

 Only 20% of the population uses the healthcare system at any one time. As it is there are too few physicians accepting both Medicare and Medicaid.

People who can afford it have to go out of the system and pay extra for concierge physicians to have a doctor they can communicate with. Few physicians are willing to accept Medicaid reimbursement. It is hard to get an appointment with a physician.

President Obama just undermined Primary Care Physicians by letting their promised increase in reimbursement expire.

The Obama administration has delayed implementation of the law even though the law specifies an implementation timetable.

Why doesn’t the Republican Party explain this to the public?

The implementation of penalties to consumers and businesses, which are supposed to start January 1, 2015, will probably be delayed by executive order. President Obama’s Democratic base is unhappy with the penalty and that frightens Democrats in congress.

Obamacare taxes have been collected for the past four years while full implementation of the law has been constantly delayed. Some of the executive orders have been constitutional and many of the delays in implementation have been unconstitutional.  

The deceptions and unconstitutional maneuvers are TNTC (too numerous to count.)

Republicans should point this out clearly for taxpayers and those people who do not earn enough to pay tax. Yet the Republican Party gives all these maneuvers a pass.

The Supreme Court will decide the King v. Burwell case in June. The law clearly states that only States with Health Insurance Exchanges can provide subsidies to qualified consumers.

The law does not provide for Federal Health Insurance Exchanges to grant subsidies to consumers buying insurance through Federal Health Insurance Exchanges. It can be done by congressional changes in the law. The Obama administration cannot change laws according to the constitution.

President Obama and his administration have ignored the law. The subsidy restriction was written into the law to encourage States to set up State Health Insurance Exchanges.

Thirty-three states felt that health insurance exchange formation was a bad deal for their state, their state deficits and the people living in the state. Those states   refused to set up a state health insurance exchange.

President Obama even told the state governments he would pay the costs for three years. It still worked out to be too expensive for the states.

Two appeals courts voted in favor of the plaintiffs against the government and one voted for the government. It was a Democratic full court in one state and a judicial panel in Washington D.C that voted in favor of the plaintiff.

Congressional Republicans are convinced that the Supreme Court will rule against the government. If that happens Obamacare will collapse because 85% of the enrollees receive subsidies.

This is part of the reason Republicans are not offering an alternative to Obamacare.

Even though I believe the Obama administration is wrong in providing subsidies that are not written into a law by congress and signed by the President I would not bet on the Supreme Court’s decision.

Secondary stakeholders in the healthcare system are resilient. They have figured out how to make more money with Obamacare. It happens to be at the expense of consumers.

These secondary stakeholders are now appealing to the Supreme Court to uphold President Obama’s unconstitutional executive order.

These business supplicants have little and often nothing to contribute on the legal merits. But they do want the Justices who might be inclined to obey the law’s text—which limits subsidies to exchanges established by states, not the 36 run by the feds—to know the woe that withdrawing the subsidies would visit on patients and especially on their corporate welfare.”

Obamacare enrollment is going poorly. Potential enrollees now understand that Obamacare is a bad deal for them.

In 2015 only 10.5 million have enrolled at the end of the enrollment period. The original projection for 2015 enrollment was 17 million enrollees. This goal was modified by the Obama administration in 2014 to 13 million and then at the start of enrollment to 10.5 million.

The public does not know how many of the 10.5 million enrollees paid their January premium and how many qualify for subsidies in 2015.

America’s Health Insurance Plans notes that 85% of Obamacare enrollees claim subsidies, which on average fund 76% of their premiums. Cancelling this “would make health insurance less affordable—the precise result the tax credits were intended to prevent.” 

The healthcare insurance is unaffordable now even that the subsidies cover 76% of the premiums. The government pays the remaining premium fee.

The deductibles are also unaffordable. Last year many paid their premiums initially and dropped out during the year because of the high deductibles. The number of people dropping out might be more that 1 million of the 8 million who supposedly enrolled and paid their first month’s premium.

The higher the enrollment the more secondary stakeholders profit. The taxpayers and patients are the losers.

A system needs to be developed that levels the playing field for patients.

 These irrelevant arguments belong to the larger lobbying campaign to intimidate the High Court into disregarding the law to rescue the political project of Obamacare. If the Justices must do so, we hope they find a better reason than the health industry’s self-interest.

The lobbying groups must not influence the Supreme Court’s decision. It would be wrong.

 Obamacare is bad law that has been subjected to unconstitutional executive orders.

Two wrongs do not make a right!


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

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