Dr. Hal Scherz: "Circumnavigating Obamacare"

Another great article by Dr. Hal Scherz, founder of Docs4PatientCare "In the three years since the law passed, it is becoming increasingly clear to everyone that centralizing control of the healthcare economy in Washington is increasing costs, causing confusion and making the bureaucracy more difficult to navigate. With each passing month, new surprises are revealed, just as Nancy Pelosi predicted. The newest revelation coming from Washington is the need for Obamacare Navigators. These individuals are “necessary” to assist people signing up for health insurance under the new state exchange systems. The “simple” 21 page application for federal insurance subsidies, along with the 61 page addendum, is apparently not quite as straightforward as promised. It has been suggested that these positions would be “awarded” to deserving individuals - supporters of this administration- union members, former ACORN employees, and other political cronies. The fact that voter registration has been included in the application suggests that only the “right people” will be hired as navigators. The truth is that the ACA is not and never was intended to “fix” American health care. Its purpose is to place control of American’s health care in the hands of Washington bureaucrats giving them enormous power and control of the electorate. If there was any doubt about this reality, it is quickly evaporating as the details of the law become clearer with each new healthcare revelation, now happening almost daily. The only possible way to accomplish the overly ambitious goal of providing health care for all, is with the creation of a massive and expensive new bureaucracy. The paradox should not be overlooked- healthcare spending is bankrupting our country, yet we are primed to spend far more money to create a massive bureaucracy in order to put it under government oversight. How everyone could not predict what we are currently witnessing is amazing. The ACA created 159 new commissions, boards and departments. This translates into a huge, new and expensive bureaucracy. It has been predicted that in California alone, 20,000 navigators will be necessary, which means that nationally, hundreds of thousands will be needed. The number of new government employees needed to staff all of these new agencies is incalculable. Currently, 1/3 of Americans are covered by government financed healthcare, which accounts for 1/5 of our GDP. If some in Washington have their way, and healthcare is eventually totally financed by the federal government, the costs of running the bureaucracy will consume such a large part of our budget, that we will be able to afford little else...." Full article here

Fed Up With Obamacare, Doctors Increasingly Prefer Cash For Care

Dr. Sally Pipes describes in this article an important option for patients concerned about the quality and availability of health care services to keep in mind as they notice growing bureaucratic restrictions on their choice of health care providers, diagnostic testing and procedures under increasing govt regulation: More doctors may be looking to cut out the progressively increasing paper work and extra-ordinary time and money-wasting and cost -inflating effects of government and insurance middle men through direct contracting with patients and direct payment for medical services: "Obamacare’s most intrusive changes to the healthcare marketplace — including the individual mandate whereby Americans must secure health insurance or pay a fine and its massive expansion of Medicaid — are less than a year from taking effect. Many doctors have decided that they’re not interested in seeing how those changes play out in their own practices. Nearly two-thirds of doctors say that they or their colleagues will retire earlier than planned over the next few years, according to a survey conducted by consulting firm Deloitte. Others are considering a departure from the current system of third-party payment. Instead, they’re exploring direct payment, with patients paying for care on their own. Patients should welcome this development. Not only does the move toward direct payment have the potential to reduce health costs — it could also yield higher-quality care..... Nearly 7 percent of doctors say they are planning to change to some form of direct-pay care in the next three years, according to a survey of 13,000 doctors done for the Physicians Foundation. The consulting firm Accenture projects that one in three doctors in independent practice will adopt “subscription-based care models.” One direct payment model that’s growing in popularity is “concierge” care, whereby doctors charge a monthly or annual fee for care — and bypass the administrative headaches associated with insurance and government programs altogether. The American Academy of Private Physicians — which represents cash-only doctors — estimates that the number of concierge doctors has shot up 30 percent in just the last year. Examples of these practices abound...."

"Married to Medicine" - The Scape-goating of Physicians and Propagandizing of ObamaCare

A recent post on an online forum for radiologists about a "trashy Bravo TV show" called "Married to Medicine" recently caught my eye. The original radioloigst poster on this blog urged readers to "take it with a grain of salt..it focuses on the gold digging wives of MDs and their fancy mansions and extravagant lifestyles". <<....It perpetuates the myth of the billionaire physician rolling in the dough, raking it in. Especially at a time when doctors salaries have been slashed and most MDs are living an upper middle class life certainly not a Romney life. Ortho, ED, and OB GYN are featured. No radiologists thank goodness....>> I think it is important to understand what is driving this - and the insidious, though critical, political purpose it serves in the context of the rapidly progressing government take-over of health care. In the overall scheme of things, the poster's observation and false sense of relief that radiologists per se were not one of the medical specialities portrayed in such fashion on this particular show, at this particular time, misses the point. Trashy? Yes. But also very dangerous- to dismiss its power in shaping public opinon and support for government policy by using popular culture as a tool of propaganda to villainize doctors in general as the prime cause of America's health care woes. Welcome to 1984- and the rise of State Bureau of Propaganda, staffed by Michael Moore and fellow billionaire Hollywood left-wing elitists. Art, popular culture and mass media all have a tremdously powerful impact on shaping the political and cultural views of the masses. The modus operandi and the purpose of left wing supporters of government-run medicine in Hollywood is to portray and demonize all doctors as exploitative, fat cat billionaire Robber Barons running roughshod over patients. Cast as such, they are depicted as greedily exploiting patients and defrauding 3rd party payers by ordering unnecessary expensive tests with the sole purpose of paying for their own yachts, mansions and spoiled, pampered wives. The consequences of government and 3rd party payer bureaucratic regulations, ever -expanding health system consolidation, unchecked patient demand for services in the ever progressing hyper-inflation of health insurance premiums and prices in medical and services can be thus ignored. We now have the "real" culprit: the unquenched thirst of doctors to bilk patients, the government and the system for ever more Porsches and Rolls-Royces and "deprive patients of their "inalienable right to unlimited medical services, provided by or paid for by others"- at least, as the producers of this show would have you believe... Clearly such vicious exploiters of the helpless and weak proletariat require the heavy regulatory protective hand of benevolent, public-spirited, "chamnpion-of-the-little-people", government politicians to ride in on a white horse and save the day by reining in the financial abusives caused by unchecked greed, and slash reimbursements and the filthy, unearned lucre of greedy, over-paid capitalist doctors", thus protecting the rights of the proletariat from the exploitative bourgeosie. Never mind the irrational, out- of- control medical malpractice laws which forces the hand of doctors in ordering extra unnecessary expensive diagnostic medical testing of marginal utility to avoid avoid potentially professionally catastrophic and bankrupting litigation by ruling out the "1 in 10,000,000 chance of a rare disease".... Or the low deductible, out- of- pocket expenses of most pre-paid health care policies which misleadingly cause the patient/ medical consumer to grossly under-estimate, and thus, grossly over-demand-and-consume inherently expensive medical diagnostic services, regardless of actual actionable medical benefit in some cases. The show is not designed to inform, but to mislead. The purpose, intent and aim is to use the power of pop culture and popular media to shape the opinions of the uneducated underclass who watch trashy Bravo TV- even inflame class envy and warfare by making doctors the scapegoat. The dual goal- direct the voting public's attention away from the 50 years of progressively advancing failed government policies and regulations over the health insurance and medical services industry which actually lie at the root of the problems in the US health care system today. This show represents an example of the propagandization of ObamaCare by Hollywood, warned about by Dr. Paul Hsieh, a radioloigst colleague in Colorado in his blog in Sept 2012 here: http://blog.westandfirm.org/2012/09/propagandizing-obamacare.html Propagandizing ObamaCare "The 9/15/2012 New York Times reports on how government officials want Hollywood to promote ObamaCare in the plots of TV shows like "Grey's Anatomy" and "Modern Family"."

Medical Freedom vs Financial Security for Doctors Under ObamaCare. Both? Neither?

According to a recent article in Forbes online entitled "Obamacare's 73% Medicaid Pay Raise For Doctors Is Delayed": "A huge pay raise promised under the Affordable Care Act for primary care doctors who treat the nation’s poor covered by Medicaid health insurance is nearly three months behind schedule and may take another three months before it kicks in, state Medicaid directors say..." As Ben Franklin sagely pointed out: "They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety." Nor financial security, as it turns out... A word to the wise is apparently insufficient. Those doctors and other medical care providers who were conned into voting for ObamaCare on the hope/expectation /promise of growing fat on increased payments / hand-outs from government -financed medical programs are about to learn the hard way . Making oneself dependent on the false promises and largesse of "beneficent" political operatives and administrators in Washington DC - is neither a tool for personal or professional liberty nor financial security. The ripple effect on voters/ patients/ the US health care system is sure to follow- as well as on your federal and state taxes: If you just happen to be the type that might be re-assured that "the check is in the mail", don't forget that those who are empowered to write, or re-write, your check make the rules- and can change, re-write or cancel either- according to their personal whim, convenience and political expediency. #suckers

The High Price of Nickel-and-Diming Doctors

 

By Shannon Pettypiece on November 21, 2012

 / Bloomberg Business Week

The above article describes the difficult decisions that more and more physicians are forced to make to abandon private practice and take a salaried position with a hospital - and how this affects your health care, and the cost of care in general:

"Dr. Thomas Lewandowski, a Wisconsin cardiologist, had a tough choice to make in 2010 after the federal government yet again reduced the payments he received for treating Medicare patients: He could fire half his staff to keep his practice open, or sell it to a local hospital. He sold, becoming one of more than 6,000 employees at ThedaCare, which runs five hospitals and numerous clinics in the northeastern part of the state. Lewandowski is among thousands of once-independent doctors who are joining with hospital chains to stay afloat, a trend that threatens to raise the price of health care even as the federal government strains to keep a lid on costs."

Read the whole thing here.

The above article does a nice job explaining the tremendous short-term health care cost -inflating consequence and other adverse consequences of driving former private practice physicians into hospital employee status. With it, the delivery of all health care services is forced into the setting of expensive high-overhead, high-tech, glossy, magnificent glass - and steel corporate settings. By that standard, ObamaCare would seem not to make sense and to produce the opposite effect of its promise of making health care "affordable". 

Of course, it does- but n reality, ObamaCare is not about affordability or health care- it's about control. 

First step: Raise administrative costs and hassles and drop reimbursements to force all previously private, independent  physicians into salaried employee status- where they seek refuge for a stable salary from the government onslaught. Benefit: they are now under the control of  a couple hundred giant hospital corporations - the new "Accountable Care Organizations" (and thus hospital administrators),  which can then be much more easily controlled by the federal government.

Next step: Bundled lump sum payments  from Medicare / Medicaid - and federally organized state-wide insurance monopoly exchanges- to  hospitals and their employed, salaried doctors- now run as  "Accountable Care Organizations"-  to force employed doctors to ration out medical services to patients under financial or administrative pressure or threat - from hospitals- under threat or risk of their own financial self- sacrifice or self-destruction or professional self-destruction/ job loss by their powerful ACO employer.

Next step: Structure all private and employer-provided health insurance in such a way that insurance premiums will be driven progressively higher, and simultaneously institute much less expensive  fines. 
This provides a double incentive for individuals and employers to forgo buying - or just dump-  their own private coverage and for  businesses to stop providing employee health coverage and dump their employees into the federally -run, state-labelled insurance monopoly exchanges.

As premiums rise, the private insurers which were jumping up and down with delight when ObamaCare was passed thinking they were now guaranteed massive profits by all the people and businesses now *forced* to buy their products- will progressively fail financially and dump their newly uninsured onto the government exchanges and directed onto the government Medicaid roles. Presto: single payer government run health care. One payer- the US government- sets all the rules and the payments.

Next step: Let the blood-letting and cost cutting begin. Across the board cuts to all hospitals/ ACO's  and their employed doctors while simultaneously and progressively squeezing more and more work for them for less pay like blood like a stone- far worse than the current situation. 

Next step: Meltdown across the system- Physicians and nurses will resign from the employed status under slave labor conditions in beautiful glass and steel hospital structures (don't worry - the physical plant  will rapidly deteriorate as number of support staff get cut) , with diminishing numbers of demoralized, overworked, underpaid medical staff with lower and lower staff to patient ratios, higher stress and ever expanding hours and responsibilities with prison-like working conditions. Mass exodus- back into fee for service system or out of medicine entirely for self-preservation. 

All of this , of course, will be happening simultaneously over the next several years- rather than in discrete steps - and all is brought to you by your federal government- who "cares' about your health care....

Why States Should Resist ObamaCare and Refuse to Setup Exchanges | MediBlog

IMPORTANT WEBINAR VIDEO:

Why States Should Resist ObamaCare and Refuse to Setup Exchanges | MediBlog


Michael Cannon of the Cato Institute, Byron Schlomach and Nick Dranias of the Goldwater Institute, and Twila Brase expose the pitfalls of having the state set up an Obamacare exchange and the advantages of not doing so. This webinar was presented to elected officials in Tennessee and concerned citizens.

Michael F. Cannon is the Cato Institute’s director of health policy studies. Previously, he served as a domestic policy analyst for the U.S. Senate Republican Policy Committee.

Dr. Byron Schlomach is an economist and works as the Director of the Center for Economic Prosperity at the Goldwater Institute. He has 15 years of experience working in and around state government.

Nick Dranias, is an attorney and the director of the Joseph and Dorothy Moller Center for Constitutional Government at the Phoenix, AZ think tank the Goldwater Institute.

Twila Brase, RN, is the founder and President of the Citizens’ Council for Health Freedom, a free-market resource for designing the future of health care.

Ralph Weber of MediBid.com moderated this panel discussion

WATCH THE VIDEO HERE:
Why States Should Resist ObamaCare and Refuse to Setup Exchanges | MediBlog

Action Alert!! Tell Your Governor to Say “No” to ObamaCare Exchange

Action Alert!! Tell Your Governor to Say “No” to ObamaCare Exchange

From the American Association of Physicians & Surgeons :

"States have been asked to submit to HHS their intention with regard to a state health insurance exchange as outlined in Obamacare by Friday, November 16.

Please contact your governor ASAP, asking him or her NOT to commit to any kind of Obamacare health insurance exchange. Even if your state has already declared its intention, please voice your opposition before Friday.

http://www.aapsonline.org/index.php/site/article/tell_your_governer_to_say_no_to_obamacare_exchange/

More Info:

A list of contact information for all 50 state governors can be found here:

Sample letter sent to governors.

Webinar Video: Why States Should Oppose ObamaCare Exchanges, featuring Michael Cannon of Cato, Twila Brase of CCHF, Nick Dranias & Brian Schlomach of the Goldwater Institute, hosted by Ralph Weber of MediBid.

According to Michael Cannon of Cato:
"Operating an Obamacare exchange would be illegal in 14 states. Alabama, Arizona, Georgia, Idaho, Indiana, Kansas, Louisiana, Missouri, Montana, Ohio, Oklahoma, Tennessee, Utah, and Virginia have enacted either statutes or constitutional amendments (or both) forbidding state employees to participate in an essential exchange function: implementing Obamacare's individual and employer mandates."
http://www.cato.org/publications/commentary/obamacare-is-still-vulnerable

15 REASONS: Oppose Obamaʼs Health Insurance Exchanges
 
1.   Exchanges are Federal Takeover Centers, not marketplaces. The federal government controls the health plans and the benefits—and oversees patient care. Exchanges will also become single-seller bureaucracies where only government- approved health plans are sold and no real “market” exists. It is expected that all people in the future will be required to buy insurance from the Exchange. (see #5)
 
2.   States will lose. State-run exchanges will hide the federal takeover; enable federal access to state-held data on citizens, patients and providers; and shift the annual
$10 million - $100 million cost of operating the exchange to State taxpayers.
 
3.   State-run Exchanges are not required. That would be commandeering of the state by the federal government. Obama’s health care law acknowledges this fact by having a fallback plan for creation of a Federal Exchange—but no money to do it. They’ve asked for ~$750 million, but Congress has thus far refused.
 
4.   All Exchanges are Federal Exchanges. State-run Exchanges must follow the federal law and all federal rules. They are required to report annually to the U.S. Secretary of Health and Human Services (HHS) and are under control of HHS.
 
5.   State-run Exchanges are part of a National Exchange. State exchanges are 50 state-named website portals of a national system. They are extensions of the federal government into each state through the “Federal Data Services Hub,” which will receive and share private data. Data entered online to buy insurance is sent for verification through the Federal Data Services Hub (“Hub”) to at least
five federal agencies, and compared with myriad state databases and data systems
made accessible to the Hub by state government.
 
6.   The Exchange is a national registration and enforcement tool. The National Exchange (with 50 website portals) will register the insurance status of every citizen and allow the IRS to enforce the penalty-tax for refusing to buy health insurance. The purpose is universal coverage — national health care. Registration takes place through purchase of insurance or online registration of an exemption.
 
7.   The Exchange will create an unprecedented tracking system. Whether they pay taxes to the Federal government or not, everyone must annually register with the IRS either on their own through the Exchange or through their employer. State governments are already considering how to “pre-populate” the exchange using other databases such as state taxpayers, voting registration, and vital statistics.
 
8.   The Exchange will enable Obamacare fines. Employers face significant fines if even one of their employees buys health insurance on a state-based Exchange.,,,

See the rest here:

15 REASONS: Oppose Obamaʼs Health Insurance Exchanges