Archive for May, 2014


Wednesday, May 21st, 2014

By Jane M. Orient, M.D., President of the Association of American Physicians and Surgeons

The Republican “repeal and replace” slogan sounds simple and appealing, but gets very complicated when you get to the next step. “Repeal” generally means “repeal Obamacare,” which is often immediately qualified: ”except for the parts we like.” The problem is that the parts you like depend on the parts you, or your fellow Americans, don’t like.

For example, you may like not being denied coverage because of pre-existing conditions. But you may not like having to pay more to cover other people’s pre-existings. You might like the “free” contraceptives, but not like the mandates that force you to pay for “free” care for other people’s children. Then what do we replace it with? Republicans have a bunch of competing ideas. Each would replace the Obamacare centrally planned system of subsidies, thresholds, and mandates with a different system of government dictates. The Republican mandates might be milder, at least at first. Call it Obamacare lite.

We’ve seen them do it before. We already have Clintoncare lite: the so-called Health Insurance Portability and Accountability Act, or HIPAA. That was supposed to solve the problem of pre-existings and insurance cancellation. It didn’t. What it did accomplish is to establish a pervasive web of federal controls over medical practice that becomes more expensive and onerous every year. Republicans might use a different term, such as “refundable tax credits” instead of “subsidies,” but it’s still forced redistribution of wealth. The cut-off points (thresholds) constitute a cliff where marginal tax rates leap upward, punishing those who increase their income, and thus creating a poverty trap.

So how do we solve the problem? The basic problem is this: Medical care costs too much. The basic solution is to get the federal government out of medicine, and replace the third-party payment system with the only honest ways of paying for medical care: cash, catastrophic insurance and charity. It’s simple – but extremely difficult. Obamacare didn’t create the problem. It just made it a whole lot worse, destroyed much of the system that people depended on and created vast new dependencies. The tax code, Medicare, Medicaid, the HMO Act, HIPAA, the stimulus bill and other laws created our situation. Obviously, we can’t just repeal Medicare.

Obama’s phone and pen cannot make doctors any smarter or more efficient. But even making them perfect wouldn’t begin to solve the problem. Some estimate that at least 40 percent – possibly much more – of the $2.7 trillion poured into the “health-care system” does not buy a single doctor visit, X-ray, aspirin, wheelchair, hospital meal or anything else recognizable as medical care. It buys compliance officers, planners, form filling, paper shuffling, coding, insurance and hospital executives – and a lot of graft and corruption. It’s an attractive target for fraudsters, even organized crime. And a lot of this is paid for with pre-tax dollars.

This hemorrhage is hidden by complex accounting designed to game the system, and facilitated by the absence of honest pricing. Nobody seems to know what anything actually costs, with all the backroom deals, secret contracts and insurance “re-pricing” scams. People don’t care too much because it appears that somebody else is paying. People have come to believe that it is terribly unfair to be sick and have to pay for medical treatment – but perfectly OK to force other people to pay, and at greatly inflated prices. Government can’t fix the “health-care system” any more than Obama can take out your tonsils. But it can refrain from tying up or tripping those who are trying to take care of patients.

We should start by repealing the mandates – on individuals, employers, medical facilities and professionals and insurers. No American should be forced to buy a product he does not want or need or feels he cannot afford. No individual or company should be forced to provide services or products to government specifications. The American way is the voluntary way. We also need to stop trying to operate in the dark. Government should actually be transparent and not just talk about it. And instead of spying on Americans in their doctors’ offices, it should be shining a bright light on exactly where all that Medicare and Medicaid money ends up.


Read this and you have to cry for America

Tuesday, May 20th, 2014

Obamacare Will Cause Longer Lines for Health Care By Scott Galindez, Reader Supported News, 17 May 2014

Opponents of Obamacare are right. You might just have to wait longer for that tummy tuck. I suppose you might even have to wait a little longer for that surgery on your knee, unless it’s an ACL and you’re a professional athlete – then you can still get operated on right away. It might even take longer to get an appointment with your doctor. I can hear the tea partiers shouting, “I told you so.” But guess what: it’s a good thing.

I hear the Republicans saying all the time that Obamacare will cause waiting lines like they have in Canada. My response to that is, “Fantastic!” If they took the time to think, they would realize that all they are saying is more people will be receiving health care. Maybe Jane from across the street will be getting a procedure done before you, but Jane couldn’t afford the procedure last year, so she wouldn’t have been in the line.

Millions of Americans who suffered through injuries and illnesses without health care are now in line. Of course more patients are going to cause longer waiting times. I have never met a Canadian who would give up their health care in exchange for our system. I guess if I met Wayne Gretzky, he might like a system in which only those who can afford it get treated. But I’m betting before he made millions playing hockey, he was happy to go to a Canadian doctor instead of suffering through the pain of an injury because his parents couldn’t afford a visit to the doctor.

Obamacare is only a step in the right direction. We need longer lines. We want everyone in line.

Most opponents of Obamacare are, deep down, good people who have been duped by the greedy one percent who want to keep the line short. They want the specialists to be caring for only their families. God forbid the janitor or the maid get the same health care as the rich.

To get everyone into the line, we need to first get rid of the middle man. When the public option was being debated, all we heard was how insurance companies couldn’t compete with the government-negotiated rates. My reaction was always to say, wouldn’t that be wonderful? No more insurance companies to deny us procedures they think are too costly. What do they provide? They are nothing more than payees who add to the cost of health care. Let’s give their job to a non-profit driven entity like the government and save money.

Yes Obamacare opponents on the left, you are right too – single payer will make the lines even longer. Won’t that be wonderful? But in the meantime let’s give credit where credit is due. Obamacare is causing longer lines for health care, so let’s celebrate.
Scott Galindez was formerly the co-founder of Truthout, and is now the Political Director of Reader Supported News.
Reader Supported News is the Publication of Origin for this work. Permission to republish is freely granted with credit and a link back to Reader Supported News.

Why? How? When?

Monday, May 19th, 2014

Obamacare harms millenials 8 ways

Sunday, May 11th, 2014

“Millennials,” the group of young people born after 1980, overwhelmingly voted in 2008 for politicians who promised “health care for all” and sponsored the “Affordable Care Act” (aka Obamacare). Sadly, young people took on faith the promises of an orator and did not read the text of the law before it was passed on a 100 percent Democrat partisan vote by politicians who didn’t read it either.

These millennials are finding out they’ve been “had” in promises not kept. Their health insurance premiums are skyrocketing. Their mandated coverage is far broader (ergo, more expensive) than many healthy young people need. Their choices of doctors and hospitals are now limited.
Because young people voted in droves for Obama in 2008 and 2012, architects of the health-care law assumed they would “vote” for the ACA by enrolling in Obamacare. Young people, however, are pretty savvy. They have learned a lesson: Read what you sign up for before you buy. They are not signing up as anticipated.
Here are the top eight ACA harms to young millennials:

1) Health insurance premiums are much higher. Before ACA, a young person typically paid $100-150 per month for a basic policy. Now, for Aetna’s ACA-compliant Classic Silver Plan, a young person making $25,000 per year would now pay $2,424/year (10 percent of income) in Arizona, or $3,576/year in Illinois.

2) Deductibles have doubled, tripled or quadrupled. For the plans above, before the ACA, a young person paid $1,000-$2,000 out of pocket to meet the deductible before insurance coverage started. After the ACA, average deductibles range from $4,000 to $6,000 before insurance starts to pay!

3) Today’s millennials are less able to afford insurance than baby boomers were at their age. Millennials may be more educated, but they have also accumulated greater debt and face a stagnant employment and income situation – partly created or worsened by ACA. In 2014, nearly half of the unemployed in the U.S. are under 34. That is a catastrophic change from the year 2000. Then, the U.S. had the lowest unemployment rate for those 18-34, compared to other wealthy economies.

4) ACA insurance is not sustainable. Millennials have done the math. They have seen it costs less to pay the mandated penalties (taxes), pay for basic medical care out of pocket and only sign up for an insurance plan if something serious happens. Thus, sign-ups are far lower than needed for the economics of ACA to work, so future premiums will be even higher.

5) ACA means less employer-sponsored insurance. Higher costs and mandates, coupled with slow growth and uncertainty, have meant that employers are not hiring as many full-time employees to avoid paying for high cost health insurance.

6) Millennials are overcharged for insurance to subsidize the costs of aging baby boomers. They must also pay for mandated benefits they will never use. For one example: Why does a single male need to pay for pregnancy and maternity care insurance benefits?

7) The quality and availability of care will worsen for everyone as services are cut to rein in spending: Fewer doctors and specialists, more use of physician assistants and nurse practitioners, fewer specialty cancer centers and other hospitals in allowed networks.

8) The enormous costs of implementing ACA will add to the crushing debt burden that millennials, and the generations following them, will be expected to pay despite their drastically reduced income opportunities.
Millennials are coming to see that they were pawns used to meet goals of a government-run, top-down health-care ideology that has never worked in any economy. Concept has trumped concern for young people’s real medical care needs as well as their economic future. Millennials are seeing that the elites and political cronies get exemptions, but the “average Joe” does not.

Millennials create infinitely varied custom set-ups for their smart phones and computers. They are not a group who takes kindly to “one-size-fits-all” medical insurance policies! They need to look at the expanded opportunity and freedom that comes with individual control and free markets.

Betrayed by politicians, millennials need to get engaged and fight for true, patient-centered reform. Their health – and their lives – depend on it.


Wisconsin almost voted to secede

Sunday, May 11th, 2014

It’s a shame, really. I’d actually relish the opportunity to see a state legislature debate the merits of secession or status quo … but I’ve gotten ahead of myself.

By the time you read this, Wisconsin Republicans will have considered a resolution that, among other items, would give the Badger State (or is it the Cheese State? Or the Cheesy Badger State?) the right to secede from the union, if it so chose. You’re reading about this after that, since the Republicans were set to vote on the measure Saturday. My bet is that headlines in Milwaukee this morning are announcing that the resolution was either abandoned or voted down by a wide margin. That makes sense because, from what I’ve read, no one in the Republican Committee knows how the resolution found its way into the party’s resolutions in the first place, though everyone acknowledges that there was a lot of states’ rights zeal at the caucus meeting back in April. And that’s really the story here. A Rasmussen poll from last fall found that nearly one in five Americans is ready to toss in the flag, call it quits and have their state break away from what has clearly become a painfully, sadly, imperfect union.

A change to America’s geography is just a matter of time. I was in Independence, Kansas, recently for my grandmother’s funeral, and I noticed an old map of America hanging on the wall of a local restaurant. Texas stretched up into Kansas and part of Colorado. The Oregon Territory stretched well into Canada. West Virginia didn’t exist. New Mexico was a sliver. California extended from the Pacific to what is today Colorado. My point is that the map of the U.S. has changed dramatically, radically and often throughout the years … and it’s on the verge of changing yet again, in many different ways, because of the antics of an over-reaching, bloated, out-of-touch, avaricious government beholden to an elite, moneyed crowd. We pretend to be a democracy; we talk up the ideal of liberties; we speak of the power of one man’s vote to make a real difference, when in reality the America of today operates not dissimilar to a Russian oligarchy — the uber-wealthy are the uber-powerful who set the direction of America. Our vote? It’s an American Idol moment once every four years. We pretend it means something … but it’s just Hollywood antics. Republican or Democrat, does it really matter beyond a few social differences? Was the warmonger, liberty-thieving, debt-addled Bush administration remarkably different than the Obama administration and its overreach with health care and education?

Wisconsin is the canary in the cheese factory. And it’s not alone. Yes, there are a lot of fringe elements pushing secession movements in America, and they are easily dismissed. But not everyone who sees secession as a viable option hangs from the lunatic edge of that fringe. An urge to demerge in Southern California came from a level headed city-council member simply disgusted with government antics. An active drive to cleave New York apart is not headed by a nut. In Colorado, a collection of average people — largely farm families — across several northeastern counties wants their own state. It’s happening in Arizona, Michigan, Western Maryland, Alaska, the Pacific Northwest, Vermont … and Scotland and Barcelona and Venice … and and and. It’s the movement that will define the next two decades or so: big to small. People all over the world feel oppressed by bloated, unresponsive Western governments. They’re angry. They’re restive. And greedy politicians have only themselves to blame for the cartographic destruction that is about to occur.

Wisconsin — probably — didn’t vote to secede. But give it time. Like a good cheese, this effort needs a little aging before it’s ready. – Jeff Opdyke

A tale of two UPMCs

Tuesday, May 6th, 2014

The UPMC-Highmark dispute is bigger than either institution, writes UPMC physician Dr. Dennis Gabos
May 4, 2014 12:00 AM

In June of 2013. the board of “nonprofit” UPMC, assumed to be community conscious and independent thinking, unanimously reaffirmed its plan not to contract with Highmark, the area’s largest insurer.

Prominent local leaders such as Paul O’Neill and Jim Roddey, and a long list of physicians, lawyers, business executives and citizens have articulated compelling opposition to UPMC’s intentions. The vast majority of health care professionals and all patients and citizens that I encounter also disagree with UPMC’s arbitrary and unprecedented policy to restrict access to our hospitals. But many of my professional colleagues fear openly defying UPMC by defending the rights of patients to access UPMC hospitals and doctors.

What is UPMC?

The reality is that there are two UPMCs: “UPMC-Corporate” comprised of CEO Jeffrey Romoff, his million-dollar executives and his board of directors; and “UPMC-Real Health Care” comprised of patients, physicians, nurses and others. UPMC’s health care professionals yearn to foster enduring relationships with their patients without barriers like those imposed by UPMC-Corporate.

What are hospitals?

They are shelters where we seek refuge from the storms of illness. Hospitals are not private or corporate property. They are no one’s yet everyone’s. They are community assets sustained by citizens — via health insurance and cash payments, taxes that support state and federal grants, Medicare and Medicaid, philanthropy and volunteerism, as well as the privilege of nonprofit status.

Nonprofit UPMC is obligated to be a responsible steward of our hospitals, honoring the needs of all citizens, not just the ones they choose. Highmark, the Allegheny Health Network, the Pennsylvania Insurance Department and the state Legislature likewise should not permit the creation of prohibitive barriers to health care access.

Read more:

California Obamacare Victims

Thursday, May 1st, 2014

A Thursday Huffington Post article highlighting Obamacare victims is causing quite a stir on the left.

The piece, titled “How Obamacare Leaves Some People Without Doctors,” breaks from the Huffington Post’s usual embrace of Obamacare and features the voices of Covered California customers who are already dissatisfied with the health insurance they bought through the Covered California exchange. “My insurance is pretty useless,” 35-year-old new Los Angeles mother Ruth Iorio told HuffPo. “I don’t know what to do. I may just drop it for myself and keep my son on it. It’s really depressing.”

Iorio says her Obamacare plan is worthless because after over a dozen calls, she still cannot find doctors who accept her Obamacare plan who are also practicing in a hospital that accepts her coverage. Prior to buying through the California Obamacare exchange Iorio had an individual Blue Shield plan that cost less and covered a wide array of doctors and hospitals. Iorio’s plan is so bad that after giving birth to her son she learned her Obamacare plan did not cover her UCLA ob-gyn, forcing her to pay out of pocket.

“I’m paying $500 a month and every doctor I’m calling is saying, ‘No, I can’t see you,'” said Iorio.
She added, “I feel like a second-class citizen.” Iorio is not alone, reports the Huffington Post. Another woman, Noam Friedlander, 40, needed back surgery for a herniated disc and thought her Obamacare plan would cover the costs. But after spending “days on the phone, hours on hold, making dozens of calls across Southern California, trying to match a surgeon with a hospital that would both be covered,” Friedlander came to a stark realization.
“No one could help me. Some expressed sympathy. They told me, ‘I’m so sorry–it’s all just so new. You’re a victim of the changes. No one knows what they’re doing,” Friedlander said.

After calling 20 surgeons and five hospitals, Friedlander, had to get two credit cards to pay $16,000 out of pocket. Iorio and Friedlander are feeling the pain of Obamacare’s “narrow networks,” which the Washington Post warned “are going to make people furious–but they might control costs.” Democrats like Senate Majority Leader Harry Reid (D-NV) and Democratic Senate candidate Gary Peters have attacked Obamacare victims and their stories. Reid went so far as to say “all of them are untrue.”