The Right Man for Healing and a Rare Find

Hippocrates of the Hippocratic Oath

I was not sure my ENT specialist was a good fit for me even though I read the glowing praises framed on his office walls, praises coming from his patients, colleagues, and other doctors. The young man seemed to know what he was doing but his bedside manner was brief and rather cold.

I attributed his demeanor to his introverted personality, his professionalism, and to his respect for his patients’ time. Very punctual, he very seldom made anybody wait to see him, he was always on time.

One day I realized that he was much more caring on the inside than he let people see. A young woman with her mom and a three-year old in tow had an appointment to see the doctor. The receptionist, Lupe, asked her if she was prepared to pay for that day’s visit. The young woman had a grief-stricken look on her face and wondered how much the visit was going to be. The receptionist told her that she did not know because each patient was different, depending on the problem. The prospective patient replied in a sad and disappointed voice that she will reschedule until such a time that she would have enough cash on hand to pay for the visit.

Lupe kindly explained that her insurance, Obamacare, had a huge deductible, and unless she met this deductible for the year, it will not pay the doctor anything. She offered to ask the physician, left the young woman waiting, and returned to tell her that the good doctor will see her anyway.

I decided then that this man was the right person to see in an ENT medical emergency or a problem requiring a caring specialist. His humanity, in addition to his medical professionalism, punctuality, and his education in the U.S., made him, in my opinion, an exceptional doctor, a rare find.

At the other end of the spectrum was the endocrinologist’s office in Fairfax who told me, they are no longer taking any new Medicare patients, just the already established ones who were in transition to Medicare. The receptionist’s explanation was that Medicare does not allow their patients to be seen every three to six months as needed.

I was told previously by a doctor friend that Medicare made low and very slow reimbursements to physicians because of Obamacare; therefore I did not believe the office’s explanation. Personally, I would not want to be seen by a doctor who put her profit motive above the care for a patient, any patient.

But I pressed on. What if I paid in cash, could I then see the doctor? The answer was again no because, she said, they had a contract with Medicare and thus could not accept cash payment.

Having read the pertinent section of the law, I knew this was part of the Affordable Care Act as well, the euphemistically named piece of legislation Obama’s administration and Nancy Pelosi’s Congress forced down middle class America in the middle of the night, “pass the bill to find out what’s in it.”

We did find out all right, and we did not like the price we had to pay for it in order that the Democrat Party could unilaterally force an entire nation, one fifth of the economy, to become a socialized medicine nightmare for decades to come.

More insultingly, members of Congress have their own subsidized and separate health care insurance and can see whatever doctors they wish to see.

It used to be the case in America once when patients could pay cash for doctors’ visits and the fees were affordable. But that gradually changed thanks to modifications in health insurance, new cafeteria health insurance plans, in-network and out-of-network type of employer insurance, and health savings accounts that disappeared at the end of the year if unused.

If you lost your job or quit, the insurance terminated, and you were at the mercy of Cobra insurance for a while, at confiscatory monthly premiums, but nothing as expensive as Obamacare premiums today that can easily exceed a family’s mortgage and car payments combined.

Lack of insurance portability across state lines had always been a problem for Americans seeking affordable insurance. Aggressive law suits against doctors and medical malpractice awards by the courts, forced doctors to drastically buy more and more expensive malpractice insurance, making care more expensive for the average patient who did have insurance. The infamous $50 aspirin in a hospital setting was legendary.

As a student without insurance in the early 1980s, I paid $10 cash per visit to my children’s pediatrician. Once we could afford and bought insurance, each visit was $85. The pediatrician made a comfortable living, had a thriving practice, but he was certainly not a millionaire.

If you ask most doctors today what they spend a good portion of resources and time, it is not patient face to face care time but electronic documentation, record keeping, and staff to handle insurance justifications and payments – bureaucracy.

Primary medical care, day-to-day healthcare, is now provided by a general practitioner, a family physician, a gerontology, pediatric, or family nurse practitioner, a physician assistant, a registered nurse, and even a pharmacist who coordinate and triage specialist care that a patient may need.

Secondary and tertiary care is harder to find as physicians are cutting their losses and focusing on accepting private insurance rather than Medicare and Medicaid.

We are headed to a single payer socialized medical insurance which will limit doctor visits and access to procedures based on rationed care. The entity that will hold the key to your ability to pay for and receive medical care when you need it will be the federal government, the same bloated, out of control entity that spent your Social Security lock-box savings and has doubled the national debt in eight years of the Obama’s administration.

Economic Miseducation

I have taught basic principles of economics for thirty years to groups after groups of college students who were often cross-eyed, bored, running late, playing with their phones, angry that I gave them too many notes, “hard tests,” and too many assignments which interfered with their busy social lives.  

Many students were there just to get a grade and to complete their useless social studies degrees on the way to an advisor’s assurance of a six-figure salary job on day one, an offer that would never materialize on their limited horizons. They did not care that their parents went in debt to pay for this college miseducation they received or that hard-working taxpayers funded their federal grants for four years. Most of them had no clue how the economy ran nor did they care.

It is painfully obvious that today students and college graduates are just as woefully incompetent and uninformed. They are voting in droves for their Marxist/communist of their choice, falling for empty promises of free education in their communist utopia of free birth control pills and free legalized drugs.

None of them paid attention in Economics classes that in communism abortion is not a choice, birth control pills are not available or expensive, and drug use is punishable with hard time in jail.  Education is free technically but there is no room to educate everybody in the halls of higher learning, so only a select few are chosen, usually the elite’s children are picked first, regardless of grades. If there are places left, then those with the highest scores are admitted.

Someone who spends a lot of his time running computer models to predict economic downturns, upturns, bubbles, crashes, and collapse, attempted to educate the audience on Facebook. Most of his advice fell on deaf ears because people are tired of listening to anybody, they know it all already, and have already made up their minds to go full speed ahead off the cliff, they want to try things for themselves, why listen to reason and rational thought. Repeating failed history in hopes of a different result seems enticing to most people.

In his analysis, in an economic environment of “120 percent debt to GDP ratio, we have less than five years before economic implosion.” He defined “Point Zero” as the point where the national debt becomes 120 percent of GDP, an unsustainable scenario that would cause an unrecoverable spiraling downturn of the economy. A black swan event would make things much worse.

In order to make sure the economy becomes sustainable again in the face of a 19 trillion national debt, “entitlements” must be reformed, spending and waste must be cut, some regulatory burdens on corporations must be reduced or eliminated, and taxes must be raised.

And this does not even begin to address unfunded liabilities such as Social Security and Medicare. Entitlements comprise 70 percent of the budget and debt servicing is 10 percent. This leaves just 20 percent of the budget that can be cut. Is that sufficient to even begin reducing the huge national debt?

Cutting the corporate credit card will force Congress to balance the budget. They cannot spend more than they take in from Treasury auctions and taxpayers. How many Congressmen will risk their careers in order to do what is right? Congress does not seem willing to address any of the above because they do not want to compromise their political careers and thus destroy the power they yield in Washington.  

Even though both spending cuts and tax increases are necessary, Congressmen fight and politically posture on both sides of the isle while nobody’s pet project or state funding gets cut. Why are Congressmen unwilling to cut pet projects? When they do, they know their constituents will vote them out of office.

We keep giving money to the U.N., we fight unwinnable wars with strange rules of engagement, and we waste more money on our political friends and foes overseas at a time when we can ill-afford it.

To make matters worse, inflation is looming on the horizon because of the three quantitative easings (QEs), printing money without the backing of goods and services in order to purchase our own debt.

The corporate mandate of the Affordable Care Act (ACA) has not even taken full effect yet. We are not sure if Congress will repeal Obamacare without a replacement. The preexisting conditions’ feature of ACA is a good idea.  In spite of dishonest political rhetoric, nobody will die in the streets without medical care.

But there is rationing occurring already due to the burgeoning and very expensive bureaucracy. We cannot offer care to more people and illegal aliens without substantial costs to the nation which so far seem to be far greater than if we would have given free premiums to the millions of uninsured who, before ACA, could not secure nor afford medical insurance. Some of them were already recipients of Medicaid.

We are sitting on a social unrest powder keg as evidenced by Ferguson, Baltimore, the Black Lives Matter, the collegiate race-baiting violence, and ISIS coming to our shores via unprotected borders. The social cohesion is breaking down faster than you can say All Lives Matter.

Even though our national debt to GDP ratio is quite high (104.7%), our economic situation is slightly different than Greece’s because we can print our own dollars. http://www.tradingeconomics.com/united-states/government-debt-to-gdp

Our fiscal policy is in a mess. Taxation burdens the middle class and favors crony capitalism while spending is out of control.  Almost 50 percent of the country does not pay any taxes and crony corporations move their headquarters to other countries to avoid paying proper share of taxes. Because corporate tax in the U.S. is one of the highest in the world, Congress enabled corporations to move overseas via Congressional bills.

The burden of taxation falls on the middle class yet again. TPP is going to move most of the remaining manufacturing sector overseas, transforming U.S. into a service economy and destroying many blue collar and white collar jobs in the process.

Congress originates the spending bills and approves them. The President can express what he wants and signs or vetoes bills, but the ultimate spending power and control rests with Congress. Congressmen are few and far between who have strength of character or the will to do what is unpopular. Nobody wants to be perceived as hurting parents trying to feed their kids, put a roof over their heads, or as “throwing grandmas over a cliff.” So the out-of-control spending continues to balloon.

American citizens themselves do not want to give up their instant gratification and suffer without their Starbucks coffee and the pain or indignity of a less than 75-inch TV or other electronic gadgets that are creating the blue screen hunchback nation. Why bear responsibility for yourself when Uncle Sam can do it for you?

Presidential hopefuls make promises to the electorate that will not reduce debt substantially in the absence of a robust and sustained economic growth that would bring in additional revenues. Some talk about “entitlement” reform by increasing the retirement age. Proposals to create economic growth are not very encouraging. There is no magical pot of gold at the end of the rainbow, nor another bubble that would bring in enough revenue to offset the very large budget and reduce the unpayable national debt.

How Obamacare is Destroying our Health Care

Romanian hospital 2014
Photo courtesy: Digi24 on line

Virginia is one of the few states in the nation who has taken the bold step to automatically enroll all Virginians covered by the traditional Medicare/Medicaid plan into a Humana managed health care plan. By managing elderly care (read rationing), money will be saved by denying needed medical tests, surgery, care, and physical therapy to elderly Americans who have paid into Medicare/Medicaid for decades.  How else will millions of illegal aliens recently granted amnesty by executive action receive free ObamaCare?

There is an option to opt out of the Humana managed care in Virginia and return to the traditional Medicare/Medicaid plans but few patients understand the language in the letter or are able to read it for themselves. This is one of the veiled moves to strip Medicare of $719 billion dollars in order to help fund and support the (Un) Affordable Care Act.

If you like your rationing of care, you can keep your rationing of care. If you like the loss of your well-trained physician, you can keep your third world doctor who is yet to be licensed in this country.

If you enrolled in a plan that fit your budget and your medical needs last year, the Centers for Medicare and Medicaid Services (CMS) has proposed the rule to strip that option from your list of choices, they are going to enroll you this year by December 25 into a cheaper plan of their choice. Too bad you forgot to choose a plan annually. They will select what is best for you, without knowing your medical history, your financial situation, your current treatment under a specialist, and maybe take away access to your favorite doctor who did not play by the new government rules.

When the open enrollment ends, the government would have effectively stuck you with a plan you did not want. Rep. Mark Meadows from North Carolina wrote, “I sent a letter to CMS demanding they immediately strip this provision from the pending rule and abandon any future attempts to single-handedly choose Americans’ healthcare plans.” I am sure the bureaucrats will listen, just like they listened when a majority of Americans asked them to defund ObamaCare. http://www.washingtontimes.com/news/2014/dec/19/rep-mark-meadows-obamacares-christmas-surprise/

Because there is a “war on doctors,” as Dick Morris so aptly described it, we will eventually have a sort of CastroCare in this country that Americans are not prepared to deal with but will be forced to accept it.

The double reimbursement for procedures that doctors in a hospital setting receive when compared to doctors in private practice, will eventually regulate doctors into a 8-4 hospital employment which I witnessed recently when my mother was in a hospital for 8 days and I never saw the doctor visit her once, she was treated by a nurse practitioner the entire time. There was not much hands-on care, just robotic, computer-driven medical care delivered by inadequately trained people. They were more concerned about her falling out of bed and a lawsuit from a potential fall than anything else. She was discharged without a proper diagnosis.

The forced electronic medical records-keeping will make it more difficult and expensive for private practice physicians who would be forced to spend a large part of their day on record-keeping and data entry instead of treating the patient.

In addition to reducing doctors’ income, physicians retiring early because they do not want to practice government-regulated medicine, Congress won’t expand residency programs to train more doctors.

Residency programs are funded by Medicaid/Medicare which gives higher reimbursement rates to teaching hospitals. Since the government refuses to pay for more residency programs, Americans should prepare themselves for substandard care delivered by nurse practitioners, nurses’ aides, and ER treatment replacing high quality medical care.

Hospitals are busy buying up private practices of retiring doctors in order to “capture their patients.” Most physicians are busy forming Accountable Care Organizations (ACOs) which combine multiple care providers under a hospital umbrella which has better access to capital.

This will lead to a doctor passing the care of his/her patients after the end of the shift to someone less qualified whom the patient has never met.

I recall the EU-modeled socialized medical care in 2012 Romania where I saw no doctor or RN anywhere in the large hospital in which my uncle was a patient. His wife delivered all his care, meds, diabetic shots, bandage changes, bed linens, bathing, towels, food, and trash removal. She was the de facto medical person caring for her own husband who would otherwise die of medical neglect in one of the largest hospitals in the capital. Incidentally, the courtyard was littered with stray dogs and we had to pay 5 euros to the gate guard to gain access into the hospital with five dingy floors and no operational elevator.

Online magazine Digi24 reported on December 17, 2014 that patients’ rights are often trampled on by medical personnel who refuse medical services unless the patients offer them personal benefits in the form of bribes. The accompanying photograph published by Digi24 is visual confirmation of the unsanitary conditions in some socialized medicine hospitals. http://www.digi24.ro/Stiri/Digi24/Actualitate/Sanatate/Ministerul+Sanatatii+intreaba+pacientii+Cat+de+multumiti+sunteti

According to Zoel M. Zinberg, associate clinical professor of surgery at Mount Sinai Hospital in New York City, “The new breed of physician-employees will split their allegiances between their employers and their patients.” The employer’s goals of making money and saving a buck every which way and the patient’s welfare will not coincide, and the physician will seldom be allowed to use his best judgment in treating a patient. He continued, “Salaried employees and independent professionals behave differently.” http://www.city-journal.org/2014/eon1218jz.html#.VJO-l_vj7J4.facebook

Dr. Zinberg cited a recent study in Health Affairs which found that …”practices owned by hospitals had 50 percent more preventable admissions than practices owned by physicians.” He concluded that “The days of the family physician who made house calls are long gone. The doctors who would squeeze you in for a visit on short notice and take your calls after regular business hours are disappearing.” http://content.healthaffairs.org/content/33/9/1680

The less discussed issue of economic side effects of the Affordable Care Act should not be overlooked. Casey Mulligan, professor of Economics at the University of Chicago, in his speech
delivered to Hillsdale College on October 24, 2014, explained the three taxes in ACA, two taxes on full-employment and one on income. All three combined have a net effect on employment (3 percent less) and on Gross Domestic Product (2 percent less).  He concluded, “If you like your weak economy, you can keep your weak economy.”

ObamaCare and a Bundle of Cash

Photo: Wikipedia

I’ve watched Americans cheering in mass hysteria for the Affordable Care Act of March 23, 2010 that would provide health insurance for 15 percent of Americans who either could not afford health care premiums, were denied insurance based on pre-existing conditions, or chose not to purchase insurance, gambling on their good health and immortal youth.

They believed the promised moon and the stars and Nancy Pelosi who refused to give details when asked - they had to “pass the bill to find out what’s in it.” Four years and a trillion wasted dollars later there are more American citizens without insurance, and with substandard and more expensive insurance that does not meet their needs.

Americans young and old found out what’s in Obamacare and did not like it. Elderly were kicked out of their Medicare plans and moved into Humana. Patients lost their doctors, lost their insurance plans they liked and were forced into exchanges. Premiums were much higher, deductibles through the roof, and reimbursement varied from 60, 70, to 80 percent, depending on whether they had bought bronze, silver, or gold plans.
Congressmen and their staff were in a separate category, a “platinum and diamonds” plan for elitist lawmakers who promptly complained they could not afford the premiums and voted themselves a subsidy.
I suppose those who were uninsured thought Obamacare to be free since they touted health insurance as a right, not a service. Why reward and pay the “greedy” doctors for their expertise and years of expensive schooling and hard training? Everyone should be equally paid in the new, “fundamentally transformed” socialist America.

Things did not work so well when it came time to fund this bonanza of good health. Young people preferred to pay the lower penalty instead of enrolling. Medicare was stripped of $719 billion over ten years to fund Obamacare at the expense of rationed care for the elderly.

It is sad when a patient over 70 becomes a “unit” whose worth to society is being calculated and then services are curtailed based on their “utility.”

Who said there are no death panels when patients in need of physical therapy or expensive chemo are being told, sorry, we’ve done all we can for you, you are just too old and you are never going to get better. A far away bureaucrat makes life-altering decisions for patients they have never met who paid taxes and premiums for years so that their golden years would be protected.

On the other hand, if you are an illegal immigrant, fresh off the train or airplane, Obamacare is free and readily available the very same day, no questions asked.

Scandal after scandal revealed how badly veterans were treated in VA hospitals – many died waiting to be seen by a physician. These were our heroes who put their lives on the line for America and were promised first class care for the rest of their lives and received the worst. Their worth to the new socialist bureaucracy is less than that of illegal aliens. Veterans and military families experienced first the ill-effects of socialized medicine.

You may not like your premiums, you may not like your deductibles, you may not like the loss of your doctor who is not “a preferred physician” under Obamacare and perhaps practices “concierge” medicine or has retired, but socialized medicine is here to stay.

You may have to accept the care of a nurse practitioner or of someone trained in a third world country who was hurriedly licensed in order to fill the void of doctors. No bureaucracy, once ensconced with deep roots in Washington, can be uprooted and nullified no matter how ill-conceived it was.

You may think, how bad can socialized medicine and a single payer system be? Not bad if you have the sniffles, pretty bad if you take into account what happened to Maureen in Ireland and hundreds of thousands of patients just like her who are subjected to nationalized health care in Western Europe, the model for the Affordable Care Act.

Trying to recover from surgery for a broken femur caused by multiple myeloma and blood clots in her lungs, she had to share a room, a bathroom, and a shower with six other co-ed patients. Her femur broke while waiting for a CT scan at one hospital and was then transported to another hospital for surgery.

After a three day wait, she was prepped for surgery but the ambulance did not arrive to pick her up until the following morning. Kept in a semi-coma to alleviate the pain, when she got to the other hospital, the surgery was postponed twice. If that was not enough pain and suffering, Maureen was infected with the dreaded MRSA staph bacterial infection in her nose.

What caused her blood clots? After a 15 minute infusion to strengthen her bones, she was told to wait for her surgeon who wanted to see her and give her biopsy results and discuss treatment. She sat in the waiting room all day, from 7 a.m. to 5 p.m. By nightfall she was short of breath and very weak and had to be rushed to the hospital by ambulance in order to save her life.

On discharge day, she had to wait 12 hours until a fourth person was found to sign off the release papers. Treatment can be good, but the patient can die waiting for it, and the nurses, although very kind and well-trained, are grossly overworked and underpaid, just like doctors.

Maureen had the option to buy a private room for the price of 1,000 euros per day. Single payer insurance in Ireland does not prevent patients from buying additional private insurance if they can afford it. Unfortunately that may not be the case in this country eventually, as more insurers would be unable to underwrite policies profitably and in line with the Affordable Care Act’s dictates.

As Jonathan Gruber said, the American voters were too stupid to understand the ramifications of the passage of the so-unaffordable Affordable Care Act and did not comprehend how their health care will be fundamentally and irreversibly altered.

Do we really want socialized medical care for our American patients? Unfortunately, what happened to Maureen is inevitably coming to the U.S. There will come a time when doctors, proper medical care, treatment, surgery, and drugs will be so scarce that patients will walk around with envelopes stuffed with cash in order to be treated in a timely manner and will look to the black market to find the drugs they need.
Copyright: Ileana Johnson 2014

Butler on Business, October 3, 2014 Ebola and Obamacare

My weekly segments with Alan Butler. Topics: Obamacare, how they treated my mom, and the Ebola situation. I come on at the second minute mark.
http://host1.cyberears.com//27861.mp3

Free Cheese in a Socialist Mousetrap

“There is always free cheese in a mousetrap.” – Retired Marine Colonel Martino

Public Citizen.org, self-described as “advocates for a healthier and more equitable world,” sent a fundraising letter to Democrat voters, claiming that “millionaires who run the largest corporations on Earth want to slash the social insurance programs the rest of us rely on.” By slashing, they are referring to the logical proposal to increase eligibility age for Medicare, to correlate Medicare to income, and to modernize/privatize it.

Who are these “mega-corporations” that apparently want to destroy our healthcare? Public Citizen points out that CEOs of AT&T, Boeing, Dow Chemical, Exxon, Mobil, General Electric, JPMorgan, and Wal-Mart have no idea “what it’s like to worry if you can retire with dignity and security.”

So far, class division and envy rhetoric, blaming the “evil” rich for the world’s problems and social injustice, has worked for progressives because they appeal to the lowest information voters, people who watch “reality” television and take their news information from comedians on the alphabet soup channels, the media machine of the Democrat Party.

It is not the CEOs who have destroyed the middle class and the opportunity to succeed in America, it is the race baiters, politicians, and the community organizers who keep the low information voters misinformed and beholden to their supposed saviors, the very people who control them and benefit from their misfortunes.

Public Citizen, a progressive organization for the “defense of democracy from corporate greed” and for social justice, with specialists in Community Organizing, lobbyists, environmentalism, and attorneys is “fighting not only to preserve Medicare, but to improve and expand it into the universal, single-payer health insurance system our nation needs to make the ideal of health care as a human right the reality for every American.”

Somebody needs to tell low information Democrats that medical care is not a human right, it is a service, provided by medical professionals who expect to be paid for their service, expertise, and the many years they’ve spent in medical school studying diligently for exams, writing papers, dissecting, doing 36-hour rotations at hospitals for free, paying high tuition fees, and buying high-priced specialty books. These medical professionals have loans to repay, families to feed, bills to pay, office overhead costs, malpractice insurance (due to the extremely litigious society that we live in), and employees who must be paid for their work as well.

Somebody should also tell uninformed Democrats that Medicare was not designed as a universal, single-payer health insurance system and that it is President Obama who is stripping Medicare of $719 billion over the next ten years in order to fund his unaffordable Affordable Care Act. Additionally, Americans have not asked for a single-payer, national socialized health care system but they got it, it is the law; even if ACA is defunded completely, all Americans must still pay the tax next year if they do not have proof of insurance.

Public Citizen claims that “an immoral (and ineffective) for-profit health insurance regime” dominates in our country. The medical system has its problems and is in need of tort reform and insurance portability across state lines, but it is the best health care system in the world, everyone who needs serious medical care comes to the United States for surgery. It is not an immoral system, anybody who comes to an emergency room is treated, and nobody is refused care.

On the contrary, millions of illegal immigrants take advantage of our generous health care system and overuse emergency rooms as their private doctors and as their OBGYNs, forcing taxpayers to foot the bills for the delivery of anchor babies and the care of their mothers while Americans buy insurance for their families. Americans, who cannot afford premiums because they fall below the poverty line, receive medical treatment through Medicaid.

“The private, for-profit health insurance establishment” has been able to offer free medical care to all people who could not afford to pay but needed care. Nobody died unnecessarily because they were turned away as the Public Citizen fundraising letter implies.

Unfortunately, with the new Obamacare, rationing will become the norm and people will be turned down for treatment based on their age and utility to society, they will become “units.” There is a 15-member death panel written into Obamacare. We will find out soon enough when the unfortunately-named Affordable Care Act starts enrolling people on October 1, 2013.

Public Citizen is mobilizing the “public and allies in Congress to block any cuts to Medicare.”

Pushing a “national single-payer system,” they are joined by “Sen. Bernie Sanders and Rep. John Conyers, the congressional champions of single-payer legislation.”

The letter concludes, “We are supporting state efforts to adopt a single-payer system in the framework of the Affordable Care Act.” The truth is that many states are pushing back and do not wish to have a single-payer system because it is unworkable and they lack the funds to do so.

Unions want Obamacare repealed or defunded because their members wish to keep their current Cadillac health insurance plans and their doctors, as promised by the President. Congress, who wrote the bill, does not want Obamacare for themselves and their staffers. They have strategized and manipulated behind closed doors until the President gave them a special status and a 75% subsidy towards the annual premium.   

Giving potential donors misguided statistics on the status of our healthcare, Public Citizen’s President ends his message of gloom and doom with the chilling “onward.” “Onward” is an interesting variant to “forward,” euphemisms recognizable to me as socialist slogans.

The Affordable Care Act Nobody Can Afford

I was just handed the Phreesia computer tablet by the receptionist under the guise of updating my medical and insurance information. I had seen this orange notebook in another doctor’s office and I became suspicious. Is this really meant to verify, as the website claims, my insurance eligibility automatically and help doctors collect on their insurance while easing the load of paperwork? Or is it forced electronic data compliance to Obamacare?

As soon as I started reading each screen, I realized that it was asking me to consent to third parties to obtain my medication prescription history from my pharmacy and to my entire medical history.

I had the right to request and restrict as to how my protected health information was used or disclosed. However, when I declined to sign, the computer stopped, and prompted me to talk to the receptionist. She informed me that diagnosis and/or treatment “may be conditioned upon my consent.”

The electronic screen and the paper copy the receptionist gave me said, “The [name withheld] is not required to agree to the restrictions that I may request and may refuse treatment based on my restriction as permitted by Section 164.506 of the Code of Federal Regulations.”

Suddenly, because I refused the IRS and HHS meddling in my personal health affairs, I had become persona-non-grata (unwanted person) to my doctor who had sworn a Hippocratic Oath to care for me and any patient who comes across his/her path.

In other words, I would not be treated if I did not sign yes. I had the right to say no, don’t’ give my medical information and history to anyone else but the doctor is not required to honor my request and may refuse treatment to me as permitted by Section 164.506 of the Code of Federal Regulations. http://www.gpo.gov/fdsys/pkg/CFR-2011-title45-vol1/pdf/CFR-2011-title45-vol1-sec164-506.pdf

What if I said no, do not release my medical history to a third unapproved party and I paid cash? The doctor would not see me. Welcome to the destruction of our stellar healthcare and patient/doctor confidentiality, compliments of Obamacare.

How affordable is this Obamacare, the unfortunately named, the Affordable Care Act? The Democrats and the President said that costs would be so much lower; it would save the typical family $2,500 per year.

The cheapest category of Obamacare is the Bronze Plan which costs $20,000 per year for a family of two adults and three children and it pays only 60% of medical costs after the deductibles for the year have been met. And the deductibles are high per person and per family. The following tiers are Silver (70%), Gold (80%), and Platinum (90%).

During my 30 year teaching career, I seldom had to pay more than $3,600 a year premium for private insurance for my family. Even a retirement private plan did not cost more than $8,000 per year with 80% reimbursement as opposed to only 60% reimbursement under the Obamacare Bronze Plan. Is Obamacare really affordable? The answer is a resounding no.

According to the IRS, the penalty for not buying insurance is capped for now at either the annual Bronze premium, 2.5% of taxable income, or $2,085 per family in 2016.

President Obama said, “If you are one of the more than 250 million Americans who already have health insurance, you will keep your insurance.” Heritage’s Amy Payne estimated that “more than 11 million people will no longer have their employer-sponsored health coverage once Obamacare is fully implemented.” (Businesses Cutting Hours, Bracing for Costs of Obamcare, December 6, 2012)

Obamacare employer mandate is killing jobs. An employer with 50 employees must provide coverage or pay $2,000 penalty for each employee after the first 30 workers. It is easy to see how an employer would have to cut back employees to 30, replacing full-time employees with part-time ones, in order to avoid the penalty or the skyrocketing premiums for private coverage.  These private insurance premiums rose significantly because Obamacare mandates insurance for all children up to 26 years old and for those insured with pre-existing conditions whose treatment can be costly.

Breitbart News reported that Pennsylvania Community College of Allegheny County had already cut the hours of 400 adjunct professors, staff, and part-time teachers, saving $6 million in potential Obamacare fees. (Wynton Hall, Obamacare Layoffs, Hiring Freezes Begin, January 5, 2013)

Because of the Obamacare medical device 2.3 percent excise tax, Stryker medical supply cut 1,170 employees (5%). Boston Scientific, Welch Allyn, Medtronic, Kinetic Concepts, and Smith & Nephew are also contemplating cuts in their work force. Zimmer Holdings, makers of hip replacement implants, laid off 450 workers in expectation of a $60 million tax bill in 2013. (Bob Unruh, Democrats in Congress ‘want out’ of Obamacare)

Everybody’s private insurance has been disrupted and private premiums have escalated, in addition to adding the “Cadillac tax” to plans that are judged too generous. According to Jonathan Gruber of MIT and the actuarial firm Milliman, non-group premiums rose 19-30% in some states and 55-85% in others.

The federal government has built a data hub to be used only for Obamacare without saying how it will be run. The HHS has released 13,000 pages of regulations with only 30 days for public comment while attempting to re-engineer 17% of the economy. (WSJ, It’s a Mad, Mad, Mad Obamacare, December 13, 2012)

On the deadline of December 14, 2012 states had to declare health insurance exchanges. At that time, only six states (Colorado, Massachusetts, Maryland, Oregon, and Washington) received conditional approval from the Department of Health and Human Services (HHS) to operate their own exchanges. Twenty-six states stated that they will not set up exchanges.

If a state operates its own exchange, it must come up in 2015 with its own source of revenue to run the exchange, making a state a vendor to HHS. The state running an exchange must also expand Medicaid to “able-bodied, low-income, childless adults” in spite of the fact that the Supreme Court ruled the Medicaid expansion voluntary. The federal government was not planning on covering the full cost of such Medicaid expansion. “Half of the reduction in the number of uninsured promised under Obamacare was based on mandating that states expand Medicaid.” (Heritage’s Morning Bell, December 13, 2012)

Several states asked Sibelius, the HHS Secretary, if they could expand Medicaid less. The answer was that only full compliance with the law will garner 90% reimbursement from the federal government. Nine states have refused to expand Medicaid to cover new populations. The feds will set up their own exchanges in those states but final regulations and specifics for the federal exchanges are not made public yet. Oklahoma and Maine have sued over Medicaid expansion and over statutory language and Medicaid expansion, respectively.

Three deadline extensions of implementing health exchanges have passed. Most states will share responsibilities with the federal government or default to a federal-run exchange. Only a minority of states have agreed to run their own exchanges.

A 3.5 percent administrative fee on coverage sold through federally-run exchanges will be levied. An additional $63 fee per employee must be paid in federal fees to cover people with pre-existing conditions.

Government funds will be set aside to promote/advertise [on primetime] Obamacare. Critics of the unaffordable health care law call such advertising “political advocacy.”

Practicing medicine will become more and less a government-run monopoly instead of the current monopolistic competition where patients are free to choose what doctors they go to, based on preference, doctor qualifications, specialty, reputation, insurance types, and premiums they choose to pay.

Doctors will either merge with hospitals, insurance companies, and specialty management firms or become “concierge” doctors, serving a reduced number of patients for a set fee. Consolidation will have a negative effect on patient access, price, and competition. Mergers in the 1980s and 1990s had negative effects in terms of patients being restricted or blocked from access to specialists and procedures.

More than $719 billion will be taken from Medicare over the next ten years to pay for Obamacare. According to Rep. Wally Herger, Chairman of the House Ways and Means Subcommittee on Health, the Independent Payment Advisory Board established by Obamacare is authorized to unilaterally impose price controls and de facto rationing of medical care.

http://www.washingtontimes.com/news/2012/dec/11/medicare-reform-crucial-for-economic-health/

Medicare is already in trouble. Taking $719 billion over ten years from Medicare to fund Obamcare will exacerbate financial problems. Medicare benefits are not a return on taxes paid into the system over time because Medicare is run as “pay as you go” - today’s wage earners pay taxes to fund benefits for today’s retirees. Since people live longer, “Medicare payroll taxes cover only 38 percent of current benefits.” (Rep. Wally Herger)

Obamacare depends on bringing young, healthy people into insurance markets to help offset the costs of insuring the old and the sick. If young people do not participate in the program and elect to pay the fine instead, Obamacare will not be able to make coverage affordable for the uninsured.

Most young Americans do not have insurance. Young people who do have insurance purchase less coverage. Under Obamcare, young Americans must get more coverage and pay more whether they want the added coverage or not. Private insurers have increased their premiums because the law prohibits them from rejecting the sick, and are no longer allowed to charge higher premiums to older customers. Premiums for a young, healthy male could go up as much as three times. Young adults could then opt out of private coverage, causing the market to implode. (Washington Post, Insurers Warn of Health Law ‘Rate Shock,’ N.C. Aizenman, February 16, 2013)

To make matters worse, government officials announced on February 15, 2013 that state-based “high-risk pools” under Obamacare will be closed to new applicants on February 16 through March 2, depending on the state, because funding is running low. The existing 100,000 enrollees will not be affected. If the funding is running low now, what will happen by the time Obamacare is fully in force?

There is a glitch in Obamacare that could leave more than 500,000 children uninsured. Congress defined “affordable” in the Affordable Care Act as coverage not exceeding 9.5 % of family income. If people have coverage that fall under this 9.5% affordable, they cannot get subsidies to go into new insurance markets. This restriction was put into place to prevent people from switching from employer coverage to exchanges in droves. “Affordable” was calculated based on self-only, individual worker, with an average market cost of $5,600. But the current market family coverage, according to the Kaiser Family Foundation, is $15,700 per year. IRS announced on January 30, 2013, that employers are not required to pay for dependents, leaving the employee to pay the family premium since he/she will be locked out of subsidies in the federal exchanges.

Betsey McCaughey wrote that Congressional Budget Office (CBO) prediction that Obamacare would leave only 30 million people uninsured in 2016 was predicated on the assumption that kids would be covered by employees. If a parent is covered at work, no subsidies will be provided for the child in the health exchange.

Millions of people will remain uninsured because their states are choosing [wisely] not to expand Medicaid. The states do not have the money to expand Medicaid.

By the time the uninsured will be counted, almost as many Americans (40 million plus) will be left without insurance as the number of uninsured before the Democrats passed their signature monstrosity, the Affordable Care Act. Having sat in a drawer for decades, the bill was dusted off, repackaged, and polished. Nobody took the time to publicly debate or read the bill that passed after some arm-twisting.  The Democrats, who had promised free health care for all, feverishly proceeded to spend trillions of dollars we did not have to re-engineer our health care system in the name of social justice.

The states that refuse to set up health exchanges are expected to sell the government-mandated plans and to give out taxpayer-funded subsidies to those who enroll. Betsey McCaughey identifies the glitch:

“The law says that in states that refuse, the federal government can set up an exchange. But the law empowers only state exchanges, not federal ones, to hand out subsidies. The Obama administration says it will disregard the law and offer subsidies in all 50 states anyway, but the case will likely go to the Supreme Court.” http://www.nypost.com/p/news/opinion/opedcolumnists/wheels_coming_off_QPojjZX0Bd8BU80hDpcKZP

To safeguard from disaster, take care of your body, eat right, exercise if you can, and pray very hard that you will not get sick. There is a good chance that there will not be enough highly qualified doctors to deliver care when needed even if you do have insurance. Should you need specialists, expensive drugs or surgery, you are out of luck. Rationing will tell you, “no, you can’t have it.” The emergency rooms will be filled to capacity with confused, desperate, sick people, and new illegal alien arrivals.