Seniors Feel They Earned their Benefits: They Don’t Want Change

A CNN opinion Research Corporation survey results demonstrate that as opposed to younger voters, seniors do not want change.

The majority of seniors have insurance, seventy-five percent of which is Medicare or Medicaid.  They have worked very hard, contributing into the system during their younger years.  They have seen two World Wars, among many, the depression and evolved through an incredible number of changes that no other generation has witnessed.  Still, amidst all this, they worked hard and contributed to the system on a regular basis.

Now, they hear that billions of dollars are going to be taken from the Medicare and Medicaid system to fund other insurances.  This at a time when 30% of the population will be newly entering the complex  Medicare network.

They have been assured that nothing will change.  They have a right to be nervous.  They have already lived through change on a grander scale.

White House to keep Physicians Aware of Healthcare Proposals

Notices went out to physicians yesterday by the Medical Society of the State of New York, informing them that the White House was holding a conference call on health insurance reform. Providers were invited to write in their questions prior to the teleconference.

Obviously this is an issue held dear to healthcare providers as well as the public at large.  Many are quite passionate about it.

Nineteen hundred physicians “showed up” last night.  There were 400 questions submitted.  This did not include the questions that were asked in the Q and A period at the end of the call.

Unfortunately, information disseminated over the 60 minute period did not vary from the standard message that the White House has been trying to sell with the AMA over the last several months.

When asked about tort reform at the end, the moderator stressed only that President Obama does not feel that there should be a cap on non-economic malpractice awards.

How healthcare costs can decrease significantly without taking money from liability premiums seems unlikely.

Passion for Healthcare Reform but also Passion for Protecting Our Constitutional Rights

The following is a letter for Blue Dog Democrats that was made by and circulated by members of Individuals United for Freedom, a group who feels passionately about protecting our Constitutional rights and puts their point of view over in a respectful but assertive manner.

There are many excellent points made in this letter.  I welcome any comments that you care to share with me on it.

Dear Congressman:

I’m writing to express mty opposition to the healthcare “reform”legislation that has been voted out of committee in the U.S. House of Representatives.  However, after watching several key senators interviewd on CNBC coupled with the reticence of many members of the Blue Dog Coalition to rush the ill-advised legislation through before the August recess, I am at least somewhat encouraged that a common sense, serious debate may still be possible when addressing an issue of such vast importance for this nation.

I believe that H.R. 3200 is a travesty and neither the administration nor the House leadership have been honest about its cost or its impact on the healthcare delivery system and, more critically, American patients.  Not only can’t we afford it, there is no way a private insurer can compete with a government-subsidized, tax-exempt program and the proposed regulations are writen in such a way that tens of millions of Americans will be forced into the government “option” giving up their current plan with which they are very satisfied.  Why should we turn our system over to a bureaucracy  that has driven Medicare and Medicaid toward bankruptcy while adding or expanding more than fifty government agencies?  I like my current healthcare insurance-please don’t take it away from me!

I am a baby boomer aproaching retirement age and I am etrified about what the propolsed plan and half trillion-dollar Medicare cut will mean to me.  Specifically:

  • I don’t want rationed health care, to be told I can’t get treatment because I’m too old and no longer a worthwhile contributor to the greater good of society
  • I don’t want to be told the operation is too expensive for me because I don’t have enough remaining years in my life
  • I don’t want to be told that I should “take a pain pill and just get used to it”
  • I don’t need mandatory end-of-life counseling to encourage me to go comfortably to my death
  • I don’t want the government playing G-d with my life.

The President said two-thirds of the cost of the proposed legislation will be financed by wrining out the fraud and abuse in the current Medicare/Medicaid programs.

Legislation for that is not needed, so why not just do it to bring down healthcare costs significantly (and shouldn’t you waith until the savings are actually realized before you spend them like I have to do in my own house)?

The absence of tort reform- it’s never mentioned- and the threats of relentless litigation and outrageous judements have caused massive escalations of malpractice insurance premiums.  It encourages physicians to order multiple costly tests, in part, to provide them needed protection, driving healthcare costs dramatically higher.  it must be addressed.

Allowing purchase of health insurance across state lines (it works with car insurance) and establishing non-profit, non-government insurance cooperatives would also increase competition brining premiums down while preserving our free market structure and thus deserve consideration.  The goal of providing insurance to currently uninsurable Americans and to immigrants here legally is admirable and the savings mentioned above should address that problem economically.

Contrary to the President’s perorations, the healthcare system is not broken-it is the best and most innovative in the world. (It must be. People from abroad, particularly in countries with socialized medicine, come here for treatment.  We don’t go there!)  Yes it needs reform; no it doesn’t need dismantling and it certainly does not need to be destroyed.  Take healthcare reform step by step to see what does and doesn’t work-we don’t need everything crammed down at once!  Test different options at the state level before mandating them nationwide.

I am both angry and scared.  Our budget must be brought under control, and that is the sole responsibility of Congress.  I was brought up believing that we were “endowed by our Creator with certain inalienable rights, among them life, liberty and the pursuit of happiness”.  With each vote that balloons our deficit and expands the reach and power of central government (e.g. stimulus and budget packages), I lose more of my liberty.  With each vote that raises taxes and impedes my ability to maintain my economic independence (Cap-and Trade tax bill), my pursuit of happiness turns ito a pursuit of survival.  And if this healthcare bill is passed in anything near its present form, turning decisions about my health into dollars and cents decisions made by an “independent board” of government bureaucrats, my most precious right, my life, is jeopardized, too.

Why is this happening?  Is it simply an attempt to promote the biggest transfer of power from the people to the government in the name of a radical ideology?  Is this the destruction of limited government, personal freedom and individual responsibility?  I hope not-we need representatives who think frugally, independently, beyond party lines, who use common sense and do what’s best for Americans, particularly those most vulnerable.

The Blue Dogs willingness to take a step back and participate in meaningful discussion has given me hope that perhaps you think that way too.

Fear of Medicare Fund Cuts : Justification vs Anxiety

Medicare was created by a law in 1965, which states in part that there shall be no “federal interference in the practice of medicine or the manner in which medical services are provided”. In addition, the government is barred from interfering with the operation of any health care facility.

While this was meant to assure seniors that the system that they paid into over their many years of employment would always be there for them, this now translates into creating financial pressure but not taking any responsibility for the results.

When acting as an advocate for patients and confronting health insurance personnel about pre-certification rejection, I have actually been told the following. “We are not telling you how to practice medicine. We do not have the knowledge to do that. You are the one with the expertise. If you feel that something should be done medically for the patient, then you must do it. But while we don’t have the right to tell you how to practice medicine, we do have the right to say that we will not pay for it.”

So, what happens when procedures should be done for those patients who  cannot afford them unless the insurance company will pay for it? Well, a certain percentage will forgo having it done and pray for the best.

The malpractice lawyers are waiting in the wings, salivating, rubbing their hands and getting ready for their commercials- “ if you are suffering from xyz disease and haven’t had this procedure, call 1800 Ima-lawyer and we will further punish your physician and sue.”

Is it any wonder that both seniors and the medical community are nervously waiting what the real financial status of Medicare will be?

Health Care Media Blitz

NBC’s latest  poll shows 43 percent are in favor of a public health option but a full 47 % oppose it. The proponents have decreased by 3 percent within the last month. Although 60 percent feel that a “major reform” must be forthcoming, many are skeptical about the proposed reforms currently.

The government is arduously addressing all objections to the healthcare reform in social media under WhiteHouse.gov. The site starts with the statements from President Obama where he comments, “This isn’t about politics. This is about people’s lives. This is about people’s businesses. This is about our future.”

There are 9 videos available for viewing:

  • The Indian Health Service
  • Elimination of insurance discrimination against disabled
  • Issue of health care rationing
  • Viral emails against healthcare
  • Advantages of Small businesses with the new plan
  • Medicare is safe and stronger with reform
  • You can keep your own insurance

While the videos are reassuring and are conducted by high-level people, the information within them is in direct contraindication to news reports about details within the healthcare reform proposal.

So, this begs the question as to whether their “reality check’” videos are accurate or whether there are details that are being sugar coated with half -truths.

Sure, we all want to sleep better at night knowing that the government has come up with the “ideal plan” and that the objectors are doing so due to their own agenda and strictly for political reasons. Yet, have they come up with a panacea or do the many objectors see a frightening scenario that could be played out across the nation should the reform take place?

One thing is for sure. The government is using social media to get their side out in a media blitz. It is up to you to wade through the data and decide how accurate the information actually is.

Good Co-op Health Care May not Be Good or Cooperative

Proponents of health care co-ops are enthusiastic about their individual models and tout them as being cost efficient and worthy of taking them to a national level. They feel that cooperatives would compete with larger insurance companies to lower costs. Certainly there are current models of health care co-ops that are working well. Group Health Cooperative of South Central Wisconsin, which has been going more than 25 years, is one example of efficient performance and is well received.

Yet, health insurance plans have been fraught with failure to sustain new models for cost containing systems historically. Iowa tried to form a co-op for health care that dissolved after only 2 years.

Centrists and some Republicans have looked at the idea of health care co-ops eagerly but they admit that it would take time and money to get everything in place between negotiating contracts with hospitals, providers and enrollees as well as establishing technology systems.

Orrin Hatch, Senator from Utah, states, “You can call it a co-op, which is another way of saying a government plan”.

The interesting question that acts like the 500-pound gorilla in the room is this-Why isn’t the liability cost tied into health care being addressed? If liability premiums did not have to be considered, health care costs could go down dramatically overnight, no matter what plan was initiated.

Healthcare debate- Don’t Let a Broken System Break Us

The healthcare debate is currently raging across this country.

The healthcare crisis has been highlighted by the recession. A full 48 states have been seeing budget shortfalls due to either mismanagement or the recession and one of the first things cut in cost saving measures is a Medicaid or health benefit program for the needy.

Dennis Smith, the man in charge of Medicaid during the Bush administration is very worried that the private health system will be harmed. “When you are taking people out of the private sector, you are eroding it” according to him.  His model is to stay in the private sector and that those that can not afford it should be subsidized so that you can get the insurance that you want and need while continuing to participate in the private system.  He would like to see government support of Medicaid scaled back considerably.

Losing one’s job or preexisting conditions should definitely be addressed to that insurance is obtainable for the masses.  Mr. Smith suggests that government give tax credits or debit cards to allow them to choose the program they want.

There is no doubt that the healthcare issue provokes strong emotion from both sides, for and against President Obama’s health care plan.

Many people see this not just about healthcare, but also about individual rights and freedom.  They view the proposals as eroding into the very constitution that has sustained our country and inalienable rights.

Interest groups have spent over $57 million on television commercials and competing ads on healthcare has swamped the airwaves.  The debate has become a full-blown national campaign with leaflets, surveys, polls, town-hall meetings and media articles.

Many of those objecting to the proposals fear that the government will ration health care or that senior citizens will be denied end of life care.

Either way, the plan does call for a massive bill for over $1 trillion dollars that we do not have.  We do not want the current health care system to break us but we should not have a reform system that breaks us either. 

Medical Care decisions- Fraught with Disaster

President Obama is pushing for healthcare reform as everyone in the country is now aware.  The danger in trying to save money however is that decisions on health care treatment options may be based on economic reasoning as opposed to sound medical considerations.

Treatment protocols for premature infants for example,  are extremely expensive running over one hundred thousand dollars in some instances.  Perhaps some government official will say that it is not worth the money.  Tell that to the mother who just gave birth. Perhaps that infant is the next Albert Einstein or the next Beethoven.  

Will medical decisions be left to bureaucrats instead of physicians?  Will they be telling us who will be treated and who will be left to die?

Will humans be losing their humanity for the sake of saving a few dollars?

I certainly hope not.  We would certainly rue the day this occurs.

Physicians’ Declaration of Independence…Million Med March

This declaration from the  Association of American Physicians and Surgeons, Inc. was written so well and expresses my opinion so precisely that I wanted to bring this to you today.

The Physicians’ Declaration of Independence

 

When in the Course of human events, it becomes necessary for one Profession to dissolve the Financial Arrangements which have connected them with Medicare, Medicaid, assorted Health Maintenance Organizations, and diverse Third Party Payers and to assume among the other Professions of the Earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of Mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident: that the Physician’s primary responsibility is toward the Patient; that to assure the sanctity of this relationship, payment for service should be decided between Physician and Patient, and that, as in all transactions in a free society, this payment be mutually agreeable. Only such a Financial Arrangement will guarantee the highest level of Commitment and Service of the Physician to the Patient, restrain Outside Influence on Decision-Making, and assure that all information be kept strictly confidential. When a Third Party dictates payment for the Physician’s service, it exercises effective control over the Decision-Making of the Physician, which may not always be in the best interest of the Patient. The Third Party then intrudes heavily into the sacred Patient-Physician relationship and demands to inspect the Medical Record in a self-serving attempt to satisfy itself that its money is being spent in accordance with its own pre-ordained accounting principles.

The Financial Arrangements between Physicians and the Third Parties have become so destructive to the Patient-Physician relationship, and to the Medical Profession as a whole, that it is the Right, and Obligation, of the Members of the Profession to abolish them. Prudence will dictate that arrangements long established should not be changed for light and transient causes; and accordingly all experience has shown, that Physicians are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations evinces a design to reduce them under absolute Despotism, it is their Right; it is their Duty, to throw off such arrangements, and to provide new Guards for their future security.

Such has been the patient sufferance of this Profession; and such is now the necessity that constrains them to alter their former Financial Arrangements. The history of the present system is a history of repeated injuries and usurpations, all having in direct effect the establishment of an absolute Tyranny over the Medical Profession. To prove this, let Facts be submitted to a candid world.

 

  • The Tyranny began during the Second World War, when Companies, suffering under Wage and Price Controls, were forced to lure workers by offering Health Insurance Benefits. This benefit, in lieu of cash, received favorable tax treatment and was allowed to continue after the War, even with the removal of the Wage and Price Controls. This system created a strong incentive to use Medical Care and set the stage for massive Cost Inflation. 
  • Slowly, insurance changed into payment for all Medical Expenses, minus a small and shrinking Deductible, which led to further Inflation, and a call to control costs. 
  • The Government decreed that Employers must offer Employees the option of a Health Maintenance Organiz-ation. Thus were born the HMOs: Private Insurance Entities designed to ration Medical Care for their Members. These Organizations received Tax-favored treatment that allowed them to survive in spite of their horrendously flawed concept. 
  • The Government, in 1965, in its Infinite Wisdom and going far beyond its Powers as set out in the Constitution, decreed that the Poor and the Elderly should receive Health Benefits funded by the Taxpayer. Thus came into existence Medicaid and Medicare. Medicaid, from the Conception, paid Physicians such a lowly wage that few participated, thereby creating a Two-Tiered System. Medicare payments to Physicians were initially fair and reasonable, and many Physicians participated in Medicare. Both Systems flooded the Medical Marketplace with Money, which fueled Inflation even more. 
  • Alarmed by the Medical Cost Inflation that it had engendered, the Government set out to restrain costs, principally by limiting fees to Physicians. These Price Controls had the effect of increasing Medical Inflation, as Volume of Services went up, and Quality went down. 
  • With each new round of Controls, Regulations and Paperwork multiplied many fold. This caused Physicians great Anguish, and took more time away from the Patients, with attendant loss of Quality and increase in Medical Inflation. 
  • Government policies continued to favor the HMO, in the hope they would tame Inflation. These Organizations skimmed Money off the Premiums as Profit, but which they called “Savings.” They spent less on Medical Care by denying or limiting access to Specialists, Procedures, Hospitals, and High Technology. Since this strategy mostly delayed care, it was ultimately more expensive. Thus did the Premiums again start to rise. 
  • The HMOs paid the Physician by Capitation; Physicians could stay profitable by having large numbers of Capitated Patients, which they would see rarely, if at all! There were other Financial Incentives to Physicians to limit their Patients’ access to Tertiary Care. These incentives set Patient against Physician, thus destroying this Sacred Trust. 
  • Remuneration for Physician services by the Government and the HMOs has dwindled to the point of Unprofitability and has compelled the Bankruptcy of increasing numbers of Practices, and the search for Other Sources of Income by Physicians. No other Profession in the United States is denied the ability to raise fees to cover increasing costs of doing Business. 
  • The Government, becoming increasingly desperate that all its strategies to control costs had failed (because they themselves were the cause of Cost Inflation!) resorted to Criminal Prosecutions of Individual Physicians and Hospitals for alleged Fraud. The Regulations being so Arcane and Vague, a simple Billing Error could be interpreted as Fraud. Most of those so pursued, being financially unable to defend themselves, simply capitulated and paid Huge Sums to the Government. Some were imprisoned. 
  • The Government passed a Massive Bill called HIPAA, which forced Doctors and Hospitals to spend billions to comply, with absolutely no positive impact on Patient Care. 
  • The Government passed a law called SGR which automatically lowers Physician Payment when total spending and volume increase, virtually assuring a downward spiral in Payments. 
  • The Government and HMOs now conspire to limit fees to Physicians by a diabolical machine known as “Payment for Performance,” based on “Practice Guidelines.” In addition to insulting our Ethic, this system will close the circle between the Central Payment for Care and the Central Prescription of Care. Thus do we completely lose our Professional Autonomy.

In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A System whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a Free Profession.

We, therefore, the undersigned Physicians of the United States of America, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name of our Patients solemnly publish and declare, that we will withdraw our participation in all above-described Third Party Payment Systems. Henceforth and Forever, we shall agree to provide our services directly to our Patients, and be compensated directly by them, in accordance with the ancient customs of our Profession. As has always been true of our Profession, our charges will be adjusted to reflect the Patients’ ability to render payment. Nothing prevents any patient from purchasing and using Insurance. The Patients’ medical interactions with us will remain completely confidential. We pledge the highest level of Service and Dedication to their Well-Being.

And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.

Richard Amerling, M.D., New York, NY, April 2009

Congress Smiled. They had their own Physicians

Congress wanted to decrease healthcare costs to the public as they smiled knowingly.  They had their own physicians.

Government mandated computers to advise people on how to treat themselves.  The public   eagerly approved as it meant empowerment.  Congress smiled.  They had their own physicians.

The government stated that physicians should not wear white lab coats anymore.  It spread bacteria and caused “white coat syndrome”.  This usurped physicians but they reluctantly agreed.   Congress smiled.  They had their own physicians.

Government cut spending to hospitals and patients went to medical houses to be treated, recovering at home.  Congress smiled.  They had their own physicians.

Government cut financial incentives to hospitals for medical student training.  Schools cut back enrollment.  Congress smiled.  They had their own physicians.

Government said, “We have too many specialists”. Training programs closed.  Older physicians retired.  Newer candidates went into business school instead.

Congress stopped smiling.  They no longer had their own physicians.