and the role of Government-run Healthcare
Please read on regarding Obamacare and the “Affordable Care Act”
What is Obamacare or Accountable Care Act (ACA) and what does it mean for you?
It has many different aims, but that can be summed up by a few principles and facts. The ACA seeks to reassign fiscal risk fropm those who earn more money to those who earn less. The ACA seeks to diminish the overall amount of money Americans spend on health care, whether it be governmental expenditure (because the government has $16,000,000,000.00 of debt. Or $ 57,000.00 of debt per American. But it also aims to decrease the total amount of money that is spent on healthcare even by individuals.
16% of our total money generated by America (GDP) services our health. Interestingly, it is equal to the amount of money Americans spend on entertainment, but for some reason entertainment is more important than health care.
First and foremost the ACA means different things to different groups of people. There are winners and losers. Each group will respond differently. Some of the groups may overlap. For example, people without insurance win, as they will now have insurance. People who are obese or for any reason are high risk will be losers. People who are sick, will become sick or who need more than rudimentary healthcare will be losers.
The government is an health insurance company. If you didn’t like health insurance companies before, you will be sure to hate the most powerful health insurance company in the world, one enforced by law, one that you, by re-electing President Obama voted for. If you didn’t vote for Obama, you are still responsible, because you have not written your congress people.
Why now? The government can no longer afford to service its people, because it must now service its debt. The debt is so incredibly huge because your politicians have spent and spent in order to buy your favor for re-election. We’re out of money. Imagine your teenager stealing your credit card and running up such an enormous bill, that it would take your entire paycheck for four years to pay it off. 16t(rillion) in debt. 4t in tax revenue per year. However, the most sobering debt of all is the personal debt if you add the personal debt of Americans to the governmental debt it is a staggering $50,000,000,000,000.00 or 50t!!!! That’s a staggering $600,000 per household. In short, were broke. Despite all the taxes you’ve been paying all those years. So now, after all the saving you’ve been putting away there’s nothing left. Your government hasn’t been saving for your old age as it had promised. The money’s gone. And the dirty secret is almost out. It’s hard to wrap your mind around such awful news, but you have to, because it’s true.
Now on to the ACA.
The ACA serves to create health exchanges, where all Americans can go to buy insurance. The insurance offered by the government will be on sale next to the insurances offered by private carriers. That doesn’t seem like a bad thing, and at first it doesn’t, but what you don’t realize, is that the government decides what care you can and can’t have, at every step. It’s not a choice between you and your doctor anymore. But it does it in a wicked and brilliant way. Meet the ACO aka “Accountable Care Organization”.
The government is setting rewards for physician participation in ACOs, and penalties should we not participate. So for example at the end of the year if a physician participates, and decreases the amount of total money spent on his patients he will get a bonus. If he increases his expenditure he will pay extra tax. It’s very similar to a HMO, however now the physician and the insurance company medical director are the same person. Why’s that a bad thing? The medical director makes more money, the more care he or she denies.
Lets take a scenario. A patient comes with longstanding intractable low back and leg pain. It’s probably spinal stenosis. Under our current system almost extinct (now changing and completely changed by Jan 2014) I would call up the medical director and argue that my patient needed physical therapy, an epidural to help him walk better and then an MRI to further diagnose his problem and then possibly life improving surgery of decompression, which has a high likelihood of RETURNING THE PATIENT TO NORMAL. The medical director will drag his feet at each step, not wanting to spend money on his insuree, knowing for each dollar spent a small bit comes out of his paycheck too. We argue, and I usually guilt him into paying, exposing his reticence to provide scientifically proven care for a patient. I more often win, but loose with increasingly frequency. It takes time, money, effort, and a huge base of knowledge of the literature and supporting science to make my argument. In the current model I win financially when I get to treat you, I win financially when you get better and tell your friends about our success. In addition to providing the best feeling in the world: helping another person, the better I do for you, the better I do for myself.
The ACO makes me, your treating physician the medical director. Now each time I (your physician) decide to diagnose or treat you, I loose money. Even though I care for you, I still have to feed my family and the government has incentivized me to give you less care. A Tylenol will always be better for my economy; an OxyContin will be cheaper than a MRI.
Technology that is curative is expensive. Technology that is innovative is expensive. Companies and physicians who look for and innovate medical answers for improved outcomes know the government and insurances will only pay for cheap care in the future. The US is no longer the place to lead innovation.
Medicare and the dropping reimbursement: why it manipulates your care and takes care away from you.
This is what Medicare and other insurances are already doing, and what Obamacare accelerates.
Lets say you got your MRI (in the pre-obamacare health setting!), and indeed it showed spinal stenosis from a disc bulge and you had dramatic and incredibly painful sciatica that prevented you from walking. Your doctor gave you three options: live with the pain, have a percutaneous, minimally invasive discectomy, or an open surgery. Medicare says yes! We pay for all of the above. But… The reimbursement for the percutaneous discectomy is less than the device cost… That means the $1000 (actual reimbursement) that the government pays doesn’t cover the cost of the $1200 cost of the equiptment (actual cost) not to mention the cost of the OR time, medical supplies, antibiotics, salaries of the nurses and doctors. So Medicare pays for it, but you can’t get it. The surgery is on the chopping block too. So now, you get Tylenol and no cure. Enjoy. Here’s the real rub: it’s illegal for you to pay me for the surgery you need, even if you have the money!!! “Balance billing” is called Medicare fraud. If I present you with the difference ($200) I get a serious fine and possibly jail. In the government’s mind I’m a criminal.
I find it particularly interesting that Obamadon’tcare does very little to incentivize health! Where are the programs designed to inprove health, cut smoking and obesity? Sickness is the prime movers of health care demand. I also find it unbelievable that Obamadon’tcare does nothing to address tort reform, another prime mover of medical cost.
Because of these two and other glaring omissions I believe Obamadon’tcare is not truly interested in reducing health care cost, its really only interested in the re-distribution of wealth and talent.
This is all horrible news, especially for the 97% of you who had paid for steak dinner, you’re not ready for a lifetime of crackers. You want the latest medical treatments, you want to see your doctor in a timely basis, you don’t think its safe for nurses to do surgeries and procedures, you want time with your doctor, you want your questions answered, in short you want the best medical system the world could ever design back.
There is only one-way to do it: Call, write and visit your representatives in Washington.
1 Miller, Jeff R 2416 RHOB 202-225-4136 Veterans’ Affairs
Armed Services Permanent Select Committee on Intelligence
2 Southerland, Steve R 1229 LHOB 202-225-5235 Agriculture Natural Resources
Transportation and Infrastructure
3 Brown, Corrine D 2336 RHOB 202-225-0123 Transportation and Infrastructure
4 Crenshaw, Ander R 440 CHOB 202-225-2501 Appropriations
5 Nugent, Richard R 1517 LHOB 202-225-1002 House Administration Rules
6 Stearns, Cliff R 2306 RHOB 202-225-5744 Energy and Commerce Veterans’ Affairs
7 Mica, John R 2187 RHOB 202-225-4035 Transportation and Infrastructure
Oversight and Government Reform
8 Webster, Daniel R 1039 LHOB 202-225-2176 Rules
9 Bilirakis, Gus M. R 407 CHOB 202-225-5755 Foreign Affairs Homeland Security Veterans’ Affairs
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11 Castor, Kathy D 137 CHOB 202-225-3376 Budget Energy and Commerce
12 Ross, Dennis R 404 CHOB 202-225-1252 Education and the Workforce Judiciary Oversight and Government Reform
13 Buchanan, Vern R 221 CHOB 202-225-5015 Ways and Means
14 Mack, Connie R 115 CHOB 202-225-2536 Foreign Affairs Oversight and Government Reform
15 Posey, Bill R 120 CHOB 202-225-3671 Financial Services
16 Rooney, Tom R 1529 LHOB 202-225-5792 Agriculture Armed Services Permanent Select Committee on Intelligence
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18 Ros-Lehtinen, Ileana R 2206 RHOB 202-225-3931 Foreign Affairs
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22 West, Allen R 1708 LHOB 202-225-3026 Armed Services Small Business
23 Hastings, Alcee L. D 2353 RHOB 202-225-1313 Rules
24 Adams, Sandy R 216 CHOB 202-225-2706 Judiciary Science, Space, and Technology
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Nelson, Bill – (D – FL) 716 HART SENATE OFFICE BUILDING WASHINGTON DC 20510
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Rubio, Marco – (R – FL) Class III
317 HART SENATE OFFICE BUILDING WASHINGTON DC 20510
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Your friend and mine:
President Barrack Hussein Obama
I don’t believe the ACA will work.
It does not incentivize excellence; it rather incentivizes treatment at the least common denominator.
I believe the main role of the ACA is to shift financial risk and costs from high risk/low income individulas to low risk or high income individuals.
The ACA is injuring doctors negatively. The ACA is injuring patients far more negatively removing choice, options and excellence from the healthcare system.
How expensive was medical care in the 1800s? Very inexpensive. Low tech, abysimal outcomes.
Were headed to back low tech under “rationing of healthcare.”
The greatest impediment to medical cost containment remains socially modifiable diseases: smoking, obesity, diabetes and diseases related to poor health choices. Change our health choices and costs go way down.
Whuy is medicine so cheap in Sweden, and life expectancy so high? They have a healthy population. Why? there is not a fast food restaurant on every corner.
The ACA undervalues the care a patient gets from a physician, lacks the fidelity to understand and aquequately weight treatment success or failure, and care little about the individual patient.
Welcome to the wal-martification of medicine.
Spill aisle 26.