A Japanese doctor said, "Medicine in my country is so advanced that we took the kidney out of one man, put it in another, and have him looking for work in six weeks."
A German doctor said, "That's nothing, we can take a lung out of one person, put it in another, and have him looking for work in four weeks."
A British doctor said, "In my country, medicine is so advanced that we can take half of a heart out of one person, put it in another, and have them both looking for work in two weeks."
A Chicago doctor, not to be outdone said, "You guys are way behind. We took a man with no brains out of Chicago, put him in the White House, and now half the country is looking for work."
Fresh and ongoing from it initiating, feeding and perpetuating the housing debacle and collapse, the Federal government with its pernicious Obamacare is poised to destroy medicine and medical care as we know it here in the United States. If allowed to take root, gone will be the world’s best and most sophisticated healthcare system, home of most of the most important innovations and discoveries in medical care. In its place will be a near 3rd world level of “quality” of care encumbered by an oppressive and arcane government controlled system. At least in third world countries they don’t have swarms of attorneys pullulating like flies looking for their next jackpot.
It is commonly known that there will be a significant shortage of primary care physicians in the future which Obamacare will tremendously exacerbate for myriad reasons. Of course, neither Obama or Congressional Democrats considered this in their reckless haste to ram the healthcare reform legislation into effect. What a surprise – politicians didn’t anticipate something inherently important?
The end result? You will have the “right” of healthcare but you may not have a doctor to provide it to you. If you are ultimately able to schedule an appointment to see a doctor, you may have to wait an excessively long period of time to finally be seen, or be seen by a physician located far from where you live or work, or be herded through like cattle spending little time with the doctor who is massively overworked and overloaded with patients (and over-regulated).
Does the word “rationing” ring a bell? Or decreased quality of care? These were all important issues that were raised by those who opposed the Democrats’ plans but were ignored or denigrated by them and the press.
What is a “brilliant” solution for this problem that is being considered by the government? Have nurses act like doctors. Add a little more training, change some statutes and voila! Doctorlight. Easy! Just don’t be very sick or you might not make it to a real doctor.
And if the nurse gets a PhD, they can officially be addressed as Dr., adding to confusion but subtracting from quality. This proposal would place millions of Americans at unnecessary risk due to inferior training and as a consequence, inferior care.
Furthermore, given the government’s plan to reimburse these nurses the same or marginally less than real doctors, why would any sane person want to become a doctor? After all, for maybe $5 to $10 more per patient that a doctor would be reimbursed versus a nurse, that person would also have to go to medical school and residency for up to 11 or more years, assume debt to pay for school of $250,000 or more and then pay malpractice rates in practice that can exceed $100,000/ year.
This will surely dissuade many including the best and brightest from seeking a career in medicine and don’t we want our doctors to be smart and competent?
Sounds like another government plan causing unintended consequences.
Doctor shortage? 28 states may expand nurses' role
By Carla K. Johnson (AP) – 4/15/2010
CHICAGO — A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called "Doctor."
For years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics.
Those newly insured patients will be looking for doctors and may find nurses instead.
The medical establishment is fighting to protect turf. In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients.
Nurse practitioners argue there's no danger. They say they're highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.
"We're constantly having to prove ourselves," said Chicago nurse practitioner Amanda Cockrell, 32, who tells patients she's just like a doctor "except for the pay."
On top of four years in nursing school, Cockrell spent another three years in a nurse practitioner program, much of it working with patients. Doctors generally spend four years in undergraduate school, four years in medical school and an additional three in primary care residency training.
Medicare, which sets the pace for payments by private insurance, pays nurse practitioners 85 percent of what it pays doctors. An office visit for a Medicare patient in Chicago, for example, pays a doctor about $70 and a nurse practitioner about $60.
The health care overhaul law gave nurse midwives, a type of advanced practice nurse, a Medicare raise to 100 percent of what obstetrician-gynecologists make — and that may be just the beginning.
States regulate nurse practitioners and laws vary on what they are permitted to do:
_ In Florida and Alabama, for instance, nurse practitioners are barred from prescribing controlled substances.
_ In Washington, nurse practitioners can recommend medical marijuana to their patients when a new law takes effect in June.
_ In Montana, nurse practitioners don't need a doctor involved with their practice in any way.
_ Many other states put doctors in charge of nurse practitioners or require collaborative agreements signed by a doctor.
_ In some states, nurse practitioners with a doctorate in nursing practice can't use the title "Dr." Most states allow it.
The AMA argues the title "Dr." creates confusion. Nurse practitioners say patients aren't confused by veterinarians calling themselves "Dr." Or chiropractors. Or dentists. So why, they ask, would patients be confused by a nurse using the title?
The feud over "Dr." is no joke. By 2015, most new nurse practitioners will hold doctorates, or a DNP, in nursing practice, according to a goal set by nursing educators. By then, the doctorate will be the standard for all graduating nurse practitioners, said Polly Bednash, executive director of the American Association of Colleges of Nursing.
Many with the title use it with pride.
"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.
What's the evidence on the quality of care given by nurse practitioners?
The best U.S. study comparing nurse practitioners and doctors randomly assigned more than 1,300 patients to either a nurse practitioner or a doctor. After six months, overall health, diabetes tests, asthma tests and use of medical services like specialists were essentially the same in the two groups.
"The argument that patients' health is put in jeopardy by nurse practitioners? There's no evidence to support that," said Jack Needleman, a health policy expert at the University of California Los Angeles School of Public Health.
Other studies have shown that nurse practitioners are better at listening to patients, Needleman said. And they make good decisions about when to refer patients to doctors for more specialized care.
The nonpartisan Macy Foundation, a New York-based charity that focuses on the education of health professionals, recently called for nurse practitioners to be among the leaders of primary care teams. The foundation also urged the removal of state and federal barriers preventing nurse practitioners from providing primary care.
The American Medical Association is fighting proposals in about 28 states that are considering steps to expand what nurse practitioners can do.
"A shortage of one type of professional is not a reason to change the standards of medical care," said AMA president-elect Dr. Cecil Wilson. "We need to train more physicians."
In Florida, a bill to allow nurse practitioners to prescribe controlled substances is stalled in committee.
One patient, Karen Reid of Balrico, Fla., said she was left in pain over a holiday weekend because her nurse practitioner couldn't prescribe a powerful enough medication and the doctor couldn't be found. Dying hospice patients have been denied morphine in their final hours because a doctor couldn't be reached in the middle of the night, nurses told The Associated Press.
Massachusetts, the model for the federal health care overhaul, passed its law in 2006 expanding health insurance to nearly all residents and creating long waits for primary care. In 2008, the state passed a law requiring health plans to recognize and reimburse nurse practitioners as primary care providers.
That means insurers now list nurse practitioners along with doctors as primary care choices, said Mary Ann Hart, a nurse and public policy expert at Regis College in Weston, Mass. "That greatly opens up the supply of primary care providers," Hart said.
But it hasn't helped much so far. A study last year by the Massachusetts Medical Society found the percentage of primary care practices closed to new patients was higher than ever. And despite the swelling demand, the medical society still believes nurse practitioners should be under doctor supervision.
The group supports more training and incentives for primary care doctors and a team approach to medicine that includes nurse practitioners and physician assistants, whose training is comparable.
"We do not believe, however, that nurse practitioners have the qualifications to be independent primary care practitioners," said Dr. Mario Motta, president of the state medical society.
The new U.S. health care law expands the role of nurses with:
_ $50 million to nurse-managed health clinics that offer primary care to low-income patients.
_ $50 million annually from 2012-15 for hospitals to train nurses with advanced degrees to care for Medicare patients.
_ 10 percent bonuses from Medicare from 2011-16 to primary care providers, including nurse practitioners, who work in areas where doctors are scarce.
_ A boost in the Medicare reimbursement rate for certified nurse midwives to bring their pay to the same level as a doctor's.
The American Nurses Association hopes the 100 percent Medicare parity for nurse midwives will be extended to other nurses with advanced degrees.
"We know we need to get to 100 percent for everybody. This is a crack in the door," said Michelle Artz of ANA. "We're hopeful this sets the tone."
In Chicago, only a few patients balk at seeing a nurse practitioner instead of a doctor, Cockrell said. She gladly sends those patients to her doctor partners.
She believes patients get real advantages by letting her manage their care. Nurse practitioners' uphill battle for respect makes them precise, accurate and careful, she said. She schedules 40 minutes for a physical exam; the doctors in her office book 30 minutes for same appointment.
Joseline Nunez, 26, is a patient of Cockrell's and happy with her care.
"I feel that we get more time with the nurse practitioner," Nunez said. "The doctor always seems to be rushing off somewhere."
As we have mentioned myriad times, an overwhelming majority of physicians are resolutely opposed and in a state of perpetual outrage at the dictates of Obamacare. This may not necessarily be apparent given that most have elected to vent their disapproval in quieter ways such as e-mailing, writing and calling their Senators and Representatives.
One physician who did decide to be a little more overt in his vehemence, Jack Cassel MD, the Florida urologist who posted a sign on his door regarding those who voted for Obama, did get his message heard … and nationally. Unfortunately, the malignant and portentous Representative of his district, Alan Grayson (D – Florida) then initiated malicious verbal assaults on him including calling him racist and unprofessional and has indicated that he will seek professional sanctions and legal charges against him. This has become a dangerous and illegal pattern of Democrat politicians pursuing whatever measures possible to squelch First Amendment Rights. Threaten and silence the opposition into submission.
With this scenario fresh in mind and cognizant of the ubiquitous threats from the Government, media and even liberal loons, Dr. Joseph Scherzer, a Scottsdale, Arizona Dermatologist in practice for 34 years, felt that for the good of the country and patient care in particular, more needed to be shared with the public. He has bravely elected to speak out on the pernicious nature of the Obamacare legislation and its severe and adverse impact on medical care in America which will lead to irreparable harm to the world’s best healthcare system.
Neil Cavuto interviews Dr. Joseph Scherzer on FoxNews:
The story below details an Orlando, Florida area urologist who posted a sign on his office door stating:
“If you voted for Obama … seek urological care elsewhere.”
This physician reaction has created a tempest in many parts, but what did Obama and the Congressional Democrats expect? They have legislated involuntary servitude of America’s physicians with their corruptly passed and ideologically radical healthcare “reform”. They are trying to pay for the Obamacare wealth transfer on the backs of productive citizens and physicians though all healthcare providers including medical device companies will be negatively impacted. They are destroying the physician-patient relationship, quality of care, etc. with the insinuation of federal officials in the mix, determining who can be treated and by what (less expensive) means.
And then there is the reimbursement part that we will put in perspective. Medicare reimbursement rates this year pay doctors below 1995 levels which were low at that time. To make matters worse, as of this April 1st, reimbursement is scheduled to drop another 21.3%. In other words, physicians will be paid almost 22% less than they were 15 years ago. Meanwhile, Congress which incredibly can vote for its own pay raise, will received nearly 95% more than they were 20 years ago!
Many physicians have been losing money for years taking care of Medicare patients at artificially low reimbursement rates that don’t even cover their expenses. Now lower that rate another 22% and add far more government bureaucracy and you have a disastrous situation.
Though it may not judged to be “politically correct” for a physician to react as this sign indicated, it is well within one’s Constitutional rights to do so and does not violate any medical laws nor should it. Despite the fine line that medical societies may need to toe in response to actions of physicians like the above, there is nothing illegal or immoral. Unfortunately, our government has facilitated such actions by their oppressive legislation.
The overwhelming sentiment in the medical community is vehemently against Obamacare for myriad reasons. Therefore, we expect to see additional significant actions in the future that would far surpass this one incident in scope and extent. Reactions to Obamacare are only just beginning...
Doctor tells Obama supporters: Go elsewhere for health care
A Mount Dora doctor posted a sign telling Obama health care supporters to go elsewhere.
By Stephen Hudak, Orlando Sentinel April 2, 2010
MOUNT DORA — A doctor who considers the national health-care overhaul to be bad medicine for the country posted a sign on his office door telling patients who voted for President Barack Obama to seek care "elsewhere."
"I'm not turning anybody away — that would be unethical," Dr. Jack Cassell, 56, a Mount Dora urologist and a registered Republican opposed to the health plan, told the Orlando Sentinel on Thursday. "But if they read the sign and turn the other way, so be it."
The sign reads: "If you voted for Obama … seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years."
Estella Chatman, 67, of Eustis, whose daughter snapped a photo of the typewritten sign, sent the picture to U.S. Rep. Alan Grayson, the Orlando Democrat who riled Republicans last year when he characterized the GOP's idea of health care as, "If you get sick, America … Die quickly."
Chatman said she heard about the sign from a friend referred to Cassell after his physician recently died. She said her friend did not want to speak to a reporter but was dismayed by Cassell's sign.
"He's going to find another doctor," she said.
Cassell may be walking a thin line between his right to free speech and his professional obligation, said William Allen, professor of bioethics, law and medical professionalism at the University of Florida's College of Medicine.
Allen said doctors cannot refuse patients on the basis of race, gender, religion, sexual orientation or disability, but political preference is not one of the legally protected categories specified in civil-rights law. By insisting he does not quiz his patients about their politics and has not turned away patients based on their vote, the doctor is "trying to hold onto the nub of his ethical obligation," Allen said.
"But this is pushing the limit," he said.
Cassell, who has practiced medicine in GOP-dominated Lake County since 1988, said he doesn't quiz his patients about their politics, but he also won't hide his disdain for the bill Obama signed and the lawmakers who passed it.
In his waiting room, Cassell also has provided his patients with photocopies of a health-care timeline produced by Republican leaders that outlines "major provisions" in the health-care package. The doctor put a sign above the stack of copies that reads: "This is what the morons in Washington have done to your health care. Take one, read it and vote out anyone who voted for it."
Cassell, whose lawyer wife, Leslie Campione, has declared herself a Republican candidate for Lake County commissioner, said three patients have complained, but most have been "overwhelmingly supportive" of his position.
"They know it's not good for them," he said.
Cassell, who previously served as chief of surgery at Florida Hospital Waterman in Tavares, said a patient's politics would not affect his care for them, although he said he would prefer not to treat people who support the president.
"I can at least make a point," he said.
The notice on Cassell's office door could cause some patients to question his judgment or fret about the care they might receive if they don't share his political views, Allen said. He said doctors are wise to avoid public expressions that can affect the physician-patient relationship.
Erin VanSickle, spokeswoman for the Florida Medical Association, would not comment specifically.
But she noted in an e-mail to the Sentinel that "physicians are extended the same rights to free speech as every other citizen in the United States."
The outspoken Grayson described Cassell's sign as "ridiculous."
"I'm disgusted," he said. "Maybe he thinks the Hippocratic Oath says, ‘Do no good.' If this is the face of the right wing in America, it's the face of cruelty. … Why don't they change the name of the Republican Party to the Sore Loser Party?"
Over the last year, we have expressed our resolute opposition to Government controlled healthcare reform independent of the various iterations that have been promulgated. The present behemoth legislation, in excess of 2700 pages, will destroy the best healthcare system in the world and ultimately bankrupt this country with uncontrollable and unsustainable costs.
There are countless reasons to oppose this legislation, many of which have received little exposure in the press or by analysts (privacy issues). Regardless, this bill must be vehemently fought and opposed by all Americans if we want to preserve the world’s best healthcare as well as our rights and freedoms.
Below, is an abbreviated list assembled by Investors Business Daily of some of the reasons why Obamacare should not be implemented.
Why Health Bill Makes No Sense
Investors Business Daily 03/12/2010
Health Reform: So it's come down to this — desperate Democratic leaders strong-arming members on the worst bill ever before they go home to explain to constituents why they decided to commit political suicide.
We've said just about all we've had to say on this issue — actually dating back to 1993-94, when we wrote nearly 100 editorials in opposition to HillaryCare. Since January of last year, we've weighed in 150 more times against the latest version of socialized medicine.
But to review, here are just 15 reasons why a government takeover of the finest medical system in the world makes no sense at all:
1. The people don't want it! This, we would think, should have some bearing on decision-making. Yet the Democrats forge ahead without consent of the governed. In the latest Rasmussen poll, 53% opposed the Democrats' reform while 42% were in favor. More than four in 10 "strongly" opposed; just two in 10 "strongly" favored. This jibes with other surveys, including our own IBD/TIPP Poll, taken since last year.
2. Doctors don't want it! A survey we took last summer of 1,376 practicing physicians found that 45% would consider leaving their practices or taking early retirements if the Democrats' reform became law. In December, the results were validated by a Medicus poll in which 25% of doctors said they'd retire early if a public option is implemented and another 21% would stop practicing even though they were far from their retirement years. Even if the bill doesn't have a "public option," nearly 30% said they'd quit the profession under the plans being considered.
3. Half the Congress doesn't want it! Not a single Republican backed the health care bill that cleared the Senate on Christmas Eve 60-39. House passage was by a slim 220 to 215, and the lone Republican "aye" has since switched to "no."
Columnist Michael Barone says other changes would put the House vote today at 216-215 in favor, and he has doubts Democrats can even muster 216.
House Speaker Nancy Pelosi made her job of securing yes votes even more difficult last week when she told a meeting of county officials that "we have to pass the bill so you can find out what is in it." Members of Congress aren't waiting: They've already exempted themselves from whatever they inflict on us.
4. People are happy with the health care they've got! Polls show that 84% of Americans have health insurance and that few are displeased with what they've got. Last month, the St. Petersburg Times looked at eight polls and reported that satisfaction rates averaged 87%.
5. It doesn't even cover the people they set out to cover! Supporters of government-run health care say there are as many as 47 million Americans — 9 million to 10 million of them illegal aliens — without medical insurance. The Democrats' plans, however, will put only 31 million of the uninsured under coverage.
6. Costs will go up, not down! Democrats say their plans will cost less than $1 trillion over the first decade. But analyst Michael Cannon at the Cato Institute puts the cost at $2.5 trillion over the first 10 years. Even if we go with the government's lower estimates, the cost is already on the rise. A new estimate by the Congressional Budget Office puts the cost of the Senate bill at $875 billion over 10 years, $4 billion more than its original projection. Imagine how fast costs would soar if one of the bills became public policy.
7. Real cost controls are nowhere to be found! The Democrats are offering no meaningful tort reform that will help push down the high malpractice insurance premiums that are a burden to doctors and their patients. Nor are they considering any other cost-saving provisions, such as allowing the sale of individual health plans across state lines or easing health insurance mandates.
8. Insurance premiums will rise, not fall! One goal of nationalizing health care is to lower costs, to bend the spending curve downward. Yet, as Democratic Sen. Dick Durbin acknowledged Wednesday, that won't be the case.
"Anyone who would stand before you and say, 'Well, if you pass health care reform, next year's health care premiums are going down,' I don't think is telling the truth," he said from the Senate floor. "I think it is likely they would go up."
An analysis completed by the CBO at the request of Sen. Evan Bayh confirms Durbin's suspicions. Insurance coverage in the individual market will "be about 10% to 13% higher in 2016 than the average premium for nongroup coverage in that same year under current law," it concluded.
9. Medicare is already bankrupting us! The Medicare trust fund, which has unfunded obligations of $37.8 trillion, will be insolvent in 2017. How can lawmakers justify another entitlement that will cost trillions when they can't pay for existing liabilities?
10. There aren't enough doctors now! Last month, 26% of physicians responding to a Web poll on Sermo.com, which calls itself "the largest online physician community," said they had been forced to close, or were considering closing, their solo practices. Providing coverage for an additional 31 million Americans when the number of doctors is shrinking won't improve our health care.
11. The doctor-patient relationship will be wrecked! The latest IBD/TIPP Poll, taken just last week, found that Americans, by a wide 48%-26% margin, believe the doctor-patient relationship will decline if the Democrats' plan is passed.
12. Medical care will also deteriorate! IBD/TIPP has also found that 51% of Americans believe care would get worse under government control. Only 10.5% said they felt it would improve. In our doctor poll, 72% disagreed with administration claims that the government could cover 47 million more people with better-quality care at lower cost.
13. Rationing of care is inevitable! Health care is not an unlimited resource and must be rationed, either by the individual, providers or government. In Britain and Canada, where the government does the rationing, medical treatment waiting lists are sometimes deadly and quite often excessively long.
For instance, late cancer diagnoses in an overcrowded public health care system cause up to 10,000 needless deaths a year in Britain. The reasons cited for the late diagnoses include doctor delay, delay in primary care, system delay and delay in secondary care.
14. Private health insurers will be destroyed! Added mandates and price controls will force many insurers to simply get out of the health plan business because it will no longer be profitable.
15. It's probably unconstitutional! One way to help bring down the number of uninsured is to demand that those without coverage buy health plans. But the government has never passed a law requiring Americans to buy any good or service.
Constitutional scholars say any such mandate would likely draw a legal challenge.
Obama and the Congressional Democrats are trying to seize control of and transform healthcare in America which parallels their Marxist doctrine. By doing so, they will ultimately dismantle the best healthcare system in the world, precipitate a mass exodus of physicians from the practice of medicine and drive our country to bankruptcy in shorter order.
There already is a physician shortage in this country partially based on rational personal decisions made by those who might have contemplated careers in medicine. With implementation of Obamacare, there will be many reasons for doctors to either work less or flee medical practice altogether. This combined with an inevitable precipitous increase in consumption of medical care by previously “uninsured” Americans and illegal aliens will result in a supply and demand imbalance, fostered by unwise government intervention.
The result: healthcare rationing, poor quality care and long waits to receive care.
The Doctor Shortage
Investors Business Daily 03/04/2010
Health Reform: Democrats promise their plan will improve care at lower cost while thinning the ranks of the uninsured. How will they do this with fewer doctors?
America's population is 305 million. If the Democrats are correct about the number of uninsured, roughly 260 million are covered by a health care plan. When the insured — and the uninsured who use the traditional method of paying out of pocket — are sick, they are treated by 800,000 physicians.
It would be foolish to believe that today's already stretched doctor-patient ratio will remain stable. In the near future we will have fewer doctors treating a growing population.
Physician search firm Merritt, Hawkins & Associates estimates that by 2020 we'll need 90,000 to 200,000 more doctors than we'll have then. As alarming as that estimate is, it could be low.
Last August, our IBD/TIPP Poll found that 45% of doctors would consider leaving their practices or taking early retirement if the Democrats' version of reform were to become law.
Last month, 26% of physicians responding to a Web poll on Sermo.com, which calls itself "the largest online physician community," said they had been forced to close, or were considering closing, their solo practices.
Reasons include "low and delayed reimbursements, problems with management companies, and a lack of business/practice management education," as well as high malpractice insurance costs.
Not every doctor who told these polls that he or she would consider leaving the field will do so. Some will go into group practices and others move on to positions at hospitals and in the military. Another group will change nothing.
Even if half followed through with their threats, our care will suffer. If the Democrats' plans become law, fewer than 700,000 physicians would be available to treat a patient population growing in size, aging in years, shunning medical education and receiving "free" health care or insurance coverage from the government in increasing numbers.
The result will be longer wait times to see a doctor and a decline in the high quality of care Americans are accustomed to as overworked physicians try to keep up.
To see how this works in reality, look at the Canadian and British government health systems that encourage unnecessary doctor visits with the illusion of free care. Both have long, and sometimes deadly, wait times. Neither provides treatment as high in quality as what's found in the U.S, where the system is supposedly broken.
With demand for doctors already outstripping supply, the last thing we need is to aggravate the situation with poorly thought-out public policy.
Washington has meddled in health care too much already.
Despite inexorable denials by Obama, Pelosi and Congressional Democrats, the basic fiscal tenet of Obamanocare is rationing of healthcare. Plain and simple. Ignore the prevarications about rationing, cost savings, compassionate care, keeping your own doctor who will make the healthcare decisions along with you, etc. These are all part of the nefarious scheming intended to deceive the public about their ultimate goal of government control of healthcare, transfer of wealth and further aggrandizement of government power.
The following editorial from The Wall Street Journal, delineates some of the inimical dictates of the legislation.
The Rationing Commission
Meet the unelected body that will dictate future medical decisions.
As usual, the most dangerous parts of ObamaCare aren't receiving the scrutiny they deserve—and one of the least examined is a new commission to tell Congress how to control health spending. Democrats are quietly attempting to impose a "global budget" on Medicare, with radical implications for U.S. medicine.
Like most of Europe, the various health bills stipulate that Congress will arbitrarily decide how much to spend on health care for seniors every year—and then invest an unelected board with extraordinary powers to dictate what is covered and how it will be paid for. White House budget director Peter Orszag calls this Medicare commission "critical to our fiscal future" and "one of the most potent reforms."
On that last score, he's right. Prominent health economist Alain Enthoven has likened a global budget to "bombing from 35,000 feet, where you don't see the faces of the people you kill."
As envisioned by the Senate Finance Committee, the commission—all 15 members appointed by the President—would have to meet certain budget targets each year. Starting in 2015, Medicare could not grow more rapidly on a per capita basis than by a measure of inflation. After 2019, it could only grow at the same rate as GDP, plus one percentage point.
The theory is to let technocrats set Medicare payments free from political pressure, as with the military base closing commissions. But that process presented recommendations to Congress for an up-or-down vote. Here, the commission's decisions would go into effect automatically if Congress couldn't agree within six months on different cuts that met the same target. The board's decisions would not be subject to ordinary notice-and-comment rule-making, or even judicial review.
Yet if the goal really is political insulation, then the Medicare Commission is off to a bad start. To avoid a senior revolt, Finance Chairman Max Baucus decided to bar his creation from reducing benefits or raising the eligibility age, which meant that it could only cut costs by tightening Medicare price controls on doctors and hospitals. Doctors and hospitals, naturally, were furious.
So the Montana Democrat bowed and carved out exemptions for such providers, along with hospices and suppliers of medical equipment. Until 2019 the commission will thus only be allowed to attack Medicare Advantage, the program that gives 10 million seniors private insurance choices, and to raise premiums for Medicare prescription drug coverage, which is run by private contractors. Notice a political pattern?
But a decade from now, such limits are off—which also happens to be roughly the time when ObamaCare's spending explodes. The hard budget cap means there is only so much money to be divvied up for care, with no account for demographic changes, such as longer life spans, or for the increasing incidence of diabetes, heart disease and other chronic conditions.
Worse, it makes little room for medical innovations. The commission is mandated to go after "sources of excess cost growth," meaning treatments that are too expensive or whose coverage will boost spending. If researchers find a pricey treatment for Alzheimer's in 2020, that might be banned because it would add new costs and bust the global budget. Or it might decide that "Maybe you're better off not having the surgery, but taking the painkiller," as President Obama put it in June.
In other words, the Medicare commission would come to function much like the National Institute for Health and Clinical Excellence, which rations care in England. Or a similar Washington state board created in 2003 to control costs. Its handiwork isn't pretty.
The Washington commission, called the Health Technology Assessment, is manned by 11 bureaucrats, including a chiropractor and a "naturopath" who focuses on alternative, er, remedies like herbs and massage therapy. They consider the clinical effectiveness but above all the cost of medical procedures and technologies. If they decide something isn't worth the money, then Olympia won't cover it for some 750,000 Medicaid patients, public employees and prisoners.
So far, the commission has banned knee arthroscopy for osteoarthritis, discography for chronic back pain, and implantable infusion pumps for pain not related to cancer. This year, it is targeting such frivolous luxuries as knee replacements, spinal cord stimulation, a specialized autism therapy and MRIs of the abdomen, pelvis or breasts for cancer. It will also rule on routine ultrasounds for pregnancy, which have a "high" efficacy but also a "high" cost.
Currently, the commission is pushing through the most restrictive payment policy in the nation for drug-eluting cardiac stents—simply because bare metal stents are cheaper, even as they result in worse outcomes. If a patient is wheeled into the operating room with chest pains in an emergency, doctors will first have to determine if he's covered by a state plan, then the diameter of his blood vessels and his diabetic condition to decide on the appropriate stent. If they don't, Washington will not reimburse them for "inappropriate care."
If Democrats impose such a commission nationwide, it would constitute a radical change in U.S. health care. The reason that physician discretion—not Washington's cost-minded judgments—is at the core of medicine is that usually there are no "right" answers. The data from large clinical trials produce generic conclusions that rarely apply to individual patients, who have vastly different biologies, response rates to treatments, and often multiple conditions. A breakthrough drug like Herceptin, which is designed for a certain genetic subset of breast-cancer patients, might well be ruled out under such a standardized approach.
It's possible this global budget could become an accounting fiction, like the automatic Medicare cuts Congress currently pretends it will impose on doctors. But health care's fiscal pressures will be even stronger than they are today if ObamaCare passes in anything like its current form. And that is when politicians will want this remote, impersonal and unaccountable central committee to do the inevitable dirty work of denying care.
The only way to take the politics out of health care is to give individuals more power to control medical dollars. And the first step should be not to create even more government spending commitments. The core problem with government-run health care is that it doesn't make decisions in the best interests of patients, but in the best interests of government.
"The Senate Finance Committee health bill released last week controls doctors by cutting their pay if they give older patients more care than the government deems appropriate. Section 3003(b) (p. 683) punishes doctors who land in the 90th percentile or above on what they provide for seniors on Medicare by withholding 5 percent of their compensation.
This withhold provision forces doctors to choose between treating their patients and avoiding government penalties. HMOs used the same cost-cutting device in the early '90s until it was deemed dangerous to patients and outlawed. Now, lawmakers want to use it against the most vulnerable patients, the elderly. This bill and four others under negotiation also would slash about $500 billion from future Medicare funding."
Do you really want the Government dictating your medical care?
If Obama were a product, we would be able to return him as it doesn’t do what it claims to do – false advertising.
If Obama were a security guard and claimed not to have committed any felonies or crimes on his employment application but he lied and actually did, he would lose his job.
If Obama were a professional, he could be sued for breach of contract which could then be invalidated.
If Obama were a surgeon who stated that he would perform one operation on a patient instead but performed a different one, he would not only be sued and lose big time but would probably have his surgical privileges taken away, be censured by the state board and even lose his license to practice medicine.
Well, Obama is President and has egregiously lied countless times, not doing what he claimed that he would do. If he were employed under the same rules that are required of those Americans who still have a job, he would probably lose his job. Since in a sense we are his employer, we should fire him:
We vehemently oppose the Democrats’ actions on healthcare reform and even more egregiously, their contemptuous and dismissive responses to an angry American public strongly against the legislation. Obama and Congressional Democrats have stated in no uncertain terms that they will impose this healthcare reform on us no matter what.
We have dissected this reform in previous editorials. This bill is ostensibly about healthcare but in actuality IT IS NOT. It will not lower costs, increase quality, or provide universal coverage which is the Democrat’s mantra. Instead, it will result in skyrocketing insurance costs far in excess of what would occur if nothing were done at all as well as massive increases in taxes. It will also lead to rationing, long waits, poorer quality of care, loss of confidentiality or our healthcare records, withholding of care and therapeutic options, increased morbidity and mortality of Americans, etc. Shall we go on?
In its essence, this bill is a naked, corrupt power grab by the Federal government, comprising an additional 17% of our economy under its control for a sum total of 43%. Its covert intentions are to steal additional freedoms and rights from us and make us more subservient and under greater government control. If you have scrutinized what legislation is available for public examination, read fact supported commentary and parsed the Democrats’ ideology, you will realize unequivocally that these conclusions are not paranoid rants. THEY ARE FACT BASED REALITY.
WE MUST RELENTLESS FIGHT AGAINST PASSAGE OF THIS LEGISLATION!!
The following is an extremely important and trenchant editorial posted in the October 19th edition of Investors Business Daily that sums up the current dire situation:
Dems Go Nuclear
Health Care: Democrats seem set to use the "nuclear option" to ram their government health takeover into law. Bipartisanship already looked dead; now it looks extinct.
The health care revolution the Democratic Congress has planned — with its inevitable medical rationing, thousands of dollars in increased insurance premiums, and coverage of illegal aliens — may get placed on the familiar fast track used to spend hundreds and hundreds of billions of taxpayer dollars this year.
Instead of the 60 votes needed in the Senate if proper parliamentary rules were followed, passing this reshaping of the medical system as a "budget reconciliation" measure would mean only a simple majority was needed.
House Ways and Means Committee Chairman Charles Rangel, D-N.Y., accused of cheating on his taxes, last week held a hearing to let the House version of the health reform bill be passed this way. As the Washington weekly Human Events reports, Democratic leaders "have apparently invoked the 'nuclear option' to shut out Republicans and ensure the bill is passed before the end of the year."
So all those "town hells" during the summer, where senators and congressmen were given an earful about passing secretly written thousand-page bills without reading them, will be ignored.
In the age of the Internet, Congress refuses to post for computer access the most consequential legislation in history, as far as its effect on human lives (and deaths) is concerned, before voting on it.
The people will have to wait until it's all signed, sealed and delivered before finding out exactly how this government-imposed monster will devour health care as Americans have known it for all their lives.
And why? Because both congressional Democrats and the White House are afraid of the power of the people. Just as they are both afraid to give the opposing party a seat at the negotiating table.
Rangel didn't allow Republicans to offer amendments in committee. Why not? Fear that Democrats might be embarrassed by having to reject a Republican amendment to protect Medicare, for one thing. And fear in general that the people might catch wind of a few bipartisan ideas that sound more sensible than their big government solutions.
The magnitude of what Congress is about to do is staggering. The federal government is about to begin dictating Americans' behavior regarding the most intimate and vital area of life — health.
You play ball with Uncle Sam and pay thousands and thousands of dollars for far more expensive insurance than what you're now used to, or you get slapped with fines. And as yet we don't know how heavy those fines will be — or if noncooperation with the new system will mean more than fines.
Doesn't Congress owe it to us to provide time to mull this over before it takes force?
Shouldn't the exact wording of this radical transformation of our medical system be available on the Internet for weeks before a floor vote takes place?
And shouldn't medical experts, health care providers and legal analysts get the opportunity to read every word of such a bill carefully, then give their well-considered analysis to concerned Americans?
Apparently not, according to those now running Washington.
To them, this is a rare opportunity to take a giant step toward single-payer, European-style socialized medicine. And they have no intention of letting the people stop them.
The following op-ed was written by well respected physician, Elizabeth Lee Vliet, M.D. In it, Dr. Vliet delineates her vehement opposition to the present healthcare reform.
In the 2008 campaign, we heard healthcare in this country is “broken” and must be “reformed.” We heard “healthcare reform” would be the signature piece of an Obama Presidency. We were promised no new taxes on anyone earning less than $250,000 per year. We heard promises of transparency in government. We heard promises of a White House that would listen to all. Now that President Obama and a Democratic majority are in office, what have we gotten?
The healthcare proposals have become a massive power grab to control your money, your health options, your businesses, your liberty, and ultimately your life. It is not about insuring the poor.We already have Medicaid to cover the poor.
What the Democratic majority is doing to healthcare in this country is a crime. Punishment won’t fall on Congress and the President, who are excluded from the healthcare proposals. Punishment falls on the American people, especially the elderly.
Word of a new “stealth” strategy to ram healthcare “reform” through the Senate raises even more cause for alarm and adds to the crime of this massive power grab. The plan appears to be for Senator Majority Leader Reid to merge the two Senate bills that have passed out of committee, and attach them as an amendment to a House TARP bill, already passed by the House but curiously gathering dust in the Senate. Once the Senate votes on this “TARP” bill with the healthcare amendment tucked neatly inside, the healthcare punishment is a “done deal” without further debate. Such an abuse of power and due process would be an unforgiveable crime against the American people, perpetrated by the very people elected to represent us.
Instead of “health insurance for all,” the House and Senate healthcare bills have become punishment for all. Here is the list of Americans who face the healthcare “reform” punishment:
- Punishment for the sick. Those who have medical expenses each year will no longer beable to deduct those expenses on taxes until the expenses reach 10% of adjusted gross income (AGI). The current deduction is set at expenses above 7.5% of AGI, so the Senate plan now ADDS a 2.5% tax on those who are already paying out of pocket for medical expenses. Clearly, if someone is spending more than 7.5% on medical costs,that person is ill. The Senate bill makes the sick even sicker from the stress of having to pay more taxes!
- Punishment for the elderly. Medicare cuts of 404 BILLION is the latest figure released by the Senate; earlier the White House budget office said $500 Billion – more than a full year’s Medicare budget – would have to be cut from Medicare. How can anyone begin to think these cuts will not penalize the elderly by delaying, rationing, or denying treatment?
- Punishment for young people. Young healthy people who do not buy government mandated insurance will be punished with the form of a excise tax – reported amounts have been from $1900 to $3800 per person.
- Punishment for anyone not paying the excise tax. The IRS fine for non-payment of tax can be $25,000 and a year in jail. So those who are punished by the new tax risk being accused of a tax crime if they don’t buy government-mandated insurance and who don’t pay the penalty tax.
- Punishment for insurance companies. Companies providing “generous health insurance plans” will be hit with a 35% tax.
- Punishment for consumers who buy “generous” health insurance policies, as the tax on insurance companies is passed on to purchasers.
- Punishment for those who buy their own health insurance…a new 40% tax. Does it really make sense to punish the responsible people who take care of their own healthcare bills?
- Punishment for low income seniors, Hispanics, and Blacks who will lose their Medicare Advantage program under the new proposals.
- Punishment for those with Health Savings Accounts – HSAs will be extinct.
- Punishment for specialists who serve mainly elderly patients, such as cardiologists and oncologists. Such specialists are slated to have their reimbursements for services slashed by 44% under the Senate bill.
- Punishment for medical device makers in the form of new taxes (a tax that will be passed on to consumers).
- Punishment for all doctors, who are required to purchase expensive new computersystems and software to convert to Electronic Medical Records to meet the 2014 mandates in the Stimulus Bill.
- Punishment for those who value their medical privacy. The Stimulus Bill requires all physicians, beginning in 2014, to send patients’ medical records directly to the federal health czar without further permission from patients.
- Punishment for all 50 State governments. Already running at a deficit with the recession, State governments face catastrophic increases in costs with Medicaid costs being shifted to them by the Federal government under the new proposals.
- Punishment for everyone, due to Speaker Pelosi’s proposal for a National Sales Tax (also called a VAT) to pay for healthcare reform. This new tax would hit everyone hard in a recession, and would be on TOP of existing state and local sales taxes.
- Punishments for all. All, that is, except the exempted elite: members of Congress, the President and his family, trial lawyers, and Unions (SEIU, AFL-CIO, and others). The exempted elite retain their private care while becoming the very ones who force more taxes, penalties, higher costs as punishment on the rest of us.
This reminds me of the Soviet Union when I visited there in 1974 and 1975. The Soviet ruling elite were the only ones with cars, comfortable apartments…and access to the best healthcare.
I understand at a personal and professional level the perils of government-run healthcare. I have patients in my practice who have come many countries with government run healthcare that doesn’t address women’s unique health needs. I live in a state with a large Native American population, whose healthcare under the Indian Health Service, run by the federal government, has been abysmal. I have personally had an emergency hospitalization in England. I am walking today because I had the best spine surgery care in the world at Johns Hopkins. If I had lived in Britain, or Canada, or Europe and had to wait for MRIs and surgery, I would paralyzed from the neck down.
I will never agree that nationalized healthcare anywhere provides better quality of care than we have in the United States. I am not alone. Recent polls by different organizations have found that 80-90% of M.D.’s and D.O.’s oppose government-controlled healthcare.
Don’t be fooled by the American Medical Associations endorsement of Obamacare. Only 17% of practicing physicians actually belong to the AMA. Last week’s “white coat” photo op at the White House was a carefully selected group of 2008 campaign donors “Doctors for Obama.” They were NOT anymore representative of practicing physicians across this country than the AMA.
The American people should be even more alarmed by a recent Investors Business Daily poll: 45% of doctors who responded said they would retire or resign from medicine rather than practice medicine under government control. Who will take care of patients then?
The proposed healthcare plans are the most massive transfer of power to the executive branch of government that has ever occurred or has even been contemplated. This concentration of power in the executive branch violates the Constitutional requirement for balance of power, and for separation of powers among the Executive, Legislative, and Judicial branches of government.
This crime against the American people is far worse than the Stamp Act levied by King George.
That was the final straw that set off the first American Revolution.
Obama held a propaganda photo-op on the White House lawn October 5th, assembling 150 physicians decked out in white lab coats who support his reform plans. The purpose was to create the illusion of strong generalized physicians support for the healthcare legislation. Fortunately, the average American saw right through this deception.
Investigating this matter further revealed that these convened physicians contributed to Obama’s campaign. Many were part of the liberal group Doctors for America, supported by the Democratic National Committee. Assisting in this deception was the Center for American Progress, a far left group funded by George Soros.
No matter what study has been conducted, an overwhelming number of doctors are vehemently against Obama’s plans for socialized medicine. As a matter of fact, in an Investor Business Daily study conducted, 45% of physicians indicated that they would consider retiring early or leaving practice if the legislation went into effect. This translates into 360,000 doctors! Similar sentiments have been voiced by nurses as well. Obama’s disingenuous and dishonest rhetoric would have you believe otherwise.
If Obamanocare is approved by Congress, you will be in for a startling discovery as paraphrased in the parlance of Congressional Democrats:
“'If you've got health insurance, you like your doctors, you like your plan, too f..king bad - you won’t necessarily see your doctor or maybe any doctor, for that matter, for a long time. And forget about your plan, we forced it into bankruptcy by our mandates and pricing policies."
Most of the news media, ideological adherents of the more liberal Democrats and staunch supporters of healthcare reform, would have you believe that a majority of physicians are in favor of Obamanocare. They use meretricious arguments with deceptive presentations of information and facts which often are knowingly false just to try to convince the public that doctor support the proposals so you should too.
A common tactic is to cite the AMA’s support of the changes while also speciously informing the public that it is “the association that represents American doctors” or that it is the “primary lobbying association for physicians”. This further “confirms” the public’s misconception of the role and importance of the AMA and adds credence to the posture these presentations are taking.
For most American doctors, the AMA is irrelevant and inconsequential. Despite the high level of importance that the media accords the AMA for purposes of their rhetoric, only 18% of American physicians are members and most belong for purposes other than lobbying. The AMA does some lobbying but that is not its primary purpose and furthermore, there is little physician support behind its positions. Many of the small minority of physicians who were members have been so outraged by the AMA’s public position that they are defecting and cancelling their memberships.
A recent IBD/TIPP Poll of 1376 randomly selected physicians revealed that two thirds opposed the present proposals. Even more significant is that 45% of physicians would consider leaving medicine or retiring early if one of these plans is passed. This extremely high percentage illustrates the immense dissatisfaction that physicians have with the present legislation and the grave consequences that the proposals would have on healthcare in general.
Although Obama claims he that he may “think about considering” some test programs regarding tort reform, his perfunctory attitude on this, ideology and the protection of his constituency do not support any serious commitment on his part. His habitual prevaricating justifies giving no credence to his comments until concrete and serious actions are taken.
Does Obama’s statement that "I don't believe malpractice reform is a silver bullet, but I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs" convey a strong conviction that litigation is a problem or that he would champion reform? Definitely not! The word “may” in “may contribute” belies his verbal “commitment” to consider tort reform.
There is abundant and irrefutable evidence that defensive medicine practiced by physicians in attempts to avert malpractice suits comprises around twenty to thirty percent of healthcare costs translating into of tens of billions of dollars wasted annually. Even with trillions dollar budgets and deficits, this is still real money.
The following article, written by a practicing physician, provides his perspectives on dealing with the government now and how this can provide insight into how severely healthcare will deteriorate in the future with the more restrictive and global Obamanocare. He cites several personal examples from his practice and applies these experiences to the broader picture.
What we also see is that government mandates and control create “unintended consequences”. He cites an interesting example where the federal government seeks gender parity for individuals being accepted to medical schools (independent of whether or not there is parity in desiring in becoming a physician) so that there are relatively equal numbers of men and women training to become doctors. Because women work far fewer hours and retire years earlier than men, the result is a relative shortage of physician services for a given number of physicians trained.
We can extrapolate consequences like this using many of the mandates and provisos of the proposed healthcare legislation and realize that we are in deep trouble if this gets enacted.
Decisive and effective tort reform is desperately needed in this country. Our uncontrolled legal system lottery has wreaked havoc on Americans, American industries, innovations and on healthcare and healthcare costs. Physicians frequently order tests that would otherwise be unnecessary for patient care just to cover all bases in attempting to reduce the risk of a lawsuit. This is also called practicing defensive medicine and may cost our country at least $200 billion dollars annually. Then there are the direct costs of defending frivolous lawsuits which add billions of dollars more.
There are also the indirect costs such as discouraging otherwise capable individuals from pursuing a career in medicine. Those who decide to become physicians may avoid training and later practicing in very high risk specialties such as Neurosurgery, Cardiac Surgery and Obstetrics, areas where there are already a shortage of providers. Then there are the extremely dedicated, experienced and wise physicians who have been in medicine for many years who no longer want to contend with these stresses and issues and either limit their practices to lower risk procedures or retire from medicine altogether. This translates into losing some of the best and most experienced doctors from the healthcare system, an undesirable and patently avoidable situation.
With this only being part of the total story, consider the arrogance and chutzpah that Obama had when he addressed the AMA on June 15th. Despite being cognizant of the exorbitant and unnecessary costs that liability issues add to the overall price of healthcare, he stated in no uncertain terms that tort reform was not presently a negotiable issue. Of course, this should come as no surprise to anyone as attorneys are among his biggest supporters. With one of his stated goals being to reduce the cost of healthcare cost, it is imperative that he needs to seriously and effectively address tort reform.
The Association of American Physicians and Surgeons, Inc. (AAPS) and the Coalition for Urban Renewal and Education (CURE) filed a lawsuit on August 27th against the Office of the President and other White House officials charging that the White House has “unlawfully collected information on political speech,” used its position and power to suppress opposition to health care reform. Despite some changes that were made in the White House website designed to serve as a repository of “fishy” comments about Obamanocare sent in by snitching Americans, the Plaintiffs note that there is still this “unlawful pattern and practice to collect and maintain information” on the exercise of free speech, which “continues in violation of the Privacy Act and First Amendment even if the Defendants terminate a particular information-collection component due to negative publicity.”
The following news release briefly enumerates the issues and concerns of the lawsuit. There is also a video of Stuart Varney interviewing Kathryn Serkes of the AAPS.
We wonder how many of our Congressional Representatives and Senators have actually read the Healthcare Reform Bill personally rather than having their staff provide them with a synopsis. If consistent with their previous history of presumptuously not reading legislation that they have written and sponsored (Cap and Trade and Porkulus Spending bills, etc.), we surmise that a majority of Democrats have no clue what is contained in the Obamanocare legislation. Fortunately, many Americans have made the prodigious and heroic effort to scrutinize the bloated and arcane 1017 page bill and what they have uncovered has been shocking to say the least. What has been discovered are provisos that often have nothing to do with healthcare delivery or quality but instead with such inimical dictates as wealth redistribution, affirmative action, rationing, and unwarranted government intrusiveness and control. These are dangerous for America and Americans. We have dissected many of these issues here in previous articles.
The following is a letter to Senator Bayh written by Dr. Stephen Fraser, an Anesthesiologist practicing in Indianapolis, who pored through the entire document and enumerated several areas of concern. Many of these issues have been intentionally and dishonestly denied by Obama, Pelosi and the Congressional Democrats. You can check them out for yourself to vouch for their validity.
July 23, 2009
Senator Bayh,
As a practicing physician I have major concerns with the healthcare bill before Congress. I actually have read the bill and am shocked by the brazenness of the government's proposed involvement in the patient physician relationship. The very idea that the government will dictate and ration patient care is dangerous and certainly not helpful in designing a healthcare system that works for all. Every physician I work with agrees that we need to fix our healthcare system, but the proposed bills currently making their way through congress will be a disaster if passed.
I ask you respectfully and as a patriotic American to look at the following troubling lines that I have read in the bill. You cannot possibly believe that these proposals are in the best interests of the country and our fellow citizens.
Page 22 of the HC Bill: Mandates that the Govt will audit books of all employers that self insure!!
Page 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get.
Page 29 lines 4-16 in the HC bill: YOUR HEALTH CARE IS RATIONED!!!
Page 42 of HC Bill:The Health Choices Commissioner will choose your HC Benefits for you. You have no choice!
Page 50 Section 152 in HC bill: HC will be provided to ALL non US citizens, illegal or otherwise
Page 58 HC Bill: Govt will have real-time access to individuals finances & a National ID Healthcard will be issued!
Page 59 HC Bill lines 21-24: Govt will have direct access to you ur banks accounts for elective funds transfer.
Page 65 Sec 164: is a payoff subsidized plan for retirees and their families in Unions & community organizations: (ACORN).
Page 84 Sec 203 HC bill: Govt mandates ALL benefit packages for private HC plans in the Exchange.
Page 85 Line 7 HC Bill: Specifications for of Benefit Levels for Plans = The Govt will ration your Healthcare!
Page 91 Lines 4-7 HC Bill: Govt mandates linguistic appropriate services. Example - Translation: illegal aliens.
Page 95 HC Bill Lines 8-18: The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan.
Page 85 Line 7 HC Bill: Specifications of Benefit Levels for Plans. AARP members - your Health care WILL be rationed.
Page 102 Lines 12-18 HC Bill: Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.
Page 124 lines 24-25 HC: No company can sue GOVT on price fixing. No "judicial review" against Govt Monopoly.
Page 127 Lines 1-16 HC Bill: Doctors/ American Medical Association - The Govt will tell YOU what you can make! (salary)
Page 145 Line 15-17: An Employer MUST auto enroll employees into public option plan. NO CHOICE!
Page 126 Lines 22-25: Employers MUST pay for HC for part time employees AND their families.
Page 149 Lines 16-24: ANY Employer with payroll 401k & above who does not provide public option pays 8% tax on all payroll.
Page 150 Lines 9-13: Business's with payroll btw 251k & 401k who doesn't provide public option pays 2-6% tax on all payroll.
Page 167 Lines 18-23: ANY individual who doesn't have acceptable HC according to Govt will be taxed 2.5% of income.
Page 170 Lines 1-3 HC Bill: Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)
Page 195 HC Bill: Officers & employees of HC Admin (GOVT) will have access to ALL Americans finances /personal records.
Page 203 Line 14-15 HC: "The tax imposed under this section shall not be treated as tax" Yes, it says that!
Page 239 Line 14-24 HC Bill: Govt will reduce physician services for Medicaid Seniors, low income and poor are affected.
Page 241 Line 6-8 HC Bill: Doctors, doesn't matter what specialty you have, you'll all be paid the same!
Page 253 Line 10-18: Govt sets value of Doctor's time, proffession, judgment etc. Literally value of humans.
Page 265 Sec 1131: Govt mandates & controls productivity for private HC industries.
Page 268 Sec 1141: Federal Govt regulates rental & purchase of power driven wheelchairs.
Page 272 SEC. 1145: TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!
Page 280 Sec 1151: The Govt will penalize hospitals for whatever Govt deems preventable re-admissions.
Page 298 Lines 9-11: Doctors, treat a patient during initial admission that results in a re-admission -Govt will penalize you.
Page 317 L 13-20: PROHIBITION on ownership/investment. Govt tells Doctors what/how much they can own!
Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion- Govt is mandating hospitals cannot expand.
Page 321 2-13: Hospitals have opportunity to apply for exception BUT community input is required. Can u say ACORN?!!
Page 335 L 16-25 Pg 336-339: Govt mandates establishment of outcome based measures. HC the way they want. Rationing.
Page 341 Lines 3-9: Govt has authority to disqualify Medicare Advance Plans, HMOs, etc. Forcing people into Govt plan.
Page 354 Sec 1177: Govt will RESTRICT enrollment of Special needs people! Unbelievable!
Page 379 Sec 1191: Govt creates more bureaucracy - Tele-health Advisory Comittee. Can you say HC by phone?
Page 425 Lines 4-12: Govt mandates Advance Care Planning Consult. Think Senior Citizens end of life patients.
Page 425 Lines 17-19: Govt will instruct & consult regarding living wills, durable powers of attorney. Mandatory!
Page 425 Lines 22-25, 426 Lines 1-3: Govt provides approved list of end of life resources, guiding you in death. (assisted suicide)
Page 427 Lines 15-24: Govt mandates program for orders for end of life. The Govt has a say in how your life ends.
Page 429 Lines 1-9: An "advanced care planning consultant" will be used frequently as patients health deteriorates.
Page 429 Lines 10-12: "advanced care consultation" may include an ORDER for end of life plans. AN ORDER from GOVT!
Page 429 Lines 13-25: The govt will specify which Doctors can write an end of life order.
Page 430 Lines 11-15: The Govt will decide what level of treatment you will have at end of life!
Page 469: Community Based Home Medical Services = Non profit organizations. Hello, ACORN Medical Services here!!?
Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED ORIGINATION. 1 monthly payment 2 a community-based organization. Like ACORN?
Page 489 Sec 1308: The Govt will cover Marriage & Family therapy. Which means they will insert Govt into your marriage.
Page 494-498: Govt will cover Mental Health Services including defining, creating, rationing those services.
I guarantee that I personally will do everything possible to inform patients and my fellow physicians about the dangers of the proposed bills you and your colleagues are debating.
Furthermore, if you vote for a bill that enforces socialized medicine on the country and destroys the doctor/patient relationship, I will do everything in my power to make sure you lose your job in the next election.
Respectfully,
Despite the potentially grave consequences that Obamanocare will have on Americans, a little humor is always welcomed.
The following is an assessment of the healthcare legislation derived from polls taken of the members of various medical societies:
The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves.
Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve.
The Obstetricians felt they were all laboring under a misconception.
Ophthalmologists considered the idea shortsighted
Pathologists yelled, "Over my dead body!" while the Pediatricians said, "Oh, grow up!"
The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.
Surgeons decided to wash their hands of the whole thing. The Internists thought it was a bitter pill to swallow, and the Plastic Surgeons said, "This puts a whole new face on the matter."
The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea..
Anesthesiologists thought the idea was a gas, and the Cardiologists didn't have the heart to say no.
In the end, the Proctologists won out, leaving the entire decision up to the assholes in Congress.
The president elect of the Canadian Medical Association, Dr. Anne Doig, stated that Canada’s health care system is “sick” and “imploding”. She also went on to say that that Canada’s universal health care system is not giving patients optimal care and that “the system that we have right now — if it keeps on going without change — is not sustainable" .
These are not strong words of support by the future leader of the Canadian Medical Association for a healthcare system that Obama and the Democratic Party are using as a model for government controlled healthcare in America. The rationing of care, long waits to be seen by a physician, and markedly increased mortality rates of many diseases compared to here, and unsustainable costs are indisputable.
So why do Obama and the Democrats want to establish a similar system here when they know it is failing everywhere it has been implemented? It is politics, wealth transfer, arrogance and greater government control over the lives of Americans.
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