With the 2011 and 2012 budgets occupying much of the news these days, coverage of attempts to defund and dismantle Obamacare by the Republicans have been relegated to low priority and interest by the liberal “mainstream” media. We must make sure that the anathema of Obamacare be relentlessly publicized.
This dangerous, disastrous and extraordinarily expensive government take-over of healthcare and usurpation of our rights must be abrogated. The American people have unequivocally voiced their antipathy of this government confiscation. They know what this will lead to and on virtually all accounts, it is extremely bad.
Socialized medicine has been an abysmal failure worldwide and there were and are so many models that exemplify this. Canada and Great Britain are quintessential examples of this. Both countries are have been seeking radical changes in order to improve their abject care and bankrupting costs.
We must continue to keep the pressure on our politicians for the repeal of Obamacare. This corruptly passed (and probably unconstitutional) legislation was all about power and control by the Democrats – and not about costs or access.
Pain And Suffering
Investor’s Business Daily 04/06/2011
Health Care: Recall the complaints that the U.S. is the only developed nation in the world that doesn't provide universal medicine? So how's that arrangement working elsewhere? Rather poorly, particularly in Britain.
Agitators for government health care can no longer, as they did at one time, hold up the British system as the model the U.S. should follow. They've learned to stay away — and for good reason. The system has followed the path that all socialist systems must follow: It is breaking under its own weight.
The nation with the reputation for rotten dental care is quickly developing a reputation for delays in medical treatment. "Devastating and cruel" is how British surgeons are now describing the long waits for operations.
It's the National Health Service's way, reports the BBC, of finding nearly $33 billion in efficiency savings by 2015. To achieve those savings, knee and hip replacements apparently have been limited by the bureaucratic rationing teams.
"We've started to get reports over the last nine months that access to these services is being restricted," Peter Kay, president of the British Orthopaedic Association, told the BBC. Of the 692 surgeons contacted by the broadcaster, 106 said "routine operations had been put on hold in their area. Others described new limits on when patients qualify for hip or knee replacements."
Meanwhile, "152 specialists said patients now have to be more disabled or in greater pain, and 118 told us hip and knee surgery had been regarded as a procedure of low priority."
The consequences of trying to treat everyone through the government go far beyond the pain and suffering of missed joint-replacement surgery. Sometimes, the wages are death.
That's how it ended for Margaret Hutchon, who happened to be a former NHS director. She died last month, the Daily Mail reported, "after waiting for nine months for an operation — at her own hospital" (emphasis ours).
She "had been waiting since last June for a followup stomach operation," but "her appointments to go under the knife were cancelled four times and she barely regained consciousness after finally having surgery."
Not only are treatments being delayed, so is NHS legislation that would, among other provisions, make the system less bureaucratic and increase private-sector involvement.
The political left, which clings tenaciously to government programs that permit the exercise of power over others, has demagogued the legislation, sounded the dreaded "privatization" alarm and won a delay.
Britons should be outraged. If the government taxes them to fund universal care, they should get the care. If the government can't do the job — which clearly it can't — it should get out of the business of meddling in people's lives and let everyone take care of his or her own health care.
Americans should be outraged as well, because a Democratic Congress and White House have forced on them a program that will be no more successful than the British health care wreck.
Yes, ObamaCare is an unpopular law with low approval ratings. But the antipathy toward it and those who engineered its passage over constitutional limitations and public opposition is not as intense as it should be.
Pressure for ObamaCare's repeal should be so sharp that official Washington will be left with no other option. If not, the British health care problems of today will be America's health care problems tomorrow.
The arrogance, disdain for the average American, limitless deception, elitism and egregious naked power grab of Obama, Pelosi and the Congressional Democrats in the formulation and corrupt passage of government controlled health care exceeded a level of reprehensibility unparalleled in Washington politics. It irrefutably demonstrates an intention and method for stealing our personal rights and liberties away and providing an irreversible way for the federal government to rule us – not represent us.
This is government by fiat as in many Third World countries – not by legal, Constitutional means. As enumerated below, the Democrats sought to shield this legislation from attempts to change or nullify it and did so in ways that were blatantly unconstitutional and depraved.
The Goldwater Institute is attempting to block a crucial provision of Obamacare: the creation of the Independent Payment Advisory Board which is charged with creating Medicare policies and health care payments. It is an autonomous commission with members appointed by the President that is designed to have no Congressional oversight or be subject to judicial review.
This arrangement wreaks tyranny – and was just what Obama and Pelosi wanted.
The election was one payback for the public’s rebuking of this pernicious legislation. We strongly recommend that the soon to be Republican dominated House impose condign retribution for the depraved actions of these two despicable politicians. It can start, for example, by severely curtailing Obama and Michelle’s White House budgets including for parties, trips, etc.
Keep them on a short leash and punish them financially when possible!
Goldwater Institute Asks Court To Block Key Provision of Federal Health Care Law
Health care bill created ‘untouchable’ Independent Payment Advisory Board
Goldwater Institute News Release
November 16, 2010
PHOENIX – The Goldwater Institute has requested an injunction [1] to block a provision of the federal health care law that prevents Congress from repealing a new agency that would control health care payments. A preliminary injunction is needed so Congress can consider revoking the Independent Payment Advisory Board before the agency has been established.
Among other measures, the federal health care law orders the creation by 2012 of the Independent Payment Advisory Board, an unelected commission that will be free to set Medicare policy and health care payment rates with no meaningful congressional oversight and without the possibility of judicial review. The law also prohibits Congress from acting to repeal the agency in perpetuity, except for a narrow window in 2017.
“Protecting any new federal agency from being repealed by Congress appears to be unprecedented in the history of the United States,” said Diane Cohen, the Goldwater Institute’s lead attorney in this case.
The motion for preliminary injunction has been filed as part of Coons v. Geithner [2], one of nearly two dozen lawsuits around the country challenging the health care law. If granted by U.S. District Judge Murray Snow, the injunction will be the first time that any part of the law has been blocked, said Clint Bolick, litigation director at the Goldwater Institute.
“This injunction would restore power to our elected representatives to repeal an agency with new sweeping powers that are removed from any semblance of legislative, executive, or judicial review,” Mr. Bolick said.
The Goldwater Institute Scharf-Norton Center for Constitutional Litigation represents a number of clients in this lawsuit including U.S. Representatives Jeff Flake, Trent Franks, and John Shadegg of Arizona. The congressmen have supported repeal of the Independent Payment Advisory Board, a 15-member commission appointed by the president that will have far-reaching and uncontrollable powers, Ms Cohen said.
Unlike any other federal commission, the Independent Payment Advisory Board won’t have to follow the basic steps for adopting and enforcing administrative rules. The board’s annual payment schedules and policy proposals can’t be examined by the courts and automatically will become law unless amended by Congress through a difficult and complex procedure.
Finally, even if Congress were to approve a repeal of the board in 2017, following the complex process allowed in the health care law, that repeal automatically would be delayed until 2020.
“No possible reading of the Constitution supports the idea of an unelected, standalone federal board that’s untouchable by both Congress and the courts,” Mr. Bolick said.
Many of the Democrats who are either up for re-election or are seeking political office for the first time are claiming that they oppose much of Obamacare and plan to fix it if elected/re-elected.
Don’t believe any of this rhetoric. There is an ulterior motive to these specious statements: to win election by whatever it takes. After that, expect most of these Democrats to toe the party line, either by coercion or personal convictions, and therefore not repeal Obamacare.
Only the Republicans can be trusted to attempt to repeal or defund Obamacare.
Vote Republican in November if you want to fight Obamacare … and to take back our country from the arrogant, elitist and radical Democratic politicians.
Dear Patients: Vote to Repeal ObamaCare Don't believe Democrats who promise to fix the bill once they're re-elected.
By Hal Scherz
Facing a nationwide backlash, Democratic congressional candidates have a new message for voters: We know you don't like ObamaCare, so we'll fix it.
This was the line offered by Democrat Mark Critz, who won a special election in Pennsylvania's 12th congressional district after expressing opposition to the law and promising to mend it—but not to repeal it. As a doctor I know something about unexpected recoveries, and this latest attempt to rescue ObamaCare from repeal needs to be taken seriously.
For Democrats who voted for ObamaCare, this tactic is an escape route, a chance to distance themselves from the president with a vague promise to fix health-care reform in the next Congress.
To counter this election-year ruse, my colleagues and I at Docs4PatientCare are enlisting thousands of doctors in an unorthodox and unprecedented action. Our patients have always expected a certain standard of care from their doctors, which includes providing them with pertinent information that may affect their quality of life. Because the issue this election is so stark—literally life and death for millions of Americans in the years ahead—we are this week posting a "Dear Patient" letter in our waiting rooms.
The letter states in unambiguous language what the new law means:
"Dear Patient: Section 1311 of the new health care legislation gives the U.S. Secretary of Health and Human Services and her appointees the power to establish care guidelines that your doctor must abide by or face penalties and fines. In making doctors answerable in the federal bureaucracy this bill effectively makes them government employees and means that you and your doctor are no longer in charge of your health care decisions. This new law politicizes medicine and in my opinion destroys the sanctity of the doctor-patient relationship that makes the American health care system the best in the world."
Our doctor's letter points out that, in addition to "badly exacerbating the current doctor shortage," ObamaCare will bring "major cost increases, rising insurance premiums, higher taxes, a decline in new medical techniques, a fall-off in the development of miracle drugs as well as rationing by government panels and by bureaucrats like passionate rationing advocate Donald Berwick that will force delays of months or sometimes years for hospitalization or surgery."
We cite the brute facts of ObamaCare's passage:
"Despite countless protests by doctors and overwhelming public opposition—up to 60% of Americans opposed this bill—the current party in control of Congress pushed this bill through with legal bribes and Chicago style threats and is determined now to resist any 'repeal and replace' efforts. This doctor's office is non-partisan—always has been, always will be. But the fact is that every Republican voted against this bad bill while the Democratic Party leadership and the White House completely dismissed the will of the people in ruthlessly pushing through this legislation."
Then we address the Democrats' evasive campaign maneuver:
"In the face of voter anger some Democratic candidates are now trying to make a cosmetic retreat, calling for minor modifications or pretending they are opposed to government-run medicine. Once the election is over, however, they will vote with their party bosses against repealing this bill."
The letter's final lines are the most important:
"Please remember when you vote this November that unless the Democratic Party receives a strong negative message about this power grab our health care system will never be fixed and the doctor patient relationship will be ruined forever."
This message is going out to an electorate that is already frustrated over what they see happening to health care. Missouri voters rejected ObamaCare overwhelmingly in August, voting by a margin of 71%-29% to reject the federal requirement that all individuals purchase health insurance. Democratic pollster Douglas Schoen has assessed that ObamaCare is "a disaster" for Democrats. And around the country many little-noticed primaries have reflected voter rage—including the Republican primary victory of surgeon, political newcomer, and advocate of repeal Daniel Benishek in Michigan's first district.
Meanwhile, the Obama administration's damage-control efforts have fallen flat. The latest round of pro-ObamaCare television spots targeting the elderly and starring veteran actor Andy Griffith have not only failed to move the polling numbers. They have caused five U.S. Senators to ask for an investigation of the ads as a violation of federal laws barring the use of tax dollars ($750,000) for campaign purposes.
America's doctors have millions of personal interactions each week with patients. We have political power. And we intend to use it by working to defeat those who have disrupted and gravely endangered the best health-care system in the world.
Dr. Scherz, a pediatric urological surgeon at Georgia Urology and Children's Healthcare of Atlanta, serves on the faculty of Emory University Medical School and is president and cofounder of Docs4PatientCare.
In just one more of the innumerable examples of the unalloyed arrogance and irresponsibility of the Congressional Democrats, one of the primary authors of the Obamacare legislation, Max Baucus (D-Mont.), indicated that he has never read the entire legislation.
He states: “I don’t think you want me to waste my time to read every page of the healthcare bill… We hire experts.”
Are you kidding, Max?
You want Americans to be forced to pay trillions of more dollars for your health care system that severely restricts their rights and choices and will result in rationing of care. Many will be refused medical care that would have received it before and for significantly less. It is arcane and burdened by multilevel bureaucracies.
And, best of all, you and all your Democratic buddies in Congress won’t have to use it as you have your own, expensive, gold-plated plan with countless choices and ease of access.
That’s why the Democrats in the House and Senate who are up for reelection in November, must be voted out of office.
Vote Republican in November!
Key Senate Democrat suggests that he didn't read entire healthcare reform bill
Jordan Fabian 08/25/10
Senate Finance Committee Chairman Max Baucus (D-Mont.), one of the chief authors of the healthcare law, suggested Tuesday he did not read the entire piece of legislation.
Speaking at a forum in his home state, Baucus and Health and Human Services Secretary Kathleen Sebelius were asked by an audience member if they had read the whole bill and “if not, that is the most despicable, irresponsible thing.”
“I don’t think you want me to waste my time to read every page of the healthcare bill,” Baucus said, according to the Flathead Beacon. “You know why? It’s statutory language. ... We hire experts.”
Republicans, who opposed the law in lockstep, frequently criticized Democrats for the length of the bill and often pressed members if they had read the legislation or not. In March, Congress passed the legislation and President Obama signed the 961-page final bill into law.
At least one Democratic lawmaker, Sen. Claire McCaskill (Mo.) made a public showing of reading the bill.
Democrats dismissed the criticism, saying it did not have anything do to with the contents of the legislation.
Baucus's office said that his comments did not mean that he does not know what it is in the law.
"Senator Baucus wrote the bill that passed the Finance Committee and then worked with his colleagues to write the health care bill that is law today. He has spent years crafting this policy and hundreds of hours reading and perfecting it," spokeswoman Erin Shields said. "There is simply no question that he understands the provisions in the health care law and knows it is a historic improvement that will make our health care system more affordable and accessible for families in Montana and across America."
Baucus held frequent hearings and published multiple reports about the legislation during the process of its passage.
At the town-hall event, Baucus defended the sweeping law.
“It’s not perfect, nothing’s perfect, but I’m telling you, ma’am, it’s a good start,” Baucus said. “Mark my words, several years from now you’re going to look back and say, ‘Eh, maybe it isn’t so bad.’ ”
Great Britain and Canada are finding that the relentlessly escalating costs of socialized medicine present a financially untenable situation. There is not enough money to meet the needs of the unrestrained demand. Of course, this situation was entirely predictable despite the dissembling and prevarication by liberals.
How are they contemplating addressing this problem? Rationing.
Since they can’t afford to pay for all the services demanded, the governments will selectively limit usage by restricting visits, procedures and other utilizations. In addition, there will be a requisite deterioration in quality of care.
Such an outcome was resolutely predicted and feared by millions of Americans who opposed Obamacare. In spite of this vociferous opposition, Obama and the arrogant elitist Congressional Democrats rammed the legislation through, needing corrupt stratagems in order to bribe some of their fellow ideologues to vote yes.
If Obamacare is not repealed or defunded, what is transpiring in Great Britain, Canada and elsewhere will occur here as well, long after the deconstruction of the world’s best healthcare system. And we will also be tens of trillions of dollars more in debt than necessary … and probably bankrupt.
The Doctor Will See You Later
Investors Business Daily 06/07/2010
Health Care: The British government has decided that it needs to cut millions of operations because the public system cannot afford them. This is coming soon to a hospital or doctor's office near you.
According to the Daily Mail, Britain's National Health Service is "preparing to cut millions of operations" so that it can save $29 billion by 2014. Procedures that will be "decommissioned," if we may borrow a particularly descriptive term used by one doctor, include hip replacements for obese patients, some operations for hernias and gallstones, and treatments for varicose veins, ear and nose problems, and cataract surgery.
Thus is the future of all socialized medicine. Bureaucratic rationing of treatment is inevitable. No system can forever meet the demand of "free" care. Jeff Taylor of the Economic Voice clarified the problem when he wrote last week that "the U.K. is broke."
"Our whole society and way of life is now built on the shaky foundation of debt," he writes in response to the NHS cuts.
"Our hospitals, schools, armed forces, police, prisons and social services are founded on debt. In truth we have not yet paid for the operations that have already taken place."
As former British Prime Minister Margaret Thatcher famously — and fittingly — said: The problem with socialism is you eventually run out of other people's money to spend. This is a universal truth, more universal than the health care provided in Britain. To trifle with it, ignore it, disrespect it, attempt to repeal it or arrogantly try to bypass it will always lead to trouble.
Yet the political left continually makes those mistakes and operates as if governments will never run out of other people's money. Until it does. And then the government has to make cuts and ration the benefits.
What have the congressional Democrats who rammed through their health care overhaul been watching over the years as both hard and soft socialist governments have either collapsed, continued to bring misery or become unsustainable? Despite ample evidence that a welfare state cannot thrive, these lawmakers have forced on the country a "reform" that will load Americans with a burden they will not long be able to bear.
Though it was sold to the public as a plan that, at $940 billion over the first decade, would bring down the deficit, the real cost for the initial 10 years could be as much as $2.5 trillion, including mandates placed on the private sector, according to an estimate by the Cato Institute.
It's possible that the Cato projection is off. But history shows us that it's more likely to be right than Washington's estimate. Government programs always cost more than the rosy initial projections that are used to drum up public support. It's another lesson that remains unlearned by most of our elected officials and the voters who keep putting them in office despite the problems the lawmakers refuse to stop creating.
Given our lawmakers' inability to learn from the health care policy blunders committed in Britain and Canada — which is reassessing its model because of ruinous costs — no one should be surprised when rationing by bureaucracy becomes a feature of the U.S. public health care system.
There should be no shock when waiting lists for treatment are simply rosters of Americans suffering — and in some cases dying — from a lack of care. No astonishment when those who do get treatment get substandard care, no dismay as a two-tiered system develops in which the more important among us get top-flight medicine while the rest get what the public clinics have to offer.
Our own polling shows that the disapproval of the Democrats' health care legislation is beginning to wane. That's as alarming as the heated opposition to the law had been encouraging. If we surrender ourselves to the soft tyranny of elected officials gone too far, we will be leaving an America that future generations won't want.
To no one’s surprise, the total theorized costs of Obamacare are continuing to increase years before the first patient is planned to be seen under the system. That is, if the nationalized healthcare fraud doesn’t die a quick death beforehand from strangulation by defunding or repealing. The whole process was interminably corrupt and opaque in order to be able to pass it against the vociferous opposition of a large majority of Americans.
Just to implement one of their ideological linchpins.
Fiscal Fraud of Obamacare Snowballing Already
Terence P. Jeffrey 6/02/2010
Remember the health care issue? Well, the fiscal consequences of the socialized medicine scheme enacted by President Barack Obama and Congress just two months ago are already beginning to snowball.
Democratic Rep. Henry Waxman of California, the chairman of the House Committee on Energy and Commerce, was one of the key architects and advocates of Obamacare. He was back on the House floor on Friday delivering an urgent plea to fellow Democrats that inadvertently -- or, perhaps, unavoidably -- revealed the fraudulent nature of our new national health care regime.
It was supposed to save the taxpayers money, remember?
"This legislation will lower costs for families and for businesses and for the federal government, reducing our deficit by over $1 trillion in the next two decades," Obama said when he signed the bill.
On Friday, Waxman declared that the sky is about to fall on the Medicare system. He went to the House floor to "urge" his colleagues to vote for a bill that includes $102 billion in new federal spending and would add $54 billion to the national debt over the next 10 years -- $25 billion of it in the few months remaining in this fiscal year.
Why did Waxman believe this new borrowing-and-spending was necessary?
"It's absolutely critical to do this if we are going to keep doctors in Medicare and keep the promise to Medicare beneficiaries that they will have access to physicians' services," said Waxman. "This provision will provide a moderate increase in physicians' fees, 2.2 percent for the rest of the year. If we don't act, doctors' fees will be cut by 21 percent from where they are today. This would be unconscionable."
It would not merely be unconscionable. If the 21-percent cut in Medicare fees for doctors -- that, in fact, legally took effect on June 1 -- is allowed to stand, many doctors in this country will simply stop seeing Medicare patients. They will not be able to afford it. The cost to them of serving their patients will exceed what they are paid. Their profit margin will be swept away.
To make precisely this point, 12 national surgeons' associations -- including the American Association of Neurological Surgeons, the American Association of Orthopedic Surgeons and the American Academy of Otolaryngology-Head and Neck Surgery -- sent House Speaker Nancy Pelosi a letter last Wednesday warning her what would happen if Medicare doctors' fees are slashed as they are scheduled to be under current law.
"These continued payment cuts, rising practice costs and a lack of certainty going forward, make it difficult, if not impossible, for already financially challenged surgical practices to continue to treat Medicare patients," the surgeons' associations told Pelosi.
The letter pointed the speaker toward the results of a survey of more than 13,000 physicians done in February by the Surgical Coalition, a group of more than 20 medical associations. The survey asked these doctors what they would do if Medicare fees were slashed by the scheduled 21.2 percent.
Twenty-nine percent said they would opt out of the Medicare system entirely. Almost 69 percent said they would limit the number of appointments they would take from Medicare patients, 45.8 percent said they would start referring complex Medicare patients to other physicians, 45.3 percent said they would stop providing certain services, 43.8 percent said they would defer purchasing new medical equipment and 42.7 percent said they would cut their staff.
Almost 4 percent of the doctors said they would close or sell their practices.
Why did Congress plan to slash the doctors' Medicare fees in the first place? It didn't. In the past, the majority in Congress has routinely enacted budget bills that fraudulently assumed that on some future date the federal government would dramatically slash the Medicare fees paid to doctors, knowing that before that date arrived the majority would pass "emergency" legislation postponing the cuts to some still-future date. The majority in Congress does this so the long-term deficits caused by their spending bills appear to be smaller than they actually are.
As originally proposed, Obamacare would have ended this practice, permanently setting Medicare reimbursement rates for doctors at the true anticipated level. But the Congressional Budget Office determined that doing so would have added $208 billion to the cost of Obamacare over 10 years, forcing the CBO to declare that Obamacare added to the deficit rather than reduced it. That would have cost Obamacare votes on the House floor and quite possibly defeated the legislation.
So the congressional leadership stripped the "doc fix" out of Obamacare and left it to another day.
Waxman went down to the floor last Friday to declare that day had come. Unfortunately, for him, the Senate had already left town for its Memorial Day vacation. So, the current fix will have to wait until it returns.
Even then, the fix only accounts for $22.9 billion of the $102 billion cost of the bill the House did pass on Friday. Most of the rest of the money is for extending unemployment benefits and special targeted tax breaks.
The $22.9 billion fix for the doctors' fees -- if passed by the Senate -- would only last through September 2011. Then Congress will presumably do it all again -- or let the Medicare system collapse.
In the meantime, Obamacare is supposed to cut half a trillion in spending from elsewhere in Medicare, while Obama's budget -- not counting the $54 billion in new debt included in this bill -- is expected to add $9.8 trillion to the national debt over the next 10 years.
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."
Once again firebrand Rep. Alan Grayson (D-Fla.) is spewing irresponsible, incendiary and groundless charges against the Orlando, Fla. Area urologist who posted a sign on the door of his office recommending that those who voted for Obama seek care elsewhere. In fact like many other uber partisan Democrats of his ilk, he has now transformed this freedom of speech issue into a racist one.
Despicable!
The level of hatred and intolerance which Grayson exhibits regarding this situation (as well as many others in the past) shows him to be emotionally and rationally challenged and not fit for his job as Representative. He should be investigated and censured as well as removed from office by those in his district.
Any attempt to silence this free speech is an attack on us all. Furthermore, we must prevent the government from using bullying, heavy handed or legal tactics to challenge our rights of expression and freedoms in general. By the way, where are all those demagogue Democrats who speciously claim that there is unwarranted vitriol in American discourse yet won't rein in one of their own? (They won't because they would level the same charges!)
As for you, Alan Grayson, we have an open question indirectly related to this case:
How can you reconcile the fact that 95% of all blacks voted for Obama and yet not charge that this constitutes racism?
There can be no other rational explanation for this yet we have not heard one word about this from any Democrat regarding this racist vote.
What if 95% of whites had voted for McCain? We are sure that you would vehemently consider that to be egregious racism!
Grayson: Doctor shooing away Obama backers will deny treatment to blacks
By Jordan Fabian - 04/03/10 11:28 AM ET
A doctor who posted a sign at his practice asking Obama supporters to seek care "elsewhere" will end up denying service to many African Americans, Rep. Alan Grayson (D-Fla.) said Friday.
Dr. Jack Cassell, an opponent of the healthcare law President Barack Obama signed last month, put up the sign at his office in Grayson's district.
"Well, in fact, where he lives, in Mount Dora, which is in my district, many, many of the Democrats who live in Mount Dora happen to be African-Americans," Grayson said on CNN. "So, by saying that he will not treat somebody who supported Obama, he's saying that he's not going to treat a large number of African-Americans in the community."
Grayson, a freshman who represents a Republican-leaning district, gained national attention during the healthcare debate last year when he said the GOP's healthcare plan was for seniors to "die quickly."
Cassell has said that he is not violating medical ethics rules.
"I'm not turning anybody away — that would be unethical," Cassell, 56, told the Orlando Sentinel on Thursday. "But if they read the sign and turn the other way, so be it."
But Grayson said that he was violating the rules and that he will probably be disciplined by medical licensing authorities.
"How many people walked in -- walked up to his front door, saw the sign, and turned away?" he asked. "How many people referred from other physicians in the community, including primary care physicians, how many patients saw that sign and walked away?"
Asked what kind of punishment Cassell should receive, Grayson said "Well, whatever the medical authorities think he should get. But it is a clear violation of ethics, and it's a particularly ugly one. Why is it that the right wing is so preoccupied with denying people health? Why is that?"
Probably by now, many people are aware of the exclusion from Obamcare that Congress granted itself, staff members, the President and Vice President. As has been stated myriad times, if the legislation was so utterly fantastic for the American people, why is it not good enough for Congress and the President?
We all know that the political rhetoric which was employed for the bill’s passage was not merely disingenuous but overtly and despicably dishonest and criminal. As stated in a previous post, these politicians see themselves as elitists, members of a privileged class much as was extant in Russia in the 1970’s and early 1980’s – the nomeklatura.
As their employers (at least on paper), we must now revoke their privileges, limit their unrestrained actions, mandate that they abide by the same laws as the rest of us, and vote the offenders out of office.
No Obamacare for Obama
THE WASHINGTON TIMES March 23, 2010
President Obama declared that the new health care law "is going to be affecting every American family." Except his own, of course.
The new health care law exempts the president from having to participate in it. Leadership and committee staffers in the House and Senate who wrote the bill are exempted as well. A weasel-worded definition of "staff" includes only the members' personal staff in the new system; the committee staff that drafted the legislation opted themselves out. Because they were more familiar with the contents of the law than anyone in the country, it says a lot that they carved out their own special loophole. Anyway, the law is intended to affect "ordinary Americans," according to Vice President Joe Biden (who - being a heartbeat away from the presidency - also is not covered), not Washington insiders.
Mr. Obama frequently tossed around the talking point that the new law gave people the same type of coverage as Congress enjoyed. In his March 20 health care pep talk to wavering Democrats on Capitol Hill, the president said one of the advantages of the health care legislation was that "people will have choice and competition just like members of Congress have choice and competition." At yesterday's signing ceremony, Mr. Obama said Americans will be "part of a big pool, just like federal employees are part of a big pool. They'll have the same choice of private health insurance that members of Congress get for themselves." But the American people will have a public pool; the executive branch and congressional staffers kept their country-club pool private.
Last year, Sen. Charles E. Grassley, Iowa Republican, spearheaded efforts to have all Americans included in the plan, but he ran into heavy opposition from unions representing federal workers - the same unions that were pro-Obamacare stalwarts. In September, the Senate approved a scaled-down amendment that covered members of Congress and their staff. When this provision later emerged from Senate Majority Leader Harry Reid's office, the leadership and committee staff loophole had appeared. A move in December by Mr. Grassley and Sen. Tom Coburn, Oklahoma Republican, to close this loophole and to extend the law to senior members of the executive branch - including the president, vice president and Cabinet members - was blocked by Senate Democratic leaders.
Mr. Grassley has introduced an amendment to the Senate health care reconciliation bill that also will apply the law to the upper tier of the executive branch and all Capitol Hill staffers, but it remains to be seen whether Democrats will let this measure move forward.
The special exemptions slipped into the health care law are another example of how those statists who rule consider themselves a privileged class, imposing burdens on the country that they will not accept themselves. Candidates for office in 2010 should pledge to close these and other loopholes in the law that impose unequal burdens and create exclusive privileged classes in America. Meanwhile, we await Mr. Obama's explanation why if his "historic" health care law is so great for America, it's not good enough for him and his family.
Many Democrats are revealing what countless opponents of Obamacare were claiming: the legislation had far more to do with wealth redistribution than it did with healthcare. This is not about quality of care or access or even reducing total medical care costs. If it were, malpractice reform would have been implemented and there would not have been an additional 159 new federal agencies created or the provision to hire almost 17,000 new IRS agents.
That is why the numbers never added up, the legislation was written in secrecy, negotiations were conducted behind locked doors by Democrats only with Republicans being totally excluded, opponents were gratuitously charged with racism, etc.
Obamacare was mainly aimed at redistributing wealth
By: Byron York Chief Political Correspondent
April 2, 2010
It hasn't attracted much notice, but recently some prominent advocates of Obamacare have spoken more frankly than ever before about why they supported a national health care makeover. It wasn't just about making insurance more affordable.
It wasn't just about bending the cost curve. It wasn't just about cutting the federal deficit. It was about redistributing wealth.
Health reform is "an income shift," Democratic Sen. Max Baucus said on March 25. "It is a shift, a leveling, to help lower income, middle income Americans."
In his halting, jumbled style, Baucus explained that in recent years "the maldistribution of income in America has gone up way too much, the wealthy are getting way, way too wealthy, and the middle income class is left behind." The new health care legislation, Baucus promised, "will have the effect of addressing that maldistribution of income in America."
At about the same time, Howard Dean, the former Democratic National Committee chairman and presidential candidate, said the health bill was needed to correct economic inequities. "The question is, in a democracy, what is the right balance between those at the top ... and those at the bottom?" Dean said during an appearance on CNBC. "When it gets out of whack, as it did in the 1920s, and it has now, you need to do some redistribution. This is a form of redistribution."
Summing things up in the New York Times, the liberal economics columnist David Leonhardt called Obamacare "the federal government's biggest attack on economic inequality since inequality began rising more than three decades ago."
Now they tell us. For many opponents of the new legislation, the statements confirmed a nagging suspicion that for Barack Obama and Democrats in Congress, the health fight was about more than just insurance -- that redistribution played a significant, if largely unspoken, part in the drive for national health care.
"I don't think most people, when they think of the health care bill, instantly think it's a vehicle to redistribute wealth," says pollster Scott Rasmussen. "But we do know that people overwhelmingly believe it will lead to an increase in middle class taxes, and we do know that people are concerned that it will hurt their own quality of care, so I think their gut instincts point in that direction."
By talking openly about redistribution, Baucus and others have gone seriously off-message. Democrats knew there was no way they could ever sell a national health care bill to a skeptical public by basing their case on income inequality.
That's one reason they went to such lengths to argue -- preposterously, in the view of most Americans -- that the bill could cover 32 million currently uninsured people and still save the taxpayers money.
After Baucus' statement, I asked a Democratic strategist (who asked to remain nameless) whether fighting income inequality was one of his goals in supporting the legislation. Never, he said. "That's what the tax code is for."
"It was not to take something away from rich people, it was to provide something to people without coverage," he continued, making a distinction between striving for universal coverage and seeking to redistribute income. But he quickly saw that Democrats talking about redistribution could be politically damaging, echoing the controversy that erupted when candidate Obama famously told Ohio plumber Joe Wurzelbacher that "when you spread the wealth around, it's good for everybody."
" 'Redistribution' is an easy charge to make," the Democrat said. "I'm not surprised that it's an argument critics make; what I'm surprised at is that Democrats are making it."
This week the DNC group Organizing for America offered a commemorative certificate to supporters who helped pass the health care bill. The certificate said, "We achieved the dream of generations -- high-quality, affordable health care is no longer the privilege of a few, but the right of all."
The privilege of a few? It is widely accepted that about 85 percent of all Americans have health care coverage, and the overwhelming majority are happy with it. There's simply no way anyone could plausibly claim that health coverage is the privilege of a few.
And yet that is the bedrock belief of some who supported the health care makeover. So it's no wonder that we're hearing about health care as the redistribution of income. Of course, we're only hearing it after the bill has passed.
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