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Feb 16

If It Ain’t Broke, Fix It and Create Obamacare

If It Ain't Broke, Fix It!

This is exactly what our government is doing with healthcare via Obamacare. Instead of some and changes and reforms, they are destroying the world's best health care system that will in the end cost far more, provide significantly inferior care, that is, if will even be able to obtain it, and have limited choices.

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Jan 26

Obamacare Is A Health Care Dictatorship

Former Speaker of the House, Newt Gingrich, bluntly has stated that with full implementation of Obamacare, health care will be a government run dictatorship. He has identified 1968 new and expanded powers of the federal government in addition to 159 new federal agencies. At the top of this pyramid of power is the Secretary of Health and Human Services which at present is Kathleen Sibelius.

Do we really want a health care system that grants the federal government such immense power and control?

Of course not!

Each agency and rule further erodes our health care rights and freedoms.

Why does Obamacare require the hiring of 15,000 new IRS agents? What does this have to do with health care? Will they make our care less expensive? Will their presence make it more efficient?

You get the picture – and this is only a fraction of the abominable issues inherent in the Obamacare legislation.

This legislation needs complete repeal. Anything short of this will be a failure.

Gingrich: Country in danger of health dictatorship
Misty Williams The Atlanta Journal-Constitution  January 20, 2011

States should be given more control over how to run health care programs rather than broaden the federal government’s role in a system that’s already rife with problems, former House Speaker Newt Gingrich said Thursday.

“Maybe we would be better off having 50 parallel experiments,” Gingrich told reporters at the Center for Health Transformation, which was unveiling its latest review on the impact of the federal health care law.

The law grants the federal government 1,968 new and expanded powers -- most of which would fall under the purview of Health and Human Services Secretary Kathleen Sebelius -- and 159 new federal offices, according to the center founded by Gingrich.

Those controls cover a range of issues from access to drugs and insurance coverage to how care is delivered and changes to Medicare, the group said.

America is in danger of a health dictatorship, Gingrich said.

“I think it means that the next time you need a health consultation, you may want to consult with your lobbyist rather than your doctor, because the fact is your doctor is not going to be able to make a whole range of decisions,” he said.

The former speaker, who said he will decide by the end of February whether to form an exploratory committee for a presidential run, described Wednesday’s vote to repeal health care reform as more than symbolic.

He said, “It is the beginning of a dialogue and the beginning of a process which I think over time is going to be very, very powerful.”

Proposed alternatives to the current health care law should have bills dealing with malpractice reform and fraud, which is especially prevalent in the Medicaid arena, Gingrich said. If the federal government can’t run Medicaid, it’s better for the states to take the helm, he said.

He added that states should develop their own health care exchanges instead of leaving it up to the federal government. The exchanges, which go into effect in 2014, would allow small businesses and individuals to form large pools to garner better insurance prices.

Each state is unique and faces different issues, Gingrich said.

http://www.ajc.com/health/gingrich-country-in-danger-810399.html

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Jan 21

Massachusetts Healthcare Model, A Microcosm of Obamacare, Is An Exorbitant and Abject Failure

The Massachusetts health care model, which was touted by politicians and other “experts” to be the panacea for health care coverage, costs and care, has been an abysmal and exorbitantly costly failure. Used and cited ad nauseum as a paradigm for health care reform by Obama and Congressional Democrats, it is now placing that state in significant financial straits. Costs are skyrocketing, the number of Medicaid patients has expanded by 25% since 2006 and insurance premiums have risen significantly.

The glowing promises and predictions by the state’s politicians about their health care overhaul plan have been proven to be wild fantasies. Opponents of this government fiasco knew these would be the consequences and the program was doomed to fail long before it was implemented.

So as expected even with this knowledge, in the infinite wisdom of government, Obama and many Congressional Democrats continue to staunchly support and defend their massively larger bankrupting fiasco in the making – Obamacare.

Has Massachusetts Experience Put ObamaCare On A Path To Repeal?
Sally C. Pipes 1/12/2011

The new GOP majority plans to introduce a bill to repeal ObamaCare soon. What the Republicans are trying to prevent is what is already happening in Massachusetts, where a similar health care bill was enacted in April 2006. It is already imploding.

Unless ObamaCare is repealed, we're on a path to Massachusetts' future.

Eager politicians from former Gov. Mitt Romney to current Gov. Deval Patrick marketed Massachusetts' health care plan, like Obama's, with a series of distortions:
• The uninsured — especially young invincibles — were costing hospitals money that could be redirected to insurance premiums.
• They promised government efficiency.
• They focused on the assertion that primary care would replace emergency room use.
• They claimed both in Massachusetts and Washington, D.C., that we could build all this government health care bureaucracy and hand out these new benefits without new taxes while actually reducing long-term costs.

"Every uninsured citizen in Massachusetts will soon have affordable health insurance, and the cost of health care will be reduced," then-Republican Gov. Romney wrote in the Wall Street Journal in 2006. "And we need no new taxes, no employer mandate and no government takeover to make this happen."

Proponents of the Massachusetts plan now pretend that it never sought cost control. "The goal of the law was covering people," says MIT economist and Massachusetts plan architect Jonathan Gruber, who also consulted on ObamaCare.

"It couldn't have gone better," he told the Washington Post. And the Post's lead health-reform cheerleader, Ezra Klein, wrote, as if it's fact, that the Massachusetts law "was not designed to control costs."

The only measure by which Massachusetts can be judged a success is the number of people enrolled in Medicaid and other government-subsidized insurance plans. Of the 410,000 newly insured in Massachusetts, three in four are either paying nothing or very little for their insurance. They've also been successful in continuing to pull down massive subsidies from Washington to support the overhaul.

Spending has exploded. Medicaid, a problem in every state, is destroying Massachusetts. The health overhaul was really Medicaid expansion, and with the rolls up nearly 25% since 2006, Massachusetts is struggling to pay the bills.

The other promises turned out to be bogus as well. Despite the near-universal insurance, the state still spends $414 million on uncompensated care, an expense that Romney and his architects promised would disappear. Emergency-room use has not dropped as predicted. From 2006 to 2008, emergency room use under Mass Care increased by 9%. And private employer insurance costs, far from dropping, have continued to increase.

A 2010 study published in the Forum for Health Economics & Policy found that health insurance premiums in Massachusetts, prior to its overhaul, increased at a rate 3.7% slower than the national average. Post-overhaul, they are increasing 5.8% faster.

The individual mandate, as onerous as it is, is set at a level to encourage gaming the system. A family with an income of $55,000 in 2014 will face the choice of paying $4,428 a year for health insurance or a $550 fine. Given that insurance will be available on demand, it's rational to pay the fine until a serious illness strikes.

Indeed, there is no strong demand for insurance among the uninsured. The individual market has existed for years and is lightly subscribed. The new high-risk pools created by ObamaCare are very undersubscribed. Bureaucrats projected that 375,000 would sign up by now. The actual number is 8,000.

The lie that Massachusetts never promised to control costs is amplified by the belief that Obama's plan would do so. Other than price controls, commissions recommending best practices and a stealth HMO program for Medicare renamed Accountable Care Organizations, there's little to control costs in the near term.

This brings us back to the Bay State, where politicians, bureaucrats and health policy sages have embarked on what they bill as phase two of the health care overhaul. Now that nearly everyone is insured, the effort is to replace the decentralized reimbursement system with a global budget.

In other words, give hospitals and doctors a pool of money and tell them to make do. Change the incentive from providing the best possible care to the best care the bureaucrats can possibly afford.

"Clearly we are going to have less resources," Gary Gottlieb, CEO of Partners Health Care in Massachusetts, recently told a medical conference. "The most extraordinary ICU and the most extraordinary technology, without necessarily the evidence that it extends life ... is not going to be accessible to us."

A government-run HMO. Welcome to your future.

• Pipes is president, CEO and Taube fellow in health care studies at the Pacific Research Institute. Her latest book is "The Truth About

http://www.investors.com/NewsAndAnalysis/Article/559597/201101121838/Has-Massachusetts-Experience-Put-ObamaCare-On-A-Path-To-Repeal-.aspx

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Oct 31

The Beginning of the Repeal of Obamacare Can Start With Election Day Votes: Against Democrats

Obamacare was rammed through Congress by the Democrats and signed by “president” Obama against the vociferous opposition of the majority of Americans. They knew what its passage and implementation meant such as extremely high costs, oppressive increases in fees and taxes, rationing, loss of decision making in their own care and even withholding of care and options. In fact, we are already experiencing this even as Obamacare is just beginning.

We must remember this when voting on Tuesday November 2nd. Throw all the Democrats out of office. Then, the country can move on. As for Obamacare, it MUST be repealed in its entirety. Anything less than that is a failure.

We can then examine other options for further improvements of our present healthcare system.

A government takeover is not one of them.

50 Laboratories For Health Reform
Investor’s Business Daily     10/27/2010

Mandates: The constant complaint is that health care costs too much. But a federal takeover of the system wasn't needed to trim expenses. Reasonable policy changes at the state level would cut costs significantly.

Americans will spend $2.65 trillion on health care this year, or about 17% of the entire economy and roughly $8,000 per person. Health care is also growing as a share of GDP, crowding out other sectors of the economy in a trend that many would say isn't, well, healthy.

The reasons for this are varied. Government has established and nurtured a system in which most patients are distantly connected to payment for services. This encourages them to spend without regard to expense. A lack of self-rationing increases demand, which drives up costs.

Changes in this arrangement would help cut costs, but Americans tend to like this setup, so don't expect lawmakers to do much here.

The aging of our population is another factor, as is chronic illness in a country where life spans are lengthening. Costs are also pushed up by advanced treatments, the best doctors in the world and innovative diagnostic equipment.

Few would suggest cutting expenses by pulling back in these areas. Real progress, however, can be made in states where lawmakers have heaped costly mandates on health insurance policies.

In three states, mandates require such policies to include benefits for Oriental medicine. Another 10 require plans to cover hair prostheses. All but four mandate that insurance cover alcoholism treatment while 34 require the same for drug abuse. A benefit for smoking cessation is mandated in six states while port-wine stain elimination is required in two.

In 12 states, insurance policies must include access to acupuncturists. Three states say plans must provide for athletic trainers, and dozens make insurance pay for a variety of marriage, occupational and massage therapists, pastoral counselors and social workers. Four states even require that insurers provide for naturopaths.

In all, there are 2,156 mandates at the state level, according to the Council for Affordable Health Insurance (CAHI), 23 more than last year. Most of the mandates cover common benefits or providers, but as the foregoing list shows, some are highly suspect.

Few of these are costly by themselves; most increase the price of premiums by less than 1%. But when added together in a plan, insurance coverage becomes considerably higher. CAHI believes the mandates increase the cost of basic health coverage nearly 20%.

That's actually a starting point. CAHI says it could "be much higher, depending on the number of mandates, the benefit design and the cost of the initial premium." In some states, mandates increase the cost of health care plans by more than 50%.

With the average premium for a family insurance policy purchased through an employer costing about $13,000 a year — which is much higher than the $8,000-per-person cost of health care — a cut of 20% or more would not be trivial.

It's obviously a better way to hold down costs than ObamaCare, which we learn at every turn is going to cost far more than its backers projected and has its own expensive mandate requiring coverage for every American.

The mandates are an insult to common sense. A single man does not need an insurance package that covers in vitro fertilization, maternity leave, a midwife, breast reduction or mammograms. Neither is it necessary for a childless, unmarried woman to have a plan that includes care for a newborn and screening for prostate cancer.

And a teetotaler should have the option of choosing a plan that doesn't have benefits for alcohol and substance abuse.

In many cases, however, they have to pay for such coverage, either through individual policies or employer-provided plans. State legislators could restore good sense to the law and provide a genuine measure of reform by backing off the mandates and letting people buy from an a la carte menu of benefits and providers.

http://www.investors.com/NewsAndAnalysis/Article/551888/201010271922/50-Laboratories-For-Health-Reform.htm

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Jul 1

Just A Few More Reasons Not To Vote Democrat In November

"Remember in November"

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May 5

Obamacare Legislation Mandates 1099′s For Every And All Business Transactions In Excess of $600!!

We have relentlessly been stating that Obamacare was not truly about improving the quality, cost or availability of health care but instead about government control and power. The following discovery exposes yet another example of this and adds to the litany of egregious mandates contained within this corrupt, dishonest, destructive and freedom and rights abrogating legislation.

A New ObamaCare Horror Story
Rick Manning 4/29/2010

America is discovering in horror just what Nancy Pelosi meant when she famously stated during the health care debate that, “we have to pass the bill so you can find out what is in it, away from the fog of the controversy.”

The past couple of days the news has been filled by reports that the Obama Administration’s own actuary for the Center for Medicare Services estimates that costs of the law are anything but revenue neutral and that they far exceed the ‘estimate’ provided to the public by the Administration. While many are chasing the question of if Obama knew about the higher estimates, when he knew, and if he suppressed them until the vote occurred, there is another massive problem discovered within the law.

Businesses will have to file 1099 forms with both the IRS and send them to the company that provided the services or sold the product for every expenditure that exceeds $600. If you react to this sentence the way my wife, who has run a small business did, you are saying, “that can’t be right, 1099s are only for contract employees.”

Well forget everything you thought you knew about 1099 forms, because Obama’s health care law has changed it.

In practical terms, here is what the new law means. Joe’s Plumbing prints up 100 color presentations at FedEx Kinko’s for a trade show in New Orleans, where they are staying at a Holiday Inn for six days.

At a minimum, Joe’s Plumbing will have to contact FedEx Kinko’s, the airline, Holiday Inn, the rental car company, and the organization sponsoring the trade show and get taxpayer identification numbers from them so they can comply with this tax law. The company will then have to send out 1099 forms to each of these vendors and dozens, hundreds or thousands more vendors, depending upon the size of the company, thus adding significant compliance costs to every business in America. Everyone from a company’s accountant, to building supplier, to carpet cleaner to janitorial service will be trading 1099 forms.

Yes, that’s right, trading 1099 forms, because at the same time, Joe’s Plumbing will also be receiving 1099 forms from every one of their business customers who spent more than $600 with them over the course of the year, which they will be required to keep and reconcile against their books.

Do you have any wonder why Joe’s Plumbing might be more than a tad bit irritated? The new Obama health care takeover just took a guy with a pipe wrench, pvc pipe and a plunger and forced him into Dante’s eighth circle of hell – tracking and filing IRS paperwork.

So, what kind of IRS rules will be put into place to set the framework for how all these tax forms must be filed and stored?

Actually, bombshell number two is that the IRS will not be setting these rules. Instead, those noted tax experts at the U.S. Department of Health and Human Services will be writing and overseeing these tax regulations. Why? Who knows? It is the Alice in Wonderland world of the Obama health care bill.

U.S. Representative Dan Lungren (R-CA) has taken the first steps in alleviating this paperwork chokehold on America’s small business by introducing legislation to repeal this new burden.

Let’s hope that America’s businesses tell their Members of Congress to repeal what Lungren calls the “rat” tax, but what many observers believe should rightfully be called the preparation for the liberal Shangri-la of the VAT tax.

After all, once businesses are tracking every transaction over $600 and filing IRS paperwork on it, how much harder will it be for Congress to just say, add 10% to each bill and send it our way, extending taxation to every level of business unseen to unwary consumers who suddenly just see retail prices rise without knowing the increase is a new, hidden tax.

The requirement goes into effect January 2012. Better get a CPA on retainer. And stock up on toner and paper.

Rick Manning is the Director of Communications for Americans for Limited Government, and the former Public Affairs Chief of Staff for the U.S. Department of Labor.

http://www.netrightnation.com/index.php?option=com_content&view=article&id=1252650:a-new-obamacare-horror-story-&catid=1:nrn-blog&Itemid=7

http://www.getliberty.org/content_images/New%20ObamaCare%20Horror.png

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May 1

Some Important Conclusions Reported By The Medicare Chief Actuary On The Expected Effects Of Obamacare

With every week that passes, we learn more about ObamaCare and it just gets worse.  The recent report on the practical effects of ObamaCare from the Chief Actuary of the Centers for Medicare and Medicaid (CMS) is devastating.

Here are the salient findings of this report:

•  Health care costs will go up, not down. National health expenditures will increase from 17 percent of GDP now to 21 percent under the new law and will be higher than without the legislation. Net federal spending on health care will also increase.

•  Health care shortages are "plausible and even probable." Because of the increased demand for health care, "supply constraints might initially interfere with providing the services desired by the additional 34 million insured persons."

•  14 million employees will lose their employer coverage. Employees of small firms are especially at risk (despite small employer tax credit subsidies).

•  2 million employees who lose coverage will have to enroll in Medicaid.

•  A Medicaid insurance card is not a guarantee of care. An estimated 18 million people will be added to Medicaid. However, because there is no corresponding increase in the supply of caregivers, "it is reasonable to expect that a significant portion of the increased demand for Medicaid would be difficult to meet, particularly over the first few years."

•  One in ten insured workers will see their health benefits taxed. By 2019, more than 10% of insured workers will "be in employer plans with benefit values in excess of the thresholds (before changes to reduce benefits) and this percentage would increase rapidly thereafter."

•  Higher taxes will lead to higher premiums. The new taxes on medical devices, prescription drugs, and insurance plans "would generally be passed on through to health consumers in the form of higher drug and device prices and higher insurance premiums."

•  There are more than one-half trillion in Medicare cuts. The new health law cuts "$575 billion" from Medicare.

•  Medicare cuts would threaten almost one in every seven hospitals. About "15 percent of Part A providers would become unprofitable within the 10-year projection period."

•  Overall access to care for seniors would go down. Because of the law's payment reductions, "providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program.

•  7.4 million people will lose access to Medicare Advantage plans. Enrollment in MA plans will be cut in half (from its projected level of 14.8 million under the current law to 7.4 million under the new law).

•  False advertising: The new "Medicare Tax" doesn't go to Medicare. "Despite the title of this tax, this provision is unrelated to Medicare; in particular, the revenues generated by the tax on unearned income are not allocated to the Medicare trust funds."

•  False advertising: Budgetary double-counting does not improve Medicare's solvency. Medicare cuts "cannot be simultaneously used to finance other federal outlays (such as the coverage expansions) and to extend the [life of the Medicare] trust fund, despite the appearance of this result from the respective accounting conventions."

•  The new long-term care insurance plan (CLASS Act) is unsound. The program faces "a significant risk of failure" because the high costs will attract sicker people and lead to low participation.

•  The promise to those with pre-existing conditions is unfunded. "By 2011 and 2012 the initial $5 billion in Federal funding for [high risk pools] would be exhausted, resulting in substantial premium increases to sustain the program."

•  The law does almost nothing to limit actual fraud and abuse. The fraud provisions in the law will save only about two percent of $47 billion in suspect claims.

http://stickerpatch.blogspot.com/

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Apr 20

“Brilliant” Solution To Worsening Physician Shortage As A Consequence of Obamacare: Creating Nurse “Doctors”

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."

http://www.google.com/hostednews/ap/article/ALeqM5jCB6VTbMN12zQSwafnZfBJovMseAD9F2CK880

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Apr 16

Nobamacare: When I’m 64

Another spoof on Obamacare/Nobamacare/Obamanocare. The music is better than the healthcare will ever be … and at a better price!

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Apr 6

Why Have Congress and Obama Intentionally Excluded Themselves From Having To Participate In Obamacare If It Is So Wonderful?

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.

http://www.washingtontimes.com/news/2010/mar/23/obamacare-for-everyone-but-obama/

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