He must be thwarted in his efforts. This starts with voting in a Republican majority in Congress in the November elections.

Death Panels Begin As Reform Takes Shape
Investor’s Business Daily   08/18/2010

Medicine: After the recess appointment of a Medicare and Medicaid head, an FDA panel drops its endorsement of a widely used cancer drug. Another FDA-approved cancer therapy may not be paid for. It begins.

It didn't take long for the health care philosophy of Dr. Donald Berwick, President Obama's choice to head the Centers for Medicaid and Medicare Services, and an appointee we have labeled a "one-man death panel," to have an effect.

Berwick is an admirer of Britain's National Health Service and its National Institute for Clinical Excellence, with the Orwellian-acronym NICE.

"NICE," Berwick has said, "is extremely effective and a conscientious, valuable and — importantly — knowledge-building system." But NICE is really a system of rationing, through a bureaucratic formula for "cost-effectiveness," that has rushed untold numbers of Britons to an early grave.

Avastin, the marketing name for the drug bevacizumab, is the world's best-selling cancer drug. Used mainly to treat colon cancer, it was approved by the Food and Drug Administration in 2006 after it was found that by cutting the blood flow to tumors, it helped in treating breast cancer.

An estimated 17,500 American women are treated with the drug each year. It is effective, having been shown to extend life by at least 20 months, but it is not cheap.

Under the new "cost-effectiveness" philosophy of this administration, an FDA advisory panel has voted 12-to-1 to drop the endorsement of Avastin for breast cancer treatment. The FDA usually follows advisory panel recommendations, and a final decision will be announced Sept. 17. If approval of the drug, approved for colon, lung, kidney and brain cancer, is revoked for breast cancer, it is likely that insurers would drop that coverage.

In a joint letter sent to the FDA and key congressional lawmakers last week, Susan Komen of the Cure and the Ovarian Cancer National Alliance (OCNA) urged that Avastin continue to be approved for metastatic breast cancer patients and warned of the message this "decision sends about drug development for women with advanced breast cancer."

Breast cancer, the second most common cause of cancer death among U.S. women, claimed 40,000 lives last year. Komen says the decision to use Avastin should be made between a woman and her doctor after a thoughtful consideration of the benefits and risks. We agree.

The Obama administration's health care overhaul is all about cost and little about care. Berwick has opined: "We can make a sensible social decision and say, 'Well, at this point, to have access to a particular additional benefit (new drug or medical intervention) is so expensive that our taxpayers have better use for those funds."

In other words, the government will decide whether treating you and extending your life is worth it.

OCNA is also concerned whether Berwick's CMS, the Centers for Medicare and Medicaid Services, will pay for Provenge, a vaccine to treat the recurrence of prostate cancer, and at what rate. The vaccine is made from a patient's blood cells with cancer cells and an immune-boosting substance. A three-dose course of the immunotherapy is estimated to cost $93,000.

There's a conflict in mission statements. The FDA is supposed to approve drugs that are safe and effective. The CMS statute says it must pay for treatments that are reasonable and necessary. Provenge is ominously still under review by CMS.

"The decision is not whether or not we will ration care," Berwick says. "The decision is whether we will ration with our eyes open."

Well, all our eyes should be wide open by now.

http://www.investors.com/NewsAndAnalysis/Article/544231/201008181842/Death-Panels-Begin-As-Reform-Takes-Shape.aspx

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.

http://www.investors.com/NewsAndAnalysis/Article/536549/201006071833/The-Doctor-Will-See-You-Later.aspx

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

The following and not uncommon example from Canada is what we can expect here if Obamacare is passed.

Sick man faces bankruptcy — or death
Cancer patient must pay for drug needed to keep him alive
By MARK BONOKOSKI, QMI Agency  March 6, 2010

Kent Pankow and wife Deborah, fought the Alberta government to have his brain-cancer treatment paid by the province.

Kent Pankow lives in Edmonton, in a province and a country that is trying to either kill him or bankrupt him.

No sense mincing words.

Suffering from brain cancer, Kent Pankow was literally forced to go to the Mayo Clinic in Rochester, Minn. for lifesaving surgery — at a cost to family and friends of $106,000 — after the health-care system in Alberta left him hanging in bureaucratic limbo for 16 crucial days, his tumour meanwhile migrating to an unreachable part of the brain, while it dithered over his case file, ultimately deciding he was not surgery worthy.

Now, with the Mayo Clinic having done what the Alberta Cancer Board wouldn’t authorize or even explain, but with the tumour unable to be totally removed, the province will now not fund the expensive drug, Avastin, that the Mayo prescribed to keep him alive and keep the remaining tumour from increasing in size — despite the costs of the drug being totally funded by the province for other forms of cancer.

Kent Pankow, as it turns out, has the right disease but he has it in the wrong place.

Had he lung cancer, breast cancer, or colon cancer, then the cost of the drug — $4,555 per treatment, two times a month — would be totally covered by Alberta’s version of OHIP.

But he doesn’t.

And so he is not only a victim of brain cancer, he is also a victim of arbitrary discrimination.

Full disclosure. Kent Pankow, a 40-year-old Red Seal sous chef, is a son of the man who married the spouse of my late brother. And it was while vacationing with them at their winter home in Los Cabos, Mexico, recently that this story began to unfold back in their home province of Alberta.

But do not think, even for a moment, that this could never happen in Toronto or other parts of Ontario.

Our supposedly universal federal health care system, the pride of most Canadians and the political struggle of America, is only as good as the length of the waiting line and whether you have the right disease at the right time.

After writing more than 150 letters to everyone from the prime minister to virtually all health authorities both federal and provincial, and being ignored in return, Kent Pankow’s wife, Deborah Hurford, decided to finally go public.

CTV Edmonton did a major feature on the family’s plight on the 6 o’clock news and, almost before the program ended, Alberta’s health and wellness minister, Gene Zwozdesky, was on the phone to their home — ensuring himself some positive press in the followup that aired later that night.

Then, when he heard the Pankows had filed a human rights complaint against the province, justifiably citing medicare-based discrimination, Zwozdesky suddenly went mute — stating he could no longer discuss the matter publicly.

Ten years ago, when first diagnosed with a glioblastoma multiforme brain tumour (GBM), Kent Pankow was given five years to live.

After beating it down once, however, with his first surgery having been performed in Alberta, he spent nearly seven years in remission until the cancer’s return in 2008.

And he is not prepared to give up.

“He’s a fighter,” says his wife, admitting, however, that the cost of the drug has been a significant drain on friends and family who have not only donated large sums of their own money, but have also organized fundraisers to keep hope alive, including school penny drives.

“When Kent goes for his Avastin IV injection, he sits next to patients who receive the same drug for free because they have another type of cancer — like colon cancer,” Hurford says.

“Brain tumour patients deserve the same rights as other cancer patients, including access to the same lifesaving treatments — and without additional costs.

“I can’t begin to tell you how frustrated, angry, disgusted and appalled I am with both the Alberta health system and the individuals within the system who continue to perpetuate such an archaic and inhumane approach to the treatment of patients.” she says. “It seems like they are doing everything in their power to ensure that Kent succumbs to an early and unnecessary death.”

“The Avastin is working. The size of the remaining tumour has remained static since October,” she says.

“But how can anyone afford almost $10,000 a month for a drug — even if it is saving a loved one’s life?”
When Alberta health minister Gene Zwozdesky called the Pankow home on the night CTV Edmonton aired its story, he purportedly blamed the feds, namely Health Canada, for deciding what drugs are covered, and for what.

Federal Health Minister Leona Aglukkaq, however, in a letter to Deborah Hurford, wrote that “while Health Canada is responsible for the market authorization of drug products, the province and territorial governments are responsible for managing the list of drugs for which public reimbursement from government drug plans is available.”

This, too, is passing the buck.

What Aglukkaq would not explain to Hurford — citing confidentiality — was why Avastin received a notice of compliance from Health Canada for other forms of cancer, but not yet for brain cancer as in the United States.

Nor would she offer any information regarding any application before her department for the use of Avastin in the treatment of brain tumours.

“Based on Kent’s MRI’s and radiology reports, and analysis by his surgeon at the Mayo Clinic, Avastin is playing a key role in stabilizing Kent’s tumour,” says Hurford.

“Without it, Kent’s tumour will grow and he will die.

“So why then,” asks Hurford, “is (everyone) choosing not to help Kent and other brain tumour patients who are forced to go public with their private health issues and fundraise for their lifesaving medical treatments?

“Where is the dignity in that?”

http://storage.canoe.ca/v1/dynamic_resize/?src=http://www.calgarysun.com/news/canada/2010/03/06/p1cancertoo07web.jpg&size=248x186

http://www.calgarysun.com/news/canada/2010/03/06/13138731.html

There are countless reasons to oppose this legislation, many of which have received little exposure in the press or by analysts (privacy issues). Regardless, this bill must be vehemently fought and opposed by all Americans if we want to preserve the world’s best healthcare as well as our rights and freedoms.

Below, is an abbreviated list assembled by Investors Business Daily of some of the reasons why Obamacare should not be implemented.

Why Health Bill Makes No Sense
Investors Business Daily   03/12/2010

Health Reform: So it's come down to this — desperate Democratic leaders strong-arming members on the worst bill ever before they go home to explain to constituents why they decided to commit political suicide.

We've said just about all we've had to say on this issue — actually dating back to 1993-94, when we wrote nearly 100 editorials in opposition to HillaryCare. Since January of last year, we've weighed in 150 more times against the latest version of socialized medicine.

But to review, here are just 15 reasons why a government takeover of the finest medical system in the world makes no sense at all:

1. The people don't want it! This, we would think, should have some bearing on decision-making. Yet the Democrats forge ahead without consent of the governed. In the latest Rasmussen poll, 53% opposed the Democrats' reform while 42% were in favor. More than four in 10 "strongly" opposed; just two in 10 "strongly" favored. This jibes with other surveys, including our own IBD/TIPP Poll, taken since last year.

2. Doctors don't want it! A survey we took last summer of 1,376 practicing physicians found that 45% would consider leaving their practices or taking early retirements if the Democrats' reform became law. In December, the results were validated by a Medicus poll in which 25% of doctors said they'd retire early if a public option is implemented and another 21% would stop practicing even though they were far from their retirement years. Even if the bill doesn't have a "public option," nearly 30% said they'd quit the profession under the plans being considered.

3. Half the Congress doesn't want it! Not a single Republican backed the health care bill that cleared the Senate on Christmas Eve 60-39. House passage was by a slim 220 to 215, and the lone Republican "aye" has since switched to "no."
Columnist Michael Barone says other changes would put the House vote today at 216-215 in favor, and he has doubts Democrats can even muster 216.

House Speaker Nancy Pelosi made her job of securing yes votes even more difficult last week when she told a meeting of county officials that "we have to pass the bill so you can find out what is in it." Members of Congress aren't waiting: They've already exempted themselves from whatever they inflict on us.

4. People are happy with the health care they've got! Polls show that 84% of Americans have health insurance and that few are displeased with what they've got. Last month, the St. Petersburg Times looked at eight polls and reported that satisfaction rates averaged 87%.

5. It doesn't even cover the people they set out to cover! Supporters of government-run health care say there are as many as 47 million Americans — 9 million to 10 million of them illegal aliens — without medical insurance. The Democrats' plans, however, will put only 31 million of the uninsured under coverage.

6. Costs will go up, not down! Democrats say their plans will cost less than $1 trillion over the first decade. But analyst Michael Cannon at the Cato Institute puts the cost at $2.5 trillion over the first 10 years. Even if we go with the government's lower estimates, the cost is already on the rise. A new estimate by the Congressional Budget Office puts the cost of the Senate bill at $875 billion over 10 years, $4 billion more than its original projection. Imagine how fast costs would soar if one of the bills became public policy.

7. Real cost controls are nowhere to be found! The Democrats are offering no meaningful tort reform that will help push down the high malpractice insurance premiums that are a burden to doctors and their patients. Nor are they considering any other cost-saving provisions, such as allowing the sale of individual health plans across state lines or easing health insurance mandates.

8. Insurance premiums will rise, not fall! One goal of nationalizing health care is to lower costs, to bend the spending curve downward. Yet, as Democratic Sen. Dick Durbin acknowledged Wednesday, that won't be the case.

"Anyone who would stand before you and say, 'Well, if you pass health care reform, next year's health care premiums are going down,' I don't think is telling the truth," he said from the Senate floor. "I think it is likely they would go up."

An analysis completed by the CBO at the request of Sen. Evan Bayh confirms Durbin's suspicions. Insurance coverage in the individual market will "be about 10% to 13% higher in 2016 than the average premium for nongroup coverage in that same year under current law," it concluded.

9. Medicare is already bankrupting us! The Medicare trust fund, which has unfunded obligations of $37.8 trillion, will be insolvent in 2017. How can lawmakers justify another entitlement that will cost trillions when they can't pay for existing liabilities?

10. There aren't enough doctors now! Last month, 26% of physicians responding to a Web poll on Sermo.com, which calls itself "the largest online physician community," said they had been forced to close, or were considering closing, their solo practices. Providing coverage for an additional 31 million Americans when the number of doctors is shrinking won't improve our health care.

11. The doctor-patient relationship will be wrecked! The latest IBD/TIPP Poll, taken just last week, found that Americans, by a wide 48%-26% margin, believe the doctor-patient relationship will decline if the Democrats' plan is passed.

12. Medical care will also deteriorate! IBD/TIPP has also found that 51% of Americans believe care would get worse under government control. Only 10.5% said they felt it would improve. In our doctor poll, 72% disagreed with administration claims that the government could cover 47 million more people with better-quality care at lower cost.

13. Rationing of care is inevitable! Health care is not an unlimited resource and must be rationed, either by the individual, providers or government. In Britain and Canada, where the government does the rationing, medical treatment waiting lists are sometimes deadly and quite often excessively long.

For instance, late cancer diagnoses in an overcrowded public health care system cause up to 10,000 needless deaths a year in Britain. The reasons cited for the late diagnoses include doctor delay, delay in primary care, system delay and delay in secondary care.

14. Private health insurers will be destroyed! Added mandates and price controls will force many insurers to simply get out of the health plan business because it will no longer be profitable.

15. It's probably unconstitutional! One way to help bring down the number of uninsured is to demand that those without coverage buy health plans. But the government has never passed a law requiring Americans to buy any good or service.
Constitutional scholars say any such mandate would likely draw a legal challenge.

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=527217

There already is a physician shortage in this country partially based on rational personal decisions made by those who might have contemplated careers in medicine. With implementation of Obamacare, there will be many reasons for doctors to either work less or flee medical practice altogether. This combined with an inevitable precipitous increase in consumption of medical care by previously “uninsured” Americans and illegal aliens will result in a supply and demand imbalance, fostered by unwise government intervention.

The result: healthcare rationing, poor quality care and long waits to receive care.

The Doctor Shortage
Investors Business Daily     03/04/2010

Health Reform: Democrats promise their plan will improve care at lower cost while thinning the ranks of the uninsured. How will they do this with fewer doctors?

America's population is 305 million. If the Democrats are correct about the number of uninsured, roughly 260 million are covered by a health care plan. When the insured — and the uninsured who use the traditional method of paying out of pocket — are sick, they are treated by 800,000 physicians.

It would be foolish to believe that today's already stretched doctor-patient ratio will remain stable. In the near future we will have fewer doctors treating a growing population.

Physician search firm Merritt, Hawkins & Associates estimates that by 2020 we'll need 90,000 to 200,000 more doctors than we'll have then. As alarming as that estimate is, it could be low.

Last August, our IBD/TIPP Poll found that 45% of doctors would consider leaving their practices or taking early retirement if the Democrats' version of reform were to become law.

Last month, 26% of physicians responding to a Web poll on Sermo.com, which calls itself "the largest online physician community," said they had been forced to close, or were considering closing, their solo practices.

Reasons include "low and delayed reimbursements, problems with management companies, and a lack of business/practice management education," as well as high malpractice insurance costs.

Not every doctor who told these polls that he or she would consider leaving the field will do so. Some will go into group practices and others move on to positions at hospitals and in the military. Another group will change nothing.

Even if half followed through with their threats, our care will suffer. If the Democrats' plans become law, fewer than 700,000 physicians would be available to treat a patient population growing in size, aging in years, shunning medical education and receiving "free" health care or insurance coverage from the government in increasing numbers.

The result will be longer wait times to see a doctor and a decline in the high quality of care Americans are accustomed to as overworked physicians try to keep up.

To see how this works in reality, look at the Canadian and British government health systems that encourage unnecessary doctor visits with the illusion of free care. Both have long, and sometimes deadly, wait times. Neither provides treatment as high in quality as what's found in the U.S, where the system is supposedly broken.

With demand for doctors already outstripping supply, the last thing we need is to aggravate the situation with poorly thought-out public policy.

Washington has meddled in health care too much already.

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=522956

No need for mental health coverage or physical therapy? Too bad! Once again you will be unnecessarily paying for it - and subsidizing the benefits of others.

Your rights to choose regarding your healthcare will be severely restricted. You will ultimately be paying far more in insurance premiums and taxes yet receiving fewer benefits, limited choices for treatments, and have to wait longer and not necessarily see the doctor of your choice.

And these are just a few of the myriad disastrous issues that we will be facing.

ObamaCare: No exit
By Scott Gottlieb                       December 21, 2009

Perhaps the most common question I'm asked about ObamaCare is: "Will I be able to buy my way out of it?" The answer is: "Not unless you're very rich."

The plan before the Senate creates a set of 50 state-based insurance "exchanges" that are established as markets for health plans. Consumers must buy policies from their employers or through the exchanges — but, either way, their choice of coverage is limited to one of four basic insurance plans that the government sanctions.

Private insurers will still compete to offer policies but must model their coverage on one of these four templates. In short, the Senate bill explicitly standardizes health benefits and then establishes elaborate mechanisms (including subsidies and penalties) to pay for them.

Here's the rub: While these four plans vary from low- to high-cost options, the benefits offered under them are pretty much the same. The difference between the cheaper and pricier plans is mostly the amount of cost sharing (e.g., you pay less for insurance if your co-pays are higher).

In effect, the plan creates a single national health-insurance policy. Consumers' only real option is to trade higher co-pays for lower premiums. But we'll all get the same package of benefits established by a series of new agencies and an "insurance czar" seated in Washington.

Once the exchanges are in place, the individual market — the ability to go directly to an insurer and buy a health-care policy — will disappear. You'll have only two places to buy insurance, in the exchanges or through your workplace.

As for health plans offered by employers, "no health-insurance policies could be issued (other than grandfathered plans) that don't meet the actuarial standards set for these plans" sold in the exchanges. The government will "define the essential health benefits" that all plans must eventually offer, not only those sold in the exchanges but also plans offered by employers. But like other elements of today's private coverage, the grandfathered plans also disappear in short time. While the bill allows some employer plans to continue as they are today, that's only so long as the policy doesn't change — and natural market forces will ensure that most such policies must change within a few years after the bill becomes law.

All of which brings us to the question of whether you'll be able to spend extra money to add benefits that exceed the government's basic package or opt out of that plan entirely. The bill doesn't address this question directly — yet I can say with great confidence that it will be costly and in some cases impossible.

The bill leaves these issues in the hands of the bureaucracies that will write the law's enabling regulations. And it's clear both what the spirit of the Obama plan and the habits of these bureaucracies will produce.

The overriding goal of this reform is to turn health insurance into a more "egalitarian" benefit that's the same for everyone, regardless of income, personal preference or need. So rules written under President Obama to implement the Obama plan are a sure bet to intentionally curtail anyone's ability to wrap around this national coverage with a supplemental policy or to contract privately with doctors to pay your way out of its limitations.

This is exactly what the bureaucracy's done with Medicare. Doctors accepting Medicare can't contract privately with Medicare patients to bill for services that Medicare doesn't cover. Nor can patients buy added coverage to help plug Medicare's gaps. (The "Medigap" that many seniors now buy are tightly regulated by the government to limit how much they expand on Medicare's basic benefits; they mostly just help defray co-pays.)

In short, beneficiaries are trapped inside the Medicare insurance scheme, just as they'll soon be trapped inside the ObamaCare exchanges. Doctors can't offer benefits not covered by the government plans, and patients can't buy extra insurance to make up for many gaps.

These restrictions were designed into Medicare for a reason: Progressives don't want it to be easy for rich seniors to buy their out; they fear that if the well-off can leave the federal plan, it will become a lower-end benefit. That is, it will wind up like Medicaid, whose enormous problems are largely ignored by politicians because poor Americans don't have the political power to force improvements.

The very rich, of course, will be able to buy their way out of ObamaCare. Many of the best doctors will go cash only, opting entirely out of the Obama program, to cater to a wealthy clientele. But only the truly affluent will have the cash to escape.

The vast rest of us will be locked inside the new system — stuck with the same collection of government-decreed medical benefits.

URL    http://www.nypost.com/f/print/news/opinion/opedcolumnists/obamacare_no_exit_l9njng7Izk9KYNuzdvOeOP

As we have iterated myriad times, this is not about healthcare. This is about increased government power, control and regulation of our lives and restrictions of our rights and freedoms. If we don’t become more vociferous, passionate and actively fight this legislation in a united fashion, the government will relentless continue to further diminish and suppress our rights, freedoms and choices.

We must do whatever it takes to reclaim our country!

10 Lumps Of Coal In The Health Care Bill
By Betsy McCaughey

For most Americans, the health reform bill that Senate Majority Leader Harry Reid is pushing to pass will be worse than coal in their stockings. Herewith, the Top 10 List of Things You Don't Want From Health Care Reform This Christmas — But Will Get Anyway From Congress.

1. Higher premiums: If you pay for your own insurance, your premiums will cost 10% to 13% more than if the bill didn't pass, according to the Congressional Budget Office. Insurance won't be more affordable. Sixty percent of the newly insured are being enrolled in Medicaid, the public program for the poor.

2. A cost you can't afford and can't avoid: Though moderate-income families will get subsidies, buying insurance is mandatory. A family earning $54,000 will be expected to pay $9,000 (17% of pre-tax income) for the premium, co-pays and deductibles, according to the CBO. If you don't enroll, the IRS will find you and penalize you (Senate bill, p. 345).

3. A one-size-fits-all health plan: Your benefit package will be prescribed by the Secretary of Health and Human Services. Whether you choose basic, silver or gold, and whether you pay for it yourself or qualify for a subsidy, your benefits are the same.

Gold plans simply collect more up front and give you a lower co-pay or deductible. It's unclear how possible it will be to buy supplemental insurance. The goal is to discourage health consumption and differences based on ability to pay.

4. A sin tax on your generous plan at work: This is another equalizer to discourage some people from getting more than others. The Senate bill puts a 40% tax on Cadillac plans (p. 1,980). About one-fifth of employer-provided plans fall into that "luxury" category. The CBO predicts that employers will downgrade your coverage to avoid the tax or reduce your take home pay.

5. Government controls on your doctors' decisions: The Senate bill bars doctors from participating in the private insurance system unless they implement whatever regulations the secretary of health and human services chooses to impose to "improve health care quality" (p. 149). That broad phrase encompasses everything in medicine.

This would be the first time in history that the federal government is given power over how doctors treat privately insured patients

6. Hospitals closed to seniors: The House and Senate bills slash payments to hospitals and other institutions that care for seniors. The chief actuary for Medicare, Richard Foster, warns that cuts in the House bill are so severe that some institutions may face severe losses or end their participation in Medicare (Centers for Medicare & Medicaid Services, 11/13/09 report). Some seniors won't know where to go.

7. Bare-bones hospital care: Patients of all ages (and all incomes) will suffer when hospitals are in financial distress. Hospital budget cuts will mean shortages of nurses, equipment and cleaning staff. The president's chief health advisor, Dr. Ezekiel Emanuel, argues that hospitals in the U.S. offer more privacy and comfort than hospitals in Europe, and this "abundance of amenities" drives up costs (Journal of the American Medical Association, June 18, 2008).

8. Future Medicare cuts: Look out baby boomers, the Senate bill establishes an Independent Medicare Advisory Commission to make automatic spending reductions in future years while insulating Congress from the political fallout. You won't get as much care as people in Medicare currently get.

9. A new social agenda: Money is allocated for adult preparation activities, including lessons on positive self-esteem and relationship dynamics, friendships, dating (and) romantic involvement (Senate bill, p.612). There are also giveaways to immigrants. The Senate bill hands low-income legal immigrants government subsidies as soon as they get here, instead of waiting the five years Medicaid requires (Senate bill, p. 274).

10. A tell-all relationship with every doctor you see: What happens in your doctor's office must be recorded in an electronic data base that can send the information to insurers and other medical offices (Senate bill, p. 62-66). Every doctor you see will have access to your medical history. See a psychiatrist? Your foot doctor will know about it.

These congressional tidings bring no comfort or joy. We must save ourselves from Congress' power now that it has gone astray.

• McCaughey is a former lieutenant governor of New York state and founder of the Committee to Reduce Infection Deaths.

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=516146

Congressional Democrats and Obama claim that their healthcare legislation establishes a great system for the American people. If it really is so fantastic then why are they refusing to agree to amendments that would force them to use the same healthcare system as they want to impose on us? The answer is because they know this system will be disastrous – limiting choice, rationing and restricting care, creating prolonged waiting times before receiving care and being far more costly for significantly inferior quality. Why should they have to give up their privileged premium care that is subsidized by the American taxpayer and provides them with myriad choices?

This whole healthcare reform is all about government control and nothing more. As Investors Business Daily put it:

“… health reform's purposes were advertised as cost containment and near-universal coverage. But what Democrats are set to enact will spend trillions dramatically increasing insurance premiums, and leave millions still without insurance.

In other words, their push for health reform has been based on lies. The real purpose: to gain control of America's health system.

And on top of the lies is the hypocrisy the American people have come to expect from their politicians: continuation of the nearly 50-year-old loophole providing senators and House members with a wide choice of private health plans.”

We need to continue fighting to stop this legislation as well as vigorously work at ousting these arrogant, imperious members of Congress who are ruling us rather than representing us!

Reform For You, But Not Congress
Investors Business Daily 12/04/2009

Hypocrisy: If the $2-trillion-plus government health care plan that Congress has come up with is so great, why do lawmakers refuse to live under it themselves? Their designs have been based on lies from the start.

The left thinks Sens. Tom Coburn, R-Okla., and David Vitter, R-La., have shot themselves in their feet. After unveiling last week their amendment that would force Senate and House members to cover themselves with any government health plan that passes into law, Sen. Sherrod Brown, D-Ohio, a champion of the public option, proceeded to ask if he could sign on as a co-sponsor. Liberal Sen. Ron Wyden, D-Ore., said he might want to, as well.

"Coburn and Vitter weren't counting on that kind of support," gloated Nation magazine Washington correspondent John Nichols. "If they're smart, the rest of the Democratic caucus will follow Brown's lead and sign on for the public option."

Well, when it comes to feathering their own nests, congressional Democrats are smart. And they're not about to subject themselves to anything less than the taxpayer-subsidized, gold-plated array of private coverage choices they've enjoyed for nearly a half century in the Federal Employees Health Benefits Program.

Coburn and Vitter's idea of politicians living under a government plan "was opposed unanimously by Democrats during interviews on Thursday," the Hill newspaper reports. The paper also noted opposition from senior Republican senators such as National Republican Senatorial Committee Chairman John Cornyn of Texas and Minority Whip Jon Kyl of Arizona, who asked: "Why would I want to put my family in that, let alone anybody else's family?"

Senators and representatives from both sides of the aisle know how good they have it under the FEHBP, the world's largest group health program. The reason Congress' own health care works so well is that it's based on consumer choice and market competition — the opposite of what it's trying to impose on everybody else.

Members of Congress and millions of federal workers may choose from hundreds of private fee-for-service plans, HMOs or preferred provider organizations, with no federal worker living anywhere enjoying fewer than a dozen options.

FEHBP members can easily switch plans if they become dissatisfied; that puts competitive pressure on insurers to provide quality and value. Surveys show that members love their coverage, which is why almost all federal employees join the program.

The FEHBP is shielded from state regulation and Uncle Sam subsidizes premiums by more than 70%. Canadian physician and Manhattan Institute senior fellow Dr. David Gratzer, whose opposition to government-run health care comes from first-hand experience, observes that "the federal government's role in the FEHBP is to pay the bills," unlike the fiscally doomed Medicare program, of which "Washington is the designer of benefits."

Today, instead of the federal takeover Democrats are rushing to enact, lawmakers could give Americans the kind of high-quality health care choices they enjoy. A simple system of vouchers would allow recipients to choose any health plan on the market. The system could be means-tested, with Medicare giving "larger vouchers to poorer and sicker seniors and smaller vouchers to healthy and wealthy seniors, using current health-risk-adjustment mechanisms and Social Security data on lifetime earnings," says Michael F. Cannon, director of health policy studies at the Cato Institute.

Vouchers "would contain Medicare spending, and are the only way to protect seniors from government rationing," according to Cannon.

"The FEHBP is an excellent model for designing a system based on broad personal choice," argues Robert Moffit, the Heritage Foundation's director of health policy studies. "There is no reason," he adds, "why a reform of Medicare could not establish a similar structure for national plan options," including integrating private retiree health insurance into the system.

But instead of such common-sense reform, Americans are staring at thousands of pages of new regulations on their personal medical treatment, including a government-run option that will devastate the private coverage most Americans have and like. The inevitable result, as independent studies warn, is thousands of dollars more to pay in health premiums.

In last year's presidential campaign, health reform's purposes were advertised as cost containment and near-universal coverage. But what Democrats are set to enact will spend trillions dramatically increasing insurance premiums, and leave millions still without insurance.

In other words, their push for health reform has been based on lies. The real purpose: to gain control of America's health system.

And on top of the lies is the hypocrisy the American people have come to expect from their politicians: continuation of the nearly 50-year-old loophole providing senators and House members with a wide choice of private health plans.

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=514427