Socialized medicine has been implemented in numerous countries and has failed in all its myriad manifestations. Romney-care in Massachusetts has been an expensive, unaffordable disaster.
Obamacare which is somewhat based on this model but on a massively larger scale, is doomed to fail – in quality, cost, management and, of course, in the rights of the American citizen. It is so bad already, that over 1000 waivers have been granted to various businesses and groups, most notably a very high number of labor unions.
Of course, even a history replete with uniform failure of all socialized medicine models is just not enough to dissuade another arrogant group of Democrats from seeking to implement their own “success to be” version.
Welcome the Vermont socialized medicine model.
What Doesn't Work
Investor’s Business Daily 03/15/2011
Health Care: Vermont has plans to cover everyone. But why does a state need universal care when there's already a national program? And haven't lawmakers there learned from their neighbors to the north and south?
The Vermont House Health Care and Senate Health and Welfare committees held a hearing Monday night on a single-payer health care bill brought by Gov. Peter Shumlin. For the record, he's a Democrat who believes the old leftist adage that health care "is a right and not a privilege" and rode the issue all the way to the governor's suite.
A majority of Vermont voters — 117,561 — put Shumlin in office. But all deserve better, even those who supported him. Setting up a government-run system in the state will be a mistake, no matter how many promises about cost containment and wider coverage are made.
Attempts by government to cover and treat everyone are not the glowing successes the political left makes them out to be.
To the north of Vermont, the Canadian health care system is plagued by waiting lists that are often miserable and sometimes deadly.
Costs are out of control, and the only thing universal about health care for our northern neighbors is its rationing.
Conditions in Canada have become so poor that Claude Castonguay, the man known as the father of its national health care system, has publicly supported "a greater role to the private sector" in health care "so that people can exercise freedom of choice."
To the south, an experiment in ensuring "every uninsured citizen in Massachusetts will soon have affordable health insurance" has failed. The system, a creation of former Gov. Mitt Romney, has been on line since 2006 but has yet to cover everyone. Costs have been so much higher than projected that the program had to dump 30,000 people from its rolls in 2009.
Last year, columnist Robert Samuelson, no conservative, succinctly summed up RomneyCare's problem when he wrote it "evaded the hard part: controlling costs and ensuring that spending improves people's health."
Of course, RomneyCare became the model for Obama-Care, the problems of which will be magnified by its national scope.
The tribulations of government health care continue beyond Vermont's immediate neighbors. Two states away, there's a government-run, taxpayer-funded program that's brought change but little hope. Known as Dirigo, it was sold as a means to insure all of Maine's 140,000 uninsured by 2009. But it fell far short of its goal: Only about 3,500 had been added to the rolls of the insured by that time.
Worse, instead of creating no additional burden for Maine's taxpayers, as was promised, Dirigo cost $150 million by 2009.
Despite these bitter experiences, there's always some politician on the left who believes the laws of economics can be suspended because he or she is more clever than those who've tried before. Shumlin is one of those politicians.
He even thinks he can do better than the Democrats in Washington who've already hatched their national health care scheme. But he'll fail where others have failed before him. To think otherwise is delusional.
Rather than miss the mark so spectacularly, policymakers should simply go with what works. Rather than force a plan on an ostensibly free people, let individuals and families make health care decisions for themselves.
Stop trying to create a right from the ether and move government out of the way.
Stepping back and letting the market — the peaceful, voluntary exchange between people — work freely won't yield universal coverage.
Some will always make poor decisions and forgo health insurance. But the market solution will expand coverage and bring down costs.
Neither an army of bureaucrats nor thousands of pages of dehumanizing legislation are necessary.
All that's required is for government to promote and protect liberty.
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.
Many of the Democrats who are either up for re-election or are seeking political office for the first time are claiming that they oppose much of Obamacare and plan to fix it if elected/re-elected.
Don’t believe any of this rhetoric. There is an ulterior motive to these specious statements: to win election by whatever it takes. After that, expect most of these Democrats to toe the party line, either by coercion or personal convictions, and therefore not repeal Obamacare.
Only the Republicans can be trusted to attempt to repeal or defund Obamacare.
Vote Republican in November if you want to fight Obamacare … and to take back our country from the arrogant, elitist and radical Democratic politicians.
Dear Patients: Vote to Repeal ObamaCare Don't believe Democrats who promise to fix the bill once they're re-elected.
By Hal Scherz
Facing a nationwide backlash, Democratic congressional candidates have a new message for voters: We know you don't like ObamaCare, so we'll fix it.
This was the line offered by Democrat Mark Critz, who won a special election in Pennsylvania's 12th congressional district after expressing opposition to the law and promising to mend it—but not to repeal it. As a doctor I know something about unexpected recoveries, and this latest attempt to rescue ObamaCare from repeal needs to be taken seriously.
For Democrats who voted for ObamaCare, this tactic is an escape route, a chance to distance themselves from the president with a vague promise to fix health-care reform in the next Congress.
To counter this election-year ruse, my colleagues and I at Docs4PatientCare are enlisting thousands of doctors in an unorthodox and unprecedented action. Our patients have always expected a certain standard of care from their doctors, which includes providing them with pertinent information that may affect their quality of life. Because the issue this election is so stark—literally life and death for millions of Americans in the years ahead—we are this week posting a "Dear Patient" letter in our waiting rooms.
The letter states in unambiguous language what the new law means:
"Dear Patient: Section 1311 of the new health care legislation gives the U.S. Secretary of Health and Human Services and her appointees the power to establish care guidelines that your doctor must abide by or face penalties and fines. In making doctors answerable in the federal bureaucracy this bill effectively makes them government employees and means that you and your doctor are no longer in charge of your health care decisions. This new law politicizes medicine and in my opinion destroys the sanctity of the doctor-patient relationship that makes the American health care system the best in the world."
Our doctor's letter points out that, in addition to "badly exacerbating the current doctor shortage," ObamaCare will bring "major cost increases, rising insurance premiums, higher taxes, a decline in new medical techniques, a fall-off in the development of miracle drugs as well as rationing by government panels and by bureaucrats like passionate rationing advocate Donald Berwick that will force delays of months or sometimes years for hospitalization or surgery."
We cite the brute facts of ObamaCare's passage:
"Despite countless protests by doctors and overwhelming public opposition—up to 60% of Americans opposed this bill—the current party in control of Congress pushed this bill through with legal bribes and Chicago style threats and is determined now to resist any 'repeal and replace' efforts. This doctor's office is non-partisan—always has been, always will be. But the fact is that every Republican voted against this bad bill while the Democratic Party leadership and the White House completely dismissed the will of the people in ruthlessly pushing through this legislation."
Then we address the Democrats' evasive campaign maneuver:
"In the face of voter anger some Democratic candidates are now trying to make a cosmetic retreat, calling for minor modifications or pretending they are opposed to government-run medicine. Once the election is over, however, they will vote with their party bosses against repealing this bill."
The letter's final lines are the most important:
"Please remember when you vote this November that unless the Democratic Party receives a strong negative message about this power grab our health care system will never be fixed and the doctor patient relationship will be ruined forever."
This message is going out to an electorate that is already frustrated over what they see happening to health care. Missouri voters rejected ObamaCare overwhelmingly in August, voting by a margin of 71%-29% to reject the federal requirement that all individuals purchase health insurance. Democratic pollster Douglas Schoen has assessed that ObamaCare is "a disaster" for Democrats. And around the country many little-noticed primaries have reflected voter rage—including the Republican primary victory of surgeon, political newcomer, and advocate of repeal Daniel Benishek in Michigan's first district.
Meanwhile, the Obama administration's damage-control efforts have fallen flat. The latest round of pro-ObamaCare television spots targeting the elderly and starring veteran actor Andy Griffith have not only failed to move the polling numbers. They have caused five U.S. Senators to ask for an investigation of the ads as a violation of federal laws barring the use of tax dollars ($750,000) for campaign purposes.
America's doctors have millions of personal interactions each week with patients. We have political power. And we intend to use it by working to defeat those who have disrupted and gravely endangered the best health-care system in the world.
Dr. Scherz, a pediatric urological surgeon at Georgia Urology and Children's Healthcare of Atlanta, serves on the faculty of Emory University Medical School and is president and cofounder of Docs4PatientCare.
Great Britain and Canada are finding that the relentlessly escalating costs of socialized medicine present a financially untenable situation. There is not enough money to meet the needs of the unrestrained demand. Of course, this situation was entirely predictable despite the dissembling and prevarication by liberals.
How are they contemplating addressing this problem? Rationing.
Since they can’t afford to pay for all the services demanded, the governments will selectively limit usage by restricting visits, procedures and other utilizations. In addition, there will be a requisite deterioration in quality of care.
Such an outcome was resolutely predicted and feared by millions of Americans who opposed Obamacare. In spite of this vociferous opposition, Obama and the arrogant elitist Congressional Democrats rammed the legislation through, needing corrupt stratagems in order to bribe some of their fellow ideologues to vote yes.
If Obamacare is not repealed or defunded, what is transpiring in Great Britain, Canada and elsewhere will occur here as well, long after the deconstruction of the world’s best healthcare system. And we will also be tens of trillions of dollars more in debt than necessary … and probably bankrupt.
The Doctor Will See You Later
Investors Business Daily 06/07/2010
Health Care: The British government has decided that it needs to cut millions of operations because the public system cannot afford them. This is coming soon to a hospital or doctor's office near you.
According to the Daily Mail, Britain's National Health Service is "preparing to cut millions of operations" so that it can save $29 billion by 2014. Procedures that will be "decommissioned," if we may borrow a particularly descriptive term used by one doctor, include hip replacements for obese patients, some operations for hernias and gallstones, and treatments for varicose veins, ear and nose problems, and cataract surgery.
Thus is the future of all socialized medicine. Bureaucratic rationing of treatment is inevitable. No system can forever meet the demand of "free" care. Jeff Taylor of the Economic Voice clarified the problem when he wrote last week that "the U.K. is broke."
"Our whole society and way of life is now built on the shaky foundation of debt," he writes in response to the NHS cuts.
"Our hospitals, schools, armed forces, police, prisons and social services are founded on debt. In truth we have not yet paid for the operations that have already taken place."
As former British Prime Minister Margaret Thatcher famously — and fittingly — said: The problem with socialism is you eventually run out of other people's money to spend. This is a universal truth, more universal than the health care provided in Britain. To trifle with it, ignore it, disrespect it, attempt to repeal it or arrogantly try to bypass it will always lead to trouble.
Yet the political left continually makes those mistakes and operates as if governments will never run out of other people's money. Until it does. And then the government has to make cuts and ration the benefits.
What have the congressional Democrats who rammed through their health care overhaul been watching over the years as both hard and soft socialist governments have either collapsed, continued to bring misery or become unsustainable? Despite ample evidence that a welfare state cannot thrive, these lawmakers have forced on the country a "reform" that will load Americans with a burden they will not long be able to bear.
Though it was sold to the public as a plan that, at $940 billion over the first decade, would bring down the deficit, the real cost for the initial 10 years could be as much as $2.5 trillion, including mandates placed on the private sector, according to an estimate by the Cato Institute.
It's possible that the Cato projection is off. But history shows us that it's more likely to be right than Washington's estimate. Government programs always cost more than the rosy initial projections that are used to drum up public support. It's another lesson that remains unlearned by most of our elected officials and the voters who keep putting them in office despite the problems the lawmakers refuse to stop creating.
Given our lawmakers' inability to learn from the health care policy blunders committed in Britain and Canada — which is reassessing its model because of ruinous costs — no one should be surprised when rationing by bureaucracy becomes a feature of the U.S. public health care system.
There should be no shock when waiting lists for treatment are simply rosters of Americans suffering — and in some cases dying — from a lack of care. No astonishment when those who do get treatment get substandard care, no dismay as a two-tiered system develops in which the more important among us get top-flight medicine while the rest get what the public clinics have to offer.
Our own polling shows that the disapproval of the Democrats' health care legislation is beginning to wane. That's as alarming as the heated opposition to the law had been encouraging. If we surrender ourselves to the soft tyranny of elected officials gone too far, we will be leaving an America that future generations won't want.
The Veterans Administration Hospitals, run by the Federal government, are notoriously horrific on myriad accounts and has been so for years. Negligence, poor patient care, disarray, confusion, bureaucracy are just a few adjectives that can begin to describe the “quality” or lack thereof associated with the VA. And this is just a fraction of the size that Obamacare will be.
So Obama and Congressional Democrats really believe that they can used this along with what has been learned from the Medicare program and the Post Office to provide outstanding care that exceeds what we have now, to more individuals and for less?
As we have reiterated numerous times, Obamacare is not about healthcare. It is all about government control, power and spreading the wealth around.
Obamacare must rescinded or rendered impotent!
VA Claims Office Takes SNAFU to a New Level
Jana Winter FOXNews.com April 19, 2010
Last month, a decorated Gulf War hero received a letter from the Veterans Affairs Administration that said: We are working on your claim for menstrual disorder. He was surprised -- but not as much as one might think.
Last month, a decorated Gulf War hero received a letter from the Veterans Affairs Administration that said: We are working on your claim for menstrual disorder.
There was just one problem: The claim was submitted for fibromyalgia.
Make that two problems: The claim was submitted by Glenn McBride, a 40-year-old man from Roanoke, Va., who most definitely does not get menstrual cramps.
It's a bad sign when your health insurance provider can’t figure out which gender reaches for the Midol. (Hint: it's the one without the prostate.)
The Department of Veterans Affairs is notorious for bungling health care benefits, and its Roanoke regional office, which handled McBride's claim, has long been considered among the worst.
In September 2009 a surprise inspection found the office was collapsing under the weight of its own bureaucratic incompetence. Literally.
Its filing system — floor-to-ceiling stacks of overfilled file cabinets and loose claims folders — weighed twice as much as the building's structure allowed, threatening the lives of everyone inside. Inspectors also found missing and improperly filed, stored and processed claims, among other problems. The regional office was ordered to overhaul the health care processing center completely.
By last month, six months later, there should have been some improvement. Instead, McBride received a letter that included this perplexing request for additional information:
"On the VA Form 21-4138, Statement in Support of Claim you sent on October 8, 2009, you included menstrual disorder. Please specify what you intended to claim for this condition."
McBride, whose 14 years of Army service included a combat tour with one of the most highly decorated units during Desert Storm -- and did not include any complaints about menstrual cramps, so far as he can recall -- insists this was not just a clerical error. He says it's one more example of the VA ignoring or messing up claims in order to avoid paying benefits.
"If the VA does not actually recognize the request, they do not have to give the award," he said. "Sort of like a perverted form of 'See no evil, Hear no evil, Speak no evil.' Most people just throw up their hands in frustration and walk away at this point. That is the VA's plan."
The VA, asked to comment about McBride's complaint, issued a statement in which it said:
"The Department of Veterans Affairs' (VA) mission is to be an advocate for Veterans. VA has a responsibility to assist Veterans during the claims process. Part of that duty is to include all possible issues that a Veteran references in his or her initial claim package. VA regrets any confusion that Mr. McBride's claim may have caused. VA Regional Office employees have reached out to Mr. McBride to clarify the confusion, determine the types of issues he wants to claim, and identify any outstanding concerns that he may have."
Jim Strickland, a veterans advocate who writes a regular health care benefits column on VAWatchdog.org and has his own benefits-related Web site, said he wasn't at all surprised to learn of McBride's "menstrual" letter. "There are 57 regional offices and every one is operating in total chaos and in crisis," he said. "Full frontal mass chaos. Every day."
Contacted in the middle of the week, Strickland said he'd already received two e-mails from veterans who were mailed the records of other veterans. And he provided his most ridiculous example of a nonsensical claims letter, one that managed to try to collect debt and to discuss overpaying the same debt -- at the same time.
For Gulf War veterans who fought during a certain time period, certain health conditions are considered presumptive, meaning that such a high percentage of that group has been diagnosed with the condition it's presumed that it was caused by military service, and coverage is automatically granted. Fibromyalgia, a chronic pain condition, is a presumptive one for McBride.
Because of his years of experience dealing with the VA, McBride likes to provide as much information as possible when he submits claim forms. (He also gets a signed and time-stamped receipt upon delivery.) When he sent in his claim for fibromyalgia, he typed clearly at the top of the form: "This form is an official request for SERVICE-CONNECTION for FIBROMYALGIA." He included an extract of a VA "fast letter" regarding presumptive conditions — basically providing the VA with its own policy on Chronic Fatigue Syndrome, Fibromyalgia and Irritable Bowel Syndrome. "Menstrual disorder" is included in the VA's list of symptoms.
"The VA just breezed right through the facts and settled on the obscure," McBride said. "The Roanoke office clearly hasn't changed."
Strickland says the problem at the root of letters like McBride's is a bonus structure paid out to VA claims employees.
"The more work, the better the bonus is," he said. "It's strictly volume, not quality driven. There is no accountability whatsoever.
"The art of the Teflon Jacket has been perfected at our VA. They are really totally invulnerable to your criticism."
When the editor of VAWatchdog.org posted an April Fools Day joke -- "VA DOCTOR TRIES TO GIVE PROSTATE EXAM TO WOMAN
VETERAN (April Fool); VA physician: 'Nobody told me the patient was a female. How the hell was I supposed to know that?'" -- McBride sent in his "menstrual" letter.
It was posted on the same site under the heading, "Today's Whiskey Tango Foxtrot? award goes to the VA's Roanoke, Virginia Regional Office."
The site's editor describes the award:
"Every now and then we get a story about the VA that just can't be. But, it is! Because, remember, we're not dealing with regular people ... we're dealing with the VA. That's when we throw up our hands and scream at the sky:
Fresh and ongoing from it initiating, feeding and perpetuating the housing debacle and collapse, the Federal government with its pernicious Obamacare is poised to destroy medicine and medical care as we know it here in the United States. If allowed to take root, gone will be the world’s best and most sophisticated healthcare system, home of most of the most important innovations and discoveries in medical care. In its place will be a near 3rd world level of “quality” of care encumbered by an oppressive and arcane government controlled system. At least in third world countries they don’t have swarms of attorneys pullulating like flies looking for their next jackpot.
It is commonly known that there will be a significant shortage of primary care physicians in the future which Obamacare will tremendously exacerbate for myriad reasons. Of course, neither Obama or Congressional Democrats considered this in their reckless haste to ram the healthcare reform legislation into effect. What a surprise – politicians didn’t anticipate something inherently important?
The end result? You will have the “right” of healthcare but you may not have a doctor to provide it to you. If you are ultimately able to schedule an appointment to see a doctor, you may have to wait an excessively long period of time to finally be seen, or be seen by a physician located far from where you live or work, or be herded through like cattle spending little time with the doctor who is massively overworked and overloaded with patients (and over-regulated).
Does the word “rationing” ring a bell? Or decreased quality of care? These were all important issues that were raised by those who opposed the Democrats’ plans but were ignored or denigrated by them and the press.
What is a “brilliant” solution for this problem that is being considered by the government? Have nurses act like doctors. Add a little more training, change some statutes and voila! Doctorlight. Easy! Just don’t be very sick or you might not make it to a real doctor.
And if the nurse gets a PhD, they can officially be addressed as Dr., adding to confusion but subtracting from quality. This proposal would place millions of Americans at unnecessary risk due to inferior training and as a consequence, inferior care.
Furthermore, given the government’s plan to reimburse these nurses the same or marginally less than real doctors, why would any sane person want to become a doctor? After all, for maybe $5 to $10 more per patient that a doctor would be reimbursed versus a nurse, that person would also have to go to medical school and residency for up to 11 or more years, assume debt to pay for school of $250,000 or more and then pay malpractice rates in practice that can exceed $100,000/ year.
This will surely dissuade many including the best and brightest from seeking a career in medicine and don’t we want our doctors to be smart and competent?
Sounds like another government plan causing unintended consequences.
Doctor shortage? 28 states may expand nurses' role
By Carla K. Johnson (AP) – 4/15/2010
CHICAGO — A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called "Doctor."
For years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics.
Those newly insured patients will be looking for doctors and may find nurses instead.
The medical establishment is fighting to protect turf. In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients.
Nurse practitioners argue there's no danger. They say they're highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.
"We're constantly having to prove ourselves," said Chicago nurse practitioner Amanda Cockrell, 32, who tells patients she's just like a doctor "except for the pay."
On top of four years in nursing school, Cockrell spent another three years in a nurse practitioner program, much of it working with patients. Doctors generally spend four years in undergraduate school, four years in medical school and an additional three in primary care residency training.
Medicare, which sets the pace for payments by private insurance, pays nurse practitioners 85 percent of what it pays doctors. An office visit for a Medicare patient in Chicago, for example, pays a doctor about $70 and a nurse practitioner about $60.
The health care overhaul law gave nurse midwives, a type of advanced practice nurse, a Medicare raise to 100 percent of what obstetrician-gynecologists make — and that may be just the beginning.
States regulate nurse practitioners and laws vary on what they are permitted to do:
_ In Florida and Alabama, for instance, nurse practitioners are barred from prescribing controlled substances.
_ In Washington, nurse practitioners can recommend medical marijuana to their patients when a new law takes effect in June.
_ In Montana, nurse practitioners don't need a doctor involved with their practice in any way.
_ Many other states put doctors in charge of nurse practitioners or require collaborative agreements signed by a doctor.
_ In some states, nurse practitioners with a doctorate in nursing practice can't use the title "Dr." Most states allow it.
The AMA argues the title "Dr." creates confusion. Nurse practitioners say patients aren't confused by veterinarians calling themselves "Dr." Or chiropractors. Or dentists. So why, they ask, would patients be confused by a nurse using the title?
The feud over "Dr." is no joke. By 2015, most new nurse practitioners will hold doctorates, or a DNP, in nursing practice, according to a goal set by nursing educators. By then, the doctorate will be the standard for all graduating nurse practitioners, said Polly Bednash, executive director of the American Association of Colleges of Nursing.
Many with the title use it with pride.
"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.
What's the evidence on the quality of care given by nurse practitioners?
The best U.S. study comparing nurse practitioners and doctors randomly assigned more than 1,300 patients to either a nurse practitioner or a doctor. After six months, overall health, diabetes tests, asthma tests and use of medical services like specialists were essentially the same in the two groups.
"The argument that patients' health is put in jeopardy by nurse practitioners? There's no evidence to support that," said Jack Needleman, a health policy expert at the University of California Los Angeles School of Public Health.
Other studies have shown that nurse practitioners are better at listening to patients, Needleman said. And they make good decisions about when to refer patients to doctors for more specialized care.
The nonpartisan Macy Foundation, a New York-based charity that focuses on the education of health professionals, recently called for nurse practitioners to be among the leaders of primary care teams. The foundation also urged the removal of state and federal barriers preventing nurse practitioners from providing primary care.
The American Medical Association is fighting proposals in about 28 states that are considering steps to expand what nurse practitioners can do.
"A shortage of one type of professional is not a reason to change the standards of medical care," said AMA president-elect Dr. Cecil Wilson. "We need to train more physicians."
In Florida, a bill to allow nurse practitioners to prescribe controlled substances is stalled in committee.
One patient, Karen Reid of Balrico, Fla., said she was left in pain over a holiday weekend because her nurse practitioner couldn't prescribe a powerful enough medication and the doctor couldn't be found. Dying hospice patients have been denied morphine in their final hours because a doctor couldn't be reached in the middle of the night, nurses told The Associated Press.
Massachusetts, the model for the federal health care overhaul, passed its law in 2006 expanding health insurance to nearly all residents and creating long waits for primary care. In 2008, the state passed a law requiring health plans to recognize and reimburse nurse practitioners as primary care providers.
That means insurers now list nurse practitioners along with doctors as primary care choices, said Mary Ann Hart, a nurse and public policy expert at Regis College in Weston, Mass. "That greatly opens up the supply of primary care providers," Hart said.
But it hasn't helped much so far. A study last year by the Massachusetts Medical Society found the percentage of primary care practices closed to new patients was higher than ever. And despite the swelling demand, the medical society still believes nurse practitioners should be under doctor supervision.
The group supports more training and incentives for primary care doctors and a team approach to medicine that includes nurse practitioners and physician assistants, whose training is comparable.
"We do not believe, however, that nurse practitioners have the qualifications to be independent primary care practitioners," said Dr. Mario Motta, president of the state medical society.
The new U.S. health care law expands the role of nurses with:
_ $50 million to nurse-managed health clinics that offer primary care to low-income patients.
_ $50 million annually from 2012-15 for hospitals to train nurses with advanced degrees to care for Medicare patients.
_ 10 percent bonuses from Medicare from 2011-16 to primary care providers, including nurse practitioners, who work in areas where doctors are scarce.
_ A boost in the Medicare reimbursement rate for certified nurse midwives to bring their pay to the same level as a doctor's.
The American Nurses Association hopes the 100 percent Medicare parity for nurse midwives will be extended to other nurses with advanced degrees.
"We know we need to get to 100 percent for everybody. This is a crack in the door," said Michelle Artz of ANA. "We're hopeful this sets the tone."
In Chicago, only a few patients balk at seeing a nurse practitioner instead of a doctor, Cockrell said. She gladly sends those patients to her doctor partners.
She believes patients get real advantages by letting her manage their care. Nurse practitioners' uphill battle for respect makes them precise, accurate and careful, she said. She schedules 40 minutes for a physical exam; the doctors in her office book 30 minutes for same appointment.
Joseline Nunez, 26, is a patient of Cockrell's and happy with her care.
"I feel that we get more time with the nurse practitioner," Nunez said. "The doctor always seems to be rushing off somewhere."
As we have mentioned myriad times, an overwhelming majority of physicians are resolutely opposed and in a state of perpetual outrage at the dictates of Obamacare. This may not necessarily be apparent given that most have elected to vent their disapproval in quieter ways such as e-mailing, writing and calling their Senators and Representatives.
One physician who did decide to be a little more overt in his vehemence, Jack Cassel MD, the Florida urologist who posted a sign on his door regarding those who voted for Obama, did get his message heard … and nationally. Unfortunately, the malignant and portentous Representative of his district, Alan Grayson (D – Florida) then initiated malicious verbal assaults on him including calling him racist and unprofessional and has indicated that he will seek professional sanctions and legal charges against him. This has become a dangerous and illegal pattern of Democrat politicians pursuing whatever measures possible to squelch First Amendment Rights. Threaten and silence the opposition into submission.
With this scenario fresh in mind and cognizant of the ubiquitous threats from the Government, media and even liberal loons, Dr. Joseph Scherzer, a Scottsdale, Arizona Dermatologist in practice for 34 years, felt that for the good of the country and patient care in particular, more needed to be shared with the public. He has bravely elected to speak out on the pernicious nature of the Obamacare legislation and its severe and adverse impact on medical care in America which will lead to irreparable harm to the world’s best healthcare system.
Neil Cavuto interviews Dr. Joseph Scherzer on FoxNews:
Obama is “changing” the Constitution by both by ignoring it and with insidious maneuvering. Activist judicial verdicts further pervert the original intent, reducing citizens’ rights and expanding government power and intrusion. What we need now are explicit Amendments to further delineate and proscribe federal government overreach.
Why should Congress regularly pass legislation that all Americans are mandated to follow but it is exempt from, most notably but not limited to Obamacare? What about the generous perks that they vote for themselves such as regular raises in salary and munificent retirement packages? Wouldn’t it be wonderful if the average American could also say” I deserve a pay increase this year so I am going to give it to myself”- and they then do.
This corruption, greed and lack of accountability must be extinguished. Elections alone are not the answer.
Now may just may be the perfect storm for these monumentally important changes to be made.
Will Gov't Health Takeover Bring Constitutional 'Hope And Change'?
By Larry Elder 03/25/2010
We live in a fundamentally different country from that which existed only days ago. The government now requires every American to buy health insurance. The Constitution has been attacked, interpreted in a way beyond its original intent.
Therefore, we must change it.
Ignoring the will of the majority of Americans, the discouraging experiences of countries with socialized medicine, and the already staggering amount of entitlement debt, President Barack Obama and congressional Democrats "reformed" health care.
Once a nation under a Constitution that restricted government intrusion, we now want government to provide for our "needs" by calling them "rights."
We now ask government to prop up failing businesses, make student loans, guarantee mortgages, build and maintain public housing, financially support state education from preschool though graduate school, fund private research, provide disaster relief and aid, pay "volunteers" and on and on.
Many in our nation happily submit to this bargain. They consider the Big Three entitlements — Social Security, Medicare and Medicaid — "rights," their absence unimaginable in a modern "caring" society. It is out of the question to expect people, families and communities to plan for retirement.
It's beyond reason to expect medical care, like any other commodity, to follow the laws of supply and demand — for prices and choices to allocate resources and competition to drive down prices and improve quality. It's too much to expect the compassion, morality and spirituality of humankind to aid those unable to care for themselves.
We ignore history's examples of how good intentions produce bad results. Almost 50 years ago, another "transformative" president launched a War on Poverty. But for many welfare recipients and their families, poverty became "structural."
People became dependent on government.
After the government finally placed some restrictions on welfare, dependency declined. Much to the surprise of those who denounced welfare reform as cruel, people changed their behavior.
We ignore the experience of price controls. Government can dictate prices, but cannot dictate costs. Price controls result in rationing, drive producers out of business and cause lower quality and less innovation. America, because its citizens enjoyed greater economic freedom, built a superior health care system — which ObamaCare now threatens to dismantle.
Communism collapsed under the romantic but bankrupt notion of "from each according to his abilities, to each according to his needs." Taking from the productive and giving to the unproductive does damage to the incentive of both parties.
European countries — "social justice" democracies — produce comparatively few private-sector jobs. Europe suffers from high taxes, choking union deals that make it virtually impossible to fire workers, and government policies that mandate paid vacations and other job-killing benefits.
Into this statist abyss we willingly jump.
Former Democratic presidential candidate George McGovern left the Senate after 18 years and bought a small business. It went under. He wrote: "(I) wish I had known more firsthand about the concerns and problems of American businesspeople while I was a U.S. senator and later a presidential nominee. ... Legislators and government regulators must more carefully consider the economic and management burdens we have been imposing on U.S. businesses. ... Many businesses ... simply can't pass such costs on to their customers and remain competitive or profitable."
President Obama, like many in Congress, has little experience in or understanding of the private free-market economy.
Obama never started a business, ran one or struggled to meet a payroll. He shows little respect for the hard, long hours people put in to build successful businesses that hire people. He believes unequal outcomes are unjust and government exists to right this wrong by "spreading the wealth."
If this means telling doctors how to practice, so what? If this means people will be less likely to improve themselves through education and training to get "good" jobs with benefits, so what? If this means we make employers less likely to hire for fear of fines should they fail to offer health insurance, so what? And if the "wealthy" invest less and create fewer jobs because of higher taxes and expensive regulations, so what?
Now what? As many as 39 state legislatures have taken or will take action to block the mandate. Thirteen state attorneys general immediately filed suit, arguing, among other things, that ObamaCare's insurance mandate violates the Constitution's commerce clause. Expect more states to sue.
Unfortunately, the Supreme Court broadly interprets the commerce clause — wildly beyond the intent of the Founders — to allow just about anything.
So, the Constitution must be changed. It must be amended to make what was once clear absolutely, positively, unavoidably clear.
Two-thirds of the states can call for a constitutional convention, where an amendment can be proposed to prohibit the forced purchase of health insurance. Three-fourths of the states could then ratify it.
Obama and the Congressional Democrats have corruptly and despicably passed a wealth transferring, fiscally bankrupting socialized medicine bill that legalizes seizure and control of our healthcare and privacy by the Federal Government – all in opposition to the will of the people. Though it is imperative that we continue to fight this abomination through Congress and elections, the best immediate chances that we have of overturning it are through legal challenges.
Kill It In Court
Investors Business Daily 03/22/2010
Constitution: Republicans vow to repeal health care reform. But no social entitlement, once signed into law, has ever been overturned. The way to stop this federal overreach is through the courts.
Fox pundit Bill Kristol predicts that Republicans will repeal the law in 2013. Rep. Jim DeMint and other GOP leaders have already pledged to do so.
But that assumes a lot. Republicans must first regain control of both houses of Congress, which will require sustaining the current level of public outrage for six months after the fact.
That won't be easy. While additional negative details about the 2,074-page bill will come out over the coming months, the worst parts won't go into effect for years. And the White House is already reselling the few positives, such as covering pre-existing conditions, which go into effect right away.
Yes, Republicans won Congress for the first time in 50 years after Clinton tried to socialize medicine. And yes, this bill is arguably worse, with 732 more pages, 109 more bureaucracies and just as many new taxes.
But HillaryCare failed, and was cast as a major Democrat defeat. ObamaCare, on the other hand, will be hailed as a big Democrat win. Even in the off chance that they do take back Congress, Republicans seeking repeal will have to fend off all the lobbyists who will cement around new health care rules, programs and benefits.
Then they'll have to override President Obama's veto.
The nation's best chance to kill this monstrosity before it can ruin the best health care system in the world is to get the courts to declare it unconstitutional.
The "individual mandate" is a violation of the 9th and 14th amendments. The Commerce Clause gives Congress the power to regulate the health care industry on issues of interstate trade. It does not give it the authority to force individuals to buy a service from private industry. This is unheard of. Even in World War II, the feds did not make citizens buy war bonds, for instance.
Already Virginia, Florida and South Carolina are preparing constitutional challenges.
The high court — which thankfully (for now) is led by strict constructionists — will not let stand this violence against the Constitution, which the framers designed to limit federal powers.
If the bench were to uphold mandated universal participation in a federal health system, it would give Congress license to do anything it wants under the Commerce Clause. Nothing would be out of bounds.