Stanley Feld M.D., FACP, MACE
President Obama’s goal is to destroy the healthcare system. His deals and regulations lead the healthcare system on the path of destruction.
The strategy is creating so much pain to all the stakeholders that the healthcare system will implode.
At that time public opinion will demand the government take over the healthcare system.
What makes the government a better manager than the free market? The key is to have a system that aligns all the stakeholders’ incentives.
The government is not doing a good job keeping Medicare and Medicaid solvent and providing access to care. It is providing horrible healthcare services to our veterans in the VA system.
The government has conditioned progressive Democrats to continuously declare; “ I don’t mind paying a little more to make the system better.”
The destruction of the healthcare system is a slow process. The Obama administration is proceeding step by step in a very organized fashion.
When it is replaced by a single party payer system controlled by non-elected bureaucrats, consumers will have no control over their free choices.
Hopefully, the U.S. and its citizens are too diverse and too accustomed to freedom of choice and freedom of expression to let this happen.
Hopefully, consumers realize that central government control and socialized medicine doesn’t work. The concept of central control and socialism has failed too many times to count.
Our founding fathers certainly understood this concept.
Hopefully, consumer will realize that Adam Smith was right. The free market is self-correcting. It is only self-correcting with everyone plays by the rules and the government enforces the rules.
A government run by the political establishment that is controlled by vested interests does not work. It will eventually generate mistrust among all parties.
The mistrust of government is building to a tipping point.
Most of the 242 ACOs out of 3000 potential ACOs have three-year contracts. Many ACOs are not about to reach their Shared Savings goals for the reason I have mentioned.
I don’t know if these ACOs realized in their quest to become more efficient they would eventually lose money. Next year’s sharing goal will be this year’s modified to be the new profit sharing benchmark.
It might be impossible to deliver care more efficiently by the new benchmark.
When the ACO automatically progress to track 2 and fall short of the most recent efficient cost sharing savings benchmark these ACOs will have to repay the government for the losses.
The second important point that is propelling the healthcare system to the tipping point is that the new ACO rules do not take into consideration the healthcare systems that signed up to become ACOs initially.
Any savings the new rules offer in order to attract more healthcare systems to sign up for the ACO program have not been offered to the original signees until 2019. The original 242 have to wait until 2019 to be eligible for the extra bonuses given to new signees.
This might get the original hospital systems to quit their ACO participation completely. If the old ACOs quit the program, it would create more dysfunction in the healthcare system.
It would be just the thing the Obama administration wants to happen. The more dysfunction, the closer America is to a single party payer system.
An equally frustrating example was the money promised to the healthcare insurance industry to guarantee it a profit if it participates in the federal and state health insurance exchange program.
I have described President Obama’s reinsurance program in detail previously.
I was opposed to the reinsurance program. The Obama administration is totally dependent on the healthcare insurance industry to perform healthcare administrative services.
I am not sure either house of congress was aware of or appreciated the implications of the reinsurance program until it because obvious three years after Obamacare was passed.
“The healthcare insurance industry knowing full well that they couldn’t make legitimate profits selling coverage through Obamacare’s exchanges, relied on Democrat guarantees that their losses would be covered by the taxpayers.
But a funny thing happened on the way to easy profits. Congress refused to appropriate the funds.”
When congress realized what was going on it capped the funds appropriated to the reinsurance program. President Obama is still trying to find the fund to pay the healthcare insurance industry.
Now the healthcare insurance companies that have not been paid are starting to sue the Obama administration.
The companies included are Health Republic Insurance Company. It has filed a class action lawsuit against the government for $5 billion, Highmark Health has sued for $223 million, Moda Healthfiled filed a $180 million suit. Blue Cross & Blue Shield of North Carolina has sued for $129 million. Land of Lincoln Health has filed a $70 million suit.
“The defendant in the class action suit, for example, is “The United States of America” and the plaintiffs ask the court to strike down provisions of two congressional budget resolutions that require the risk corridor program to be budget neutral.”
Congress is the only branch of government that has the power of the purse. It is not the administration or the court.
“As U.S. District Judge Rosemary Collyer put it in a ruling against the Obama administration in a similar case involving unauthorized HHS spending, “Congress is the only source for such an appropriation … See U.S. Constitution, Art. I, § 9, cl. 7”
“(‘No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.…’).” And a budget resolution becomes law once it has been signed by the President. That’s why the 2015 spending bill is titled, “Public Law 113–235.” Yet the Health Republic class action suit holds that losses somehow render the law invalid:”
Qualified Health Plans have incurred even greater compensable losses in 2015 that CMS and HHS cannot pay as a result of the 2016 Spending Bill.
“Neither the Obama administration nor the congressional Democrats with whom they made their cynical deal can save them. In the end, the Devil will have his due.”
Another way to look at the entire debacle of Obamacare is this is exactly the way President Obama and his administration wanted it to turn out. It will lead the way to a single party payer system. The single party payer system will be another disaster.
Was Obamacare designed and implemented with such incredible ineptitude that Co-Ops like Health Republic and Lincoln Health were doomed from the onset?
Were Texas and the thirty other states that did not join smart enough to know the Co-Ops and state exchanges were destined to fail and go bankrupt?
Was it done purposefully by the Obama administration in order to create chaos in the healthcare system?
Why would anyone believe that a central government that runs and controls the healthcare system be any different than the VA system and the insolvent Medicare and Medicaid System?
Who is responsible for the debacle? The traditional mainstream media such as the New York Times and the Washington Post will blame it on a Republican congress that is refusing to change the law to pay President Obama’s illegal debts.
Who do you think will pay for the upcoming debacle?
You guessed it.
The taxpayers will pay for President Obama and his administration’s obvious fiscal irresponsibility.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
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