Repairing the Healthcare System

The Devil Is In The Details

Stanley Feld M.D., FACP,MACE

 

The devil is in the details. Many of the Obama administrations sound bites are lies.

The Megyn Kelly interview of Ezekial Emanual on the Kelly File October 25^th 2013 is a must watch video. It is worth 9 minutes of every American’s time.

The Obama administration rolled out one of the chief architects of Obamacare to provide disinformation about the pending success of Obamacare.

 

  

 http://youtu.be/cwfk3vOvzvE

I have written about Ezekial Emanuel’s disinformation campaigns. His misinformation is based on incorrect facts leading to misguided conclusions.

This Megyn Kelly interview is a perfect example of President Obama’s disinformation campaign.

The interview starts with President Obama’s promise that Obamacare will let you save up to $2500 on insurance premiums and be able to keep your doctor and your insurance plan if you like them.  Obamacare will bend the cost curve. It looks like Obamacare is going to bend the cost curve up not down.

Dr. Emanuel says it is not President Obama’s fault that people cannot keep the same doctor or healthcare plan. Corporations and the healthcare insurance industry changed their insurance rules for business reasons. Obamacare did not change the rules.

Obamacare forced the healthcare insurance industry to change its rules.

Is Dr. Emanual in denial or is he lying?   

Dr. Emanuel contradicts himself immediately by saying it is unethical and immoral to sell healthcare insurance plans that do not cover bare minimum care coverage such as maternity care, preventive care (not defined), pregnancy, pediatric dental care and drug coverage.

It should be obvious that everyone does not need maternity care or pediatric dental care.

Ezekial Emanuel then continues with a rant about McDonald’s Minimed insurance coverage plans being immoral and unethical.

This is a point at which reality and being disingenuous gets buried in the weeds.

President Obama has allowed corporations to avoid penalties by using “minimal essential coverage” criteria.  Dr. Emanuel certainly knows about and understands this nuance. The Obama administration has certainly not explained it to the public.

Dr. Emanuel also ignores the fact the President Obama’s gave waivers to 13,000 companies permitting them to continue to provide Minimed coverage until January 2014. It has now been extended until January 2015.

President Obama has modified minimal essential coverage criteria through CMS administrative regulations bypassing congress.

In August 2013 The Kaiser Foundation News published an article called “Why Health Law's 'Essential' Coverage Might Mean 'Bare Bones' “

 “It came as a surprise to some that the Affordable Care Act seems to allow large employers to offer health insurance that pays for preventive care and not much else.” 

“How can Ezekial Emanual brag about a law he praises for expanding coverage -- one that includes an "employer mandate" to offer "minimum essential coverage" -- allow companies to offer insurance that might not even cover hospitalization?

I will spend the rest of this blog explaining this nuance.

Dr. Emanuel misinforms the audience throughout the interview.  

There has been no outright ban on these skinny plans -- even after the employer mandate kicks in in 2015.

Instead, large employers -- those with 50 or more full-time employees -- run the risk of fines (penalty) only if the coverage doesn't conform to ACA (Obamacare) rules.

 “ The regulations published so far, however, seem to allow skinny plans with a penalty that many employers may choose to pay because it is less costly than offering fuller coverage.”

There are two fines in the health law for large employers.   There is a $2,000 per employee fine for any company that does not offer "minimum essential coverage."

Most people do not know that the fine is only triggered when at least one employee enrolls in the health insurance exchange and receives subsidized coverage.

If none of the employees enroll and get subsidized coverage from the government, the corporation is not liable for the $2,000 per employee fine.

What is the definition of “minimum essential coverage”? It is not the same as  "essential health benefits," that include maternity benefits and prescription drugs. Those essential health benefits vs. minimum essential coverage are benefits that must be included in plans sold to individuals or small employers.

Who suffers? The small businessman, and the individual buyer in the health insurance exchange will suffer the most.

Most large corporations are self- insured. A self-insured company provides dollar coverage for their employees’ illness. The company pays the bills minus the deductibles for each employee. The corporation is assuming the risk rather than the healthcare insurance company.

The insurance company does the administrative services just as they do for the federal government for Medicare, Medicaid and government worker insurance (Medicare Part C). 

The self-insured corporation is the sponsor for the health insurance. A self-insured corporation passes one test necessary for “minimum essential coverage.” This avoids the $2,000 per employee penalty (fine).

If the company goes over the amount the company paid the previous year to cover employees’ illnesses, the corporations pays the difference in the following years administrative services fee to the healthcare insurance carrier.  

 The regulations are obscure, defining minimum essential coverage largely in terms of what it is not. Therein lies the loophole.

“As a result, many experts believe large employers can shield themselves from the $2,000 penalty by offering a plan that covers the health law's required preventive care, but still leaves workers vulnerable to thousands in bills if they're hospitalized.”

The young people working for minimum wage at McDonald don’t want to spend their money on full healthcare insurance. They believe they will not get sick. They cannot to buy insurance through the health insurance exchange.

They do not want to go on Medicaid. Many physicians view Medicaid as unacceptable insurance.

Government reimbursement is for Medicaid is extremely low. In some cases it is lower than the physician’s overhead to provide the care.

Many physicians do not take Medicaid patients. This results in long waits for appointments, a lack of access to timely care and in many cases rationing of care.

Medicaid is free to the needy. Nonetheless the government must pay the insurance industry for their administrative services.

According to Alden Bianchi, a Boston-based benefits and compensation lawyer. “

“Skinny coverage flunks the test, based on regulations that measure minimum value against "benchmark plans" in each state.”

The trick is the employer penalty is only $3,000 for each worker enrolling in subsidized exchange coverage. The fine is not imposed on the employer for all workers.  

The fine will be much less than the fine for not offering a minimum essential coverage plan of $2,000 per employee if one employee buys subsidized coverage through the health insurance exchange.

Bianchi, who represents large employers said in an industry brief.

 “The people who wrote the law intended to give companies a bare-bones option.”

"The ability to offer such plans is a result of conscious policy decisions by Congress, as implemented by the regulators."

I think he is wrong.

I think the Cato Institute’s Michael Cannon is right.

Cannon suspects the administration "had no idea what they were doing," as he wrote on the libertarian think tank's blog.

I think President Obama’s goal is to drive everyone into the health insurance exchanges and use the “public option.” 

The health insurance exchanges’ non-subsidized options are in some cases double the previous price for healthcare insurance despite the claims of the Obama administration.

Obamacare is now backfiring on the President and his administration.

I apologize for not exposing the misinformation of each point Ezekial Emanual was sent out by the Obama administration to make on the Kelly File.

It is all disinformation and spin.

I felt it was important to explain the confusion created about the $2,000 and $3,000 dollar penalties attached to the mandates.

The corporate self-insured have figured out a way to get around the mandate and penalty. They also get around the mandate by hiring only part-time new employees who work less than 30 hours per week.

President Obama has bragged that new job creation is slowly improving. However, 77% of the new job creation is for part time employment.

If one puts it all together it spells hard times for economic growth and Obamacare.

I implore you to watch the video and hear disinformation one of President Obama’s architects is peddling.

 The issue is becoming clear. Can the American people trust President Obama to tell them the real story?

My impression is that it is doubtful.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

 

 

 

The Method Of Operation

Stanley Feld M.D.,FACP,MACE

It’s clear. President Obama has used the same techniques to neutralize the scandals and mishaps during his administration.

In has been the same for Benghazi, NSA, IRS, and Fast and Furious scandals.

President Obama makes his characteristic statement, “This is unacceptable and we will get to the bottom of this.”

After this statement there is never any follow-up. What has been done? Has President Obama gotten to the bottom of it?

The public never learns who was responsible for the debacle. No one ever gets fired and the traditional media carries on. The public soon forgets about a non-resolved scandal.   

President Obama always leads the public to believe he had nothing to do with the scandals or the decision-making leading to the scandals.

He is the President. He should know. If congress investigates the scandal it gets stonewalled by the administration. The investigationg committee then is accused of muckraking.

Somehow the traditional media buys this story and sells it to the public. It is the journalist’s obligation to dig into a scandal and find out the real story. It is not done.

Nothing this administration does has been transparent. The traditional media ignores the scandals and so does the public.

The devil is always in the details.  

The real story is the attack on individual freedoms and choices. They are being impinged upon by the bureaucratic regulations of big government. The traditional media should make this clear.

America does have a freedom of information act and constitutional rights that have to be protected and not ignored.

All the participants in the various scandals finger point to others being responsible for the actions that would not be approved by the people.

No one ever questions whether President Obama is responsible for the scandals.  

The same method of operation is being put in place to explain the colossal disaster of www.healthcare.gov’s rollout.

The Obamacare web site has many problems. It is not a simple fix as the President and his administration has declared it to be.

President Obama claims he did not know anything about the problems before the launch. He has promised to get to the bottom of this.

He is finger pointing to everyone except himself and his administration. 

If the Obama administration did not know about the impending failure it is either stupid, or irresponsible or both.

President Obama is not stupid. He is cunning.

These are President Obama’s remarks in the Rose Garden of the White House last week.

 “Shortly before the president’s appearance, White House officials let it be known that the “president will directly address the technical problems with HealthCare.gov – troubles he and his team find unacceptable.” But in that Rose Garden appearance, the president did not explain what the technical problems with HealthCare.gov were, though he did acknowledge their existence and stated “there is no excuse” for them.

He then promised he would recruit the best information technology talent in the country to come to the rescue and fix the problems.

President Obama happened to hire one of Michelle Obama classmates at Princeton in a no-bid contract to build the web site. The administration paid $634 million taxpayer dollars to Michelle Obama’s friend’s company and got a disaster.

"Toni Townes-Whitley, Princeton class of ’85, is senior vice president at CGI Federal, which earned the no-bid contract to build the $678 million Obamacare enrollment website at Healthcare.gov. CGI Federal is the U.S. arm of a Canadian company.

"Townes-Whitley and her Princeton classmate Michelle Obama are both members of the Association of Black Princeton Alumni."

The Obama administration also awarded CGI another no-bid contract for 2 billion dollars to clean up from the Sandy Hurricane.

 Mr. Nelson chair of Housing Trust Fund Corporation presented that the State received a $1.7 billion allocation in CDBG Disaster Recovery aid from HUD to aid impacted businesses and residences.

 The corporation requires immediate access to consultant services to assist in policy and procedure development, training, surge capacity, and call center assistance, and stated that CGI Federal Inc. could provide such services.

The resolution was passed and scheduled to “take effect immediately.”

Nearly a year after the devastating storm, a majority of the 24,000 families that have requested monetary assistance have yet to receive a penny from the federal aid package.”

Does anyone think something funny going on at taxpayers’ expense?

Shouldn’t President Obama have hired the best minds in the country to build the web site to begin with?

Do you remember this famous statement?

 
 

http://nyti.ms/18ThbbJ

Ezra Pound is a big fan of President Obama and Obamacare. What happened? Did he change his mind?

  

http://www.youtube.com/watch?v=AQxYY2dyChY&feature=player_detailpage

 Uwe Reinhardt is an economics professor Princeton. He gave President Obama an F on his mid-term grade on Obamacare.

 “With proper management and more energetic work earlier on, and untainted by the political desiderata reported to have affected the architecture of HealthCare.gov, that Web site’s management team should have been able to achieve the same success. It did not, hence the midterm grade F.”

 

A key discussion being avoided in the mainstream media is whether President knew about the impending disaster. I suspect he did.

It was one of the reasons he gave the group healthcare insurance holders a one-year waiver. Parenthetically, he is not seeking the advice or consent of the congress. This is probably unconstitutional.

The group healthcare insurance market represents the largest percentage of people insured. The individual insurance market represents a relatively small percentage of the total insured population. The number of people affected cannot make a big enough stink to be noticed by the traditional media.

If the group insurance market were included in the rollout, the community uproar would be too great for the Obama administration to ignore or pivot from.

The public is already hearing the pivot from President Obama and Kathleen Sibelius. They claim the past is the past. We must ignore the past and go forward to fix the problem.

It sounds like the same story Hillary Clinton told congress about Benghazi when she scolded a congressman during her Benghazi testimony about Ambassador Stevens death. “He is dead. Let us go on and deal with the problem.”

This method of operation is going to back fire on President Obama for two reasons.

1. Americans are finally recognizing the Obama administration’s methods of operation. It is to deflect with half-truths, deceive and pivot. The public is getting angry.

2. There are an increasing number of people who have lost their job, their healthcare insurance and the doctors. In the last week 650,000 people lost healthcare insurance coverage they liked.

This is because of the exclusive regulatory control the Democrats gave Kathleen Sibelius in passing Obamacare.

Not one single Republican voted for the Affordable Care Act (Obamacare). 

The preparations for the implementation of Obamacare for the group healthcare insurance market through health insurance exchanges and www.healthcare.gov have unleashed gigantic outcries from both the young and the middle-aged middle class.

The outrage is not over yet.

President Obama said he did not anticipate that so many corporations would reduce insuring so many of their workers.

President Obama has discovered an obviously scapegoat.

The “glitch” is not Obamacare fault. It is the big bad corporations that are trying to make a profit.

Wait a minute! Isn’t that the American way? You build a business to try to make a profit within the rules.

The 40,000 new Kathleen Sibelius healthcare regulations are preventing them from making a profit while providing healthcare insurance. They want to provide affordable healthcare coverage.

The only way corporations can make a profit is by dropping healthcare insurance of their employees.

Maybe driving people into the health insurance exchange was President Obama’s goal in the first place. Remember Barney Frank and John Kerry’s dismay about passing a bill without a public option. President Obama response was don’t worry.

Well, we have an expensive public option that doesn’t work. Who is going to pay for it?

 The middle class is going to pay for it with increased healthcare insurance payments and increased taxes. 

 The cost of insurance on the health insurance exchange is high unless one qualifies for a government subsidy. I have previously explained the dynamics involved in the cost of healthcare insurance when a person receives a government subsidy.

Young healthy people will not buy insurance. With the present computer programs the government will not know who qualifies for a subsidy or be able to identify people will should be penalized.

A key to a business’ survival is to adjust to adverse circumstance as long as the business has the freedom to adjust.

Watch out for the freedom to adjust to anything.

Watch out seniors. Medicare is next.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

Additional Defects In Obamacare

Stanley Feld M.D.,FACP,MACE

I have been saying Obamacare is going to fail long before the bill was passed into law. Obamacare will fail because of multiple system design defects.

I would hate to believe these defects were built into the system purposefully.

It was done to prove that free market forces do not work. The Obama administration created a “not so free market”. These not so free markets have been proven to fail over and over again.

It seems logical that given the $1 trillion dollar a year deficits of the Obama administration, someone, somewhere would be interested in decreasing the deficit spending.

None of the increased government spending has improved the economy, decreased unemployment or decreased uncertainty.

The computer system defects in the health insurance exchanges are much deeper than the sound bite treatment they getting from the Obama administration.

The task of integrating 40-50 year old legacy computer systems is an extremely difficult task using 50-year-old software.

Information technology experts have told me that the health insurance exchange computer sign up system (healthcare.org) is months to years away from getting the health insurance exchange information system fixed.

It should be destroyed after spending $634 million dollars and redone using modern technology.               

The verification of people who qualify for government subsidies is being dropped. The patient’s word about need is being accepted in lieu of verification.

This is a tremendous glitch in the system, opening the system to tremendous fraud and abuse. It is not a way to run a business.

John McAfee former CEO and founder of McAfee antivirus said the health insurance exchange web site is a hacker's wet dream. The You Tube explains why he came to this conclusion.

 

 

http://youtu.be/5TCtLtzSe6I

Poor patients who might qualify for the Obamacare tax credits do not pay income tax. Therefore they have no income to apply a tax credit against.

The administration has dropped word tax credit. It is now called a subsidy. The law’s tax credit will be given to the healthcare insurance company selling the insurance.

This is a “glitch.” The law was written to pay the states for those who qualify for a tax credit. A Washington D.C. ruled that the case by states against Obamacare has merit.

The states contend that persons’ insured through the federal government exchanges do not qualify for federal tax credits. Only states can receive and distribute the tax credits.

The law was reinterpreted by the Obama administration without the consent of congress.

Another “glitch” is that the healthcare insurance industry is given limitless power to collect money from the Treasury. The mechanics are not transparent.

 “The Affordable Care Act may give health insurance companies a virtually limitless power to tap the U.S. Treasury, thereby lifting insurers' profits to undreamt-of heights. This power derives from the mathematical formula for calculating individual subsidies.”

The mathematical formula for calculating the subsidies will cause America’s deficit to skyrocket further each year.

President Obama told America that Obamacare would bend the cost curve downward and provide an efficient cost effective healthcare system for all.

Let us look at the payment formula. A family of four earning $30,000 year will not pay more than 2% a year for healthcare insurance ($600/year). This makes the Accountable Care Act (Obamacare) affordable for the poor (maybe).  

If the premium of the healthcare insurance policy obtained by this poor family costs $10,000 a year through the health insurance exchange the federal government will pay the remaining $9,400 in the form of a tax credit to the insurance company.

Originally, it sounded like the family would get a tax credit after the family paid $10,000. A family making up to $40,000 a year does not pay any taxes and therefore a tax credit is worthless.

The wording was changed from a tax credit to a subsidy.  The tax credit now goes to the healthcare insurance company providing the insurance policy.

The tricky thing about all this is the insurance industry’s tax credits  reduce the governments tax receipts and increases the insurance companies net profit.

The net effect is an increase in tax-free income from the federal treasury.

The government collects less income tax from the insurance company.

 The Obama administration has given the healthcare insurance industry a huge tax break. The tax break will increase the industry’s bottom line profits.

Obamacare has permitted the insurance company to have a Medical/Loss ratio of 80/20. The Medical/Loss ratio means that the healthcare industry must spend at least 80% of the insurance premiums collected on direct medical care.

If it only spends 75% on direct medical care, the healthcare company must give provide a 5% rebate.  

Here in lies the rub. The Obama administration has let the healthcare insurance industry define direct medical care.

These are some of the services the Obama administration has permitted the healthcare insurance industry to categorize as direct medical care.

 

1. The cost of verifying the credentials of doctors in its networks.
2. The cost of ferreting out fraud such as catching physicians over testing patients or doing unnecessary operations.
3.  The cost of programs such as help desks that keep people who have diabetes out of emergency rooms.
4.  Some insurers have insisted that typical business expenses are included — such as sales commissions for insurance agents and taxes paid on healthcare insurance companies investments

Each one of these "direct medical care expenses" has an added on profit included in the direct medical care expense category.

This is the way the healthcare insurance industry takes 40-60% of each premium off the top and leaves only 40-60% of healthcare dollars for direct medical care.

Next year the healthcare insurance company will be permitted to raise the healthcare insurance premium of a poor family to $12,000. Its excuse will be that it is losing money.

If the premium is not raised the healthcare insurer will quit providing the insurance. The government is totally dependent on the insurer whether the insurer provides insurance as it does in the health insurance exchanges or for administrative services as it does for Medicare (a single party payer).  

The poor family still makes $30,000 dollars a year and still pays $600 dollar a year for the now $12,000 dollar premium.

The insurance company now keeps $2,400 vs. $2,000 for overhead and profit plus all the profit they can get from the direct care dollars that should really be overhead.

The federal government gives the healthcare insurer a tax credit of $11,400 vs. $9,400.

 The poor insurance enrollee doesn't pay a penny more for his healthcare insurance.

The only loser is the American taxpayer who will pay the subsidy in the form of increased taxes.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

Obamacare Drives Premiums Up In 45 Of 50 States

Stanley Feld M.D.,FACP, MACE

President Obama promised during his campaign for passage of the Affordable Care Act that the Act would cause premiums "for the typical family" to fall by $2500.

He also said it would bend the healthcare cost curve and if you like your doctor you can keep him or her. We all remember these sound bites. The sound bites are all turning out to be false.

Many intelligent people who believe in Obamacare refuse to consider these facts. I can understand the denial.

They will pay attention as soon as it effects them.   

The added required benefits mandated in insurance coverage in the law and the way the healthcare insurance industry is permitted to calculate its Medical Loss Ratio makes President Obama’s calculation impossible.

President Obama has been telling the American public a lie all the while. People are starting to understand.  

The average one month premium change from buying insurance in the non-group market in 2013 versus the Obamacare exchanges in 2014 is not revealed in any government statistics. Two studies were completed by private sources.

 Premium comparisons between 2013 and 2014 are not available from Health and Human Services (HHS).

The 2013 premiums increased by double digits from the 2012 premiums because of Obamacare. The traditional media has not pressed the government to provide these comparisons.

The media continues to quote the administration press releases of lower premium prices.  The Obama administration uses CBO estimates of premium prices calculated in 2010 for 2016 by data provided by the Obama administration. The tradition media refuses to report reality.

A 50-state study has found that insurance premiums will increase the first year of Obamacare in 45 of 50 states.

Premiums paid outside the health insurance exchange will increase the same percentage or more.

No one can say the American public has not been warned.  

There is going to be tremendous public outcry in the individual market for insurance when the cost to individuals and the American taxpayers is realized.

October 1,2013 is open enrollment season for the individual and group insurance market.

President Obama has exempted the group market from Obamacare until 2015.

One of the reasons for the exemption for the group market is to try to mute the outcry by splitting the non group insurance from the group insurance holders.

Some of the premium increases have already been report in the traditional media.

 "Individuals in most states will end up spending more on the exchanges," policy analyst Drew Gonshorowski writes”

The Department of Health and Human Services published a similar report. The government’s report is incomprehensible to me.

It does not compare pre Obamacare premiums of 2013 to Obamacare Health Insurance Exchange premiums of 2014.

There are literally no comparisons to current rates. That is, [the Department of Health and Human Services] has chosen to dodge the question of whose rates are going up, and how much. Instead they try to distract with a comparison to a hypothetical number that has nothing to do with the actual experience of real people.

—Douglas Holtz-Eakin
President, American Action Forum[1]

 

The Department of Health and Human Services has declared a 16% decrease in premium costs compared to the CBO’s 2010 estimate of premiums for 2016.

It is important to remember the CBO’s calculation was with faulty data provided by the administration.

“Based on a Manhattan Institute analysis of the HHS numbers, Obamacare will increase underlying insurance rates for younger men by an average of 97 to 99 percent, and for younger women by an average of 55 to 62 percent. Worst off is North Carolina, which will see individual-market rates triple for women, and quadruple for men.”

  

http://youtu.be/JwPr59nA1fM

The Obama administration’s methods of deception are cunning, powerful and effective.

He always blames others and hides his ideology.

President Obama continues to try to fool a majority of the people most of the time.

Americans will get the point where the rubber meets the road. The public is going to have to reach into their pockets and pay these enormous increases in premiums or not buy healthcare insurance coverage.

Taxpaying Americans are also going to experience massive increases in taxes above and beyond those already experienced.

I predict the public outcry will drown out the spin of the Obama administration. The traditional media will not be able to ignore this public outcry.

People will finally realize the enormous government grab of power and control of Obamacare at taxpayers’ expense.

People can’t complete applications or secure premium prices on the health insurance exchanges because of technical problems resulting from ancient information technology used by the government to construct the exchanges.

All of the consumers’ demographics must be filled out before the government provides a premium price. There is at tricky reason for this.

This computer “glitch” solidifies my view that President Obama wants Obamacare to fail in order to replace it with a single party payer system that America cannot afford.

This last statement is counterintuitive but I believe true.

Is it wise for consumers to hand over all their medical decision making to a government that has this much difficulty with executing a computer program and providing healthcare insurance premiums?

Americans must wake up soon. They have to insist on a consumer driven healthcare system in which they have control over their healthcare and their healthcare dollars.

Americans have to insist on having an Ideal Medical Saving Account healthcare system. 

I have described the Ideal Medical Saving Account System in great detail.

 

  The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

Pure Genius Or Pure Stupidity?

Stanley Feld M.D.,FACP,MACE

President Obama’s actions as leader of this country have been either pure genius or purely stupid.

I think it is pure genius. He promised Americans he was going to fundamentally change America. He has!

Americans have been under stress during the last few weeks. First it was the government shutdown. Now it is the nation going into default. It is common knowledge the shutdown and default is political theater.

President Obama has run circles around Republican in the game of political theater.

The traditional media has ignored the underlying causes of America’s problems.

We are increasing debt to the point of unaffordability. The only way out is to increase taxes further or decrease government spending while lowering taxes.

Increased deficits are not good. Deficit increases devalues our currency. America’s currency has already been devalued by the Federal Reserve increase in printing money.

Increasing taxes leads to decreased jobs creation. Decreased employment leads to decreased discretionary spending. The result is decreased economic growth.

Rather than trying to decrease spending rationally by increasing government efficiency, President Obama has closed down silly things to make it most painful and noticeable to the public. These noticeable services have little overhead. These closures are not an example of reducing inefficient spending.

In the meanwhile his administration has spent over $600 million dollars for a health insurance exchange software program. The program is poorly designed and does not have an integrated back end.

Even if the software was great, the cost of healthcare insurance through the exchanges is increased and out of reach of the individual buyers.

 The cost of insurance is cheap for the poor who qualify for government subsidies. The poor will receive a tax credit which will be credited to the insurance company whose policy the poor person buys.

The math is grotesque. If a healthcare policy costs $10,000 and a patient makes $30,000 dollars a year, he pays only 2% of his net income for the policy or $600 per year. The taxpayer pays $9,400 a year for that policy.

This is an example of hidden “redistribution of wealth” and another entitlement.

The Obama administration has waived the verification requirement for receiving a health insurance exchange subsidy. Verification of need does not have to be fulfilled by the health insurance exchanges. Anyone can lie and receive a subsidy to purchase healthcare insurance threw an exchange.

Another big mistake was the design of the roll out to promote electronic medical records. After 4 years only 11% of these records are functional. Physicians have spent money for EMRs they could not afford. Hospital systems spent money they could not afford. The government wasted $30 -60 million dollars of taxpayers money in the unsuccessful effort to implement EMRs.

America is a long way away from being computerized with a functional EMR.

Accountable care organizations (ACO) are another important cog in Obamacare’s success or failure. The administration brags about the fact that 250 ACOs are in development.

There are over 5,000 ACOs that need to be developed. A premier organization such as the Cleveland Clinic had to drop out of the program because of the cost to the institution. The Mayo Clinic refused to participate.

At the same time ACO’s are turning out not to be cheaper or have better outcomes than traditional medical care.

ACOs were supposed to improve quality. ACOs were supposed to be a free market solution to the dysfunctional healthcare system.

The administration has been bragging about the greatness of the VA system. The bragging stopped when the system’s poor quality of care was exposed. Veterans are receiving poor treatment.

Everyone would certainly have to admit Obamacare has been disruptive to the delivery of healthcare in America.

The months of healthcare insurance open enrollment for people is starting. People are starting to see massive increases in their healthcare premiums. In order to avoid these premium increases and the Obamacare penalties, large organization such as Home Depot are hiring only part time workers.

The Obama administration has developed a low cost insurance plan for the McDonalds of the world. These health insurance policies cost little a cover less.

President Obama has also provided waivers for congress and its employees. He is at present trying to sneak in waivers from Obamacare to unions.

“First, there was the delay of Obamacare’s Medicare cuts until after the election. Then there was the delay of the law’s employer mandate. Then there was the announcement, buried in the Federal Register, that the administration would delay enforcement of a number of key eligibility requirements for the law’s health insurance subsidies, relying on the “honor system” instead. Now comes word that another costly provision of the health law—its caps on out-of-pocket insurance costs—will be delayed for one more year.”

 The Obama administration has issued a blizzard of mandates and regulations. These regulations have increased the cost of health insurance.

The caps on out-of-pocket insurance costs, such as co-pays and deductibles have not been publicized. On January 1, 2014, deductibles were supposed to be limited to $2,000 per year for individual plans, and $4,000 per year for family plans.

In February 2014, the Department of Labor published a little-noticed rule delaying the cap until 2015. The costs of these deductible limits were already built into the 2014 healthcare insurance premiums and were not removed.

The government did nothing to reduce the increased healthcare premiums after the limits did not apply.

 “Federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs. In many cases, the companies have separate computer systems that cannot communicate with one another.”

“We had to balance the interests of consumers with the concerns of health plan sponsors and carriers.”

How is it in the consumers’ interests to pay far more for health insurance than they do already?

I have a theory.

President Obama’s ultimate goal is to have a complete government takeover of the healthcare system. A takeover the government cannot afford.

He figures by creating as much chaos as possible now in the “not so free market healthcare system”, he can declare the free market healthcare system has failed.   

There will be a resulting public outcry for the government to help and take over the system.

The takeover will be with a single party payer system.

What are the chances a government takeover will result in an efficient, cost effective system that will provide access to care without rationing of care while being affordable?

With all the delays, exemptions and regulations, it looks as if Obamacare is destined to fail. Obamacare is going to be impossible to execute effectively.

Obamacare’s ultimate failure is playing right into President Obama’s     ideological goal of a single party payer system.

President Obama is not stupid. He is a genius.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

 

A Disaster, Not A Glitch

 

Stanley Feld M.D.,FACP,MACE

 

There is an important lesson in the recent Healthcare Insurance Exchange computer program “glitches”.

Once more the Obama administration only presents a fragment of the truth. Unfortunately, the traditional media accepts President Obama’s explanation and that is the news.

 

http://youtu.be/OCZLy_-IJ_s

The online health insurance exchange program should be very easy to execute. All of the major healthcare insurance companies have an online presence. People can go online, put in simple demographics, and in a matter of seconds they can have at least 100 healthcare insurance products to choose from. 

The Obama administration told the media that the software developed for the web site, by CGI a Canadian company with offices in Washington D.C., had an estimated cost of $93 million.

USAspending.gov said it cost the government $634 million dollars. The site calculated the cost from grants paid to CGI. This is seven times the estimate published by the administration.

“Not only was the site still experiencing substantial problems a week after launching, but the White House had reportedly been aware for months that the HealthCare.gov website had flaws and might not be ready to launch. Yet officials insisted on the Oct. 1 roll out anyway.”

The problems experienced by people trying to use the user interface was something that was tested least or not done right -- or both.'

- James Turner, a member of the technical staff at software firm Beeonics, Inc.

The healthcare industry, participating in the new exchange, complained “loudly” that the site had experienced problems before the launch.  

Speaker of the House John Boehner asked, "How can we tax people for not buying a product from a website that doesn't work?"

The front end user experience is only a fraction of the problem with the federal health insurance exchange site. A front end user’s experience typically means there is something wrong with the basic construction of the software.

The monumental issue of the site involves interfacing seamlessly the multiple government agencies (IRS, HSS, CMS, Welfare, Food Stamps and others) and private insurers legacy’ computer networks. Each agency and organization has a myriad of computer networks that must interface with the health insurance exchange web site.

It is reality easy to have a pretty front end interface with the user. If the software program is poor the interface is a disaster.

These computer networks must be integrated into what appears to be a fancy front end. It looks as if this software is incapable of this very complex integration.

It is one of the reasons that verifying patient for subsides has been dropped and the government is going to take the patient’s word.

These problems were published in blogs for months. The software  failed initial testing.

The Obama administration did not delay the launch despite these warnings.

Now President Obama has told us that this is a small “glitch.” He compare it a glitch Apple had with its launch and it did not put them out of business.

"Take away the volume and it works," President Barack Obama's chief technology adviser, Todd Park, told USA Today. 

Either President Obama does not know what is going on or he is not telling the truth to the American people.

The administration has blamed the glitch on the high volume of people trying to access the site. This is partially true.  

The prediction by experts is it will likely take months to get it running properly. The rollout was disastrous.  There were 8.6 million unique visitors in the first 3 days hoping to apply and enroll in a healthcare insurance plan.  Instead they experienced an online nightmare, with websites crashing, refusing to load, and failing to offer comprehensive choices.

 The demographics of the 8.6 million are unknown. They may all have been high risk uninsured people.

“The Daily Mail is reporting that sources within HHS are saying only 51,000 people signed up for insurance via the government run website Healthcare.gov in the first 12 days, 

Two HHS career civil servants told the Daily Mail that only 6200 people signed up on the first day. “

White House and administration officials continue to insist they have no idea how many people have signed up but will release the numbers monthly after November 1.

Is the administration trying to hide something?

“If the state-run exchanges were to have a similar response rate for six months, the national enrollment total would be approximately 2 million in six months."

That number is less than 29 per cent of the 7 million the Obama administration would need, according to the nonpartisan Congressional Budget Office, in order to balance the new health insurance system's books and keep it from financial collapse.”

The White House’s published goal is to enroll at least 2.7 million young, healthy people between the ages of 18 and 35 in 6 months.

The monthly premiums of healthy, low risk people are needed to offset the cost of health care for older, sicker Americans who will certainly try enroll.

The CGI website states;

“Exchanges must provide many different functions, the soundest approaches bring together expertise and best practices in federal and state health programs, commercial insurance, data exchange, portals, e-commerce over the cloud, and financial management.”

“ CGI brings all of this expertise to the table, along with direct experience in developing sustainable HIX programs. We also have a dedicated group of subject matter experts tracking best practices for state HIX and integrated eligibility systems across the United States.”

CGI knows what to say. It has not shown that they know what to do.

The Obama administration may have wasted $634 million taxpayer dollars on software that does not work.

This is more than a glitch. This is a disaster.

Just wait and see the prices for a Bronze level healthcare insurance plan once people can negotiate the site.

No one is going to be able to afford the insurance in the Affordable Care Act (Obamacare).

Another disaster will be coming your way complements of Obamacare.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

 

 

 

 

 

 

 

 

 

Don’t Confuse Me With Facts

Stanley Feld M.D.,FACP,MACE

Sometimes, in order to believe a certain ideology, some smart people take the position of not wanting to be to be confused by facts.  

Countries with socialized medicine have said their citizens are happy with their care. Therefore, this is the evidence that the U.S. should have a socialized medicine system.

Less than 20% of a nation’s population experiences the healthcare system at a moment in time. The 80% who are not sick are happy because they feel secure. If they got sick they believe they would receive free medical care. The result is the majority of the population under a socialized medical system likes the system.

This Is A FACT (TIAF)

Dr. Donald Berwick former acting head of CMS and author of Obamacare wrote, in a personal letter to “Senior Government Officials and Senior Executives of the National Health Service in England after doing a review of the NHS.”

“You are stewards of a globally important treasure: the NHS. In its form and mission, guided by the unwavering charter of universal care, accessible to all, and free at the point of service, the NHS is a unique example for all to learn from and emulate.”

Dr. Donald Berwick added, “redistribution of wealth is the very essence of a compassionate healthcare system for all.”

I disagreed with Dr. Berwick in an earlier blog. I said citizens responsible for their own health, healthcare and healthcare dollars are essential ingredients for a cost efficient healthcare system.

Patients are the primary stakeholders. Patients must be actively responsible for their health. They must have a moral and intellectual responsibility for their own health as well as a financial incentive to be responsible for themselves.

They must have own their healthcare dollars, have the freedom to make their own healthcare choices and have access to care.

The government must create educational vehicles to help patients make the correct choices.

 The government must provide financial incentives for people to make those choices.

Medical care and medical decisions made for patients by a bureaucracy has historically failed to control costs or provide efficient and compassionate medical care.

Socialized medicine run by bureaucrats has failed in England. Medical care consumes more than 50% of England’s GDP.

This Is A Fact (TIAF)

Medicare is wonderful for people over 65 years old. Seniors could not buy healthcare insurance from a healthcare insurance company. The healthcare industry had not figured out how to make money from these people so they disqualified them.

If the government got rid of the $250 billion dollars in administrative waste and inefficiencies each year, Medicare and Medicaid would become sustainable.

This Is A Fact (TIAF)

Medicare and Medicaid provide no incentives for patients to take care of their health.

Chronic diseases are ineffectively managed. The complications of chronic diseases consume 80% of Medicare’s healthcare dollars. If chronic diseases were managed properly the complication rate from chronic diseases could be decreased by at least 50%.

This Is A Fact (TIAF)

Many patients do not have the incentive to take care of themselves. They leave it up to the system to take care of them.

Unfortunately, it has be demonstrated that a government controlled system creates ever increasing bureaucracies and cost inflation.

This Is Fact. (TIAF)

Most all of the nation’s attempts to control healthcare costs in the past 50 years have failed. (Price control of the 70’s, HMO’s, Managed Care, PPOs.)

These systems had to be abandoned. Nevertheless, healthcare policy wonks continue to give the same advice and make the same mistakes. The policy wonks’ advice is to institute greater government controls over medical care.  

This Is A Fact (TIAF)

 A recent report about England’s hospital conditions in Mid Staffordshire has emphasized the defects in England’s 60 year socialized medicine experiment.

The report only covers hospital inpatient defects. It does not cover the many defects in outpatient services. 

 The report is “Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry

5 February 2013 to the Secretary of State.”

The report stated that;

1. For many patients the most basic elements of care were neglected.

2. Calls for help to use the bathroom were ignored and patients were left lying in soiled sheeting and sitting on commodes for hours.

3. Patients felt afraid and disenfranchised.

4. Patients were left unwashed, at times for up to a month.

5. Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding.

6. Staff failed to make basic observations and pain relief was provided late or in some cases not at all.

7. Patients were too often discharged before it was appropriate, only to have to be re-admitted shortly afterwards.

8. The standards of hygiene were at times awful, with families forced to remove used bandages and dressings from public areas and clean toilets themselves for fear of spreading infections.

9. These healthcare conditions caused the deaths of an unknown number of patients.  

Robert Francis QC Inquiry Chairman who wrote the report covered a wide range of system failures. I will only highlight the key failures contained in the 500-page report. This report was mandated by the House of Commons.

These defect are occurring throughout the entire NHS system. The NHS is not as glorious as the Obama administration or Dr. Berwick’s has idealization the NHS to be.

"The story the report tells is first and foremost of appalling suffering of many patients. This was primarily caused by a serious failure on the part of a provider Trust Board. (Bureaucracy)"

 "The trust board did not listen sufficiently to its patients and staff or ensure the correction of deficiencies brought to the Trust’s attention."

The NHS bureaucracy did not put patients first. It put the various levels of bureaucracy in charge. Bureaucracies deaden incentives and lose focus on who is the main stakeholder in the healthcare system.

"The trust failed to tackle an insidious negative culture involving a tolerance of poor standards and a disengagement from managerial and leadership responsibilities".

"This failure was in part the consequence of allowing a focus on reaching national access targets; achieving financial balance and seeking foundation trust status to be at the cost of delivering acceptable standards of care."

Appropriate statistical reports and collection of reports are more important that appropriate patient care.

Robert Francis goes on to outline how the bureaucracy puts measurements first, not patients.

None of the bureaucrats want to take responsibility for what is going wrong. Finger pointing and blame shifting is an occupation in the British healthcare system.

"The NHS system includes many checks and balances. These checks and balances should have prevented serious systemic failure of this sort."

"There were and are a plethora of agencies, scrutiny groups, commissioners, regulators and professional bodies, all of whom might have been expected by patients and the public to detect and do something effective to remedy non-compliance with acceptable standards of care.

For years that did not occur."

Watch out America!

We are falling into the same trap with Obamacare. It might sound good to some. It will not work judging by the experience of others.

Unfortunately, the Obamacare’s model is the British healthcare system. I do not think the traditional media should praise it. The traditional media should publish the facts of history.

The traditional media should call for the repeal of Obamacare.

 

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

 

 

Speaking Of Chaos And Uncertainty

Stanley Feld M.D., FACP, MACE

I ended my last blog with,

“President Obama’s goal is to create more chaos and dysfunction in the healthcare system. “

“Only then can the government really step in and say let me help you.”

It is the only reason President Obama told the then Senator Kerry and Congressman Frank not to worry if the final bill does not have a public option.

Kerry and Frank said Obamacare would not work without a public option. The only thing that would work is a single party payer system.

  

 

 

With limited benefit plan, employers would avoid the broader $2,000 per-worker penalty.

It is not clear is whether employers could face a $3,000 penalty per individual for any employee who opts out of the limited benefit plan.

Four problems are being discovered with the health insurance exchanges.

1. If the employee is a low wage employee that refused employer provided insurance he is not eligible for a government subsidy.

2. If the federal government runs the health insurance exchange, the federal government by law is not permitted to provide a subsidy. Only state run healthcare insurance plans can provide subsidies.

Over 50% of the states have refused to run health insurance plans. Therefore people who need subsidies are not eligible in over 50% of the states.

3. The law calls for tax credits and not subsidies. All of a sudden the words “tax credits” have been dropped in discussion. Only taxpayers who earn over $38,000 per year pay taxes. The only way a person can utilize a tax credit is by deducting the tax credit from taxable income.

The government has gotten around this problem by giving the healthcare insurance companies a tax credit in advance and calling it a subsidy for qualified persons.

Those workers who opt out of the employer provider plan for a health insurance exchange plan would not be eligible for a government subsidy. 

A full-time worker earning $9 an hour would have to pay as much as $70 a month for a mid level exchange plan from a health insurance exchange, even with the subsidies, according to the Kaiser Foundation.

At $12 an hour, the workers' share of the premium would rise to as much as $140 a month.

 A $12 an hour worker cannot afford to pay $1680 a year for healthcare insurance.

Mid level coverage is limited coverage. A patient might need a higher-level plan that costs $200 a month or $2400 per year. This plan is out of reach for most patients making $40,000/year.

 "There are going to be many people who will be ill and need a more robust plan,” a health benefit advisor proclaimed.

Currently, only one-quarter of workers eligible for the mini-med plan take it. Ms. Newman said, "We really feel like the people who are not taking it now will not take it then."

There is a huge glitch in the health insurance exchanges’ individual healthcare market. This glitch will make the health insurance exchanges more costly and less attractive to all stakeholders. It will decrease the number of people insured and increase the federal deficit.

The majority of the individual market is comprised of low wage earners with irregular work histories.

These people may be self-employed or seasonal workers with surges of income. They could be part-time workers with several part time jobs. 

Obamacare does not permit cancellation of the health insurance exchange policy because it will mean that people will be in violation of the federal mandate if they do not have insurance. 

The Obamacare bureaucrats realize that people receiving subsidies might have a hard time paying the premiums even if they receive a subsidy.

These people live from month to month. Some have surges in income. Some collect commissions one month and nothing the next month. Most have old cars. They might suddenly need new brakes or new tires. Some might get the flu and have to stay home without pay for a week. There are many reasons low wage earners suddenly have a hard time paying healthcare premiums even if they are subsidized.

Many do not have bank accounts or credit cards. There is no such thing as auto pay in their world.

The Obamacare bureaucrats writing the health insurance exchange regulations are people with nice bureaucratic jobs with steady paychecks. They have no idea how difficult it is to make ends meet for these people each month.

The healthcare insurance industry does not care about these problems. It may provide for a grace period of a week or two. If a healthcare policyholder fails to pay their healthcare policy premium the policy is cancelled in the real world.

In the bureaucratic world of Obamacare the healthcare insurer cannot cancel the insurance in the usual way.

HHS has created through multiple regulations a whole new and very restrictive method of discontinuing healthcare policies that must be followed to a “T” by the healthcare insurance industry.

This method will lead to even more dysfunction in the healthcare system.

HSS has instituted a 90-day grace period for paying premiums only for those receiving federal subsidies from the health insurance exchanges.  

At the end of the 90-day grace period the policyholders must pay the entire three months due. If they could not pay the premium monthly how are they going to pay the three month fee?

Aetna was not so dumb in dropping out of the health insurance exchange system after all.

During the three-month grace period if a policyholder get sick and needs care they will be entitled to care.

Who will bear the financial responsibility for the care? Not the patient.

HHS has decided to split the financial responsibility between the insurance companies and the providers. The insurance company will cover the first month and the hospitals and physicians will cover the next two months.

After three months the insurance company can cancel the insurance.  However people can re-enroll again during the next signup period without penalty.

If one is clever enough a patient can receive 12 months of care and coverage for nine months of premiums without penalty.  

“Along with paying for services during the first month of the delinquency, the insurer must:

1) notify HHS of the non-payment;

2) notify providers of the possibility of denied claims during the second and third months;

3) notify the insured that he/she is delinquent;

4) continue to collect the advanced tax credit on behalf of the policyholder;

5) return the tax credit for the second and third month to the Treasury;

6) issue a termination notice to the insured at the end of the grace period.”

This procedure is a very large administrative burden and potential financial loss because of the federal government's decreases in funding. Most providers and insurance companies will quit participating in the health insurance exchange program.

Rather than increasing affordability and access to care it will decrease access to care and affordability of care. It will create a more dysfunctional healthcare system.

 The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe

 

 

 

Is There A Solution?

Stanley Feld M.D.,FACP MACE

 

A study of the organization chart presented in my last blog shows that Obamacare will be an unworkable mess. 

The health insurance exchanges look like they are going to make healthcare more expensive because of 20,000 new regulations.  Employers are looking for ways to avoid Obamacare and get out of the healthcare coverage business.

Employers are realizing they can avoid certain penalties under Obamacare by offering very limited plans that lack key benefits which satisfy the true definition of healthcare insurance. 

Benefits advisers and insurance brokers are increasing their commissions by offering low benefit plans that cover minimum benefits such as preventive services. The healthcare plans provide just enough minimum benefit requirements to avoid Obamacare’s penalty. If an employee wants real coverage he is on his own.

Obamacare’s promise was that healthcare insurance coverage would broadly enrich at lower affordable costs.   

“Federal officials say these limited benefits plans, in concept, would appear to qualify as acceptable minimum coverage under the law, and let most employers avoid an across-the-workforce $2,000-per-worker penalty for firms that offer nothing.

 It is unclear how many employers will adopt the strategy this year. There are dozens of brokers and benefit administrators discussing this strategy with their clients. I bet many will adopt this strategy.

"There had to be a way out" of the penalty for employers with low-wage workers, said Todd Dorton, a consultant and broker for Gallagher Benefit Services Inc., a unit of Arthur J. Gallagher AJG -0.44% & Co., who has enrolled several employers in the limited plans.”

Obamacare requires employers with 50 or more workers to offer coverage to their workers or pay a 2,000 per worker penalty.

The employers and benefits experts initially thought the rules required robust insurance with a long list of  "essential" benefits.

Federal officials confirm the mandates affect only plans “sponsored by insurers” that are sold to small businesses and individuals.

Healthcare insurance “sponsored by insurers” that are sold to small businesses and individuals affect only about 30 million of the more than 160 million people with private insurance.

Employers provide these “insurer sponsored plans” to 19 million out of the 30 million people. These plans are going to disappear.

 Some benefits advisers feel they face regulatory uncertainty. New regulation can cancel older regulations. These advisors say they would adjust to new regulations as regulators clarify the law.

According to Obamacare, regulations written by the multiple new agencies, larger employers with more than 50 workers only have to provide preventive services, without a lifetime or annual dollar-value limit, in order to avoid the across-the-workforce penalty.

Such policies would generally cost far less to provide to employees than paying the penalty or providing more comprehensive benefits.  

Most low-benefit plans would cost employers between $40 and $100 monthly per employee, according to benefit firms' estimates.

These plans essentially provide no insurance for healthcare problems if someone needs insurance. The financial burden falls directly on the consumer.

Obama administration officials confirmed in interviews that the low benefit plans would be sufficient to avoid the across-the-workforce penalty.

Several Obama administration officials expressed surprise that employers would consider the low benefit approach.

"We wouldn't have anticipated that there'd be demand for these types of band-aid plans in 2014," said Robert Kocher, a former White House health adviser who helped shepherd the law. "Our expectation was that employers would offer high quality insurance."

 Another trick benefit managers are offering small employers in order for them to avoid higher costs of premiums due to compliance with some of the provisions in Obamacare is early yearly renewal of preexisting healthcare coverage. UnitedHealth, Aetna and Humana are offering small companies this option. The savings is significant.

Self-insured companies face fewer changes under Obamacare. Many small companies are now switching to self-insurance. Large corporations have been self-insured for years.

I have previously discussed the large trend to hire only part time employees to avoid the penalty as well as the requirement to provide insurance.

Many employers are trying to get out of providing healthcare insurance to employees. Employers fear they will be penalized by the Obama administration at a later time. The administration is constantly changing regulations. This has lead to tremendous uncertainty.

Some Obama administration regulators worry that some of these strategies will be widely adopted. If this happens it could decrease the effectiveness of Obamacare’s online health-insurance exchanges.

Only older and sicker workers, who need real healthcare insurance coverage will opt out of low benefit employer coverage and join the health insurance exchanges.

The premium cost for good coverage in Obamacare’s health insurance exchanges is high already. The adverse selection will drive these costs even higher.

The whole idea behind Obamacare’s health insurance exchanges is to force healthy people to pay for the resources used by sick people. (“Redistribution of wealth”)

The Obama administration refuses to believe options to avoid Obamacare will be a widespread trend.

How come? Didn’t congress exempt itself from Obamacare?

"Any activities that take place on the margins by a small number of employers would not have a significant impact on the small group or the individual market," said Mike Hash, director of the department's Office of Health Reform.”

These new plans are a substitute for the Obamacare exempt Minimed plans. Companies that provided Minimed plans received over 13,000 waivers for Obamacare until January 2014. Companies such as McDonald and Burger King provided Minimed Plans to employees.  

All of these twists and turns make Obamacare look like it is unworkable. It is!

President Obama’s goal is to create more chaos and dysfunction in the healthcare system.

Only then can the government really step in and say let me help you.

Then the government can provide a single party payer system and complete the journey to socialized medicine.

Based on past experience in many other countries, the result will be skyrocketing costs and increased deficits. 

Americans have a lot to look forward to. The only was out is to repeal Obamacare and replace it with a consumer driven healthcare system.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

Please have a friend subscribe