Ethics Crisis: What Government Is Doing to Healthcare

By Jeffrey A. Singer, M.D.
Reposted from Reason.com

For the past several years, the medical profession has been undergoing a disturbing transformation. The process was begun by the Centers for Medicare and Medicaid Services (CMS) in an effort to control exploding Medicare costs, and was accelerated by the passage of the Patient Protection and Affordable Care Act of 2010. As a surgeon in practice for over 30 years, I have witnessed this transformation firsthand. I fear that my profession will soon abandon its traditional code of ethics and adopt one more suited to veterinarians.

For centuries, my predecessors and I have been inculcated with what has come to be called the “Hippocratic Ethic.” This tradition holds that I am ethically required to use the best of my knowledge to recommend to my patient what I consider to be in my patient’s best interests—without regard to the interests of the third-party payer, or the government, or anyone else.

But gradually the medical profession has been forced to give up this approach for what I like to call a “veterinary ethic,” one that places the interests of the payer (or owner) ahead of the patient. For example, when a pet owner is told by a veterinarian that the pet has a very serious medical condition requiring extremely costly surgery or other therapy, the veterinarian presents the pet’s owner with one or more options—from attempt at cure, to palliation, to euthanasia—with the associated costs, and then follows the wishes of the owner.

Several factors in combination are bringing this ethical approach to my profession.

Since the mid-1980s, Medicare has imposed price controls on health care providers. Over the years, in order to accommodate increasing Medicare utilization, physician payments have steadily dropped.

Meanwhile, the regulatory burden on physicians has increased. In the last few years, CMS required all providers to adopt electronic health records or face economic sanctions from Medicare. It is the ultimate goal that every health care provider, including pharmacies, will have electronic databases that will be accessible to the U.S. Department of Health and Human Services (HHS).

In 2009, as part of the so-called stimulus bill, the Federal Commission for the Coordination of Comparative Effectiveness Research (FCCCER) was created. Its mission is to collect the data culled from all electronic health records and make recommendations regarding the comparative effectiveness of drugs, procedures, and therapies. In rendering advice, the FCCCER will essentially answer the following question: What is the most cost-effective way of allocating a fixed amount of resources among a population of roughly 310 million people?

With this same question in mind, the U.S. Preventive Services Task Force, a committee that reports to HHS, concluded in 2009 that mammogram screenings should not be recommended to women under age 50. This caused an uproar among both private health care providers and breast cancer advocacy groups, and the task force soon backed down. Similarly, in the fall of 2011, the task force recommended the abandonment of certain routine prostate cancer screenings. Once again, health care providers and cancer advocacy groups protested, and the task force rescinded its recommendation.

In 2010 the Patient Protection and Affordable Care Act established an Independent Payment Advisory Board (IPAB). Beginning in 2014, the 15 presidential appointees on this board will determine what therapies, procedures, tests, and medications will be covered by Medicare, using advice provided by the FCCCER. Such determinations will then be used to design the coverage packages for the non-Medicare insurance offered through the government–run exchanges. The decisions of the IPAB are not subject to Congressional oversight or judicial review.

Meanwhile, in an effort to control costs now, CMS has developed practice guidelines and protocols for physicians to follow. Committees of health care academics and statisticians developed these guidelines, using data from large population samples.

These protocols govern the therapeutic decisions made by the health care practitioner—right down to the pre-operative antibiotics a surgeon may order. Despite the fact that several recent peer-reviewed studies concluded that the protocols have had no positive effect—in fact, one study showed post-op skin infections increased since the protocols were instituted—CMS imposes financial penalties on hospitals that fail to get protocol compliance from their medical staff.

Medical students and residents are now being trained to follow federally-derived protocols and guidelines as a normal part of medical practice. As a result, this new generation of doctors will be less inclined to challenge the recommendations of federal task forces and agencies. Some academics also worry that “teaching to the protocol” might discourage independent thinking and the use of intuitive knowledge, two traits essential to the practice of good medicine.

In addition, decreased reimbursements and increased regulatory demands on physicians have led many to sell their practices to hospitals. The New England Journal of Medicine* estimates that 50 percent of the nation’s doctors are now hospital employees. As private medical practice becomes more economically untenable, look for the overwhelming majority of doctors to become salaried hospital employees—many working in shifts—in the next few years. Virtually every doctor now graduating a residency program is taking a position as a salaried hospital employee.

Ten thousand people will turn 65 every day for the next 19 years, placing an even greater fiscal burden on the Medicare program.

One way CMS is trying to deal with this is by penalizing hospitals and doctors who treat patients with resistant problems. Effective this year, any patient readmitted to a hospital within 30 days of discharge for the same or a related problem will be treated by the hospital without compensation. The plan is to implement the same policy with respect to the original treating physician in the near future.

To help deal with this more definitively, an old concept with a new name is being promoted and encouraged by the Affordable Care Act: the Accountable Care Organization (ACO). The ACO harkens back to the infamous HMO capitation system of the early 1990s over which the population rebelled.

In a nutshell, hospitals, clinics, and health care providers have been given incentives to organize into teams that will get assigned groups of 5,000 or more Medicare patients. They will be expected to follow practice guidelines and protocols approved by Medicare. If they achieve certain goals established by Medicare with respect to cost, length of hospital stay, re-admissions, or other “core measures,” they will get to share a portion of Medicare’s savings. If the reverse happens, they will face economic penalties.

Private insurance companies are currently setting up the non-Medicare version of the ACO. These will be sold in the federally subsidized exchanges mandated by the Affordable Care Act. In this model, there are no fee-for-service payments to providers. Instead, an ACO is given a lump sum, or “bundled” payment for the entire care for a large group of insurance beneficiaries. The ACOs are expected to follow the same Medicare-approved practice protocols, but all of the financial risks are assumed by the ACOs. If the ACOs keep costs down, the team of providers and hospitals reap the financial reward: a surplus from the lump sum payment. If they lose money, the providers and hospitals eat the loss.

In both the Medicare and non-Medicare varieties of the ACO, cost control and compliance with centrally-planned practice guidelines are the primary goal. The hospital and provider networks will live or die by these objectives.

When almost all health care providers are salaried employees of hospitals, hospitals might then be able to get ACOs to work better than their ancestor HMOs. The hospital administrators will have more control over their medical staff. If doctors don’t follow the protocols and guidelines, and desired outcomes are not reached, hospitals can replace the “problem” doctors.

So where does all this place the medical profession with respect to its ethical credo? In a few years, almost all doctors will be employees of hospitals and will be ordered to practice medicine according to federally prescribed guidelines—guidelines that put the best interests of the state ahead of the interests of individual patients.

When the physician’s primary obligation is to satisfy the wishes of the payer—ultimately the wishes of the state—how can patients be truly confident in their doctors’ decisions?

I submit that it all boils down to a question of professional ethics.

The medical profession must decide—and soon—which ethical doctrine to follow: Are doctors to be agents of their patients or agents of the state? All of us should dread the latter choice—because we will all be patients some day.

Jeffrey Singer practices general surgery in Phoenix, Arizona, writes for Arizona Medicine, the journal of the Arizona Medical Association, and is treasurer of the U.S. Health Freedom Coalition.

Doctors Going Broke

Doctors are leaving the profession, claiming bankruptcy, and/or ceasing to see Medicare patients due mainly to declining reimbursements. Once again, government is at the root of all of it. Combine this with the high costs of running a private practice, the threat of trial lawyers and the hundreds of thousands of debt accumulated in medical school and you've got a healthcare time bomb. When Obamacare goes into full effect, this could be the beginning of the end of American healthcare as we know it.

NEW YORK (CNNMoney) -- Doctors in America are harboring an embarrassing secret: Many of them are going broke.

This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists.

Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource.

"A lot of independent practices are starting to see serious financial issues," said Marc Lion, CEO of Lion & Company CPAs, LLC, which advises independent doctor practices about their finances.

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors' lack of business acumen is also to blame.

Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year. "And we still barely made payroll last paycheck," he said. "Many of us are also skimping on our own pay."

Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue. "Our total revenue was down about 9% last year compared to 2010," he said.

"These cuts have destabilized private cardiology practices," he said. "A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well."

Pentz is thinking about an out. "If this continues, I might seriously consider leaving medicine," he said. "I can't keep working this way."

Also on his mind, the impending 27.4% Medicare pay cut for doctors. "If that goes through, it will put us under," he said.

Federal law requires that Medicare reimbursement rates be adjusted annually based on a formula tied to the health of the economy. That law says rates should be cut every year to keep Medicare financially sound.

Although Congress has blocked those cuts from happening 13 times over the past decade, most recently on Dec. 23 with a two-month temporary "patch," this dilemma continues to haunt doctors every year.

Beau Donegan, senior executive with a hospital cancer center in Newport Beach, Calif., is well aware of physicians' financial woes.

"Many are too proud to admit that they are on the verge of bankruptcy," she said. "These physicians see no way out of the downward spiral of reimbursement, escalating costs of treating patients and insurance companies deciding when and how much they will pay them."

Donegan knows an oncologist "with a stellar reputation in the community" who hasn't taken a salary from his private practice in over a year. He owes drug companies $1.6 million, which he wasn't reimbursed for.

Dr. Neil Barth is that oncologist. He has been in the top 10% of oncologists in his region, according to U.S. News Top Doctors' ranking. Still, he is contemplating personal bankruptcy.

That move could shutter his 31-year-old clinical practice and force 6,000 cancer patients to look for a new doctor.

Changes in drug reimbursements have hurt him badly. Until the mid-2000's, drugs sales were big profit generators for oncologists.

In oncology, doctors were allowed to profit from drug sales. So doctors would buy expensive cancer drugs at bulk prices from drugmakers and then sell them at much higher prices to their patients.

"I grew up in that system. I was spending $1.5 million a month on buying treatment drugs," he said. In 2005, Medicare revised the reimbursement guidelines for cancer drugs, which effectively made reimbursements for many expensive cancer drugs fall to less than the actual cost of the drugs.

"Our reimbursements plummeted," Barth said.

Still, Barth continued to push ahead with innovative research, treating patients with cutting-edge expensive therapies, accepting patients who were underinsured only to realize later that insurers would not pay him back for much of his care.

"I was $3.2 million in debt by mid 2010," said Barth. "It was a sickening feeling. I could no longer care for patients with catastrophic illnesses without scrutinizing every penny first."

He's since halved his debt and taken on a second job as a consultant to hospitals. But he's still struggling and considering closing his practice in the next six months.

"The economics of providing health care in this country need to change. It's too expensive for doctors," he said. "I love medicine. I will find a way to refinance my debt and not lose my home or my practice."

If he does declare bankruptcy, he loses all of it and has to find a way to start over at 60. Until then, he's turning away new patients whose care he can no longer subsidize.

"I recently got a call from a divorced woman with two kids who is unemployed, house in foreclosure with advanced breast cancer," he said. "The moment has come to this that you now say, 'sorry, we don't have the capacity to care for you.' "

Small business 101: A private practice is like a small business. "The only thing different is that a third party, and not the customer, is paying for the service," said Lion.

"Many times I shake my head," he said. "Doctors are trained in medicine but not how to run a business." His biggest challenge is getting doctors to realize where and how their profits are leaking.

"On average, there's a 10% to 15% profit leak in a private practice," he said. Much of that is tied to money owed to the practice by patients or insurers. "This is also why they are seeing a cash crunch."

Dr. Mike Gorman, a family physician in Logandale, Nev., recently took out an SBA loan to keep his practice running and pay his five employees.

"It is embarrassing," he said. "Doctors don't want to talk about being in debt." But he's planning a new strategy to deal with his rising business expenses and falling reimbursements.

"I will see more patients, but I won't check all of their complaints at one time," he explained. "If I do, insurance will bundle my reimbursement into one payment." Patients will have to make repeat visits -- an arrangement that he acknowledges is "inconvenient."

"This system pits doctor against patient," he said. "But it's the only way to beat the system and get paid."

Obamacare to Cut Jobs of Artifical Hip, Knee Maker

Stryker, the Kalamazoo-based maker of artificial hips and knees, will cut 5% of its global workforce by the end of next year to reduce costs in the face of new fees on device makers required by the U.S. health care law.

The job cuts will reduce annual pretax operating costs by more than $100 million beginning in 2013, when the medical-device excise tax is scheduled to take effect, Stryker said Thursday in a statement. Stryker had more than 20,000 employees as of Dec. 31, according to Bloomberg News data.

Stryker expects to record $85 million to $95 million of the expense in the fourth quarter of 2011.

"These actions are part of our ongoing focus on quality, innovation and cost, and position the company to continue to provide strong, consistent growth in a changing environment," CEO Stephen MacMillan said.

Reposted from Freep

Obama Wants Your Health Records

By Kerri Toloczko, reposted from biggovernment.com

The federal government, as part of Obamacare implementation, is trying to figure out how to get its hands on everyone’s healthcare records.

It may seem like a small boat in the ocean of bureaucratic incursion that is Obamacare, but given the construction of the new law and the priority its authors and supporters place on “bending the cost curve,” allowing government access to American’s most personal records is a critical step in its effort to control healthcare costs at the expense of care.

The path to achieving this is to use treatment outcomes and other health data as instruments of rationing and denial of care through the Federal Coordinating Council for Comparative Effectiveness Research — created by President Obama — and based on European rationing boards.

There are several ways for the government to access our health records, and the U.S. Department of Health and Human Services is already contemplating options. One would be for the federal government to collect them directly. Another is mandating that the states, as part of Obamacare’s new healthcare exchanges, collect the information and pass it along to the federal government. A third would be to force private insurance companies to make the data available to the feds.

Notwithstanding any discussion of the government’s right to our private records, none of these are good ideas but not as bad as another option that some have floated; let a private contractor bid on the project to collect and maintain the information on behalf of the government.

Allowing a private company to access everyone’s healthcare records is an open invitation to disaster and a gross invasion of personal privacy. And more so as about the only company that could handle the job with any degree of competency appears to be Google.

Google’s business model is tracking and collecting preferred sites and other information from its users. Everything from favorite restaurants to marital status is fair game for the Internet behemoth, which uses sophisticated algorithms to identify who accesses the web in a given home — capturing birthdates, age, gender, imputed income and other information useful to determining what products and services might be of interest to a person when they go online.

Google collects and utilizes this information whether it has permission from the user or not, which is where the issue of private healthcare records comes into play.

Having those records, even if they are walled off and protected under law, does not mean they cannot be swept for information that is useful in other contexts. Everything from medical procedures you have had and their outcomes, medicines you take, your family health history, and details of your health insurance policy will be open to inclusion in Google data collection and marketing efforts through which the world’s largest search engine already generates much of its revenue.

Under a Google-driven collection of personal health data, there would be no “opt-in,” no “opt-out,” just your private records ripe for Internet picking.

The computerized healthcare record itself is helpful and useful. Many private studies have shown that electronic records can lead to enormous cost savings and cut down significantly on medical errors, helping to streamline costs and improve the quality of care available in hospitals today.

The problem is not that the information exists; it is how it can be used or, in this case, potentially abused. Even if no one can see the records, the possibility that they can be “data mined” if left in private hands is so strong that everyone should be concerned.

Medical records should be the property of the patient, and only the patient – an idea Congress and the states should aggressively seek to enshrine in law. Service providers and insurance companies need access to certain health information, but no outside entity should be allowed to touch them without a patient’s direct permission.

Google has turned the collection, analysis and recycling of personal information into an art form, and it shouldn’t be allowed to practice this art as the handmaiden of government with our health information. When it comes to records containing our private health data, a search engine should not be allowed any where near them. Nor, for that matter, should anyone else.

One Year Later…10 Things You Didn’t Know About Obamacare

Remember a year ago when VP Joe Biden was caught telling his boss that the massive Healthcare Reform Bill the President had just signed was (using Biden’s words) a ‘big f**king deal?’



Well folks, I hate to say this, but Joe Biden was right. This is a big deal. A big and expensive deal that still has not earned the support of more than half of America.
The as the bill was passed a year ago, a Gallup poll said:

only 49% of us think that passing healthcare reform was a ‘good thing.’
40% believe it was a bad thing

11% have no opinion

The people at Gallup asked the same question last week and not a whole lot has changed, except that more people DON’T like the idea:

only 46% support the healthcare reform bill
44% think it’s a bad idea
10% have no opinion

Maybe people just don’t know enough about what is in the bill. Remember then-speaker Nancy Pelosi telling us that we needed to pass the bill to find out what was in it?






As you know, they passed the bill, and now we know what is inside it. Bad stuff. Which might explain why even staunch Obamacare supporters like Congressman Anthony Weiner want a waiver for New York City.
But just how bad is it?

The folks at ‘Americans For Tax Reform’ have combed through the bill and found 10 Expensive Things You Did Not Know About Obamacare:

1. Did you know that . . . since Jan. 1 of this year (2011), you cannot use your flex-account at work (FSA) or health savings account (HSA) to purchase over-the-counter medicines?

2. Did you know that . . . since July 1 of last year (2010), Americans have been paying a 10 percent excise tax on all indoor tanning services?

3. Did you know that . . . starting in 2018, if your health insurance is “too good” or considered a “Cadillac” plan, then you will incur a new 40 percent tax on your health plan?

4. Did you know that . . . Obamacare has 21 new or higher taxes in it, totaling over $500 billion in increased taxes going to the government over 10 years?

5. Did you know that . . . beginning in 2014, individuals and families that do not purchase “qualifying” – as defined by federal bureaucrats — health insurance will be forced to pay a yearly tax penalty?

6. Did you know that . . . 7 tax hikes in Obamacare directly break President Obama’s “firm pledge” not to raise any form of taxes on individuals making less than $200,000 per year and families making less than $250,000 per year?

7. Did you know that . . . the capital gains tax rate under Obamacare will rise to 23.8 percent starting in 2012? That is a 59 percent increase from its current rate.

8. Did you know that . . . in 2013, those Americans facing the highest medical bills and the least ability to pay for them will find their ability to deduct medical expenses is further limited (medical expenses must be reduced by 10 percent of income under Obamacare, rather than current law’s 7.5 percent)

9. Did you know that . . . beginning in 2014, businesses with over 50 employees will be forced to offer health coverage for everyone, or pay a hefty tax for each employee?

10. Did you know that . . . in 2013, Obamacare caps the amount individuals and families can put in their flexible savings accounts at $2500? Currently there is no cap and these accounts are used for a myriad of health expenses including paying upwards of $14,000 in tuition to special needs schools for some parents?

I don’t know about you, but I‘m kind of nervous about what we will discover when this bill hits the ’terrible twos.’

(Source: The Blaze)

Wisconsin Doctors Write Fake Sick Notes For Work-Ditching Teachers

We are seeing a wholesale disregard for the common good, the rule of law, and the right to self-government by the Left in the State of Wisconsin. It's very similar to the way those on the Left have tried to impose counterfeit marriage on other states.


1) An elected governor, and a majority in the State Senate, attempt to carry out their mandate.

2) In response the Democratic legislators flee their jobs and their state so that a vote (which they know they will lose) cannot be held.

3) Wisconsin teachers, and their supports, flood the capitol to try and intimidate the remaining Senators. The teachers walk off their jobs to do this, lying about being sick, thus forcing public schools to close.

4) Now, Wisconsin doctors, who support the public sector unions which are bankrupting the state, have been caught on film writing phony excuses for those teachers who pretended to be sick. It's an ever-growing web of corruption. Watch one of the videos:




USA Today reported: "Doctors from numerous hospitals set up a station near the Capitol to provide notes to explain public employees' absences from work. Family physician Lou Sanner, 59, of Madison, said he had given out hundreds (!) of notes. Many of the people he spoke with seemed to be suffering from stress, he said."

Ann Althouse has another video:




You can voice your concern about this to the Medical Examing Board of the Wisconsin Department of Regulation and Licensing. The email address is:  DRLBoards@wisconsin.gov

Are the Airport Scanners Safe?

Are the scanners as safe as TSA claims? My guess is probably not. The fact that they haven't been properly studied, but are being pushed so hard elicits some red flags. TSA and GE have neglected to do the tests that doctors and scientists are demanding. They have disregarded expert questions repeatedly (when these experts have zero to gain and GE has 30 million).

Scientists and doctors (in the fields of biochemistry, biophysics, cancer research, x-ray crystallography and imaging) at UC San Francisco have raised some important concerns that are summarized below.

• There has not been a meeting of an impartial panel of experts, including medical physicists and radiation biologists, where ALL of the available relevant data is reviewed.

• The majority of the energy dose is delivered exclusively to the skin, which is dangerously high because it is not dispersed to the entire volume of the body. This is where TSA lied--see the next point.
  

• TSA and GE misled the public by only getting indirect radiation testing (which shows the diluted dispersion throughout the body) rather than quantifying the Flux (the dose being deposited to the skin). They avoided the independent safety data so they could falsely claim that "It's like being on an airplane flight for 3 minutes".
  

• If determining the Flux data (which is more relevant anyway) would put the whole radiation concern to rest, why hasn't this been done? Why are they avoiding it?

• The danger to susceptible groups (children, elderly, the immunocompromised, pregnant women, those at risk for testicular and breast cancer) has not been studied sufficiently and specific guidelines have not been released regarding their risk.
  

• Any glitch in the hardware or software that stops or slows the scan may cause an intense dose of radiation to a single spot on the skin. Will the TSA agent even notice the glitch? Who oversees it being fixed and ensures it is "safe" to use again?

• What keeps a TSA agent from raising the dose just a bit to get higher resolution on a certain area they need to see clearly? What if the higher resolution is needed at particularly sensitive anatomy? Is this justified?
  

TSA has not been honest with the American people. Until the proper testing is done, why should we have to subject ourselves to these risks? (The solution is not to simply get the pat down instead. Groping of sexual areas by strangers doesn't increase our safety since the the likely location to hide things would require internal manual examination by airport staff).

Death Panels, VAT Tax on Their Way, Nobel Prize-Winning Economist Says

Nobel Prize winning economist (and I'll add, Keynesian disciple) Paul Krugman is recommending "Death Panels" and a VAT tax as needed measures to balance the budget and pay for the government's Medicare/Obamacare obligations.

Anyone surprised? Have they considered getting the government out of the health care business?



http://www.eyeblast.tv/public/checker.aspx?v=hdSUSUaGnz

Via NewsBusters:

CHRISTIANE AMANPOUR, HOST: But what is going to happen? I mean, are you clear on where a compromise is going to be? It's got to be discussed before the end of the year, no?

KRUGMAN: No. Some years down the pike, we're going to get the real solution, which is going to be a combination of death panels and sales taxes. It's going to be that we're actually going to take Medicare under control, and we're going to have to get some additional revenue, probably from a VAT. But it's not going to happen now.

111 Obamacare Waivers Given Out by Obama Administration

Apparently the Health Care Reform Package was so great for our economy, 111 different companies and organizations (many of them associated with unions that backed Obama's election) have received waivers on the new regulations this year. Is this what Democrats meant when they said everyone needs to sacrifice a bit for the good of all?



http://www.youtube.com/watch?v=96Uu_tI0hTw&

Against Socialized Medicine: The One Minute Case

From One Minute Cases

There is no right to healthcare

The United States was founded with the declaration that all men have the right to “life, liberty, and the pursuit of happiness.” The Founders recognized that all men have a moral right to be free from the coercion of others, as long as they allow others the same freedom. They believed that rights do not impose a positive obligation on others, but only the negative obligation to restrain from the initiation of force.

The claim that there is a “right to healthcare” violates the principle of individual rights because it requires that the liberty of doctors and the property of taxpayers be violated to provide for others. When the New Deal and Great Society programs forced doctors and taxpayers to become sacrificial offerings to the “common good”, the current “healthcare crisis” was born.

The myth of “free” healthcare

It is a common belief that when government provides something, it is free or cheap. But politicians cannot create wealth – they can only redistribute it. Money for all government spending comes from business – whether by entrepreneurial investment, the wages of patients, or taxes.

Whether by price controls of outright nationalization, when governments make prices artificially low, demand skyrockets, and shortages result. Politicians respond by passing ever more regulations to control costs. These regulations stifle innovation, drive up costs, and force healthcare providers out of business. The end result is to replace capitalism, the greatest wealth-generating system known to man, with an onerous system of central planning.

Capitalism cannot guarantee that all our medical needs will be provided for – no system can do that. But it does give entrepreneurs the incentive to compete to provide the best possible service they can. Centralized socialized systems have no incentive to improve service or to try bold new techniques. Politicians can force prices to be artificially low, but they cannot lower costs – they can only drive doctors, hospitals, and drug companies out of business.

The victims of “universal” healthcare

The waiting time for treatment in Canada varies from 14 to 30 weeks. Waiting lists for diagnostic procedures range from two to 24 weeks. Some patients die while waiting for treatment. To stop sick people from circumventing the “free” system, the government of British Columbia enacted Bill 82 in 2003, which makes it illegal to pay for private surgery. Patients waiting for critical procedures are now forced to seek procedures in the U.S. and doctors are abandoning Canada in droves. Cleveland, Ohio is now Canada’s hip-replacement center. Ontario is turning nurses into doctors to replace some of the 10,000 doctors who left Canada in the 1990’s. ^{1 2}

What will patients do when it is illegal to seek private medical treatment in the U.S.? Politicians are already working towards that goal. State and federal regulation impose onerous regulations which forbid insurance companies from offering services such as basic coverage for emergencies by requiring coverage of many types of procedures. Medicare forces doctors to follow 130,000 pages of regulations. Critics often attack the “capitalist” nature of American health care system. The reality is that the government now pays for 50% of health care, and closely regulates the rest.

Healthcare is only affordable under capitalism

If a society is not wealthy enough to afford healthcare, health socialism will not make it richer. Cuba, a poster child of socialist healthcare schemes, spends $229 on healthcare per person each year, while the U.S. spends $ 6,096.³ Premium services are available only to paying foreigners, while natives must bribe doctors for timely treatment and bring their own towels, bed sheets, soap, food, and even sutures.⁴

A government can decide to replace individual choice with state-mandated decisions of what goods and services are more important for the “common good.” But it can only spend on one area at the expense of another. If Cubans are not totally deprived of medical treatment, it can only be at the expense of all other goods. A doctor’s salary in Cuba is 1.5 times the median at $15-20 per month. ⁵ A telling sign of their deprivation is the Cuban suicide rate, which is the highest in Latin America and among the highest in world. Cubans in Miami on the other hand, kill themselves less often than other Miamians.⁶ When they risk their lives in leaky boats to escape to the U.S., the right to make their own decisions regarding their health is among the freedoms they hope to gain.

References:

1. “Free Health Care in Canada” by Walter Williams
2. “Do We Want Socialized Medicine?” by Walter Williams
3. Reuters: Health care in Cuba more complicated than on SiCKO
4. BBC: Keeping Cuba Healthy by John Harris
5. “An Evaluation of Four Decades of Cuban Healthcare” by Felipe Eduardo Sixto (PDF)
6. Miami Herald: “Study: Suicide epidemic exists under Castro” by Juan O. Tamayo

Further reading:

• Moral Health Care vs. “Universal Health Care” by Lin Zinser and Dr. Paul Hsieh
• Health Care Is Not a Right by Leonard Peikoff, Ph.D.
• Health Care Is a Business—or Should Be by Richard E. Ralston
• Video: Unisured in America (Free Market Cure Documentary Series)
• Americans for Free Choice in Medicine
• American Health Care: Essential Principles and Common Fallacies
• FIRM: Freedom and Individual Rights in Medicine
• The “Cost” of Medical Care by Thomas Sowell
  
• Michael Moore’s Shticko by Michael C. Moynihan
• NY Times: “As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging“
• Do fat people deserve medical treatment?
• The One Minute Case for Individual Rights

Obamacare to Cost 578% More than Expected, Liberal Group Annouces

The liberal health care reform advocacy group, Families USA, commissioned a study of how many Americans will be eligible for subsidies under Obamacare. The study found 28.6 million Americans will be eligible in 2014. The CBO had estimated the number to be only 7 million. The cost difference is $91 billion a year. If this is accurate, Obamacare will cause the deficit to rise as early as 2015.

Verum Serum reported:

A new study by the Lewin Group estimates that 28.6 million Americans will be eligible for a federal subsidy to purchase health insurance beginning in 2014 at a projected cost to tax payers in excess of $110 billion. This estimate is dramatically higher (578%) than the cost of these subsidies forecast by the Congressional Budget Office (CBO) prior to the bill’s enactment into law.

Instead of hanging their head in shame for helping sell the American taxpayers a lie, Families USA bragged about it in a press release.

Beginning in 2014, almost 29 million middle-income Americans will be eligible for new tax credits to help them afford private health insurance premiums. The historic tax cut in the health reform law, which is estimated to reduce family income taxes by more than $110 billion in 2014 alone, will be provided through tax credits to offset a significant portion of private insurance premium costs.

h/t Bluegrass Pundit

63,000 Doctor Shortage Coming

The Association of American Medical Colleges recently released estimates that doctor shortages would be 50% worse in 2015 than forecast. This means we will be short 63,000 doctors, and that's just in the next 5 years. It's expected to get worse.

Is there any surprise here? Was Congress not warned time and time again during the healthcare debate? This train wreck is going to barrel down the expected socialist course and any combination of the following will happen:

1. Government will enact risky legislation get nurses (2 yr education)acting as doctors (11 yr education)

2. Government will start screwing around with medical school--taxpayers footing tuition bills as an incentive for prospective students, easier graduation requirements, subsidies, faster graduation and/or residency requirements, etc.

3. Government will bring in doctors from other countries (not uncommon in socialized medicine)

Notice that all three paths involve "government" fixing a problem that they started. Let's pray that November 2nd can put America on a new course

Obamacare Causes 22% Rate Hike in Connecticut Health Insurance Rate

The Hartford Courant reported:

Anthem Blue Cross and Blue Shield in Connecticut requested a wide range of premium increases, which will take effect Oct. 1, to cover the costs of new benefits required by federal health reform. Higher prices mostly affect new members shopping for a health plan on the individual market rather than people who have group plans through an employer or some other organization.

The Connecticut Department of Insurance approved Anthem’s request without changes, including a boost of as much as 22.9 percent just to comply with one provision: eliminating annual spending limits per customer... (emphasis mine) Read more here.

But...but...President Obama promised his health care reform bill would lower health care insurance costs.

From BarackObama.com (small pdf):

OBAMA-BIDEN PLAN TO PROVIDE AFFORDABLE, ACCESSIBLE HEALTH CARE TO ALL

Barack Obama and Joe Biden’s plan strengthens employer–based coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference. Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options. (emphasis mine)

Source: Blue Grass Pundit

White House Threatens Insurance Companies For Telling Truth About Obamacare . . . Again

Kathleen Sebelius is irate health insurance companies are exercising their first amendment right and pointing out recent hikes in health premiums are the result of mandates in President Obama's Heath Care Reform bill. Under changes taking place in the last half of 2010, parents can keep their adult children on the health insurance until age 26, more preventative coverage was mandated, lifetime limes were eliminated and pre-exiting conditions were dropped for those under 18. All these changes will insurance companies money. They are passing that along to consumers and educating the public on why this is happening. The Obama administration doesn't want consumers to know the truth and has issued a near ultimatum to insurance companies. Shut up or else.

AP reported:

President Barack Obama's top health official on Thursday warned the insurance industry that the administration won't tolerate blaming premium hikes on the new health overhaul law.

"There will be zero tolerance for this type of misinformation and unjustified rate increases," Health and Human Services Secretary Kathleen Sebelius said in a letter to the insurance lobby.

"Simply stated, we will not stand idly by as insurers blame their premium hikes and increased profits on the requirement that they provide consumers with basic protections," Sebelius said. She warned that bad actors may be excluded from new health insurance markets that will open in 2014 under the law. They'd lose out on a big pool of customers, as many as 30 million people nationwide.

Source: Bluegrass Pundit

Harry Reid Complains About New Health Care Law

Nancy Pelosi said they would have to pass the bill so people could learn what is in it. Harry Reid has learned something he doesn't like. Medicare payments to hospitals will be going down.

Missouri Votes Down Health Care Reform Law

Missouri became the first state this week to express their displeasure with the healthcare reform bill that was pushed by Democrats through congress into law, despite widespread opposition by a majority of Americans.

Missouri voters on Tuesday overwhelmingly rejected a key provision of President Barack Obama's health care law, sending a clear message of discontent to Washington and Democrats less than 100 days before the midterm elections.

With about 90 percent of the vote counted late Tuesday, nearly three-quarters of voters backed a ballot measure, Proposition C, that would prohibit the government from requiring people to have health insurance or from penalizing them for not having it.[...]

Louisiana and Virginia have passed similar statutes, and voters in Arizona and Oklahoma will vote on such measures as state constitutional amendments in November. But Missouri was the first state to challenge aspects of the federal law in a referendum.

[Read more]

Obamacare Lawsuit Upheld in VA

Let us hope this is the beginning of the repeal of this monstrous government power grab.

The state of Virginia can continue its lawsuit to stop the nation's new health care law from taking effect, a federal judge ruled Monday.

U.S. District Court Judge Henry Hudson said he is allowing the suit against the U.S. government to proceed, saying no court has ever ruled on whether it's constitutional to require Americans to purchase a product.

"While this case raises a host of complex constitutional issues, all seem to distill to the single question of whether or not Congress has the power to regulate -- and tax -- a citizen's decision not to participate in interstate commerce," Hudson wrote in a 32-page decision.

"Given the presence of some authority arguably supporting the theory underlying each side's position, this court cannot conclude at this stage that the complaint fails to state a cause of action," he wrote.

The decision is a small step, but in no way minor matter to opponents of the health care bill rejected by all congressional Republicans but signed into law by President Obama earlier this year.

Virginia Attorney General Ken Cuccinelli filed the suit almost immediately after the law was signed, arguing that it conflicts with Virginia's legislation -- also passed this year -- exempting state residents from the requirement that all Americans be forced into health care coverage. Cuccinelli argued that the law violates the Constitution's Commerce Clause.

More than a dozen other state attorneys general have filed a separate lawsuit in Florida challenging the federal law, but Virginia's lawsuit is the first to go before a judge.

[Fox]

Obama Budget Director Confirms Death Panels

In this video clip, President Obama's budget director Peter Orszag discusses the immense powers (including the power to determine levels of care and reimbursement) granted to the unelected Independent Payment Advisory board under ObamaCare.

Orszag also reveals that the word “advisory” is a farce, because the panel can do pretty much anything it wants unless it is specifically voted down by congress and signed by the President.

Healthcare Reform WILL Raise Costs, Supressed HHS Report Said

Obama's Health and Human Services office recently admitted that they received a report from Medicare's Office of the Actuary days before the passage of the Health Care Reform package, clearly stating that the bill would raise health care costs and premiums. HHS Sec. Sibelius' office admits that they suppressed the the report so that the health care bill could pass.

This means that Obama's administration knew that their health care bill would raise costs and consumer premiums and knowingly lied when they claimed it would cut costs.

From American Spectator:

The economic report released last week by Health and Human Services, which indicated that President Barack Obama's health care "reform" law would actually increase the cost of health care and impose higher costs on consumers, had been submitted to the office of HHS Secretary Kathleen Sebelius more than a week before the Congressional votes on the bill, according to career HHS sources, who added that Sebelius's staff refused to review the document before the vote was taken.

"The reason we were given was that they did not want to influence the vote," says an HHS source. "Which is actually the point of having a review like this, you would think."

The analysis, performed by Medicare's Office of the Actuary, which in the past has been identified as a "nonpolitical" office, set off alarm bells when submitted. "We know a copy was sent to the White House via their legislative affairs staff," says the HHS staffer, "and there were a number of meetings here almost right after the analysis was submitted to the secretary's office. Everyone went into lockdown, and people here were too scared to go public with the report."

In the end, the report was released several weeks after the vote -- the review by the secretary's office reportedly took less than three days -- and bore a note that the analysis was not the official position of the Obama administration.

NY: Healthcare Reform Drives Up Premiums, Creates Massive Deficits

In an astonishingly honest article yesterday, the New York Times admits that the policy in the Democrat Health Care Reform Bill making it illegal for insurance companies to "discriminate" against people with preexisting conditions who have not paid into the system has been going on in New York since 1993, with disastrous results.

New York’s insurance system has been a working laboratory for the core provision of the new federal health care law — insurance even for those who are already sick and facing huge medical bills — and an expensive lesson in unplanned consequences. Premiums for individual and small group policies have risen so high that state officials and patients’ advocates say that New York’s extensive insurance safety net for people like Ms. Welles is falling apart.[...]

In 1993, motivated by stories of suffering AIDS patients, the state became one of the first to require insurers to extend individual or small group coverage to anyone with pre-existing illnesses.

New York also became one of the few states that require insurers within each region of the state to charge the same rates for the same benefits, regardless of whether people are old or young, male or female, smokers or nonsmokers, high risk or low risk.

Healthy people, in effect, began to subsidize people who needed more health care. The healthier customers soon discovered that the high premiums were not worth it and dropped out of the plans. The pool of insured people shrank to the point where many of them had high health care needs. Without healthier people to spread the risk, their premiums skyrocketed, a phenomenon known in the trade as the “adverse selection death spiral.”

“You have a mandate that’s accessible in theory, but not in practice, because it’s too expensive,” said Mark P. Scherzer, a consumer lawyer and counsel to New Yorkers for Accessible Health Coverage, an advocacy group. “What you get left clinging to the life raft is the population that tends to have pretty high health needs.”

Since 2001, the number of people who bought comprehensive individual policies through HMOs in New York has plummeted to about 31,000 from about 128,000, according to the State Insurance Department.

At the same time, New York has the highest average annual premiums for individual policies: $6,630 for single people and $13,296 for families in mid-2009, more than double the nationwide average, according to America’s Health Insurance Plans, an industry group.

The Democrats, have tried to prevent this from happening on a national level by forcing the well people to buy health insurance and redistributing their premiums to pay for the sick and belatedly paying people. But since they are not trying that hard to enforce this (either because they are afraid of the people revolting or because they want the system to fail: take your pick), our nation is headed down the same path of higher premiums, national debt, health care rationing and ultimately socialized medicine.