Tag Archives: Obamacare

Life, Liberty and the Pursuit of Practice Happiness

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Most physicians, by our very nature, are not inclined to make waves, especially when it comes to politics. Those that are interested in getting involved may actually run for office, or, like me, resort to writing a blog in an effort to make their opinions heard. Others get caught up in professional organizations such as state medical societies, specialty associations or other national organizations. For the more ambitious, making periodic trips to Washington, DC, to lobby their representatives gives them a sense of active participation in “the system.” I know, I’ve done all these things myself (except running for office) with little to show for the effort.

The fact is, as individual doctors we have very little power to change anything that happens in the political arena. And, while it is true that as a collective we could have significant influence, it doesn’t appear likely that physicians will ever unite behind any single idea, philosophy or action plan. We are indeed a dysfunctional group of cats, and will not be herded no matter how desperate our circumstances become.

This past weekend I heard Andrew Schlafly, Esq., the General Counsel for the Association of American Physicians and Surgeons give a talk on what he referred to as “A War on Doctors.” He accurately described the coordinated efforts by hospitals, third party payers and the government, all designed to control physicians through employment, intimidation, regulation and economic coercion. None of the strategies or tactics he described came as any new revelation to the audience comprised almost exclusively of doctors, but it did serve to focus the discussions that occurred for the duration of the meeting.

Our current healthcare payment system is at the heart of this war on American Medicine. It is an unchallenged fact that healthcare related costs have escalated to the point where they threaten our national financial security. But if you look at where the money actually goes, it isn’t into the pockets of doctors. Estimates place the percentage of total healthcare spending that goes to pay physicians at between 10% and 12% of the healthcare budget. The bulk of the payments go to hospitals, pharmaceutical and device manufacturers, insurance companies, and a myriad of secondary and tertiary “providers” of various health related goods and services. It would then seem reasonable to ask, why wage war on the docs? Simple, we are the easiest targets.

The general lack of organization among physicians makes it possible to manipulate us using the strategies and tactics mentioned above. Similar efforts don’t work well against massive hospital groups and industrial giants, each of whom maintain multi-million dollar lobbies designed specifically to improve their relative position in the system, or at the very least, maintain their status quo. The arguments are also easily made that physicians are responsible for ordering all those expensive tests… and doctors prescribe all those useless drugs… and they are the ones who perform those unnecessary procedures… and they keep people in hospitals for no apparent reason other than money… So, it only follows that doctors must be brought to heel or appropriately punished. Besides, all doctors are rich, right?

I do not wish to imply that America’s doctors are the victims here. In large part we have unwittingly brought this war upon ourselves. For more than 30 years now, the vast majority of doctors have been systematically lured into participating in what has become a corrupt third party payment system. They have passively, and in a some cases actively, participated in “contract medicine” where the payers have subtly and systematically seized control over medical decision making. Problems arise whenever the absolute loyalty and commitment of physicians to their patients becomes an inconvenient obstacle to either the political or economic gain of the payer. Their answer is to attack the physician’s core principles contained in the Code of Medical Ethics. Their weapons include complex economic incentive programs shrouded in innocent sounding names names like “quality improvement”, “gain sharing”, “pay for performance”, and the latest effort, which is tucked neatly inside Obamacare, “Accountable Care Organizations”. Failure to comply with these efforts results in harsh penalties, including both financial penalties and professional sanctions. The strategy is clear, offer small carrots followed by a very large set of sticks.

By all appearances this war is not likely to end well for the doctors. We have limited ammunition, no coordinated strategy or battle plan, and few if any allies. Many physicians have already given up on the idea of independence. It is for this reason that I, and many like me, have chosen a path less traveled. One that can only be referred to as individual, passive non-participation. For the last 12 years I have not participated in any third party contract-based payment schemes, and as of January 2013, I have opted out of the Medicare program. For me, this was a difficult decision, but it was the only option I could see that would allow me to be a truly independent physician.

Some will undoubtedly criticize my stance as being contrary to their interpretation of the Hippocratic Oath. Others may consider me to be selfish and uncaring. To them I would simply offer my signed “Independent Physician’s Rights and Obligations Pledge” as proof of my intent. I’m not sure if any of my colleagues will assume a similar strategy since, as I said, we are all a bunch of cats, and it is not my intent to suggest this is the only course of action. However, I believe that as an American, I have the inalienable right to life, liberty and the pursuit of happiness, including the joy of practicing my life’s work for the benefit of those who seek my help without pressure or interference from the government or any other controlling entity.

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The Independent Physician’s Rights and Obligations Pledge

As an independent practicing physician, I hereby acknowledge my role is central to ensuring quality care for all patients. I further recognize the potentially disruptive nature of outside influences on the patient-physician relationship, including various methods of payment. Through this pledge I hereby reaffirm my unconditional commitment to my patients, my colleagues and my profession, and to maintaining my SPIRIT as a physician.

I pledge, to provide personal healthcare to all those who I am privileged to treat, in accordance with my training and experience with a spirit of personal Service.

I pledge, to uphold, defend and perpetuate the time-honored ethics of the medical Profession.

I pledge, to conduct my practice with openness, honesty, fairness and personal Integrity.

I pledge, to keep the time-honored patient-physician relationship based on mutual trust, mutual respect and mutual Responsibility.

I pledge, to establish just and appropriate fees for the services I provide, treating all patients fairly and with compassion, free from any third party attempts to influence my professional judgment or Independence.

I pledge, to work within the community of physicians to ensure the medical profession remains self-regulating and self-governing with respect to education, training, quality assurance and peer review, according to our time-honored Tradition.

Now, before all who are my witness, I accept and embrace these fundamental rights and obligations freely and without reservation, and declare my willingness to abide by them to the best of my ability.

Robert Sewell, MD

 

The opinions expressed are my own and do not necessarily reflect those of any organization or group. please feel free to review other posts on www.spiritofhealthcare.com and check out my clinical site at www.robertsewellmd.com

Observations on Politics, Profiteering “Incentives”, and the Struggle for a Profession’s Soul

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Robert W Geist, MD

The new 2010 federal Patient Protection and Affordable Care Act (ObamaCare) attempts to control society’s rising cost of care, but does so by expanding on an ethically questionable payment system. The system increases the control of managed care “payers”, HMO corporations and government agencies, by paying physicians monetary incentives for reducing the amount of care they provide. The specific objective is to encourage all healthcare providers to limit patient use of private health insurance premiums as well as tax dollars.

The law calls for the creation of Accountable Care Organizations (ACOs) consisting of hospitals and staff physicians, merged into risk-bearing, gate-keeper insurance corporations with fixed global budgets. The amount of money allocated to each ACO is determined based on auctions of populations of insured lives to be serviced, on a per capita basis. When payers contract only with risk bearing ACO corporations, clinicians are effectively forced into gate-keeping contracts, since unaligned and independent clinics or individuals would be totally excluded from this type of payment program.

To implement these market controls, ObamaCare creates a powerful public-private cartel system. In the new system merged ACO-HMO insurance corporations are shielded by virtue of the sovereignty of the federal government from legal challenge for any activities that limit competition and/or fix prices. These shields were established through the 2011 waivers of federal anti-trust, anti self-referral, and anti fee-splitting patient protection laws.

Demand for healthcare services will naturally increase as a byproduct of this politically motivated and tax-subsidized system. Clinicians at the bedside will continue to be powerless to reverse this demand inflation unless coerced into the role of gate-keepers denying services. Likewise, there will be a continuation of the kind of quality distortions, which have resulted from decades of government price-fixing and previous failed managed care rationing methods. One can predict that these economic “fatal flaws” of this legally insulated, gate-keeping system will lead to a progressive deterioration in overall access to quality healthcare in America.

The pretext of ObamaCare as a “social good” to control cost and improved quality, has been used to justify highly questionable means, including patient auctions and monetary incentives, which reward rationed care. Under this system, patients can, and very likely will, lose the protection of law, as this law now legalizes corporate-government profiteering for rationing access. This is also how the medical profession and individual physicians can be coerced into losing their professional soul—the ancient covenant of loyalty to each patient.

Why Obamacare Must Be Repealed

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Over the last two years I have made a number of efforts to outline the problems with what we affectionately call Obamacare. It is unclear whether those efforts have been effective or not, but these have been my best efforts. However, I just watched a video called “The Determinators Movie” which far exceeds any effort I could ever summon. Please watch it now, and forward it to everyone you know, because sooner or later we will all be patients.

Next – We Indict the Media

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My friend and fellow advocate of Repealing Obamacare, Adrian Murray, posted the following on Facebook and with his permission I am re-posting it here. In the wake of last night’s Presidential debate in Denver it should be crystal clear to everyone that the Mainstream Media has an agenda that includes doing whatever it takes to keep the current President in office. Their blatant partisanship under the guise of reporting the news has become a modern day “Yellow Journalism” and borders on the criminal.

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NEXT – WE INDICT THE MEDIA

It was clear to anybody paying even the remotest attention four years ago that the media was selling the American public a fraudulent bill of goods called Barack Obama. The man clearly hadn’t the slightest qualification to be President of the United States and yet the mainstream media refused to properly vet him, refused to explore his past, ignored any relevant criticism and generally acted like preteen schoolgirls at a Justin Bieber concert. Talent schmalant. He’s just so dreamy.

That’s not meant to be a knock on the President. No one will deny his oratory skills and his unique ability to stir passions in his followers with thrilling platitudes about nothing. That a significant portion of the American public is so alarmingly naïve and simplistic is not Barack Obama’s fault. Ambitious men seize upon opportunities and if the media was intent upon creating a wedge formation to allow Obama to waltz into the end zone, we cannot fault him for taking the ball and running with it.

What we saw last night was the bare exposition of the media lie. For weeks we have been assured by both print and broadcast that the Romney campaign was all but over, that he had imploded and his campaign has fizzled. “It’s over,” we were told. “Disarray” was the buzzword most often heard. Ask yourself: who was in disarray last night, Mitt Romney or Barack Obama?

It’s often been said that the media elected Barack Obama in 2008, acting as little more than cheerleaders and adeptly playing defense for the man. But Obama was not so much elected by the media as he was inflicted by the media, a consortium of liberal and leftist feel-gooders so awash in white guilt they never even once considered that absolving themselves of their self-induced guilt by abetting the election to the presidency of the United States a man not remotely qualified for the position might, just might, not be a good thing for the citizens of this country.

Oh, how the American people have suffered these last four years. Twenty-four million unable to find a job. Think of that for a second. We bandy about numbers and percentages so much that we often forget those are real people, maybe your neighbor, maybe a relative. Imagine every man, woman and child in Texas out of work, living on food stamps and government handouts, without homes or hope. That’s what Obama’s presidency has inflicted on the American people. That is a direct result of the media’s malpractice and they should be made to pay the price.

Many viewers last night were presented with facts that the media has carefully hidden. Did you know that the big tax breaks oil companies (not much more than depreciation) is just $2.9 billion while Obama’s gifts to the wind and solar industries (i.e., Obama donors) amounts to $90 billion? Neither did I. The utter, complete and devastating failure of the Obama presidency was on full display last night and along with it the media conspiracy to cover it up.

It is often said that the cover up is worse than the crime. That is certainly the case with the media’s protective fawning of Barack Obama. They can almost be forgiven for 2008. At the time many Americans were suffering from Bush-fatigue and, let’s face it, McCain was an uninspiring candidate. Maybe the media’s wet dream would have a happy ending. Most of us woke up the day after the election and hoped that would be the case.

But the disaster that has ensued is blindingly clear to all but the blind. The American people have suffered enough. Too many homes have been lost. Too many suffer without work. Too many are made to shed their dignity for government handouts. Too many face an uncertain future and live in fear of what tomorrow may bring. The media must be called to account. The curtain was pulled back last night and the emperor had no clothes, his empty suit carelessly draped over an empty chair.

Democracy cannot exist in a vacuum and that is exactly what the mainstream media has dutifully created to cover up their 2008 crime.

Off with their heads.

Forestalling the Demise of Freedom

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I am attaching an e-mail letter I received recently without specific permission, but, you will see at the end there is a request to forward it to everyone, thus the inclusion in this blog. I actually thought about trying to rewrite this in my own words, but I’m not sure there is any way I could deliver this message any more clearly than this author has.

Obama’s Second Term Transformation Plans

The 2012 election has often been described as the most pivotal since 1860. This statement is not hyperbole. If Barack Obama is re-elected the United States will never be the same, nor will it be able to re-capture its once lofty status as the most dominant nation in the history of mankind.

The overwhelming majority of Americans do not understand that Obama’s first term was dedicated to putting in place executive power to enable him and the administration to fulfill the campaign promise of “transforming America ” in his second term regardless of which political party controls Congress. That is why his re-election team is virtually ignoring the plight of incumbent or prospective Democratic Party office holders.

The most significant accomplishment of Obama’s first term is to make Congress irrelevant. Under the myopic and blindly loyal leadership of Harry Reid and Nancy Pelosi, the Democrats have succeeded in creating an imperial and, in a second term, a potential dictatorial presidency.

During the first two years of the Obama administration when the Democrats overwhelmingly controlled both Houses of Congress and the media was in an Obama worshipping stupor, a myriad of laws were passed and actions taken which transferred virtually unlimited power to the executive branch.

The birth of multi-thousand page laws was not an aberration. This tactic was adopted so the bureaucracy controlled by Obama appointees would have sole discretion in interpreting vaguely written laws and enforcing thousands of pages of regulations they, and not Congress, would subsequently write.

For example, in the 2,700 pages of ObamaCare there are more than 2,500 references to the Secretary of Health and Human Services. There are more than 700 instances when he or she is instructed that they “shall” do something, and more than 200 times when they “may” take at their sole discretion some form of regulatory action. On 139 occasions, the law mentions that the “Secretary determines.” In essence one person, appointed by and reporting to the president, will be in charge of the health care of 310 million Americans once ObamaCare is fully operational in 2014.

The same is true in the 2,319 pages of the Dodd-Frank Financial Reform Act. which confers nearly unlimited power on various agencies to control by fiat the nation’s financial, banking and investment sectors. The bill also creates new agencies, such as the Consumer Financial Protection Bureau, not subject to any oversight by Congress. This overall process was repeated numerous times with other legislation all with the intent of granting unfettered power to the executive branch controlled by Barack Obama and his radical associates.

Additionally, the Obama administration has, through its unilaterally determined rule making and regulatory powers, created laws out of whole cloth. The Environmental Protection Agency on a near daily basis issues new regulations clearly out of their purview in order to modify and change environmental laws previously passed, and to impose a radical green agenda never approved by Congress. The same is true of the Energy and Interior Departments among many others.

None of these extra-constitutional actions have been challenged by Congress. The left in America knows this usurpation of power is nearly impossible to reverse unless stopped in its early stages.

It is clearly the mindset of this administration and its appointees that Congress is merely a nuisance, and can be ignored after they were able to take full advantage of the useful idiots in the Democrat controlled House and Senate in 2009-2010, and the Democrat Senate in the current Congress.

Additionally, Barack Obama knows after his re-election a Republican controlled House and Senate will not be able to enact any legislation to roll back the power previously granted to the Executive Branch, or usurped by them. His veto will not be overridden as there will always be at least 145 Democratic members of the House or 34 in the Senate in agreement with or intimidated by an administration more than willing to use Chicago style political tactics.

The stalemate between the Executive and Legislative Branches will inure to the benefit of Barack Obama and his fellow leftists.

The most significant power Congress has is the control of the purse-strings as all spending must be approved by them. However, once re-elected, Barack Obama, as confirmed by his willingness to do or say anything and his unscrupulous re-election tactics, would not only threaten government shutdowns but would deliberately withhold payments to those dependent on government support as a means of intimidating and forcing a Republican controlled Congress to surrender to his demands, thus neutering their ability to control the administration through spending constraints.

Further, this administration has shown contempt for the courts by ignoring various court orders, e.g. the Gulf of Mexico oil drilling moratorium, as well as stonewalling subpoenas and requests issued by Congress. The Eric Holder Justice Department has become the epitome of corruption as part of the most dishonest and deceitful administration in American history. In a second term the arrogance of Barack Obama and his minions will become more blatant as he will not have to be concerned with re-election.

Who will be there to enforce the rule of law, a Supreme Court ruling or the Constitution? No one. Barack Obama and his fellow-travelers will be unchallenged as they run roughshod over the American people.

Many Republicans and conservatives dissatisfied with the prospect of Mitt Romney as the nominee for president are instead focused on re-taking the House and Senate. That goal, while worthy and necessary, is meaningless unless Barack Obama is defeated. The nation is not dealing with a person of character and integrity but someone of single-minded purpose and overwhelming narcissism. Judging by his actions, words and deeds during his first term, he does not intend to work with Congress either Republican or Democrat in his second term but rather to force his radical agenda on the American people through the power he has usurped or been granted.

The governmental structure of the United States was set up by the founders in the hope that over the years only those people of high moral character and integrity would assume the reins of power. However, knowing that was not always possible, they dispersed power over three distinct and independent branches as a check on each other.

What they could not imagine is the surrender and abdication of its constitutional duty by the preeminent governmental branch, the Congress, to a chief executive devoid of any character or integrity coupled with a judiciary essentially powerless to enforce the law when the chief executive ignores them . Americans must come to grips with this moment in time and their historical role in denying Barack Obama and his minions their ultimate goal. All resources must be directed at that end-game and not merely controlling Congress and the various committee chairmanships.

Steve McCann, May 12, 2012

Please forward this to all you can, maybe together we can save America for ourselves and those who will follow after us

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I would only add, if we (the American public) accidentally overheard this President telling Russian President Putin that he would have a lot more flexibility after the election, how many other “deals” has Obama made with those who would seek to destroy our freedoms and the American way of life? Now is a time for choosing. “We The People” of this great nation must stand against the tyranny that Abraham Lincoln warned us about 150 years ago. He said  “America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves.”

 

As an American…

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I received a letter recently from a young, black, conservative physician named Dr. Robin Armstrong. He was recently elected to the Republican National Committee from Texas and is obviously a supporter of the Romney/Ryan ticket. However, the specific points he made in his letter were more than just the usual partisan politics; they were a plea to all Americans to come to our collective senses and change the direction of our nation. Dr. Armstrong said,

“As a proud American, I am offended that Barack Obama has attacked our institutions that have made our nation great!

As a Texan, I am angry that Barack Obama has abused his executive authority to attack our voter ID laws, and to attack the oil and gas industry with radical environmental restrictions and regulations!

As a Christian, I am disappointed this president has abused his office to impose his will and his values on religious institutions despite the clear violation of the First Amendment!

As a Conservative, I am offended this president considers me his enemy and a greater danger to our nation than radical Islamists!

As an African American, I am saddened this president’s policies have expanded the welfare state, skyrocketed the black unemployment rate to 14.4%, and further isolated our community!

As a Physician, I am frightened by Barack Obama’s unconstitutional assault on the healthcare industry, which will lead to bankruptcies in both government budgets and healthcare quality!

As a Taxpayer, I am angry this president wants to raise my taxes even further because he thinks I do not pay my fair share!

President Obama has stated he wants to fundamentally change our nation.  He is well on his way and he must be stopped!”

There is really nothing to add to Dr. Armstrong’s arguments except to say, as each of us is awakened to the fact that our freedoms and our very way of life are being stolen from us, and our posterity, it is our duty and our moral obligation to do whatever we can to arouse those around us before our current American Nightmare becomes the new and permanent American Reality.

Make no mistake, Barack Obama is a Marxist, socialist and should he win re-election, even if he loses Democrat control of the Senate, he will continue to seize more and more power through executive orders.

We were warned about the process we are now witnessing by none other than Abraham Lincoln when he said, “America will never be destroyed from the outside. If we falter and lose our freedoms, it will be because we destroyed ourselves.”

 

Stop Calling It Obamacare

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By Adrain Murray

When Mitt Romney went before the convention of the NAACP and said that as president he would repeal “Obamacare”, he was roundly and predictably booed.  In doing so, he stepped into a carefully laid trap.

Why is the Patient Protection and Affordable Care Act routinely referred to as “Obamacare”?  Surely no one seriously believes President Obama wrote the 2,700 page bill or, for that matter, even knows what is in it.  Yet the act is commonly labeled President Obama’s signature piece of legislation, the crowning achievement of his first term.

Even Nancy Pelosi would not take credit for authoring the bill, famously declaring we had to pass it in order to find out what’s in it.  So if the president didn’t write the Affordable Care Act and the Speaker of the House didn’t know what was in it, why is it called Obamacare?

One could make the argument that it’s just laziness on the part of the media, which revels in finding the lowest common denominator to explain complex issues.  One could argue that it is political posturing by Republicans who want to saddle the president with responsibility for what is undeniably an unpopular law.  One could argue it is the president himself, trying to take legislative credit for something he had nothing to do with, popular or not.  In fact Obama, a supporter of a single payer system, actively campaigned against many of the provisions that have ended up as cornerstones of the ACA law.

One could make a lot of arguments, but calling the Affordable Care Act “Obamacare” is a huge tactical error.  Why?  Because naming the law after Obama personalizes it and, as Romney learned from the NAACP audience, opposing Obamacare equals opposing Obama and the only reason anyone opposes Obama is, of course, because he is black.  To those inclined to think as such, opposing the complete government takeover of the healthcare system and changing the status of Americans from private citizens to property of the state is, quite simply, racist.  It also distracts from the true question that should be asked:

Who, precisely, wrote the Patient Protection and Affordable Care Act and why?

Our first clue comes from testimony given by Peter Orszag, then-Director of the Office of Management and Budget, before Congress in August of 2009.  “Ultimately,” he said, “without structure in place to help contain health care costs over the long term as the health market evolves, nothing else we do in fiscal policy will matter much, because eventually health care cost will overwhelm the federal budget.”

If Orszag had been addressing the board of directors of Wellpoint, the nation’s second largest managed health care company, such a statement might seem perfectly proper.  But, even accepting the wildly suspicious claim that 30 million Americans were uninsured, that’s still just 10% of the population.  If 90% of Americans in 2009 were covered by private insurance, why would health care costs overwhelm the federal budget?  It is more likely that rising health care costs would soon overwhelm the nation’s health insurance providers.

According to Kaiser Permanente, total health insurance costs in 1980 were $286 billion.  By 2010, they had increased nearly tenfold to $2.3 trillion.  As the population ages, that number is expected to soar.  According to federal estimates, health care costs will double in the next decade and are likely to double again by 2030, when 70 million Americans – fully 20% of the population – will be over the age of 65.  Could such dire estimates have provided the health insurance industry with a powerful $10 trillion incentive to move this looming liability off their balance sheets and onto the backs of the American taxpayer?

In May 2010, after final passage of the current health care law, Senator Max Baucus, from whose Finance Committee the legislation emerged, stood before the Senate and members of the press to publicly thank the person he credited with making it all happen:

“I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform because she wanted that to be, in a certain sense, her professional lifetime goal. She put together the White Paper last November–2008–the 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures in all bills on both sides of the aisle came.”

So who is Liz Fowler?  Prior to joining Baucus’ staff as the senior advisor on health care, she was Vice President of Public Policy and External Affairs for none other than the aforementioned number two insurance company, Wellpoint.  Not to put too fine a point to it, but the chief lobbyist for AHIP (America’s Health Insurance Plans), a national trade organization of over 1,300 insurers, infiltrated the Senate Finance Committee and wrote a law to benefit not the American people, but the entire insurance industry.  As it turns out, the Patient Protection and Affordable Care Act is not intended to make health insurance more affordable for the American people.  It is designed to make the American people more affordable for the health insurance industry.

As it further turns out, Baucus’ staff was infested with Wellpoint hirelings.  Prior to Fowler arriving on scene, the chief advisor on Senator Baucus’ team was Michelle Easton.  Upon passing the baton to Ms. Fowler, Easton went to work as a lobbyist for Wellpoint at Tarplin, Downs and Young, a DC-based lobbying firm founded in 2006 “specializing in strategic consulting and policy development with a particular focus on health care”.

Keep turning the wheel, though, and we come to Stephen Northrup.  Northrup was the chief health advisor to Wyoming Senator Mike Enzi when Enzi pushed similar health care legislation in 2006.  Prior to joining Enzi’s staff, Northrup was the executive director of the Long Term Pharmacy Alliance, an organization that played a lead role in drafting the mother of all giveaways to Big Pharma, Medicare Part D.  Not surprisingly, the revolving door and interchangeable roles of advisors/staff/lobbyists eventually lead Northrup in 2007 to Wellpoint, where he served as Vice President of Federal Affairs.

The insurance lobby, tired of decades of failed attempts to influence Congress to create a national health care plan which would immunize them from the looming trillions of dollars in liabilities they faced as the boomer generation aged, simply decided they would infiltrate Congress instead and write the legislation themselves.  Time, after all, was running out.

But simply enacting the legislation was not enough.  Big Insurance also demanded a seat at the table when it came time to actually drafting the regulations and implementing the law, since incompetent government bureaucrats could not be trusted to enact regulations and procedures that would fully indemnify the insurance lobby to its complete satisfaction.  Which brings us to the return of Liz Fowler, the author of the Affordable Care Act who is now the Deputy Director of Consumer Information and Oversight at the U.S. Department of Human Services, sort of an industry cop on watch to be sure government employees do what they are told.

Despite Big Insurance’s success in pulling off one of the most intricate swindles in the history of mankind by transferring tens of trillions of dollars of liabilities from their balance sheets to that of the Treasury Department, all to be paid for by massive tax increases on the American people (or fees, if you’re still arguing about the Commerce Clause in the increasingly irrelevant Constitution), the whole transaction would certainly deserve a special place in the pantheon  of lawlessness were it not for the decidedly unhappy outcome it will have for the true victims of this crime – the American citizens, who are now merely the property of an insurance industry that has a vested interest in keeping them healthy while they are still useful.  Those 22 year-olds who are today gleeful that they can stay on Mommy and Daddy’s insurance for a few more years won’t be quite as cheerful in 2030 when they are called before a panel Liz Fowler will undoubtedly have had a role in creating to explain why their cholesterol level has increased or are informed that certain substances detected in their last blood test indicated they are surpassing the monthly limit on pepperoni pizzas.  After being sent home with a hefty fine and orders to adhere to a strict diet of carrot sticks and mineral water, along with the latest behavioral modification drug developed by the recent merger of Pfizer and Merck, they may well wish they had been paying attention back in 2012, when there was still a chance to put a stop to it all.

In the meanwhile, it would be nice if certain political figures would put a stop to feigning political courage by mockingly referring to this legislation as Obamacare.  Obama didn’t write it or read it and there is nothing caring about it.  Call it what it is:

The Health Insurance Industry Protection Act.

You could also call it the end of freedom.

 

This post was authored by Adrian Murray is a business man in Fort Worth, Texas (President and CEO of Painless Performance Products) and an ardent Conservative thought leader in the North Texas community. It is with his expressed permission that this incredible piece is offered here. Thank You Adrian for your patriotism.

A Second Declaration Of Independence – “If Not Now, When?”

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Two hundred and thirty-six years ago a small group of brave souls stood up to what was at the time the most powerful nation on earth, declaring their independence from the tyranny of the British Crown. The Sugar Act of 1764, the Stamp Act of 1765, and the Declaratory Act of 1766 (Collectively known as the Townsend Acts) along with the Quartering Act of 1765 and the Tea Act of 1773 all lead to the uprising of the colonies and the American Revolution. Today we are faced with a tyranny of a different sort, which is similarly unacceptable. The Patient Protection and Affordable Care Act of 2010 (Obamacare) has now been upheld by the Supreme Court on a rather thinly veiled technicality. Its not a tax, but its constitutional because it really is a tax. No matter what you call it, this law represents historically the most significant overreach by our own government, and all freedom loving Americans should vigorously oppose it.

As a physician I am privileged to represent the American Society of General Surgeons both as a Delegate to the American Medical Association and as a representative to the Coalition of State Medical and National Specialty Societies; a rather loose consortium of conservative organizations within the AMA, where we’re in the minority to be sure. Following the annual meeting of the AMA House of Delegates in Chicago in June, 2011, we were frustrated by the fact that the House reaffirmed existing AMA policy, supporting a government requirement that every American purchase health insurance, the so-called individual mandate. In the wake of that defeat our Coalition came away without a clear understanding of what our next move should be. Various e-mail threads since then have failed to define a coherent physician-lead strategy. One such series of communications was titled “What is the Battle Plan?” While some would prefer the term Game Plan, either way its clear that we’re talking about a critical contest.

It seems obvious that before any competition one must first determine what is the object of the battle, or game. The problems that exist within the healthcare system are myriad, but central to every argument is one question. Is healthcare a basic human right and therefore the responsibility of government to provide for its citizens, or is it a benefit that has been developed by a civilized society and should be available to those who exercise individual responsibility to obtain it? Not surprisingly this question is quite polarizing, both for healthcare professionals (notice I didn’t use the demeaning term “providers”) and for the public as a whole. This is obviously a complicated issue for which there is no simple answer.

It is ridiculous to imply that American healthcare is bad, as some have claimed. It is the best in the world, but its also the most expensive, and no matter what anyone says, this fact is the sole reason behind the impassioned pleas for reform. Part of the reason our system is so expensive is because there are so many hands in the cookie jar. For years special interest groups have invested heavily in obtaining power within the ranks of government and they were actually the authors of the more than 2,000 page healthcare reform act.

The AMA is often considered to be the doctors’ special interest group, but It is important to recognize that the AMA, and all doctors for that matter, were only peripherally involved in the process of producing Obamacare. AMA leaders were wooed by the White House, but not as potential authors of the new law. Instead they were relegated to the role of commentators. Then during the actual public debate, they inexplicably seemed content just to be at the table, failing to recognize that our profession was indeed the main course. AMA leadership openly supported some elements of the bill, but the public never heard about the parts they objected to. AMA leaders told their dwindling membership (now less than 17% of America’s physicians) that problem areas, like the Independent Payment Advisory Board (IPAB) and the flawed Medicare payment system known as the Sustainable Growth Rate formula (SGR), would be “fixed” when the House and Senate versions came to conference committee. But, as we all found out, aggressive back-room politicians who recognized their opportunity (“If not now, when?”), worked in concert with the giddy media to push the Senate bill through unaltered. In no small way, AMA statements that sounded like doctors supported the bill helped put it on the President’s desk. The total lack of transparency and last minute parliamentary maneuvering made this perhaps the most shameful act of legislative cowardice in American history.

Whether you agree with the concept of universal health insurance or not, (again note I didn’t say universal healthcare because they are clearly not one and the same) the question remains whether it is the role of the government to command it. Patronizing lawmakers have told America’s physicians and our patients that this Congress and this President know what is best for us, and that we’ll like this new system once we get used to the idea. That reminds me of a statement made during a campaign by a gubernatorial candidate in Texas a few years back. He offered this advice to any woman being raped. “As long as it’s inevitable, you might as well lay back and enjoy it.” Well, obviously he lost the election, and based on the results of the 2010 midterm elections, a clear majority of Americans have not yet learned to “enjoy it”, preferring instead to fight back. Many of my fellow physicians have joined in that fight through organizations like the Association of American Physicians and Surgeons and Docs4PatientCare. So to the rest of my colleagues, and to the patients we serve, I would offer the following as a guide for our collective efforts.

  1. What is the objective of this fight? Repeal the ENTIRE law that we unaffectionately call Obamacare, and start over to create a patient centered system that encourages personal responsibility and rewards individuals for good health practices rather than punishing those who refuse to submit to some government mandate.
  2. What is the Battle Plan? Practicing physicians must get to work, joining other similarly minded groups and individuals to save our beloved profession. This battle starts with winning the hearts and minds of our fellow physicians. Our message must be that the future of healthcare relies on the individual physician’s moral compass and professional ethics and responsibility, not arbitrary controls mandated by any third party, be they the Federal government or private insurance companies. If we provide clear leadership for those who have lost faith in their representative organizations we will be able to effectively call up the vast militia of practicing physicians to join the fight. They will in turn be able to marshal the support of their patients who intuitively trust their doctors and want us to lead the way.
  3. What is our first engagement? Our main obstacle to achieving the basic objective of repealing Obamacare is the current uncompromising administration in Washington. Therefore, our primary mission must be to change the current regime. Unlike the Patriots in Philadelphia in the summer of 1776, we can accomplish this change at the polls, but it will not be easy. Between now and November 6, 2012 we must work tirelessly to turn the political tables on those who believe they know what is best for us and all our fellow citizens. There is a true urgency to get to work immediately as the elections are just four months away. Our battle cry in this effort should include that now famous phrase “if not now, when?”

Our God given freedoms and individual rights are like a handful of sand. We don’t lose them all at once; rather they slip through our fingers one grain at a time. The election this coming November has become our final opportunity for “We The People” to declare our independence from a government which openly seeks to control our personal health and individual wellbeing. If we fail in this effort to change the course of this nation now, how can we hope to retain any of our precious few remaining freedoms for ourselves or our posterity.

“The best way to predict your future is to create it.” Abraham Lincoln.

 

The opinions expressed are my own and do not necessarily reflect those of any organization or group. please feel free to review other posts on www.spiritofhealthcare.com and check out my clinical site at www.robertsewellmd.com

TO ARMS! TO ARMS! British Healthcare Is Coming!

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In the Spirit of the 4th of July holiday, the following is an updated version of an article published in “General Surgery News” – August 2009.

April 18, 1775 was a fateful date in American history. That night, Paul Revere, a Boston silversmith, rode his horse through the countryside and called his fellow colonists “To Arms!” British troops were arriving by sea to suppress any effort by the colonists to gain their freedom from the tyranny of the crown. Once alerted, the Minutemen responded at Lexington and Concord, and the rest is, as they say, history. The event was immortalized by Longfellow nearly a century later. But to be sure, not everyone in the colonies was in favor of revolution. There were those who were loyal to the crown called Tories or Loyalists, and those who vigorously opposed the repression of King George, commonly referred to as Whigs or Patriots. Thank God the Patriots’ efforts didn’t stop with the first “Tea Party.”

Today, we face another British invasion of sorts, and once again we must be called “To Arms!” This time the threat is to our personal healthcare freedoms, and is being imposed by our own government as it now has the power to regulate patients’ rights to choose what is best for them, as well as physicians’ rights to practice as independent advocates for our patients. Make no mistake, Obamacare has a distinctly British look and feel to it. In Great Britain everyone has access to “free” care through the National Health Service. While this sounds good, in reality diagnostic tests and treatments are frequently delayed for months or even years, and some treatments are denied as not cost effective.

Our Congress and the President have effectively seized the practice of medicine by controlling both reimbursement and access under the direction of a Healthcare Czar, otherwise known as Secretary of Health and Human Services, Kathleen Sebelius. Although government take-over of medicine has been occurring incrementally for decades, this current effort was designed to absorb the final segment, known as private practice.

Perhaps of even greater concern to all Americans is the precedent that has been set. This law was rammed through Congress based on the claim of an “economic crisis” requiring “emergency surgery.” This approach is now the model for achieving any additional “reforms” supposedly designed to “help us.” Thomas Jefferson once said “Be most on guard for your personal freedom when the government’s purposes are beneficent.” Interestingly, the members of Congress who proposed this new and improved healthcare plan voted down an amendment that would have forced them, their families and all government employees to participate in it.

Every American deserves a healthcare system that maintains our fundamental freedoms, including the right to choose and maintain their own physician. Obamacare severely curtails or eliminates these freedoms. Furthermore, it does nothing to improve the insolvent Medicare system. It actually makes it worse by cutting $500 Billion from the Medicare budget over the next ten years. It also failed to address the medical liability crisis that exists in most parts of this country, and does nothing to address the fatally flawed physician payment formula. The net effect of Obamacare promises to exacerbate the growing shortage of physicians in critically important specialties like General Surgery. New physicians won’t choose this or other equally demanding fields of medicine, and those who are in practice won’t remain because it simply isn’t worth it.

Many patients have asked, “Why don’t you doctors do something?” Well, many of us are trying but our influence is limited, partly because physicians are not well organized. On the issue of healthcare reform there are basically two camps, much like the colonist who were either Loyalists or Patriots. The AMA is often described as the voice of doctors, but it has fewer than 17 percent of America’s physicians as members. This is in no small part due to the fact the AMA leadership chose a “Loyalist” approach to government reforms, while the overwhelming majority of practicing physicians favor a “Patriot” strategy of active resistance. Organizations like the Association of American Physicians and Surgeons and Docs4PatientCare are among those attempting to carry this banner and are thus deserving of our support.

President Obama warned that writings such as this are the scare tactics of those who want to preserve the status quo. With all due respect, America’s physicians don’t need scare tactics. The public is already frightened and so are their doctors. A government take-over of our profession has everyone worried, as it should. Personally, as a physician who has been in practice for more than thirty years, I see this simply as an unacceptable intrusion by the federal government. However, it appears the only thing that can save American medicine is a general outcry from the public militia, our patients; thus the reason for this “Call to Arms.” All freedom loving Americans must make their voices heard at the polls in November.

Although this is a political process, it is actually very similar to the treatment of a patient with a life-threatening illness or injury. DIAGNOSIS: Obamacare threatens the very existence of what has been the best healthcare in the world. TREATMENT: Vote for  candidates who will repeal this law. In addition we must also remove Mr. Obama from the Presidency to avoid his certain veto of the true will of the people. FOLLOW-UP: Watch closely what happens and call or write your representatives to ensure they don’t forget what you’ve sent them to Washington to do.

Liberty, like life, is a precious commodity and once lost cannot be replaced. We simply cannot give up the fight to retain the freedoms others have fought and died to secure. So, before you say “my voice and my vote don’t really matter,” consider what would have happened had the Minutemen remained safely in their beds, allowing the Red Coats to cross Concord Bridge unopposed.

Robert Sewell, M.D., F.A.C.S.

 

The opinions expressed herein are my own, and do not necessary reflect those of any group or organization. Visit my web site at http://www.robertsewellmd.com