Dr. Vladimir Gressel, MD
Hi everybody, I was asked to put my 5 cents on this topic (but nobody asked us, doctors in practice, and our opinion about it before this became a law 2 years ago).
Ponzi- Madoff Scheme:
America is a “dream comes true” country for every immigrant for the last 200 years, regardless when you immigrated. Remember those Irish and Germans in the late 18Th century, or eastern European Jews in the beginning of 19Th, or Cubans who run out from Fidel. And, of cause, latest flow of Mexicans, Dominicans, Pakistanis…., do not forget about us, Russian Jews in 1980-1990Th. We all came for a dream, and we all got one. Yes, it was same dream for everybody: we all wanted a ”good life”, not this miserable, poor struggle in our native country. The only difference is that some of us achieved it here by working very hard as traditionally this country was built on, but lately we see that more and more immigrants start obtaining their dream by totally different way. They start to figuring out about how to “milk” the system, how to become a “taker” of free stuff. You can ask me “what system”?, America is known only for capitalism, which make it so great. How can you “milk” capitalism, which supposed to promote hard work and innovations, support individual responsibilities?
Unfortunately, we ourselves created another system for the last century which allowed those who does not have desire to work hard have this wonderful American Dream anyway.
This system was sold out to us by politicians the same way as Mr. Ponzi did it in early 1920s: promise great returns for small investment in your future. More than that, they promised it GUARANTEED by the government! Social Security-failed, almost bankrupt, Medicare-already bankrupt, Medicaid-all in red ink. There is not, I repeat, not even one federal program in existence right now which is financially solvent and delivered what it was promised to do. But results of those “experiments and deviations from capitalism” are devastating for our kid’s future: almost 100 trillion dollars in unfunded liabilities for above mentioned programs and tens of millions of people who are become dependent on those programs. I should mention also food stamps, housing programs, free education, extended unemployment benefits, welfare and on and on…..
It is all done with one purpose only. Government can grow only if it controls your life as much as possible, through taxes, regulations and…Benefits, so called free stuff. When you become addicted to free stuff, you will beg your government (as an alcoholic) to give you more,…. in exchange for your freedom.
If anybody could tell me that Obamacare will be somewhat different, it is a joke. It is again and again, same Ponzi- Madoff-type of lie, but this time it is much worse than you think.
Myths vs reality:
Let’s review some facts. What was the main ”selling points” of Dems and president Obama two years ago
1. New law will decrease cost of private medical insurance.
False. Last year, even though main components of Obamacare will start only in 2013, average cost of private insurance increased dramatically by average of 12-15%. Why? Because, insurance companies started hiring large legal teams just to figured out how to comply with new, more than 2400 pages monstrosity. You right, only people who will benefit from this Obamacare are lawyers. And again, you right, who were the major supporters and lobbied this in Congress-LAWYERS, not doctors. By the new law, if you not comply with myriads of new regulations, your insurance company can be kicked out of business. Also, last year all insurances were forced to insure so called “kids” till age 26 for free (before it was till age 21). They also will be forced to insure everybody regardless of his/her medical history for the same price. Let me ask you “are you as a business owner would run your business without profit?” Of cause, not, you will increase price for premiums for everybody to cover your losses with sick insured people. Even my teenage son understands it, but our politicians pretend that they are not.
2. New law will provide medical coverage (or force to have insurance) to everybody, which will again (in theory) will control overall cost of healthcare. The argument was, that by insuring everybody we will dramatically decrease number of ER visits; that generally those people will have access to regular checkups and by early prevention we will safe tons of money on hospitalizations.
False. Besides the fact, that it is unconstitutional for federal government to force somebody to buy product (insurance), insuring everybody means only one thing: now patient can go to see a doctor without paying out of pocket. Those 32 million uninsured Americans consist of two separate groups: ones who obtained coverage as a free gift from the government and others who must buy it as they have income. Later group is young working people who did not have to spend money on insurance as they are again young and healthy. Now, since they invest their hard earned money in health insurance, they will come to see doctors as many times as possible, demanding expensive services, just to make sure their good health still “very good”.
Some of them will pay penalties for not buying insurance, calculating it is cheaper and, anyway, “I can always go to ER”, as before.
But it is even worse for those in the first group, they can do anything they want since it does not cost them anything, but it will cost tons of money for taxpayers, as we see it with Medicaid.
3. New law will dramatically improve quality of medical care
Another idiotic joke. How in the world we can improve it with sudden influx of 32 million new customers, but no new providers of this service. Actually, now we have significant shortage of doctors in this country. More than that, 46%(! ) of physicians considering leaving private practice medicine or work part time only, if Obamacare will be implemented. Do you want to be seen by a doctor, who does not even have time to look at your face, since he will be already writing on the computer your visit note to EMR (electronic medical record). News for you: your EMR should and will be available for governmental agencies reviews without your consent, and do not forget about computer hackers, if they can get into the files of Pentagon, it is a piece of cake to still your medical record.
4. Our senior’s Medicare program will not be affected, it will be even better.
How? By cutting it’s funding by 500 billion dollars? By cutting doctor’s fees by average of 25% in 2013? In 10 short years we expect 30% more Medicare recipients due to demographic changes (people live longer, plus huge number of baby boomers). Who is going to take care of them? More and more doctors thinking to opt out from Medicare, since it pays less and less, and they have to spend more time with those patients as they get older.
5. Nobody will be telling your doctor how to treat you
Another lie. Actually, very scary one
Most of you do not even know that Obamacare is already a part two of healthcare reform. First part was sneaked in in almost 1trillion dollars stimulus bill early 2009. In this bill 1,1billion dollars was allocated to create a Federal Coordinating Council for Comparative Effectiveness Research. Just three days after passage of Stimulus Bill, Obama appointed all 15 members of this Council.
The Federal Council is modeled after a U.K. board. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.
In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.
Later, in Obamacare bill, another new bureaucracy, the National Coordinator of Health Information Technology, was created and should monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions.
Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far. More than that,
hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the bureaucrats at Health and Human Services Department, who will be empowered to impose “more stringent measures of meaningful use over time”.
What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. It is just another appointed body with vast powers to make the “tough” decisions elected politicians won’t make.
6. Doctors support Obamacare
Not true. Obama’s administration pointed out on American Medical Association, who endorsed it, but membership of this organization dropped dramatically for the last 10 years. AMA does not represent physicians long time ago; it became another lobbing entity for special interests.
You might ask me about solutions, what you would do to improve health care and make it more affordable.
The answer is always in a free market, not in governmental bureaucracy
Just about 60 years ago there was no health care insurances, no Medicare or Medicaid and 85% of Americans were able to afford their doctor and hospital admissions. People understood then that they have to do priorities for their budget: either to do savings for future medical care or just spend money on entertainment, travel, extra clothing and etc…
Personal responsibilities were taught by parents and in schools. Now we are hearing something like “right to have free medical care”. I am aware of only three unalienable rights from our constitution: right to live, right for liberty and right to have property. We already ignored constitution when we proclaimed free government-sponsored education, which is declining ever since.
Give consumers (patients) power to choose which doctor or hospital to attend and let providers of service (doctors and hospitals) freedom how much they want to charge.
Remove thousands of regulations and policies and those charges will drop dramatically.
You would argue that to go back to simple times when nobody was standing between doctor and patient is unrealistic. Sadly, I agree with you.
But some common sense changes without spending a single penny of taxpayers must be done immediately to avoid disaster.
First, Obamacare should be repealed RIGHT NOW
Second, allow to purchase insurance for everybody across state lines
Third, stop greedy lawyers who sue for everything and scare every single doctor in this country. Doctors are ordering multiple and unnecessary tests just to protect themselves from lawsuits. Malpractice insurance for OB/GYN specialist in NYC about $180,000.00 a year!
Forth, reform Medicare ASAP, before it completely collapsed
My prediction for the next 10-15 years, if we will stay with Obamacare, is very pessimistic:
1. Most of the specialists will stop seeing patients with any insurance, including Medicare, accepting only private payments.
2. Most of the primary care doctors will be forced out from private practices and will work only for big hospitals or government-sponsored clinics.
3. In about 15-20 years public will demand from government access to specialists and doctors generally, as it will be tremendous shortage of physicians.
In response, and it is the only way, government will employ all doctors (and all other medical professionals with license) to order to provide all medical need of population. If you, as a physician, disagree to work for them, you license will be suspended. Do not forget, that it is a State who granted Medical License for Physician
My advice for everybody: hope for the best in 2012 elections, but prepare for the worst as your American dream could be a nightmare of socialism