Supreme Court Ruling on Individual Mandate – A Better Plan Awaits No Matter What the Decision. Thanks to the Florida Medical Association.

While most Americans are hoping the Supreme Court overturns the Congressional mandate to buy health insurance, Americans will still have much work to do to fix the health care system no matter how the Court rules.  The law is clearly an onerous and unnecessary intrusion into the lives of Americans and is part of a larger bill that establishes active rationing by government and insurance companies in ways never before seen in America.  Obamacare (PPACA) drives up the cost of insurance and is a gift to the insurance companies. Every American will be forced to buy their private product.  There will be about $120 billion in tax dollars “redistributed” to the insurance companies (in the form of subsidies to buy insurance) . The companies will use the money to increase profits and will further line their pockets by denying care with the force of government behind them.  When they use an accounting gimmick to show they are “running out” of money, you can bet there will be politically motivated bailouts to help them. In other words, they privatize the profits and nationalize the risk!!  Government and insurance companies win and individual Americans lose. (Continued below)

PPACA  (The inaccurately named “Patient Protection and Affordable Care Act”) will actually increase cost of insurance, expose patients to more harm through rationing and is therefore more accurately described as PEUCA – the Patient Endangerment and Unaffordable Care Act – that is pronounced “Puke-Ah” by the way. If the Supreme Court adheres to the Constitution, they will throw out PPACA since the commerce clause does not grant authority to Congress to force someone to buy a product as a requirement of citizenship.  The Commerce Clause has been long abused by the Supreme Court and Congress, and hopefully the Court will reverse that trend.

As stated above, Americans will still need to demand change no matter what the Court does.  If the Court throws out all or part of the law, a better system must be built.  If the Court upholds the law, Americans must work to have Congress repeal it piece-by-piece or all at once. Congress has already started working to dismantle it. Even the Secretary of Health and Human Services has done so by acknowledging that the CLASS act, designed to provide “free” home-based services for some patients through a Medicare-style insurance plan is a fiscal train wreck; the program was scrapped. 

Health care in our country is too expensive, quality is suffering and more people need access.  There are ways to solve these problems, but it is not through more government programs. These programs caused our problems in the first place.  The way to solve the problems require removing the role of government as much as possible and returning financial and medical-decision making control and responsibility to the hands of patients. This will benefit 90% of American immediately. It will also help the poor and those who don’t have insurance since it will drive down the costs of all health care and create competition to see more patients.  In addition, charity care can and should be bolstered.  

The Florida Medical Association spent nearly two years developing a health system reform plan for the nation that will increase affordability, access and quality of care.  It calls for insurance to be tied to the individual through their lives, not to their job.  Tax cuts for health insurance and health care purchased by individuals and the ability to carry insurance across state lines.  Insurance companies would not be allowed to raise the rates on the young and the healthy to cover the older and sicker.  Pre-existing conditions would be handled better by having individuals carry insurance with them throughout their lives, rather than buying a new plan every few years. There would be no rationing and those in Medicaid would shrink, but those covered by Medicaid would no longer have trouble finding a doctor.  (In the interest of full disclosure I am an FMA Board member and led the effort to develop this plan).

The FMA plan is a good alternative and is the reform Americans should demand no matter what the Supreme Court does.


 The Florida Medical Association

 Policies on Health System Reform

The Florida Medical Association (FMA) represents more than 20,000 physicians in the legislative and regulatory arena, as well as on public health and ethical and legal issues. As the largest professional association for physicians in the state, the FMA seeks to enhance the quality and availability of health care in the Sunshine State and to help physicians practice medicine. The following policies on health system reform were adopted by the FMA’s Board of Governors.

 1. The FMA will advise congress on health system reform policies that it opposes and those that it supports.

2. The FMA supports the following policies to increase access to affordable and high quality care:

 a. Promote Patient Rights

 i. Ensure that patients can receive medical care in their best interest within the patient physician relationship.

 ii. Ensure that third parties refrain from creating direct and indirect rationing of medical services.

 iii. Ensure that third parties refrain from creating “cookbook” medicine protocols that don’t help individual patients.

 b. Increase Affordability of Medical Services and Health Insurance

 i. Limit or end guaranteed issue and community rating for health insurance products.

 ii. Allow the interstate purchase of health insurance.

 iii. Promote the growth and expansion of health savings accounts and ensure that covered medical expenses are broad for these accounts.

 iv. Minimize state and federal health care coverage mandates.

 v. Encourage competition in the health industry by ending Certificate of Need laws, repealing Stark rules and self-referral laws, and allowing physician ownership of health care facilities.

 c. Promote tax fairness for health care financing

 i. Allow tax deduction for individuals who purchase health insurance outside of their place of employment.

 ii. Expand contribution amounts for tax-free health savings accounts and ensure roll-over of unused funds each year.

 iii. Create refundable, advanceable tax credits (vouchers) at the same rate regardless of income level for all Americans who purchase health insurance.

 d. Encourage private control of health care spending

 i. Reinstate right of Medicare and privately insured patients to privately contract with their physicians for medical care.

 ii. Create a choice for younger workers to contribute payroll taxes to an individually owned Medicareaccount or to keep money in the Medicare system.

 iii. Allow Medicare beneficiaries who opt out of Medicare the right to continue to collect other Social Security benefits.

 e. Ensure economic sustainability of Government financed health care

 i. Encourage transition of Medicare to an individually owned account for younger workers and subsidize cost of older workers who choose to transition to an individually owned account.

 ii. Establish means testing for Medicare recipients for benefits and premiums.

 iii. Reserve public financing of health care for those of lower incomes.

 f. Guarantee access to medical care

 i. Ensure economically sustainable medical practices and health care facilities.

 ii. Pass tort reform by capping payments for non-economic damages and protect patient rights by creating special liability courts and tribunals for liability cases.

 iii. Pay physicians and hospitals fair market value for services delivered to patients covered by publicly financed programs.

 iv. Minimize regulations that increase cost of care with no benefit to individual patients.

 g. Ensure high quality health care and protection of patient and physician rights.

 i. Ensure fair and strenuous board certification and licensing laws.

 ii. Promote fair, unbiased peer review as basis of quality and protect this review through federal law.

 iii. Ensure that only physicians practice medicine.

 iv. Allow access to courts and full judicial review for patients and physicians participating in publicly financed health programs and ensure full payment of attorney fees to prevailing party.

 3. The FMA opposes the following as health system reform policy:

 a. Creation of expanded public financing of health care through a “public option”.

 b. Individual and employer mandates to purchase health insurance supported by tax penalties.

 c. Value Based Purchasing and Pay for Performance programs that are not compliant with the AMA’s Principles and Guidelines on Pay for Performance.

 d. Mandated use of Electronic Medical Records or Electronic Prescribing.

 e. Reducing physician and hospital payments to fund incentive programs for value based purchasing.

 f. Bundling of physician payments with hospital payments for medical practice reimbursement.

 g. Financial penalties to physicians and hospitals for non-participation or non-compliance with government cost control and medical practice control programs.

 h. Economically undermining physician practices or hospitals by providing incentive payments for competitors in certain programs such as pay for reporting and accountable care organizations.

 i. Increasing payments for medical home physicians by cutting payments to specialists.

 j. Public reporting of physician and hospital practice data.

 k. Forced compliance with cost control protocols established by the Federal Coordinating Council on Comparative Effectiveness.

 l. Expanded scope of practice of non-physicians to practice medicine.

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