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Obamacare Advocates Hide the Truth: Obamacare RATIONS!

caseforkillinggrannyimagesYet another op. ed. Piece the the Tampa Bay Times refused to publish, again showing their bias in favor of Obamacare….

Recently local Physician and leader of the Obama teams’ “Doctors for America” group promoted Obamacare on the pages of the Tampa Bay Times. Dr. Mona Mangat extolled the virtues of law’s intention of expanding health insurance coverage and the idea that pre-existing conditions would be covered.  Unfortunately, Dr. Mangat does not report that under Obamacare, 30 million American residents will still not be covered by insurance.


 This cover of Newsweek advocate the kind of rationing that Obamacare Establishes.


 In addition, Obamacare advocates always seem to equate having an insurance card with the equivalence of having actual health care. The sad fact is that the history of government issued insurance cards demonstrates that Americans are likely to be disappointed by their perceived “coverage”.  For instance, Medicaid patient have great difficulty finding primary care doctors and specialists who will take their “insurance” because Medicaid pays barely over half of the already low Medicare rates.  I have had a patient drive from west of Pensacola for my neurosurgical services.  Medicaid patients have been shown to go to the Emergency room twice as often as uninsured patients since they can’t find doctors to see them in their offices. This is not coverage, and sadly Obamacare seeks to place 16 million more Americans into this substandard “insurance” program.

Obamacare advocates also celebrate the expanded coverage by claiming pre-existing conditions will not be denied by insurance companies.  First, Dr. Mangat is in error when she states there will be “no lifetime limits” on coverage. That is true only for the government-defined “essential benefit packages”.  However the insurance companies will not have to pay unlimited amounts for benefits that are not considered “essential”. That could mean many advanced treatments like hip surgeries, heart stents and other things described below.  Obamacare advocates always neglect to mention that under Obamacare Americans will face insurance companies with brand new government-granted rationing powers that won’t cover their new conditions!  Doctors will be placed on budgets through organizations called “ACO’s” (Accountable Care Organizations).  Doctors that go over their assigned budget for each patient “encounter” will be financially penalized. This causes gaming of the system by doctors to avoid sicker, more costly patients and possible penalties.  Doctors and hospitals will be coerced to comply with government standards that have been shown to have no benefit for patients while actually causing some negative effects. Recently hospitals began to suffer financial penalties for admitting patients within 30 days after discharge based on the faulty notion that the government can fine hospitals into “good behavior”.  This is while hospitals are also being pressured to not discharge patients too early while facing hundreds of billions of Medicare cuts by President Obama. A recent study revealed that for knee replacement surgeries, patients experienced higher readmission rates as they were also discharged earlier.  In the end, patients won’t be able to trust doctors and hospitals that will be working to prevent a fine or earn a financial “incentive” to meet government and insurance-company cost saving goals. (Continued below)

 This is what happens with you rely on health insurance for all your health care needs. You will find yourself the patient in this scene in “Doctor ACO” on You Tube. Here the doctor has turned into an HMO on steroids called an “accountable care organization” (ACO) and is actually rationing your care to make sure he gets paid as much as possible. A change is needed.

 Dr. Truth Hurts Warns us about Obama care on this Xtranormal Video.


There is a more disturbing trend among my physician colleagues and some organizations in medicine. Many of them are embracing the concept of ensuring that the resources of the state are protected at the same time they care for patients.  Ask any attorney if they would see their job in this way and they would tell you they serve only their client, not the government or corporation and its “resources”.  Recently the AMA, over my objections and those of the Florida Medical Association, adopted language that says the physicians have the “responsibility to be prudent stewards of shared societal resources”. This is, sadly, an identical concept embraced by the German Medical Association during the Hitler years and they recently issued an apology and “warning to the future” to avoid embracing such a faulty philosophy in medicine. Yet on a regular basis I now see my colleagues prematurely stopping critical care for elderly patients in the ICU and not advising patients of expensive treatments and screening procedures. These include Avastin, an expensive drug rejected by the FDA for breast cancer patients since “only” about 20% of patients respond to it; or the PSTF’s rejection of screening mammograms for those under 50 or prostate cancer screening for men.

There are better ways to provide high quality, lower cost care to more people in America. For instance, pre-existing conditions can be covered if people were able to keep their health insurance from job to job or state to state.  Costs would go down if people treated their insurance like “catastrophic coverage” for rare, expensive health events rather than a health benefits plan that covered every sniffle and twisted ankle.  The poor would get more help if costs were driven down by true free market competition, rather than the “Faux market” of government created insurance cartels that were just strengthened by Obamacare through the mandate to purchase their product.  No, people have nothing to fear by ending Obamacare, only fear if it continues to be implemented as planned.  A maxim in medicine is “First do no harm” and Obamacare does far more harm than good.

 Sources:

 Obamacare leaves 30 million uninsured. http://cnsnews.com/news/article/cbo-obamacare-will-leave-30-million-uninsured

 Readmissions and knee replacements: http://jama.jamanetwork.com/article.aspx?articleid=1362003 http://www.advisory.com/Daily-Briefing/2012/09/28/JAMA-Demand-for-knee-replacements-could-reach-3-5M-per-year-by-2030

 PSA screenings/ PSTF. http://www.aafp.org/online/en/home/publications/news/news-now/health-of-the-public/20120522psascreenrec.html

 Mammogram screening http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

 Avastin/FDA

 http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm280536.htm

 Obamacare/Medicaid/16 million http://www.forbes.com/fdc/welcome_mjx.shtml

 AMA “Prudent steward”

 http://www.ama-assn.org/amednews/2012/07/02/prsd0702.htm

 German Medical Association warning

 http://jama.jamanetwork.com/article.aspx?articleid=1346175

 (“The German physicians believed they were behaving morally and following the dictates of the Hippocratic Oath by transforming the doctor-patient relationship into a new relationship in which the state became the doctor and the German people became the ‘patient,’ or the volk,” said Sheldon Rubenfeld, MD, clinical professor of medicine at Baylor College of Medicine and president of the Center for Medicine After the Holocaust, in Houston, in an e-mail.”)

 Gaming the pay for performance system:

 http://www.jpands.org/vol14no4/mckalip.pdf

 On Medicaid overutilizing the ER. URBAN INSTITUTE REFERENCE with QUOTE:

 The uninsured and the privately insured adults have the same risk of being frequent users, but publicly insured adults are 2.08 times more likely to be frequent users.”

 And “It seems hard to blame the overcrowding of EDs on the uninsured.”  http://www.urban.org/publications/1000728.html

 

 References on increased use of ER: http://liberalarts.iupui.edu/cher/uploads/docs/deleirepaper.pdf (Wisconsin Medicaid expansion)

 http://www.rwjf.org/files/research/072109policysynthesis17.emergencyutilization.pdf (National ER utilization)

 Massachusetts ER visits up…

 http://www.reuters.com/article/2011/06/02/us-health-reform-er-idUSTRE7514VX20110602

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