Liberal legislation continues to disrupt our healthcare system

By the time you read this the physician reimbursement crisis may have been averted, yet again. But if not, doctors who still treat Medicare and Medicaid patients will see a reduction of 21.2 percent for Medicare patients and as much as 42.8 percent for Medicaid patients for services rendered on or before March 31, unless Congress enacts another “doc fix” before April 1

If the “doc fix” hasn’t yet been approved and isn’t approved today, both Medicare and Medicaid patients may have a far more difficult time getting medical care. And if it is fixed this time, what will happen when this fix expires?

This is yet another of the blessings of Obamacare, the Patient Protection and Affordable Care Act, enacted in 2010, and through tortured legal reasoning was ruled constitutional by the U.S. Supreme Court.

Obamacare is not the first government action to reduce reimbursements for Medicare and Medicaid patients, but because Obamacare put millions more people in the Medicaid system in order to increase the number of Americans who could then be counted as “insured,” it gets credit for the current crisis. And to keep down vocal physician opposition to adding millions more to an already broken system, Congressional Democrats who created Obamacare included a two-year increase in reimbursement rates that are now set to expire April 1, and that means the lower reimbursement rates will be back, if the “doc fix” isn’t passed.

Doctors generally get paid less for Medicaid and Medicare patients than their cost basis in treating them, and situations like this one magnify that problem. Consequently, some doctors limit the number of Medicaid and Medicare patients they see, and some do not treat them at all. Don’t be surprised if this situation causes more doctors to join those ranks every year until reimbursements for services to these patients are stabilized at a higher level so that doctors don’t lose money treating them.

On one hand we should support efforts to reign in absurdly high levels of government spending, which in 2014 was approximately 17 percent higher than revenue, meaning that for every dollar of tax revenue there’s 17 cents of deficit spending that the government has to borrow. But on the other hand, shortchanging physicians who treat America’s elderly and low-income or welfare-supported citizens is a foolish way to do that.

This is especially unfair to Medicare patients, who are not welfare recipients, and who, of all those who receive government benefits, are truly entitled to them. They receive essentially their own money, and that of their employers, both of whom had money taken from them by the government to fund Social Security, and later Medicare. These benefits are not the same as Medicaid, food stamps, child support and other welfare money.

The Social Security Act was passed in 1935 and is a promise government made to American workers and their employers that the money government took from them would be put in a trust fund and invested, and returned to them in their later years.

Predictably, the government then used that money for other purposes, not for the benefit of the people the Social Security Trust Fund exists to serve. The Trust Fund is now bankrupt, for all practicable purposes, being in the red approximately $300 billion.

And that raises the question: How is it possible that the Social Security Trust Fund, which was built by the monetary contributions of its recipients and their employers, can run out of money, but the “fund” that pays from $700 billion to $1 trillion annually for welfare in all its numerous forms, never runs out of money?

The “doc fix” that will help doctors who treat Medicare and Medicaid patients will also add to the deficit, and that obviously is bad. We need to spend less money, but we also need to not limit medical care to those who need it. The solution lies in repairing the Medicaid system, which provides care to millions, and many are perfectly capable of funding some or all of their own care. Welfare must be reserved for those who are truly needy and have no other solution.

And now, from centuries ago, here is a statement addressing the situation in which our once great nation now finds itself:

"A nation can survive its fools, and even the ambitious. But it cannot survive treason from within. An enemy at the gates is less formidable, for he is known and carries his banner openly. But the traitor moves amongst those within the gate freely, his sly whispers rustling through all the alleys, heard in the very halls of government itself. For the traitor appears not a traitor; he speaks in accents familiar to his victims, and he wears their face and their arguments, he appeals to the baseness that lies deep in the hearts of all men. He rots the soul of a nation, he works secretly and unknown in the night to undermine the pillars of the city, he infects the body politic so that it can no longer resist. A murderer is less to fear. The traitor is the plague." - Marcus Tullius Cicero (106-43 B.C.)

Ebola infected West Africa – Will it now infect the United States

President Barack Obama said the following on September 16 at the Centers for Disease Control and Prevention in Atlanta: “First and foremost, I want the American people to know that our experts, here at the CDC and across our government, agree that the chances of an Ebola outbreak here in the United States are extremely low. We’ve been taking the necessary precautions, including working with countries in West Africa to increase screening at airports so that someone with the virus doesn’t get on a plane for the United States. In the unlikely event that someone with Ebola does reach our shores, we’ve taken new measures so that we’re prepared here at home. We’re working to help flight crews identify people who are sick, and more labs across our country now have the capacity to quickly test for the virus. We’re working with hospitals to make sure that they are prepared, and to ensure that our doctors, our nurses and our medical staff are trained, are ready, and are able to deal with a possible case safely.”

Four days later the “unlikely” occurred: the first person infected with Ebola arrived in the U.S. from Liberia, where he had assisted an infected woman, become contaminated, but did not tell anyone about it in order to get on a plane and travel to Dallas, Texas. It took three different flights for him to get here and no one along the way apparently knew he had been in Liberia, or was able to determine that he had been infected, since he was asymptomatic until after he got here.

After developing a fever, he visited Texas Health Presbyterian Hospital was treated and sent home, despite having recently been in Liberia. He was staying with relatives in Dallas and as the disease progressed he got sicker and became contagious, and after that he returned to the hospital and was diagnosed with Ebola. Several days later, he passed away.

His relatives were exposed to Ebola, and the residence and outside areas were contaminated. Who knows how many others were exposed to the virus?

Mr. Obama said we can handle this, should the need arise. But the need arose, and a well-respected hospital didn’t handle the first infected person very well at all.

The first airport screenings began Saturday at New York’s John F. Kennedy International Airport in New York. Other airports were to begin screenings this week. Screenings at African airports and another screening at U.S. airports, the president said, would make it unlikely that someone infected with Ebola will get to the U.S.

Given the botched handling of the first Ebola patient in our country, can we believe Mr. Obama? “No matter how many of these procedures are put into place, we can’t get the risk to zero,” said the Centers for Disease Control and Prevention’s Martin Cetron, director of the Division of Global Migration and Quarantine. He told a news conference that these new measures wouldn’t necessarily have detected Ebola in the patient who traveled to Dallas.

Complicating an already unnerving situation, a second case of Ebola at the Dallas hospital has now been confirmed. A female nurse who had cared for the Ebola patient prior to his death was assessed on Friday, CDC Director Dr. Thomas Frieden said, and on Sunday it was confirmed that the nurse has Ebola.

The nurse’s infection is blamed on a breech of protocol. One report said that when removing the protective clothing she was wearing, the nurse inadvertently touched her cheek with her gloved hand, a glove that was contaminated with the virus. And now she has Ebola. And now, the disease has a small, but troubling presence in America.

This second error at this hospital has put other hospital personnel at risk, and may have infected one or more of them. Raise your hand if you believe the U.S. healthcare system really is prepared to deal with Ebola patients.

Even without these errors in handling Ebola in Dallas, it simply makes no sense either to bring potential or actual Ebola patients here, or allow people from countries where the disease exists to come here. Why take the chance of exposing Americans, particularly healthcare workers, to this vicious disease?

Columnist Thomas Sowell outlines the situation: “There was a time when an outbreak of a deadly disease overseas would bring virtually unanimous agreement that our top priority should be to keep it overseas. Yet Barack Obama has refused to bar entry to the United States by people from countries where the Ebola epidemic rages, as Britain has done. In other words, the safety of the American people takes second place to the goal of helping people overseas.”

President Obama has a giant blind spot when it comes to protecting the country from illegal entry of who knows who through the southern border, and now that blind spot extends to failing to stop people potentially infected with Ebola from coming into the U.S.

In situations like this one, we need to be smart, not compassionate. We can help the unfortunate West Africans by sending medical supplies and assistance without needlessly putting ourselves at risk. And we must.

Obamacare has been successful only in its ability to create chaos

Many people who have influence with President Barack Obama have gotten relief from the terrors of the Affordable Care Act we now know as Obamacare, but the great majority of the American people are still expected to follow the dictates of the healthcare “reform” law next month.

The administration’s announcement July 2 delaying the employer mandate was the first in a series of goodies provided to favored constituencies. And, about 20 percent of waivers went to gourmet restaurants, nightclubs, and fancy hotels in Rep. Nancy Pelosi’s (D-Cal.) district.

But as maddening as this discrimination is to us common folk, exempting Members of Congress and their staffs is far worse.

Under heavy pressure from Democrat leaders, Mr. Obama agreed to ignore the terms of the law that he pushed so hard for and now requires taxpayers to subsidize coverage for representatives, senators, and their employees to lessen the financial burden of Obamacare.

What a hardship these taxpayer-supported elected officials and employees suffer: The Office of Personnel Management reported that as of September 2012, the average salary for a full-time, permanent, non-seasonal government position was $78,467, and rank and file members of Congress make $174,000. The average American in the private sector makes less than $50,000.

It is possible for others to receive subsidies, too, and the key is income level. But, typical of this law’s rampant failures, there is no mandate to verify eligibility for a subsidy, virtually guaranteeing extensive fraud, and an additional expense burden on taxpayers.

Only about 36 percent of Americans have a positive opinion of the law, and now even Mr. Obama’s strong union supporters are calling for repeal or major repair of this debacle because it is decimating the 40-hour workweek that is the backbone of unionized labor.

Throughout the debate over Obamacare, a major claim was that it would cover the 30 million people that at the time did not have some sort of health insurance, ignoring the fact that a significant number chose not to have insurance. However, the Congressional Budget Office says that over the next decade there will never be a point where the number of Americans who remain uninsured will drop below 30 million. In other words, the main reason for ramming Obamacare down the throats of 270 million people who were happy with their health insurance is a falsehood.

Other of the President’s promises also have been broken:

Promise: “If you like your health care plan, you’ll be able to keep your health care plan, period.”
Truth: As many as 30 percent of employers will stop providing their existing health care coverage, while many are reducing employee hours below the 30-hour/week full-time level, or are trimming total employees to fewer than 50 to escape the crushing costs imposed by Obamacare.

Promise: “I will not sign a plan that adds one dime to our deficits — either now or in the future.”
Truth: We now know that health care “reform” will cost a trillion dollars.

Promise: “I will protect Medicare.”
Truth: Obamacare ends Medicare as we know it by imposing, among other things, severe reimbursement cuts that threaten access to care for seniors.

Promise: “I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family’s premium by up to $2,500 a year.”
Truth: There are at least 12 ways that Obamacare will increase premiums instead of reducing health care costs.

Promise: “Under my plan, no family making less than $250,000 a year will see any form of tax increase.”
Truth: Obamacare includes tons of new taxes and tax hikes. One that began this year is the 2.3 percent excise tax on manufacturers and importers of certain medical devices that will raise $20 billion by 2019.

It’s not that Barack Obama deliberately misleads; it’s just that so much of what he says isn’t true.

Few people now defend Obamacare besides the Congressional Democrats who participated in the dishonorable process of throwing it together, voting for a 2,700-page bill they had never read, and which had zero bi-partisan support.

Many believe that Barack Obama never really cared what was in the Affordable Care Act or if it ever makes it to implementation, and in fact wants it to fail miserably. And that’s because once it becomes law, replaces the prior system, and causes mass chaos, the stage would be set to move to a single payer, government healthcare system as the only way to fix the resulting mess.

In his worldview, socialistic/communistic systems are the solution to all the country’s problems, and that is how he wants to “fundamentally transform the United States of America.”

The best thing for the country is to repeal Obamacare and begin again to make the several relatively minor adjustments to the current system that should have been done several years ago. Short of that, delay implementation for everyone until the numerous problems can be addressed and repaired.

Neither is likely to happen, of course, because too many people can’t admit they made a mistake, or they truly want government controlled health care.

Obamacare’s serious weaknesses driving even strong supporters away

Commentary by James H. Shott

Although Sen. Max Baucus (D-Mont.) only recently acknowledged that the health care reform bill he helped create – the Patient Protection and Affordable Care Act (ACA), also known as Obamacare – is a “train wreck,” most Americans suspected that at its creation.

Things are so bad that President Barack Obama, trying to prevent some of the disastrous results, did something he is not allowed by the U.S. Constitution to do: postpone implementation of part of the law by suspending the employer mandate until 2015 and leaving the rest of the law intact. The Executive Branch of our government is obligated to enforce the laws – all of them, and all of each of them – and does not have the power to choose which ones, or parts thereof, it will enforce.

The House of Representatives passed two measures delaying the employer and individual mandates for one year, with 35 and 22 Democrats respectively joining in those efforts, which Mr. Obama has curiously threatened to veto.

And more recently, one of Obamacare’s most devoted groups of supporters has jumped ship. In a letter to Democrat Congressional leaders, Teamsters union president James Hoffa, and the presidents of two other unions, said this: “Right now, unless you and the Obama Administration enact an equitable fix, the ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.”

The law has already encouraged some employers to trim their staffs to fewer than 50 full-time employees to avoid the expense of the mandate, and in other cases to decide against providing insurance altogether, and pay a much cheaper fine.

Nevertheless, Mr. Obama declared last week that "the law is working the way it was supposed to for middle-class Americans,” and criticized House Republicans for trying to dismantle it.

Polling data from five different polling organizations from mid-May through July 13 shows continuing disfavor among Americans, with the disparity of opposition-to-support running from as little as 5 points to as much as 15 points, and the Real Clear Politics average of the five polls at 10.2 points.

According to the Gallup poll from late last month, 42 percent say that in the long run the law will make their family's healthcare situation worse, and only 22 percent say it will make it better. And 47 percent believe the law will make the healthcare situation in the U.S. worse, while only 34 percent say it will make it better.

Republicans also are criticized for offering no alternatives while trying to dismantle the measure. “Three years after campaigning on a vow to ‘repeal and replace’ President Barack Obama’s health care law, House Republicans have yet to advance an alternative for the system they have voted more than three dozen times to abolish in whole or in part,” Sunday’s editorial in The Washington Post complained. That ignores, however, H.R. 3400 - Empowering Patients First Act, introduced in 2009 before Republicans campaigned for and won control of the House.

And now there is another, H.R. 2300 – the Empowering Patients First Act of 2013. Its principal sponsor is Rep. Tom Price (R-Ga.), who sponsored H.R. 3400, and he has credentials for health care issues matched by few in the Congress. Rep. Price is also Dr. Price, a physician who actually delivered and understands patient care.

This measure allows patients, families and doctors to make medical decisions, not Washington, DC. That is an excellent place to begin improving health care. What a shame that wasn’t the driving factor behind the ACA.

“You can get folks covered, you can solve the insurance challenges, and you can save hundreds of billions of dollars in this health care system,” said the physician/Congressman, “all without putting Washington or health insurance companies in charge of those decisions that ought to be between patients, and families and doctors.”

How can H.R. 2300 – a bill of only 249 pages, less than a tenth the length of the monstrous Obamacare bill – accomplish this?

Rep. Price describes it as comprehensive legislation under which “every single American has the financial feasibility to purchase the coverage they want, either through tax deductions, or credits, or advanceable credits or refundable advanceable credits so that they can purchase the coverage they want for themselves or their families, not what the government forces them to buy.”

He says further that everyone owns their own coverage, like a 401k plan, so if they change their job or lose their job, they take their coverage with them, and it allows all of those with pre-existing conditions to pool together, giving them the purchasing power of millions so that no one person’s adverse health status will change the cost for anyone else, including that one person.

While H.R. 2300 has the great advantage of being properly focused on patients and physicians, trying to straighten out the voluminous failures of the ACA in one bill is a Herculean feat. Obamacare needs to be repealed in total, and as soon as possible, and then Congress must undertake a sensible approach to correcting the problems of the health care system without turning it over to the government.

Cross-posted from Observations

Continuing our head-long slide down the slippery slope of abortion

When people challenge and attempt to liberalize valued traditions, there is usually great concern that doing so is the first step down the "slippery slope," which ultimately leads to bad results. The “slippery slope” is considered a logical fallacy, but in the case of abortion, evidence supports that it is an apt argument.  

We started down this slope when abortion was legalized 40 years ago. If it was not the original intention, abortion certainly has become a thinly disguised mechanism for after-the-fact birth control. Pregnancy is not a mystery; we know what causes it. There are numerous ways to prevent pregnancy whenever people decide to forego the one certain way to prevent pregnancy: abstinence.

Birth control devices, while not perfect, are very dependable when used properly. However, somewhere along the way it was recognized that there were a lot of people facing the eventual birth of an unwanted child, and some thought that society was obligated to find a way to relieve these folks of having to bear responsibility for their actions. Abortion became the solution for unwanted pregnancy, under the curious label, "a woman's right to choose."

Each now-pregnant woman and her male partner had the right to choose to abstain from sexual intercourse and chose not to. They had the right to choose to use birth control, and either chose not to, or chose not to use it consistently or correctly, or it just didn't work one time. In the great majority of cases, birth control measures do work when used properly, and that means that in the majority of cases the right to use birth control actually was not chosen.

The "right to choose" is little more than a mechanism for prospective parents to avoid creating a child at an inconvenient time: In 2004 fully 74 percent of women getting an abortion said a child would "dramatically change their life."

Since Roe v Wade imposed legalized abortion on the nation in 1973, 55 million abortions have been performed, and approximately 1.2 million future Americans were aborted in each of the last several years. Nearly half of all pregnancies in the U.S. are unintended, and nearly half of those are aborted.

Planned Parenthood is the nation's most prolific provider of abortions, performing about 1-in-4 total U.S. abortions each year, chalking up 334,000 in 2011. It received $542 million from taxpayers that year, about 40 percent of its total revenues.

And since 1973 we have witnessed the slide down that slippery slope. It has been considered acceptable by a significant number of Americans to end a pregnancy anywhere from the morning after to the day when the baby should be born healthy and ready for life.

We have been treated to horrors such as partial birth abortion where the baby is allowed to be born, but not completely, with part of the child still in the birth canal so that a butcher with MD or DO after their name can kill the child before it is "born." This nefarious procedure takes hair-splitting to a new level.

A year ago a giant slide down the slippery slope occurred when two Australian ethicists – Alberto Giubilini with Monash University in Melbourne, and Francesca Minerva at the Centre for Applied Philosophy and Public Ethics at the University of Melbourne – provided an answer to the question, "When does a fetus become a person?" Their answer: it doesn’t matter. They argued in the online edition of the Journal of Medical Ethics that if abortion of a fetus is allowable, so, too, should be the “termination” of a newborn.

This cold-blooded idea has now infected the United States. That same concept appeared in testimony at a Florida legislative committee that was considering a bill to require abortionists to provide medical care to an infant who survives an abortion and is moving on the table and struggling for life. A Florida Alliance of Planned Parenthood Affiliates lobbyist endorsed the right to "post-birth abortion." The lobbyist, Alisa LaPolt Snow, stunned legislators when she said that her organization believes the decision to kill an infant who survives a failed abortion "should be left up to the woman, her family, and the physician."

This is nothing more than pre-meditated murder, and is not so different from first responders executing a seriously injured accident victim. And just how far does this "right" to post-birth abortion extend? The first birthday? The difficult years of adolescence? Or perhaps it will extend many years after the botched abortion when under as-yet-unknown elements of the Affordable Care Act bureaucrats may be in the position to determine that it will cost too much to keep an elderly patient alive.

Fortunately, the tide appears to be turning against the grizzly practice of abortion. Last June a Gallop poll showed that 50 percent identified themselves as "pro-life" compared to 41 percent who said they were "pro-choice." And, 51 percent said abortion is morally wrong, compared to 38 percent who said it is morally acceptable. And some state legislatures have passed tighter restrictions on the procedure.

This attitude favoring preserving life and restoring personal responsibility is one small ray of light in America's otherwise darkening culture.

Death Panels are HERE

By Findalis

The Grouch at Right Truth is a practicing Emergency Room Doctor.  He is a man who doesn't give into hysterics, conspiracies, and tin foil craziness.  So when he speaks out against Obamacare I listen to him.  And you should too.  Having said that, I received this from his lovely wife Debbie of The Right Truth with a plea to pass it along.  That I am doing.

Death Panels are HERE

Today while working my shift in the emergency room, an old lady was brought in very sick and in fact near death. I did my usual workup and evaluation and attempted to administer life saving treatment. It was my plan to admit this woman to the hospital. I found out a little later that this same woman had been a patient here just slightly more than 2 weeks ago with a DIFFERENT DIAGNOSIS. I was told that if this woman was admitted, the hospital would not be paid.

The new Medicare rule now is that if the same Medicare patient is re-admitted to the hospital within 30 days, the hospital will not be paid. When they first started this nonsense they said this only applied to patients with the same diagnosis. Now they have "expanded" the rule to include re-admissions for any reason. So if you're in the hospital for pneumonia, and 3 weeks later, you break your leg.......too bad. Medicare will not pay the hospital to fix your leg.

A little later a man was brought in by ambulance, very sick, in pain, and near death. I did my usual evaluation and treatment, doing my best to ease pain and stabilize this man's illness. He needed to be admitted. To my chagrin I found out that he had been treated for the SAME problem at a DIFFERENT HOSPITAL about 10 days prior. If I admitted this man, our hospital would be paid nothing. I admitted the man.

My friends I am caught in a terrible position. I could have given treatment to both of these people and sent them out. There is no doubt that both of them would have died. Oh, I could also be sued for malpractice, but nobody cares about that. That's why we have insurance, right?

My other choice is to admit the person, knowing full well that the hospital will have to absorb the cost of care without hope of remuneration.

This is the climate we as healthcare providers find ourselves in today. How many small and struggling hospitals will survive under such ludicrous payment schemes? Indeed many facilities will close their doors. Many doctors will retire early or simply go do something else. As more and more are added to the Obamacare rolls, there will be less and less access. People will get sicker and yes, people will die because of it.

I had a sick and sinking feeling in the pit of my stomach today after both of these incidents. We have a good hospital. Our nurses, technicians, and support staff work very hard and they deserve to be paid for their efforts. I am not so worried about myself as I am near retirement, but I worry for all the younger folks in the healthcare business and I worry about our seniors who are in the long run going to be sacrificed as the government implements cost cutting shenanigans to cover up their broken promise made way back in 1964.

Folks, this is a nightmare!

Remember when Nancy Pelosi said that we had to pass the bill to know what was in the bill?  We now know what is in the bill.  AND WE DON'T LIKE IT!

If you will, please pass this along.  Either through Facebook, Twitter and/or on your own blog.  And remember to vote on Nov. 6th to remove the problem that caused this disaster:  President Barack Hussein Obama.