Tag Archives: obamacare

We Still Don’t Care About Doctors

doctors

In April, 2010, I posted a story pointing out a curious paradox. Inasmuch as healthcare—Obamacare—was such a hot topic, no one seemed to care about how poorly physicians were being treated by the system. Indeed, for all of its billions in spending, Obamacare does almost nothing to improve the lot of doctors, even as its rollout underscores the problems they face. Nor does it do much to alleviate their shortage.

It is hardly a revelation that government bureaucrats are the enemies of practicing physicians. Heck, this goes back 50 years to Medicare. But it is only recently that academic medicine, and its supporting cast of fat-cat NGOs, are also openly piling on.

I refer to the iCOMPARE and FIRST clinical trials, which are intended to test whether excessively long work-hour schedules for medical residents at hospitals across the U.S. cause more death and injuries to patients. Your first clue that these trials might be questionable is their hackneyed use of twee acronyms. Here’s the decode: Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education; Flexibility in Duty Hour Requirements for Surgical Trainees.

Notably, both of these trials allow first-year residents to work shifts lasting 28 consecutive hours or more—nearly twice the current maximum number of hours allowed by the Accreditation Council for Graduate Medical Education (ACGME). And this with the full approval of ACGME. At first blush, this seems surprising, since just four years ago, ACGME published its Duty Hour Standard Enhancing Quality of Care, Supervision and Resident Professional Development. Among other things, based on available research, it limited shifts for first year residents (PGY-1) to 16 hours.

Yet now, ACGME, one of dozens of parasitic NGOs sucking the very lifeblood out of healthcare, provided seed funding and agreed to waive its own requirements so that these trials could proceed. By odd coincidence, the American Hospital Association, whose members would benefit by getting more hours out of existing residents, is part of ACGME.

To encourage hospitals to sign up for the FIRST trial, a presentation prepared by Karl Bilimoria, MD—who would be the principal investigator—assured them that there would be no difference in outcomes. Besides, the residents would be forced to take on more hours. And here you thought that ethical research required voluntary informed consent; or that the highly touted institutional review boards actually mattered.

In theory, IRBs must ensure that risks to subjects will be minimized and would be justified, given the supposed benefits of the work. Except in so-called “low-risk” cases, researchers must obtain and document the voluntary informed consent of all subjects.

However, as pointed out by Public Citizen, the American Medical Student Association, and the Committee of Interns and Residents, informed consent was not obtained. More than that, any IRB finding of low risk is ludicrous in that the 2011 duty hour standards were adopted because risk to patients and physicians had been observed in extended hour situations. Incredibly, Northwestern University, home of dear Dr. Bilimoria, determined that its trial did not constitute research on human subjects. Yes, such mendacious ghouls really are in charge of academic medicine.

Bilimoria and his co-conspirators invoke the specious argument that it might be more risky for doctors to keep “handing-off” patients by virtue of shorter hours, thus destroying continuity of care. This is nonsense, made even more disingenuous when uttered by academic docs and healthcare bureaucrats—the ultimate fanboys of electronic health records. Pray tell, what esoteric patient information could not be documented and handed off to the next doctor?

Michael Carome, MD, Director of Public Citizen’s Health Research Group, has been spearheading efforts to get the federal Office for Human Research Protections (OHRP) to investigate both trials. Carome is asking for sanctions, but OHRP’s record in doing the right thing is far from exemplary.

Carome believes that it is “…highly unlikely that a trial that involves randomizing medical residents to a duty-hour schedule with longer shifts and less time off between shifts could ever be designed and conducted in a manner that would satisfy basic ethical principles or the federal human subjects protection regulations.” He laments that the system has broken down to such an extent that this research would be allowed in the first place.

I would expand his comments: The system has also broken down to the point that the crying need to expand residency programs has been eclipsed by our bloated and vastly corrupt federally-funded academic medical research industry.

Obamacare Was Supposed To Reduce Healthcare Costs, Right?

Obamacare

We won’t bury the lede.

“National Health Spending In 2014: Faster Growth Driven By Coverage Expansion And Prescription Drug Spending.” That’s the title of an article from the January, 2016 print version of Health Affairs, published online December 2nd. Here are a few key findings…

1.     US healthcare spending increased 5.3 percent to $3.0 trillion in 2014. That represents 17.5 percent of the gross domestic product.

2.     The 2013 growth in spending figure was 2.9 percent. 2014’s higher growth in spending rate is due mostly to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance.

3.     Retail expenditures on prescription drugs increased by 12.2 percent in 2014. Analysts pointed to the outrageously expensive Hep C drugs–Sovaldi and Harvoni from Gilead Sciences–as a factor. Prescription drugs account for around 10 percent of healthcare expenses.

 

If the $3.0 trillion didn’t blow your mind, consider that education, which involves a whole lot more people than healthcare, and can hardly be described as “efficient,” consumes only 7.3 percent of the GDP (OECD figures). You might recall that champions of the Affordable Care Act assured us that it would reduce the cost of healthcare. Their position now is a bit different: The cost increases would have been even higher without it.

“Millions of uninsured Americans gained healthcare coverage in 2014,” CMS acting Administrator Andy Slavitt said. “And still, the rate of growth remains below the level in most years prior to the coverage expansion, while out-of-pocket costs grew at the fifth lowest level on record.”

Notice how ACA cheerleaders attempt to obfuscate the findings. More people are availing themselves of healthcare under the ACA, but that was a given. Indeed, before the passage of the ACA, many people questioned how we could bring an estimated 30 million more people into the system, and simultaneously also lower the costs. Bear in mind that the per capita costs have also increased.

Ponder the nebulous statements of Slavitt. What sort of “coverage” is he talking about? Obviously, all plans are not equal, and a goodly number of those who gained coverage went onto Medicaid. Millions of others saw their previous plans, including Medicare, reduce benefits. How less specific could he have been on the rate of growth than “most years prior to coverage expansion”? Which years? How many years? Regarding out-of-pocket costs, how informative or meaningful is “the fifth lowest level on record”?

Considering that the Centers for Medicare and Medicaid Services (CMS) have an entire department devoted to healthcare statistics (Office of the Actuary), Slavitt’s remarks could–and should–have been more definitive. Hiding in plain sight is the fact that CMS essentially runs all American healthcare, “private” or otherwise. The Health Affairs article cited at the beginning of this piece was written solely by CMS officials.

Another favorite tactic of ACA fanboys is to admonish us that the ACA is about much more than insurance coverage–and it surely is. In essence, it is a power grab to gain control of an activity that makes up more than 17 percent of the GDP. And yes, there are provisions for increasing quality of care; improving payment accuracy; expanding preventive measures and corporate wellness programs; increasing the healthcare workforce (mostly through mid-level providers); modest improvements to the medical residency program; and outcomes research.

Interestingly, though, you don’t hear much about these other provisions, do you? Related to outcomes research is the matter of so-called Accountable Care Organizations, and these ACOs do get publicity. An ACO is network of doctors and hospitals that coordinates medical services for a specific patient population. The Feds set certain benchmarks for quality and spending. If the ACO meets the quality guidelines and has money left over, it gets to keep it. Otherwise, it must pay a penalty. In theory, then, there is an incentive.

Just last May, our friends at HHS announced that the “Pioneer Accountable Care Organizations,” under the Affordable Care Act, have saved Medicare $385 million. Trouble is, this figure has been widely contested, and when put to analysis by non-government sources, was reduced to around $42 million. More than that, the biggest savings came from ACOs that had the highest costs to begin with. Missing from HHS’ announcement was that 13 of the original 32 handpicked ACO groups dropped out.

Further and continuing ACO savings would likely come from flat-out rationing of care. As it is, a survey run by The Physicians Foundation found that only 13 percent of the docs believed that ACOs could enhance quality and decrease costs simultaneously. But what would physicians know about healthcare, compared to administrators, bureaucrats, and software peddlers?

Tell me if you’ve heard this one: “I’m from the government, and I’m here to help.”

The Danger of the ObamaCare Agenda Exposed

by Suzanne Eovaldi, staff writer

The glaring unfairness of ObamaCare can be seen in the anonymous analysis done by a well salaried California engineer and his very low paid girlfriend, a part time mail clerk. The lady friend earns $18,000 per year to his yearly income of $60,000 to $ 125,000. “For me, making $60,000 a year, under ObamaCare, the cheapest, lowest grade policy I can buy, with a $5,000 deductible, costs $482 a month. His gal friend, holding the exact same policy with the same deductible, pays $1.00 a month! “That’s right, $1.00 per month. I’m not making this up,” he said. Can you believe this? He invites you to check out his figures at the ObamaCare website for California residents at www.coveredca.com. Put in zip code 93940 to check his stats.

This engineer is not only complaining that our country’s healthcare burden is being shifted onto hard-hit, middle class Americans and upper income wage earners,  he holds most of his chagrin for the huge benefits illegal aliens are receiving. “A federally subsidized county medical complex that takes up an area about one-third the size of the Chrysler Corporation assembly plant in Illinois, “has the following state-of-the-art medical resources: 1) computed tomography and MRI devices; 2) 24 hour emergency room facility. All are “essentially free because almost everyone who ends up in ER is uninsured!” Can hard working, legal California/U.S. citizens get access to this outstanding medical center called Natividad Medical Center?

Are you kidding? “Last year, 2,735 babies were born at Natividad. . .32% were born to out-of-wedlock teenage mothers, 93% of which were Hispanic.” This is the group that Jeb Bush tells us came across the border to get better lives for their families. You bet they did, even before their babies left their mothers’ wombs. Yet we abort our own American citizens at appalling rates, rates that kill Afro-American babies at near 4-1 margins.

This disgusted engineer says less than 20% of these pregnant women could prove they were U.S. citizens and over 70% spoke only Spanish. Private health insurance was a non-starter for the 876 births because only 40 women had any sort of coverage that was their own. “THE TAXPAYERS PAID FOR THE OTHER” births, he said.

California is a pathetic example of rapacious rape of a blue state by Democrats so greedy for votes that they are destroying the lives, finances and homes of legal Californians. “Keep this in mind,” the long suffering engineer continues. “If I want to upgrade my policy to a low-deductible premium policy, such as what I had with my last employer, my cost is $886 per month. But my girlfriend can upgrade her policy TO THE VERY SAME LEVEL, for just $4.00 per month. . .that’s right, $4.00 per month for a zero-deductible, premium healthcare policy.” (emp. added)

Given a 500 year drought, out-of-control wildfires, a choke hold by public sector unions on the state house’s budget and Hollywood’s absolute destruction of America’s moral compass, California presents the American public with an epic disaster.

So the fed up engineer presents a best case example of what legions of hard working Americans have been flooding the web with for these last eight years of the Barack Obama attack on the once United States. “ObamaCare is not about dealing with inequities in the healthcare system. . .the real story is that it is a MASSIVE, POLITICAL POWER GRAB!” He then asks, “Why would I vote for anyone but a Democrat if I can have babies for $4.00 a month?” He points out that the long term disaster that such outrageous policies portend involves the re-population of America with inferior stock. “Think of just how many babies will be born to irresponsible, under-educated mothers. Will we get a new crop of brain surgeons and particle physicists (from the $4.00 baby pool) or will we need more cops, criminal courts, and prisons?”

So, you hard working schleps out there; do you think you matter to these Democrats, to these vicious media propagandists who are shilling for their party? Did you hear the CNN anchor falsely tell viewers that all of those poor migrants flooding into Europe at unbelievable numbers were really “Christians” fleeing religious persecution? How many young, Middle Eastern males do you see in comparison to women and children walking along Hungary’s railroad tracks? HIJRA is Islam’s word for the takeover of the West by the Muslim migratory diaspora.

America’s diaspora is flooding across the Rio Grande and through Texas and Arizona desert regions. Western civilization is under attack because these migratory movements espouse socialism, shared wealth (never with commensurate hard work), an anti-free market work ethic and yes, even forms of Marxism. That’s the new American way, if we allow it.

When legal Americans cannot get decent, free health care in their own country, but citizens of other countries can, well, how many of you out there paid $4.00 for the birth of your own children?

SOURCE: an untitled, anonymous E-mail making the web rounds.

Congress guilty of fraud and conspiracy as members steal $77 million in illegal ObamaCare benefits

By Doug Book, editor

So eager were congressional Democrats to sign Barack Obama’s healthcare servitude plan into law that nary a one recognized the fact that passage would effectively end their top of the line, taxpayer funded health insurance coverage.   obama-gay

And this would be just one of the unpleasant Affordable Care Act realities to take the legislation’s authors by surprise. For they would also lose some $10,000 in yearly premium assistance which had for decades been part of the Federal Employees Health Benefits Program (FEHBP). “In effect, the Affordable Care Act gave members of Congress a $10,000 pay cut.”

But that Washington lawmakers should be ravaged to the tune of $10,000—even as a result of their own legislative efforts—well   that sort of inconvenience is reserved for commoners, after all.

So the Office of Personnel Management (OPM)—with some slight urging on by Barack Obama—decided it might ignore that portion  of the Affordable Care Act which forbids providing generous subsidies to congressional employees.

But not even this convenient bit of contempt for the law would eliminate other problems the Affordable Care Act would cause its authors. Perhaps the greatest of these “prohibits employers from making contributions to their employee’s coverage through the American Health Benefits Exchange (ObamaCare Exchange) THABOEHNER AND MCCONNELLT SERVES INDIVIDUALS.” (my caps)

Difficult as it is to believe, members of Congress are employees of the American people. Their benefits, salaries and the like are handled by the Office of Personnel Management (OPM). If congress wanted to take advantage of the generous, ongoing premium assistance illegally afforded its members, they would have to sign up for ObamaCare with the D.C. Small Business  Exchange.

However, D. C. law “limits participation in the Exchange to small businesses employing 50 or fewer full-time employees.” This should have made it rather difficult to register the 12,359 congressmen, dependents, staffers and others currently taking advantage of taxpayer financed health insurance.

But the D.C. ObamaCare Small Business Exchange accepted applications in which the House and Senate claimed the existence of only 45 members each. Obviously these applications were known to be painfully fraudulent both by those who submitted them and by the D.C. Exchange which accepted them.

Judicial Watch, the very persistent, conservative watchdog    

Larry Klayman
Larry Klayman

organization founded by Attorney Larry Klayman is pursuing a lawsuit in the D.C. Circuit Court of Appeals, seeking to prevent the D.C. Exchange receiving $77 million tax dollars targeted to support the illegal enrollment and membership of the 12,000+ congressional minions.

So our congressional “employees” have defrauded the American people and American taxpayers by engaging in a willful conspiracy with the Office of Personnel Management, the D.C. Small Business Exchange and Barack Obama! Judicial Watch lawyers have at last forced officials at the D.C. Small Business (ObamaCare) Exchange to fess up and admit that “Congress is taking advantage of health benefits its members and staff are not entitled to claim.”  Of course, the Exchange “blacked out” the names of those who submitted the false ObamaCare applications on the part of the House and Senate; applications received in response to a Freedom of Information lawsuit filed by Judicial Watch.

Members of the House and Senate do not exhibit self-importance; rather they are self-infatuated, displaying an arrogance born of uncontested power. CiR will keep readers up to date with the progress of the Judicial Watch lawsuit.

LIES, LIES, LIES

By John Velisek USN (Ret), staff writer

I recently read about an ESPN commentator on CNN, stating that Obama had lied to the American People, but that it was not a problem because all Presidents lie. And besides, Bush was worse. This ESPN, politico wanna-be just couldn’t understand why the American people no longer trust Barack. Apparently it is perfectly acceptable to this individual that a dope smoking, foreign aid student like Obama should be placed in THE position of   

Obama with grandparents
Obama with grandparents

responsibility to the entire world. After all, other Presidents have lied. Of course with Obama it has been elevated to an art form.

The major concern of Americans is not only that Obama has lied, but that those lies have led to unconstitutional practices aided and abetted by the Democrat Party, the media and the GOP Establishment. The lying itself is based on premises grounded in Cloward-Piven and the Communist Manifesto.

There are personal lies, such as a social security number that is not his; and declaring that he was a foreign student which he then   

Obama the student
Obama the student

denied after finishing the studies for which he received aid money for foreign students!

There are environmental issues, such as the demonizing of coal, pulling permits for coal production that had been issued before his term in office causing coal producing electricity plants to shut down putting thousands of Americans out of work. Of course Obama cronies and campaign contributors received all the money they needed for “green energy projects” that have since gone    obama-gaybankrupt, making the taxpayer liable for the billions wasted.

And then there are the policy lies–remember “you can keep your doctor;” “your premiums will go down;” and the “cost of medical care will decrease?” How about suing states that follow federal laws which this administration refuses to enforce? Obama believes he has the constitutional right to ignore laws he does not agree with; to refuse enforcement of those laws and the right to create an unconstitutional amnesty by executive order.

Obama feels he has the right to censor insurance companies when they discuss raising premiums. He ordered the firing of a CEO who would not go along with the bankruptcy of General Motors because shareholders were cheated while money was given to the United Auto Workers instead. He instructed the NLRB to prevent Boeing building a new factory in a right-to-work state.    Obama-sweat-550x358

Obama put 45 Czars in place to bypass elected officials and write regulations without meddlesome interference by representatives of the people. This is also the President who claims great fondness for the military even while he told enlisted men and women that they must pay for their own health insurance because they volunteered and should have known the consequences. Barack also declared our military men and women unpatriotic for not agreeing with him.

This is the same President who promised to make every bill    Obama 2available to the public for three days on the internet. In 2007, Obama claimed the revolving door of lobbyists would be closed when he became President, but more than 40 lobbyists are currently working in his administration. This is the President with extensive ties to Wall Street even while making speeches about curtailing the massive amounts of money made there. This is the President who tramples the rights of the American people while celebrating the independence of the Occupy movement.

This is a short list of some of the lies and corruption of which this President is guilty. So much remains that volumes will be written long after Barack Obama has left office.

I would recommend that Barack Obama talk straight to the American people, but he is incapable of telling the truth. The American public see through you Barack. And you could not win a 3rd term, except with the help of the Republican Party. The question is, will the GOPe provide that assistance to Hillary?

John Velisek USN (Ret.)
Twitter:sjspecialist