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HEALTHPLANUSA. |
QUARTERLY NEWSLETTER |
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Community For Affordable Health Care |
Vol X, No 3, Oct,
2011 |
Transforming the $3 Trillion HealthCare
Industry into Affordable HealthCare
By Utilizing the $2 Trillion Information
Technology Industry
Through innovation by moving from a Vertical
to a Horizontal industry
Thus eliminating $1 Trillion wasted
Insuring every American without spending the
Extra $1Trillion Projected.
To purchase a copy of the business
plan, become an entrepreneur,
and changed the course of history, go to the bookstore at
www.healthplanusa.net/index.asp
In This Issue:
1. Featured Article: To Increase Jobs, Increase
Economic Freedom
2. In
the News: Put Doctors and Patients in charge of Healthcare
3. International Healthcare: Obamacare.
Where did it originate?
4. Government Healthcare: Most of What You Know About American Health
Care is Wrong
5. Lean
HealthCare: ObamaCare is going in the opposite direction.
6. Misdirection in: Hospitals taking
over doctor’s practices—150 percent increase
7. Overheard on Capital Healthcare
Hill: What do Wall Street protesters overlook?
8. Innovations in Healthcare: Currently
eliminated by the Government
9. The Health Plan
for the USA: Level C: Outpatient Non-Hospital Based
Medicine
10. Restoring
Accountability in Medical Practice by Moving from a
Vertical to a Horizontal Industry
The
Annual World Health Care Congress,
a market of ideas, co-sponsored by The Wall Street Journal, is the most
prestigious meeting of chief and senior executives from all sectors of health
care. Renowned authorities and practitioners assemble to present recent results
and to develop innovative strategies that foster the creation of a
cost-effective and accountable U.S. health-care system. The extraordinary
conference agenda includes compelling keynote panel discussions, authoritative
industry speakers, international best practices, and recently released
case-study data. The
8th Annual World Health Care Congress will be held April 4-6, 2011
at the Gaylord Convention Center, Washington DC. For more
information, visit www.worldcongress.com. The future is
occurring
*
* * * *
1. Feature Article: To Increase Jobs,
Increase Economic Freedom
John P. Mackey is co-founder and CEO of Whole Foods Market, a $4.7 billion
Fortune 500 company, and a "Fortune 100 Best Companies To Work For"
every year since 1998. Whole Foods is one of the top 12 supermarket companies
in America and the world's largest natural foods retail chain. He was named the
Ernst and Young Entrepreneur of the Year in 2003. Mr. Mackey is a strong
believer in free market principles and empowerment management, and co-founded
FLOW with Michael Strong to promote an integrated vision of entrepreneurship
directed towards social good. Mr. Mackey has lived on a vegetarian co-op, he
and his wife, Deborah, both practice meditation and yoga, and spend as much
time as they can on their 720 acre ranch west of Austin. John is a voracious
book reader and participates in two monthly book clubs. He is always up for a
lively debate about politics, economics, history or sports.
Source: www.workingforgood.com
Business is not a zero-sum game struggling over a fixed pie. Instead it
grows and makes the total pie larger, creating value for all of its major
stakeholders, including employees and communities.
By JOHN MACKEY
Is the United States exceptional? Of course we are! Two hundred years ago
we were one of the poorest countries in the world. We accounted for less than
1% of the world's total GDP. Today our GDP is 23% of the world's total and more
than twice as large as the No. 2 country's, China.
America became the wealthiest country because for most of our history we
have followed the basic principles of economic freedom: property rights,
freedom to trade internationally, minimal governmental regulation of business,
sound money, relatively low taxes, the rule of law, entrepreneurship, freedom
to fail, and voluntary exchange.
The success of economic freedom in increasing human prosperity, extending
our life spans and improving the quality of our lives in countless ways is the
most extraordinary global story of the past 200 years. Gross domestic product
per capita has increased by a factor of 1,000% across the world and almost
2,000% in the U.S. during these last two centuries. In 1800, 85% of everyone
alive lived on less than $1 per day (in 2000 dollars). Today only 17% do. If
current long-term trend lines of economic growth continue, we will see abject
poverty almost completely eradicated in the 21st century. Business is not a
zero-sum game struggling over a fixed pie. Instead it grows and makes the total
pie larger, creating value for all of its major stakeholders—customers,
employees, suppliers, investors and communities.
So why is our economy barely growing and unemployment stuck at over 9%? I
believe the answer is very simple: Economic freedom is declining in the U.S. In
2000, the U.S. was ranked third in the world behind only Hong Kong and
Singapore in the Index of Economic Freedom, published annually by this
newspaper and the Heritage Foundation. In 2011, we fell to ninth behind such
countries as Australia, New Zealand, Canada and Ireland.
The reforms we need to make are extensive. I want to make a few suggestions
that, as an independent, I hope will stimulate thinking and constructive
discussion among concerned Americans no matter what their politics are.
Most importantly, we need to radically cut the size and cost of government.
One hundred years ago the total cost of government at all levels in the
U.S.—local, state and federal—was only 8% of our GDP. In 2010, it was 40%.
Government is gobbling up trillions of dollars from our economy to feed itself
through high taxes and unprecedented deficit spending—money that could instead
be used by individuals to improve their lives and by entrepreneurs to create
jobs. Government debt is growing at such a rapid rate that the Congressional
Budget Office projects that in the next 70 years public money spent on interest
annually will grow to almost 41.4% of GDP ($27.2 trillion) from 1.4% of GDP
($204 billion) in 2010. Today interest on our debt represents about a third of
the cost of Social Security; in only 20 years it is estimated that it will
exceed the cost of that program.
Only if we focus on cutting costs in the four most expensive government
programs—Defense, Social Security, Medicare and Medicaid, which together with
interest account for about two-thirds of the overall budget—can we make a
significant positive impact.
Our defense budget now accounts for 43% of all military spending in the
entire world—more than the next 14 largest defense budgets combined. It is time
for us to scale back our military commitments and reduce our spending to
something more in line with our percentage of the world GDP, or 23%. Doing this
would save more than $300 billion every year.
Social Security and Medicare need serious reforms to be sustainable over
the long term. The demographic crisis for these entitlement programs has now
arrived as 10,000 baby boomers are projected to retire every day for the next
19 years. Retirement ages need to be steadily raised to reflect our increased
longevity. These programs should also be means-tested. Countries such as Chile
and Singapore successfully privatized their retirement programs, making them
sustainable. We should move in a similar direction by giving everyone the
option to voluntarily opt out of the governmental system into private
alternatives, phasing this in over time to help keep the current system
solvent.
In addition, tax reform is essential to jobs and prosperity. Most tax
deductions and loopholes should be eliminated, combined with significant tax
rate reductions. A top tax rate of 15% to 20% with no deductions would be
fairer, greatly stimulate economic growth and job creation, and would reduce
deficits by increasing total taxes paid to the federal government.
Why would taxes collected go up if rates go down? Two reasons—first, tax
shelters such as the mortgage interest deduction used primarily by more
affluent taxpayers would be eliminated; and secondly, the taxable base would
increase considerably as entrepreneurs create new businesses and new jobs, and
as people earn more money. Many Eastern European countries implemented low flat
tax rates in the past decade, including Russia in 2001 (13%) and Ukraine in
2004 (15%), and experienced strong economic growth and increased tax revenues.
Corporate taxes also need to be reformed. According to the Organization for
Economic Cooperation and Development, the U.S.'s combined state and federal
corporate tax rate of 39.2% became the highest in the world after Japan cut its
rates this April. A reduction to 26% would equal the average corporate tax rate
in the 15 largest industrialized countries. That would help our companies to
use their capital more productively to grow and create jobs in the U.S
Government regulations definitely need to be reformed. According to the
Small Business Administration, total regulatory costs amount to about $1.75
trillion annually, nearly twice as much as all individual income taxes
collected last year. While some regulations create important safeguards for
public health and the environment, far too many simply protect existing
business interests and discourage entrepreneurship. Specifically, many
government regulations in education, health care and energy prevent
entrepreneurship and innovation from revolutionizing and re-energizing these
very important parts of our economy.
A simple reform that would make a monumental difference would be to require
all federal regulations to have a sunset provision. All regulations should
automatically expire after 10 years unless a mandatory cost-benefit analysis
has been completed that proves the regulations have created significantly more
societal benefit than harm. Currently thousands of new regulations are added
each year and virtually none ever disappear.
According to a recent poll, more than two-thirds of Americans now believe
that America is in "decline." While we are certainly going through
difficult times our decline is not inevitable—it can and must be reversed. The
U.S. is still an extraordinary country by almost any measure. If we once again
embrace the principles of individual and economic freedom that made us both
prosperous and exceptional, we can help lead the world towards a better future
for all.
Mr. Mackey, co-founder and co-CEO of Whole Foods Market, is a member of the
Job Creators Alliance, a nonprofit devoted to preserving free enterprise.
http://online.wsj.com/article/SB10001424052970204358004577032442153911170.html
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* * * *
2. In the News: Put
Doctors and Patients in charge of Healthcare
This
week marks six months since Congress passed the healthcare reform
bill in what has become all-too-typical legislative chicanery. Those in power
crafted a mammoth piece of legislation and rammed it through Congress under a
dire sense of emergency. Insisting on time enough to read the bill was
dismissed as dangerous and crazy in a time of crisis. We were told that if we
really wanted to see what was in the bill we would have to pass it first. I
cannot imagine the Founding Fathers intended that Congress legislate in this
manner. I would think if a member is not absolutely certain the entire
legislation meets constitutional muster, the default vote should be “no” in
accordance with our oath of office. But now that Congress has had six months to
read the new law, there is a significant amount of buyer’s remorse on Capitol
Hill.
The
more constituents learn about the law, the more angry they become. 60% of
Americans are now to be said in favor of repealing the entire thing.
Unfortunately, it is much more difficult to repeal a law than it is to pass a
bill. I wrote a while back about the egregious provision to require businesses
to issue 1099s for all transactions over $600 as a way to partially pay for it.
I have co-sponsored legislation to fix this issue, yet this is just the tip of
the iceberg.
First
of all, in spite of the administration repeating over and over that this
legislation would not increase costs for Americans, they are now saying they
knew all along that it would. The Congressional Budget office estimates that
American families will see their premiums rise by an average of $2,100 by 2016.
The Wall Street Journal has reported that the cost of compliance is forcing
some insurers to increase premiums by up to 20% as soon as next year. Also, in
spite of repeated claims from the administration that we could all keep our
plans and doctors if we liked them, the administration’s own officials are now
predicting that won’t be true for up to
117 million Americans who will lose their current plans.
Major
insurers are also dropping child-only plans because of mandates and price
fixing on such policies leaving parents with fewer choices for their children,
not more. In addition, in spite of claiming this law would contain government
costs, not increase them, administration actuaries now predict it will increase
healthcare spending by over $300 billion. This additional spending comes along
with doctor shortages, fewer choices and more taxes, perhaps, worst of all,
increases in labor cost because of health insurance mandates are discouraging
employers from hiring new workers and even triggering more layoffs.
Anyone
with a basic understanding of Austrian economics could have predicted the
unintended consequences of these new healthcare policies. Central planning
never increases choices and quality or cuts costs as promised. Price controls
and government mandates always create artificial scarcity. Healthcare is not a
right or privilege. It is a product, like food or clothing. As with any good or
service, the free market regulation of supply and demand provides the optimal
quality to the maximum number of people.
Once
we realize the problems we are trying to solve today were created by government
intervention beginning in the 1960s, we can begin to put patients back in
control of healthcare, rather than third party oligopolies and government
bureaucrats. The sooner the better.
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* * *
* *
3. International Healthcare:
Obamacare. Where did
it originate?
Barack Obama: the Last Anti-Colonialist
Barack Obama is perhaps the least known figure ever to
enter the White House. A set of very unusual circumstances, including an
economic nose-dive just a few weeks before the election, put him there. Only
now, almost two years into his presidency, Americans are starting to ask: who
is Barack Obama? This was the title of a recent column in the Washington Post
by Richard Cohen. The question was not about Obama's policies; everyone knows
about those. Rather, it was one of Obama's underlying ideology. What motivates
this man?
Europeans are routinely given a pre-packaged portrait of
Obama: he is an historic figure, the first African-American president; he is
the embodiment of multiracialism and multiculturalism; he is a cosmopolitan, in
refreshing contrast to his parochial predecessor; and he looks and speaks the
way that many in the world think an American president ought to look and speak.
Consequently, Obama's critics are often dismissed in Europe as a bunch of
right-wing fanatics, otherwise known as the Tea Party movement. . .
Even some of Obama's supporters profess to being
mystified by what moves the man. Appearing on a TV show, Newsweek
editor Evan Thomas said he found himself curiously repelled by a president with
whose ideas he generally agreed. Thomas called Obama "slightly
creepy" and "deeply manipulative". He suggested that there was
something fake and unreal about Obama's public persona. . .
There
is no evidence that Obama is a Muslim. His father Barack Obama Sr was raised as a Muslim, the consequence of his
grand-father Onyango Obama converting to Islam. His
stepfather Lolo Soetoro was also raised in the
Islamic faith. But neither man practised Islam, and
Obama writes that his father treated Islam with the same contempt he reserved
for African witch doctors. Obama studied Islam in Indonesia, where he lived for
four years, but he also studied Catholicism and Buddhism and he seems to have
emerged with no firm religious convictions at all.
The
charge of socialism is closer to the mark. Obama as President has presided over
the largest expansion of state power in American history. To an unprecedented
degree, he has extended the tentacles of the federal government into banking,
mortgage lending, finance, healthcare, insurance, automobiles, and energy. In
Britain and the rest of Europe, such aggressive intervention is customary, but
in America it is an anomaly. While Europeans debate ways to trim the bloated
welfare state, Obama continues to make America's welfare state even more
bloated. Consequently, America has become the world's largest debtor, and Obama
threatens to stick the bill to the richest Americans, a group that he says is
not paying its "fair share". . .
A
good way to understand the American president is to ask a simple question: what
is Obama's dream? Fortunately, we don't have to speculate about this because
Obama himself provides a vital clue. Obama's autobiography is entitled Dreams
from My Father. So there it is: according to Obama, his dreams come from
his father. It is not Dreams of My Father. Obama isn't writing about his
father's dreams. He is writing about the dreams he received from his father.
This
isn't just a matter of a book title. Obama's book is chock-full of admissions
that Obama derived his aspirations, his values, his very identity from Obama pčre. Although his father was gone for most
of his life, Obama writes that "even in his absence his strong image had
given me some bulwark on which to grow up, an image to live up to, or to
disappoint". Obama writes: "It was into my father's image, the black
man, son of Africa, that I'd packed all the attributes I sought in
myself." Others who know Obama confirm this account. Obama's grandmother
Sarah Obama told Newsweek: "I look at him and I see all the same
things. This son has taken everything from his father. The son is realising everything the father wanted."
So
who was Barack Obama Sr and what did he want? As a
man, the senior Obama was deeply strange. He was a polygamist who had four
wives and eight known children. He looked after none of them, and was accused
by one of his sons, Mark, of being a wife-beater and an abusive father. He was
also a chronic alcoholic who was known at Harvard as "Double Double"
because he liked to order a double Scotch and tell the waiter, as soon as it
arrived, "Another double." Since he regularly drove while
intoxicated, he was involved in multiple accidents. In one, he killed a man; in
another, he injured himself so badly that both his legs had to be amputated and
replaced by iron rods. Eventually, he became drunk in a bar in Nairobi and
drove into a tree, killing himself. . .
Eventually,
Obama discovered the truth about his father from his half-sister Auma. Still, Obama didn't give up on his father. He went to
his grave and wept. He pressed his hand into the earth and tried to commune
with his father "through Africa's red soil". But Obama couldn't get
back his dead father, so instead he decided to take his dream. He concluded
that, although flawed as a man, the senior Obama had great ideals. Obama would realise those ideals, and perhaps in this way he could
complete the family circle and be worthy of his father's love. Through a kind
of sacramental rite at the family tomb, the father's ideology became the son's
birthright.
But
what was Barack Obama Sr's ideology? First and
foremost, he was an anti-colonialist. He came of age in Kenya during that
country's struggle for independence from the British. The Obama family suffered
the scars of colonialism. In the 1950s, when the Prime Minister, Winston
Churchill, cracked down on the Mau Mau guerrillas in Kenya,
Obama Sr was arrested for his political activities,
and Barack's grandfather Onyango Obama was placed in
a detention camp and allegedly tortured. Anti-colonialism arose out of anger
and humiliation, and in the case of Obama Sr those
sentiments were the product of direct experience. . .
The premises of anti-colonialism, although familiar, are
worth spelling out. The general idea is that the world is divided into two
camps: the colonisers who are the white West, and the
colonised, who are the peoples of the Third World.
Anti-colonialists usually assume that the rich countries got rich by invading,
occupying and looting the poor countries. Further, they claim that today it is
no longer Europe but America that is the rogue elephant stampeding its way across
the world. America now invades and occupies other countries in much the same
way that the French and the British once did. Anti-colonialists hold that even
when colonialism formally ends, there remain powerful concentrations of
economic power in the rich countries. These economic elites are faulted with
"neocolonialism", which is colonialism in a new form, economic
exploitation. In the anti-colonialist view, these wicked elites — the banks,
the insurance companies, the pharmaceutical companies, the oil companies and so
on — continue to oppress not only their own people but also people across the
globe. . .
Obama
Sr says that since wealth and power are concentrated
in the hands of economic elites, "We need to eliminate power structures
that have been built through excessive accumulation". He proposes state
confiscation of land and high taxation with no upper limit. Just in case the
point is unclear, He writes: "Theoretically, there is nothing that can
stop the government from taxing 100 per cent of income so long as the people
get benefits commensurate with the income which is taxed."
At
first glance, the idea of 100 per cent tax rates seems insane — how could an
intelligent man, let alone an economist, propose such a thing? Plug in the
anti-colonial assumption, however, and we can see the logic of the proposal.
The assumption is that the rich man became rich through exploitation. So if you
come to my house and steal my furniture, what's the appropriate tax rate for
you? Well, 100 per cent, because it's not your furniture.
It
may seem incredible to suggest that the anti-Western, anti-American ideology of
Obama Sr that justifies massive state appropriations
of private wealth is the belief system of the American president. But that is
what I am saying. For instance, I believe that the premises of Obama Sr's paper can help us understand what President Obama
means when he says the rich aren't paying their "fair share". The top
10 per cent of income earners in America pay around 70 per cent of the taxes.
By ordinary standards, it would seem that the affluent are more than paying
their share. However, if you assume that wealth is not earned through effort or
creativity but is rather the product of greed and theft, then there is no limit
to what percentage you can legitimately seize. Obama's rhetoric and actions
suggest that he feels morally justified in state confiscation of wealth to
whatever extent he can get away with it. . .
Consider
Obama's attitude towards the private sector. He seems to regard the private sector
as dominated by greedy, selfish, neocolonial exploiters. He rarely misses a
chance to flay Wall Street for its excess, insurance companies for their greed,
oil companies for their profiteering and pharmaceutical companies for their
exploitative prices.
His
solution seems to be to "decolonise" the
private sector by bringing it under the heavy hand of government control. Obama
even refuses banks that have received federal bailouts the chance to repay
them. He says that first they have to pass a "stress test". How odd
to require a debtor to pass a test before he can give you your money back.
Evidently, Obama wants these banks to keep the federal money because with it
comes federal control. . .
Consider a final detail that puts the icing, if you will,
on the anti-colonial theory. Shortly after assuming the presidency, Obama
decided to return a bust of Winston Churchill that had been displayed in the
Oval Office. The bust had been loaned to America from the British government's
art collection, and to many Britons it symbolised
America's relationship with Britain. Chagrined by Obama's decision to return
it, British officials suggested the bust could be displayed elsewhere in the
administration. Obama refused and the bust now sits in the residence of the
British ambassador.
Now
recall Obama's prejudice against Britain for its colonial rule in Kenya.
Recall, also, that Churchill was a champion of British colonialism. He famously
said he had not become Prime Minister in order to preside over the end of the
British Empire. As noted earlier, he was also Prime Minister in the 1950s when
British forces arrested both Obama's father and grandfather in connection with
the Mau Mau revolt. Later, Churchill blocked efforts
to have a government investigation of the alleged atrocities in Kenya. So when
we use the anti-colonial model we have a perfectly good explanation for Obama's
hostility to Britain in general, and Churchill in particular. Remove the
anti-colonial model and Obama's action in removing the Churchill bust becomes
inexplicable.
The
world has changed a great deal since the anti-colonial heyday of the 1950s and
1960s. Today countries are rising up not through state socialism but by using
what has been termed "the advantage of backwardness". Countries such
as India, China, Indonesia and Chile are using their low labour
costs to make stuff that other people around the world want to buy. Thus they
are growing at rapid rates. Many countries once labelled "Third
World" have now become "emerging markets" and they are engines
of global prosperity.
Many
in Britain, I know, are deeply ambivalent about Britain's colonial legacy. But
colonialism is now dead and so is anti-colonialism. No one today cares about it
— except the man in the White House. He is the last anti-colonial. Obama's
problem isn't that he opposes foreign subjugation. It is that he is trapped in
his father's time machine. He is trying to apply the ossified, antiquated
solutions of a generation ago to the very different problems of the world
today. Obama's approach does poor countries no favours,
because his remedies would not help them rise out of poverty. At the same time,
Obama is trying to end America's leadership in the world, bringing to an end
centuries of Western dominance. If he succeeds, the future for both America and
Europe is likely to be less prosperous and less secure.
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Government
medicine does not give timely access to healthcare, it only gives access to a
hazardous waiting list.
In
America, everyone has access to HealthCare at all times. No one can be refused
by any hospital.
* * * * *
4. Government
Healthcare: Most of What
You Know About American Health Care is Wrong
How failed attempts
at central planning have led to tragedy
Most of what you have heard about
the problems in American health care is wrong. Because the experts are so
consistently wrong, their remedies consistently fail, and in fact make the
problems worse than they were before.
We will get into the real
problems and the real solutions soon, but first it is necessary to grasp just
how wrong these experts have been over the years. And when I say “these
experts” I mean the exact same people that have been advising policy makers for
the past forty years. They began in the 1970s and are still at it forty years
later.
The list of such mistaken
failures is nearly endless. What follows are just a few of the highlights in
the first of a series of articles on how we got where we are in American health
policy, and where we’re headed in the future.
Soon after Medicare and Medicaid
were enacted in 1965, the nation entered a period of enormous inflation in
health care costs. This should not have been surprising. Vast amounts of new
state and federal money were pumped into the health care system with no
concurrent increase in the supply of services. Most of this was federal.
In
1965, state and local governments spent $3.7 billion on civilian health care,
while the federal government spent only $865 million. Two years later, state
and local rose 30 percent to $4.8 billion, but federal spending went up 655
percent to $6.8 billion. By 1970, state expenditures would rise to $6.6
billion, and federal spending would reach $11.2 billion over twelve times
what had been spent five years earlier. The money both the states and federal
governments spent on personal civilian health care went from 10.9% of total
national health expenditures in 1965 to 24.1% in 1970.
The
infusion of new cash into the health care system, and the fact that
beneficiaries could consume services with no constraint at all, resulted in
three decades of medical inflation rising at twice the rate of the economy as a
whole.
In the 1970s, the experts were
nearly hysterical about the rate of inflation in the health sector. Stuart
Altman, now a professor at Brandeis University, was the head of HCFA. He
recently reminisced — “When I was 32 years old, I became the chief regulator in
this country for health care. At that point, we were spending about 7 1⁄2
percent of our GDP on health care. The prevailing wisdom was that we were
spending too much, and that if we hit 8 percent, our system would collapse.”
The hysteria resulted in a raft
of new laws intended to control the rate of health care spending which was
increasing between 12 and 14 percent per year from 1972 on. These new laws
included –
·
Wage and price controls that were imposed by President
Nixon in August, 1971. They were removed for most of the economy in January
1973, but retained for health care until April 30, 1974.
·
Legislation
creating Professional
Standards Review Organizations for Medicare was enacted in
1972. These were intended to supervise physician practice to ensure appropriate
treatments and lengths of stay, and restrain costs.
·
The Federal HMO Act of 1973 provided seed money for HMOs
that met certain federal qualifications, such as being not for profit, using
community rating, providing a minimum set of benefits, and exempting HMOs from
state insurance regulations on issues such as capitalization and reserves,
board composition requirements, and advertising restrictions. It included a
“dual choice” provision that required employers with over 25 employees to offer
HMO options to their workers.
·
The National Health Planning and Resources
Development Act of 1974
required states to establish elaborate bureaucracies to control the growth of
hospitals and other health care facilities. These agencies included Health
Systems Agencies (HSAs), State Health Planning and Development Agencies
(SHPDAs), Statewide Health Coordinating Councils (SHCCs), and a host of other
committees and agencies. These efforts were designed to implement Certificate
of Need (CON) programs, through which hospitals and other facilities that
wished to make capital outlays would have to get prior approval from the
agencies.
Naturally these efforts did not
work particularly well. The thinking behind price controls and health planning
is especially puzzling. Excess demand induced by Medicare spending had
outstripped the supply of services and caused a surge in health care prices
as predicted by basic economic theory. So the government response was not to
lower demand or increase supply, but create a vast bureaucracy of health
planning agencies to further reduce supply! Small wonder health care inflation
got worse during these years.
More importantly, the whole thing
whipsawed the entire health care system and caused providers to spend enormous
sums to comply with the new laws and regulations – money that might have
otherwise gone into patient care. We will never know how many people were
damaged, perhaps even killed by this misallocation of resources.
The federal Health Planning Act
was repealed in 1982, but the experts weren’t done. They had to find new ways
to make a living and justify their PhDs now that they could no longer staff all
the agencies created by health planning, so they came up with hospital rate setting.
They knew that with Ronald Reagan
in the White House, a big federal initiative would go nowhere, so they focused
on the states. This initiative was based largely on a single study published in
the New England Journal of Medicine in 1980,
“Hospital Cost Inflation under State Rate Setting Programs” by Brian
Biles, Carl Schramm, and Graham Atkinson. The article
concluded,
“… (T)he average annual rate of
increase in hospital costs in (the six) rate-setting states has been 11.2 per
cent, as compared with an average annual rate of increase of 14.3 per cent in
states without such programs.”
Of course, those six states
(Connecticut, Maryland, Massachusetts, New Jersey, New York, and Washington)
started out as probably the most expensive and wasteful states in the nation.
That is why they were prompted to adopt these systems in the first place. There
was already plenty of fat to be trimmed, which would not be true for other
states.
Indeed, a later article by the
same authors in Health Affairs reported
that the non-regulated states had a per capita hospital cost of $107.02 in
1972, while the states that adopted the price controls were spending $135.08
per person. Further, these costs were spread over a much larger hospitalized
population in the non-regulated states, which had an admissions rate of 152.8
per thousand in 1972, compared to 131.1 per thousand in the states that adopted
regulations.
Usually in research if there is a
self-selected sample being studied, the researchers look to see what might
distinguish the sample from the rest of the population and adjust their
findings accordingly. Not so in health policy. Health policy advocates are so
eager to push their preferred remedies that they ignore what should be standard
techniques of research.
The study mentioned above
completely overlooked many pertinent differences between the six regulated
states and the forty-five (including DC) non-regulated areas. Obvious
differences include that the six states tended to be no-growth or low-growth
states, so they had little need for new hospital construction. They also tend
to be high Medicaid enrollment states, but also with higher average incomes
than the non-regulated states. Other possible differences that would have been
worth exploring include the relative percentage of uninsured, the ratio of
teaching hospitals, the availability of non-hospital alternatives such as home
health services or free standing surgical services, and the presence of
for-profit hospitals. All of these differences could have had a profound effect
on the viability of hospital rate setting in the various states but none were
even considered.
As it was, what the research
discovered was that after 13 years of experience:
·
The
high-cost states remained high cost.
·
These
states began with lower rates of admissions, and ended with lower rates of
admissions.
·
They
began with lower operating margins and ended with lower operating margins.
Yet somehow the researchers
concluded that hospitals in the regulated states were “more efficient” than
those in the non-regulated states, though it would seem that having fewer
admissions at higher costs while maintaining low profit margins would be a slam
dunk argument that these regulated hospitals were anything but more efficient.
Such one-sided research was
persuasive enough to the “health policy community” that 30 states ended up
adopting similar rate setting programs during the 1980s.
In 1997 Health Affairs published another article
with a somewhat different tone, titled “Tracking the Demise of State Hospital Rate Setting”
by John McDonough, now a prominent professor of public health at Harvard. The
article said, “Now, in the mid-1990s, state rate stetting is nearly gone; most
major systems have been deregulated during the last ten years.” (Ultimately
these systems were repealed by every state but Maryland.) The article explained
that the growing managed care companies thought they could negotiate lower
hospital rates than were available through price-controls, and that the
regulators themselves agreed their rules were “incomprehensible.”
Not mentioned by the author, but
fairly obvious, was the reality that was evident to anyone who could see the
full picture: once state government becomes responsible for setting prices, it
also becomes responsible for ensuring the solvency of the facilities.
Inefficient facilities are protected from failure, and any decision to close a
hospital becomes a political, not an economic, one. A threatened facility can
generate enough political support to keep its doors open, even when it makes no
economic sense to do so.
Once again an idea of central
planning was tried and failed miserably, at the cost of many billions of
dollars and who knows how many lives lost or destroyed. All on an idea that was
poorly thought through in the first place. And as you’ll see, within the realm
of health policy, this was only the beginning.
http://thefederalist.com/2013/09/19/most-of-what-you-know-about-american-health-care-is-wrong/
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Government
is not the solution to our problems, government is the problem.
- Ronald
Reagan
* * *
* *
5. Lean HealthCare: ObamaCare
is going in the opposite direction.
Senator
Marco Rubio’s OpEd “No Bailouts for ObamaCare” focuses on the Obama
Administration’s communications that indicate the intent to authorize what
could be a blank-check subsidy and bailout for health-care companies. But as
noted, this a fatal financial flaw imbedded with “guaranteed issue” and
“community rating” rules for health-care insurers.
Suppose we
had a similar rule for banks, requiring them to give loans to the entire population.
And further suppose that we eliminated risk-based underwriting so that every
risk brings in only the same interest rate.
The banks
would soon become insolvent, and banks would no longer be viable as independent
entities without subsidies and blank-check government bailouts.
This underlying
premise of ObamaCare will epitomize the fatal flaw of command-and-control
central planning of economic activity.
Communism’s
five- and ten-year economic plans did not work. Neither will Obama’s
health-care scheme work. There are no economic “epidemics.” But health-care
“epidemics” kill people.
Health-care
disasters will be far worse than any economic disaster.
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The Future of
Health Care Has to Be Lean, Efficient and Personal.
* * *
* *
6. Misdirection in Healthcare: Hospitals
taking over doctor’s practices—150 percent increase
BY JIM DOYLE • jdoyle@post-dispatch.com |
314-340-8372
Hospitals taking over
doctor’s practices—150 percent increase
A
few weeks after Allison Zaromb took her 4-year-old
son Meir to see a dermatologist in an outpatient office at the SSM
Cardinal Glennon Children's Medical Center campus,
she received separate bills from the doctor and the hospital. Read more . . .
The
cost for a 3-minute procedure to treat Meir's warts totaled $538, which
included a $220 bill for physician services - and a separate bill for a $318
hospital "facility fee."
Zaromb,
a periodontist who lives in University City, is now suing SSM Health Care Corp.
and Cardinal Glennon Children's Medical
Center in a proposed class action lawsuit on behalf of other patients.
The
lawsuit, filed in September in the state Circuit Court of the city of St.
Louis, accuses the non-profit hospital system of deceptive business practices -
in particular, violating a Missouri consumer practices statute - in failing to
fully disclose the costs. A judge still must decide whether to certify the
lawsuit as a class action.
"No
one told me that I would have to pay more than my co-pay before I took my son
to that doctor," Allison Zaromb said in an
interview. "Had I known they were going to charge a fee beyond my co-pay
for the physician, I would not have taken him there."
With
the proliferation of hospital-owned outpatient centers and hospital-owned
physician practices, hospital "facility fees" have become
increasingly common. Such hospital facility fees often involve greater dollar
amounts than the fees charged by physicians. And as patients bear a greater
portion of their health costs, they are voicing outrage over some of the bills
they receive.
"The
hospitals should be far more transparent in giving the consumers the
information they need to make intelligent decisions," said John Phillips,
one of Zaromb's lawyers on the case. "All the
lawsuit is attacking is the failure to give patients decent information so they
can walk with their feet and go to the low-cost provider."
Zaromb
said that she had not been charged hospital facility fees in the past when
taking her children to appointments at other outpatient centers in the St.
Louis area. In this case, Zaromb's health insurer
paid nearly half of the $538 total, but she was left to personally pay $206
toward the facility fee in addition to a $40 co-pay for the physician's
charges.
Her
lawsuit is the latest in a string of proposed class action lawsuits challenging
St. Louis area hospitals' billing practices - a thorny subject that many
hospital officials are reluctant to discuss.
SSM
Health Care officials declined to comment on Zaromb's
pending lawsuit, but described their billing practices at Cardinal Glennon and other SSM outpatient clinics. . .
Mark
Reifsteck, president and chief executive of the
southern Illinois division of Hospital Sisters Health System, which operates St.
Elizabeth's Hospital in Belleville, Ill., said that hospitals have
traditionally charged facility fees to cover the costs of their services.
But,
he added, patients have increasingly complained about such fees with the
proliferation of outpatient facilities, especially ambulatory surgery centers
and imaging centers. Outpatient clinics have lower overhead costs than a
hospital because they do not operate emergency rooms, so there is more pressure
on hospitals to make up their high costs through such outpatient clinics.
"Hospital
charging is very arcane and bizarre, and the biggest problem with the billing
is that major payers such as Medicare and insurance don't pay the full
cost," Reifsteck said. "So hospitals that
take in large amounts of Medicare and Medicaid patients need cost-shifting to
make up the difference - and sometimes outpatient procedures is the place to do
that. When patients see (the bill), they'll get sticker shock." . . .
Officials
at Mercy Health, which
operates Mercy Hospital St. Louis in Creve Coeur, declined to discuss their
billing practices, but issued this written statement: "How hospital
services are billed is governed by the Centers for Medicare and Medicaid
Services (CMS) and by individual insurance companies. Mercy follows both CMS
and insurance company requirements in our billing practices for hospital
services."
Under
federal regulations, health systems are permitted to charge a hospital facility
fee for an outpatient service if it's done in a clinic that is
"hospital-based" - meaning that the clinic is owned and operated as
part of a hospital or health system, regardless of whether the clinic is physically
located on the hospital grounds.
St. Anthony's
Medical Center and St.
Luke's Hospital declined to discuss their billing practices, but St. Luke's
said in a written statement that anytime a patient receives care at one of its
hospital-owned outpatient facilities the patient is billed for physician fees
as well as for "a facility fee that includes costs for things such as staff
services, supplies and equipment that the hospital provides."
Saint
Louis University Hospital, which is owned by Dallas-based Tenet
Healthcare Corp., has a contract with university-operated SLUCare physicians group. The hospital runs two outpatient
centers: a gastrointestinal clinic at a doctors' office building across the
street from the hospital; and an orthopedic clinic with outpatient surgery and
imaging equipment at the Anheuser Busch Institute. SLUCare
physicians, who are paid by the university, treat patients at both clinics. The
hospital staffs the two clinics with nurses, technicians, schedulers, and lab
technicians. It also pays rent on the GI clinic, and owns the building where
the orthopedic clinic is located.
"We
have signs in our clinic, and new patients get a letter when they sign up,
saying they will receive two bills," said Laura Keller, a spokeswoman for
SLU Hospital. "We are very transparent and up front with that. We're not
in the surprise business."
But
not all patients are satisfied with SLU Hospital's billing practices. John
Thomas of Ballwin said that Tenet Healthcare misled patients about the rising
cost of medical bills associated with the hospital's gastrointestinal
outpatient clinic.
He
said the hospital issued a letter in January 2010 saying that, although its
outpatient clinic would be under new hospital management, total health care charges
for outpatients would remain the same. Instead, because of the addition of
facility fees, he said, Medicare is being billed about 63 percent more for his
wife Pat's outpatient visits than it was charged in 2009.
"It's
not fraud. But just because something is allowable, does not make it
right," Thomas said. "I consider this to be a blatant abuse of
Medicare."
Phillips,
a Seattle lawyer, has brought two successful lawsuits against Seattle hospitals
that were based on similar grounds. Those cases resulted in refunds to
consumers and agreements by hospitals to provide more billing information
to patients on their web sites.
He
said that several years ago consultants began advising hospitals that if they
acquired physician practices and called those practices
"hospital-based," the hospitals could charge not only for physician
fees but also for hospital fees.
"From
a consumer's perspective, when you go see your doctor, you go see your doctor -
whether it's in an office inside a larger hospital complex or right across the
street," Phillips said. "The doctor's practice remains the same. ...
They're making the doctor's office a ‘hospital-based' clinic for one reason: to
make money by charging a facility fee, not to improve consumer service."
Editor’s Note: When you
see a physician in his private office, the cost of his office and staff is
covered by the office fee since time memorable. Hospitals have found a legal
loophole formed by government Medicare to increase charges more than 100
percent. This is fair warning to any physician who sells his practice to a
hospital that he is unknowingly involved in hospital subterfuge. The hospitals
have more clout than physicians to alter the rules in Congress or Medicare.
Thus it is unethical for any physician to sell his practice to any hospital or
corporation that is not a physician owned and controlled private practice.
Laws which formerly
outlawed the corporate practice of medicine should have prevented this.
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Well-Meaning
Regulations Worsen Quality of Care.
* * * * *
7. Overheard
on Capitol Hill: What do Wall Street protesters
overlook in their hatred of capitalism?
|
"Occupy
Wall Street Crowd Blind to Benefits of Capitalism" By Gary Wolfram Whenever I watch media coverage
of another Occupy Wall Street event I am reminded of an exchange between
Jewish protesters in the 1979 Monte Python movie Life of Brian. One of the
protesters asks another what the Romans have brought to the area and the
conversation goes like this: Question:
All right, but apart from the sanitation, medicine, education, wine, public
order, irrigation, roads, the fresh water system and public health, what have
the Romans ever done for us? The point is that the Roman
institutions brought a good deal to the area that was being overlooked by the
protesters. The Wall Street protesters, in their hatred of capitalism,
overlook things including the fact that over the last 100 years capitalism
has reduced poverty more and increased life expectancy more than in the
100,000 years prior. Every semester I ask my
students: "What would you rather be? King of England in 1263 or
you?" Turns out, students would rather be themselves. They enjoy using
their iPhone, indoor plumbing, central heating, refrigerators and electric
lighting. All of these things are available to the average person in America
today and none of them were available to the aristocracy when the West
operated under the feudal system. How is it that for thousands of
years mankind made very little progress in increasing the standard of living
and yet today half of the goods and services you use in the next week did not
exist when I was born? It wasn't that there was some change in the DNA such
that we got smarter. The Greeks knew how to make a steam engine 3,000 years
ago and never made one. The difference is in how we organize our economic
system. The advent of market capitalism in the mid-18th century made all of
the difference. We need not just rely on
historical data. Look at cross-section evidence. I try another experiment
with my students. I tell them they are about to be born and they can choose
whatever country in the world they would like to be born in. The only caveat
is they will be the poorest person in that country. Every student picks a
country that is primarily organized in a market capitalist system. No one
picks a centrally planned state. No one says, "I want to be the poorest
person in North Korea, Cuba, or Zimbabwe," countries which are at the
bottom of the Heritage Foundation's Index of Economic Freedom. What does it mean to be poor in
our capitalist society that the Occupy Wall Street crowd so hates? Robert
Rector of the Heritage Foundation has several studies of those classified as
poor by the U.S. Census Bureau. He found that 80 percent of poor persons in
the United States in 2010 had air conditioning, nearly three quarters of them
had a car or truck, nearly two-thirds had satellite or cable television, half
had a personal computer and more than two-thirds had at least two rooms per
person. Contrast this with what it
means to be poor in Mumbai, India, a country that is moving rapidly towards
market capitalism but was burdened for decades with a socialist system. A
recent story in The Economist described Dharavi, a
slum in Mumbai, where for many families half of the family members must sleep
on their sides in order for the entire family to squeeze into its living
space. The Occupy Wall Street movement
has shown a lack of understanding of how the market capitalist system works.
They appear to think that the cell phones they use, food they eat, hotels
they stay in, cars they drive, gasoline that powers the cars they drive and
all the myriad goods and services they consume every day would be there under
a different system, perhaps in more abundance. |
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What is Congress Really Saying?
* * * * *
8. Innovations
in Healthcare: Currently eliminated by the Government
Innovations in healthcare are currently stymied by the HMO system
that eliminated competition and therefore, innovations; by Medicare which
likewise eliminated competition which prevents innovation.
Thus the major component of the Free Enterprise Economic System,
which is the most ruthless controller of costs, has been paralyzed in the
healthcare system. Hence, there is nothing that the insurance industry or the
government can do about it.
The [Un] Affordable Care Act will not and cannot control the
rising cost of health care.
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* * * * *
9. The Health Plan for the USA: Planning the Patient-Centered Health Plan for
America
Level
C: Outpatient Community Non-Hospital Based Medicine (Continued from July 2011
section 9)
A graded co-payment for every level of service-
See April Issue for Level A: Hospitals
See July
Issue for Level B: Hospital Emergency Rooms, Urgent Care Centers, and
Surgi-centers.
The
research from HPUSA has elucidated some important clinical statistics to
control health care costs. This data is hard to obtain and cannot be automated.
It is labor intensive. At this point it is clinical: one on one. When we see
large expenditures in health care, we try to determine if the patient is a
candidate to be included in our series. We then indulge in a frank discussion
of his or her responses to the questions concerning percentage co-payment and
its effect on the patient’s utilization of health care benefits.
Health
care can be stratified into a number of logical tiers. The most expensive and
highly sophisticated care is in the traditional acute care hospital. We found
with a 10 percent co-payment of the hospital costs as being the best number
that did not preclude needed care and was able to allow for needed hospital
care. With a 10 percent co-payment, the patient policed his hospital cost
better than any oversight institution saving up to 40 percent of usual costs.
We
also found in our research that a 20% co-payment of emergency room, urgent care
centers and surgi-centers as being the most
appropriate in reducing emergency room and urgent care visits and did not
impose a significant risk of excluding needed care.
Level C: Outpatient Community Non-Hospital Based Medicine
Our
research continued into the appropriate co-payment for out-patient care. We
studied whether all of outpatient medical care should be treated equally. We
consider out-patient care as physician’s office visits, physician’s office
laboratory studies, laboratory testing, in clinics and freestanding labs, x-rays,
CTs, MRIs, ECG, PFTs, ABGs, or any test a physician orders or does outside of
the hospital complex.
We
found that a 30 percent co-payment was effective in reducing outpatient costs
to that which was necessary and did not diminish quality of care.
We
found that this was more cost-effective and less intrusive than the current
system of policing doctor visits and all outpatient costs in general that the
current army of reviewers and their interfacing with doctors and their staff.
A
major health insurance executive in a friendly discussion after a business
presentations mentioned that they could probably eliminate much of their costly
review process and pay that charges that doctors sent in and not lose
significant more money. When asked if that were ever considered by his company,
he replied that it never got significant traction in their meetings. The
company did not want to lose their control over doctors.
We
will proceed with Level D in the next issue as we dissect the entire proposed
HealthPlanUSA proposals.
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* * * * *
10. Restoring Accountability in Medical Practice by Non
Participation in Government Programs and Understanding the Devastating Force of
Government
·
Medicine
and Liberty - Network of Liberty Oriented Doctors, www.MedLib.ch/,
Alphonse Crespo, MD, Executive Director and Founder
Medicine & Liberty (MedLib) is an independent
physician network founded in 2007, dedicated to the study and advocacy of
liberty, ethics & market in medical services.
- We support professional
autonomy for doctors and liberty of choice for patients
- We uphold the Hippocratic covenant
that forbids action harmful to the patient
- We defend responsible medical
practice and access to therapeutic innovation free from
bureaucratic obstruction
- We work towards a deeper
understanding of the role and importance of liberty & market in
medical services
MedLib is part of a wide movement of ideas that
defends
- the self-ownership principle &
the property rights of individuals on the products of their
physical and intellectual work
- free markets, free enterprise and
strict limits to the role of the State
·
Authentic Medicine - Douglas Farrago MD,
Editor, Creator & Founder
SPEAKING
HONESTLY AND OPENLY ABOUT OUR BROKEN HEALTHCARE SYSTEM
The mission of Authentic Medicine is to rediscover how much the art of medicine means and allow us to reconnect to our roots once again. It is about fighting back against those things that are taking us away from the direct care of patients while still pointing out the lunacy and hypocrisy of this job. Be part of the movement that will take back the healthcare system from the idiots who are ruining it.
Why we are moving to an era of
Industrialized Medicine
The
Quality Movement and why it is a scam
The
ever expanding Medical Axis of Evil
Medical
Dogma and the Alphabet Soup (JC, HIPAA,etc)
Bureaucratic
Drag and the distractions from treating patients
Burnout
and depression amongst healthcare professionals
Humor in caring for the patient
and the caretaker
·
Reason Foundation: http://reason.com/about:
Reason and Reason Online are editorially independent publications of the Reason
Foundation, a national, non-profit research and educational organization.
Reason is the monthly print magazine
of "free minds and free markets." It covers
politics, culture, and ideas through a provocative mix of news, analysis,
commentary, and reviews. Reason provides a refreshing alternative to right-wing
and left-wing opinion magazines by making a principled case for liberty and
individual choice in all areas of human activity.
Reason Online is updated
daily with articles and columns on current development in politics and culture.
. It also contains the full text of past issues of the print edition of
Reason. Reason Online is entirely free.
·
Entrepreneur-Country. Julie Meyer, CEO of Ariadne
Capital, (Sorry about the nepotism, but her message is important) recently
launched Entrepreneur Country.
Read their manifesto for information: 3.
The bigger the State grows, the weaker the people become - big government
creates dependency . . . 5. No real,
sustainable wealth creation through entrepreneurship ever owed its success to
government . . . 11. The triple play of
the internet, entrepreneurship, and individual capitalism is an unstoppable
force around the world, and that Individual Capitalism is the force that will
shape the 21st Century . . . Read
the entire manifest . . .
·
Americans
for Tax Reform, www.atr.org/, Grover Norquist, President,
keeps us apprised of the Cost of Government Day® Report, Calendar
Year 2008. Cost of Government Day (COGD) is the date of the calendar
year on which the average American worker has earned enough gross income to pay
off his or her share of spending and regulatory burdens imposed by government
on the federal, state and local levels. Cost of Government Day for 2008 was
July 16th, a four-day increase above last year's revised date of
July 10th. With July 16th as the COGD, working people
must toil on average 197 days out of the year just to meet all the costs
imposed by government. In other words, the cost of government consumes 53.9
percent of national income. If we were to put health care into the public
trough, the additional 18 percent would allow the government to control 70
percent or nearly three-fourths of our productivity and destroy our health care
in the process. We would have almost no discretionary income.
·
National Taxpayer's Union, www.ntu.org/main/,
Duane Parde, President, keeps us apprised of all the taxation challenges
our elected officials are trying to foist on us throughout the United States.
To find the organization in your state that's trying to keep sanity in our
taxation system, click on your state at www.ntu.org/main/groups.php.
August 13 you can working for yourself. It takes nearly 8 months of hard work
for every American to pay for the cost of government. Read
more . . .
·
Evolving Excellence—Lean
Enterprise Leadership. Kevin
Meyer, CEO of Superfactory,
has started a newsletter which impacts health care in many aspects. Join his evolving excellence blog . . . Excellence is every physician’s middle name
and thus a natural affiliation for all of us.
Read his The Customer is the Boss
at FAVI “I came in the day after I became CEO, and gathered the people.
I told them tomorrow when you come to work, you do not work for me or for a
boss. You work for your customer. I don’t pay you. They do. . . . You do what
is needed for the customer.” And with that single stroke, he eliminated the
central control: personnel, product development, purchasing…all gone. Looks like something we should import into
our hospitals. I believe every RN, given the opportunity, could manage her ward
of patients or customers in similar lean and efficient fashion.
·
·
Ayn
Rand, a Philosophy for Living on Earth, www.aynrand.org/site/PageServer,
is a veritable storehouse of common sense economics to help us live on earth.
To review the current series of Op-Ed articles, some of which you and I may
disagree on, go to www.aynrand.org/site/PageServer?pagename=media_opeds
* * * * *
Thank you for joining
the HealthPlanUSA network of 80,000 professionals that receive our newsletter
and visit our websites. To assure uninterrupted delivery, go to www.healthplanusa.net/newsletter.asp
and enter your email address. Stay tuned for the latest innovating thinking in
HealthCare and have your friends do the same.
Articles that appear
in HPUSA may not reflect the opinion of the editorial staff. Several sections
are entirely attributable quotes in the interest of the health care debate. We
trust our valuable and faithful readers understand the need to open the debate
to alternate points of view to give perspective to the freedom in healthcare
issues. We have requested permission and many of the sites have given us
standing permission to quote extensively from their sites and refer our readers
back to their site. Editorial comments are in brackets.
PLEASE NOTE:
HealthPlanUSA receives no government, foundation, or tax favored funds. The
entire cost of the website URLs, website posting, distribution, managing
editor, email editor, and the research and writing is solely paid for and
donated by the Founding Editor (and Friends of Freedom), while continuing his
Pulmonary Practice, as a service to his patients, his profession, and in the
public interest for his country. Contributions are welcomed but are not tax
deductible since we ask for no federal tax favors. Please see your tax advisers
to see if contributions may be a business deduction for you.
Spammator Note: HealthPlanUSA
uses many standard medical terms considered forbidden by many spammators. We
are not always able to avoid appropriate medical terminology in the abbreviated
edition sent by e-newsletter. (The Web Edition is always complete.) As readers
use new spammators with an increasing rejection rate, we are not always able to
navigate around these palace guards. If you miss some editions of
HealthPlanUSA, you may want to check your spammator settings and make appropriate
adjustments. To assure uninterrupted delivery, subscribe directly from the
website: www.HealthPlanUSA.net/newsletter.asp.
Del Meyer
Del Meyer, MD, CEO & Founder
DelMeyer@HealthPlanUSA.net
HealthPlanUSA,
LLC
www.HealthPlanUSA.net
6945 Fair Oaks Blvd, Ste A-2,
Carmichael, CA 95608
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Words
of Wisdom
They use to say the
only thing the government didn’t tax was taxes. Then they invented the surtax.
Why do they couple
death and taxes. Death only comes once.
The power to tax
involves the power to destroy. . . Chief Justice John Marshall, Supreme Court
decision in McCulloch v. Maryland, March 6, 1819.
Some
Recent Postings
In
The July Issue:
1.
Featured Article: World
Health Report 2000 was an intellectual fraud
2.
In the News:
Why Medicaid Should Be Easier to Fix than Entitlement Programs
3.
International Healthcare: From the
Stockholm-Network of Think-Tanks
4.
Government
Healthcare : While the US Gov’t is
insolvent, the states aren’t far behind
5.
Lean
HealthCare: Every industry is
getting lean; we no longer have a choice.
6.
Misdirection in Healthcare: Misdirection in
our Country at Large
7.
Overheard
on Capital Hill: Rumors from Texas
8.
Innovations
in Healthcare: Telehealth
9.
The Health Plan
for the USA: Level B: Emergency Rooms, Urgent Care and
Surgi-centers
10.
Restoring
Accountability in Medical Practice by Moving from a Vertical
to a Horizontal Industry:
History
Always
remember that Chancellor Otto von Bismarck, the father of socialized
medicine in Germany, recognized in 1861 that a government gained
loyalty by making its citizens dependent on the state by social insurance. Thus
socialized medicine, or any single payer initiative, was born for the
benefit of the state and of a contemptuous disregard for people’s welfare.
Thus we must also remember that ObamaCare has
nothing to do with appropriate healthcare; it was similarly projected to gain
loyalty by making American citizens dependent on the government and eliminating
their choice and chance in improving their welfare or quality of healthcare.
Socialists know that once people are enslaved, freedom seems too risky to
pursue.
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