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CCHF Health Freedom eNews

August 22, 2012

  • President's Commentary.
  • Tax Credit Shell Game.
  • $45M Computer System Endangers Lives.
  • Don't Come Back!
  • Sobering News on Doctors
  • P4P: A Threat to Good Doctoring
  • Stats of the Week
  • News Release of the Week
  • Featured Health Freedom Minute

President's Commentary

Newsweek's cover story is making headlines. The author, Niall Ferguson, discusses why "Obama's Gotta Go." The article discusses various failed promises, but I take issue with the end of the following statement:

...the Patient Protection and Affordable Care Act (ACA) of 2010 did nothing to address "...":, the "fee for service" model that drives health-care inflation...

Fee-for-service is not the problem. It's the solution. Fee-for-service is how we pay for everything else. The grocer brings food to a central location and makes it available for a "fee." The barber cuts your hair for a fee. If you want the service, you pay the fee. If you don't like the fee, you go price(fee)-shopping.

The problem in health care is THIRD-PARTY PAYMENT of the fee. People no longer pay for the service. Health plans do, even for routine and minor care. This is not insurance. This is a very expensive way to pay medical bills. True insurance is protection against the financial loss of a rare medical catastrophe.

Third party payers are making out like bandits. Patients no longer have the power of the pocketbook, leaving government and its favored health plans in charge of most health care dollars and decisions. Meanwhile:

  • Physician income  declined 7% between 1995 and 2003. 
  • Cost of employee health care benefits are expected to rise  7.2% this year. 
  • Health plan premiums under Obamacare  will soar 19 - 30%

Third party payers got another sweet deal in Obamacare. Health plans are getting out of the insurance business. Obamacare shifts risk management -- the business of insurance -- to doctors and hospitals. Health plans will simply collect premiums, keep 15% off the top, and pay out the rest to hospitals as  "bundled" payments. In one example, Medicare says"Physicians and other practitioners would submit "no-pay" claims to Medicare and would be paid by the hospital out of the bundled payment."

Your doctor and hospital could soon be your insurer. They'll get the money and take on the financial risk. The patient becomes a liability. If this happens the more patients in the parking lot, the less dollars left at the end of the month to cover expenses or payroll. This presents a major conflict of interest. The U.S. could be headed toward Canada-style health care where doctors get a yearly lump sum and when it's gone, it's gone.

Real fee-for-service is the answer to the unethical system coming out of federal health care reform. Repealing Obamacare -- and its prohibition on true insurance -- is just the beginning of health freedom. Paying cash for most care, asking for prices, and owning lifelong true health insurance is essential. I sent Mr. Ferguson a tweet to let him know. (@twilabrase) 

Now on to the news . . .

News to Know:

Tax Credit Shell Game
"Obamacare is a massive tax cut...," claimed Center for American Progress's CEO on  Face the Nation. However the Obamacare tax credit is paid to the insurer: "The Secretary of the Treasury shall make the advance payment under this section of any premium tax credit the issuer of a qualified health plan on a monthly basis" (Sec. 1412). Obamacare consultant Jonathan  Gruber agrees"Most households will never actually get their hands on the credits, so their existing tax liabilities won't actually change." To be clear, you'll fund the tax credit through higher federal taxes. Then it will be used to pay a portion of the higher cost of your premiums under Obamacare. It's a shell game. The health plans get a direct infusion of cash. You get nothing. And if you make one penny over 400% of poverty guidelines, you'll pay the entire cost of higher premiums.

$45M Computer System Endangers Lives

A new medical computer system at correctional facilities in California recently recommended a potentially fatal dose of a heart medication. Nurses say it's one example of many close calls. The EPIC computer system is used in many hospitals nationwide. "It's dangerous. It's very dangerous," said one nurse. "What nurses want is for the EPIC program to go away until it's fixed," said nurse Lee Ann Fagan. But the chief information officer for the county says the electronic health record (EHR) is "just a tool....We can't rely just on a computerized system." The county spends $45 million and wants to rely on someone's memory to keep a patient safe? Really?

Don't Come Back!

In October, the federal government will take back about  $280 million in payments from more than 2,200 hospitals. These penalties are part of Obamacare (Sec. 3025). In short, if a Medicare patient is  readmitted within 30 days of being discharged from the hospital, the hospital has to pay a penalty to the federal government. This is counterproductive. Medicare currently pays the hospitals a set fee per diagnosis called a DRG (Diagnosis-Related Group) -- which encourages early discharge to save money. But now Medicare will penalize hospitals if they readmit patients within 30 days. The squeeze is on. Readmission rates, however say nothing about the quality of a hospital, says one hospital CEO: "Only a proportion of [readmissions] within 30-days are preventable...a quarter of most." The feds don't care. These payments fund Obamacare.

Sobering News on Doctors

The 2012 Medscape Physician Compensation Report provides the following  sobering news on physician satisfaction: "What a difference a year makes! Last year's satisfaction scores hit 80% (dermatologist), with many other specialties over 70% (radiologist and oncologists) and several over 60%. In Medscape's 2012 survey, however, there are fewer smiles. The most satisfied specialty is again dermatology, but this time with a satisfaction score of 64% -- considerably down from 80%. Close to half the specialties surveyed scored under 50% in overall satisfaction. ..."

One doctor told the survey, "My income is 60% of what it was 10 years ago, and I'm doing more work." Another said, "The regulatory environment and the onerous paperwork involved are making the current situation untenable." Still  another said, "I love being a physician, but I hate what is happening to medicine. Too many people are coming between me and the  care I provide to my patients." Expect physicians to retire early unless Obamacare is repealed.

P4P: A Threat to Good Doctoring

A new editorial in the British Journal of Medicine suggests the current Pay for Performance (P4P) programs rest on "flawed assumptions about medicine, measurement and motivation" and may encourage providers to game the system. Physicians and professors in New York and North Carolina worry that "pay for performance may not work simply because it changes the mindset needed for good doctoring." The article shares four very brief but thought-provoking takeaways:  Read it here.  

In the Medscape survey, 47% of doctors said quality measures and treatment guidelines  "will have a  negative effect on patient care." In another question, 43% said they would not reduce certain tests (e.g. PSA, mammography) to contain costs "because these  guidelines are not in the patient's best interest." Pay for Performance programs often require compliance with guidelines. Note the 7% in the image below.

Stats of the Week:

$338,827 - States' cost of the 26-state lawsuit against Obamacare

23% - amount of doctors who spend 5 to 14hours/wk on administrative work.
18% - amount of oncologists who spend at least 25hr/wk on administrative work.

News Release of the Week:

Dollars and Sense: The Real Reasons to Say No to State Healthcare Exchanges

ST. PAUL, Minn. - Many states continue to move toward implementation of the centerpiece of the Affordable Care Act: state healthcare exchanges. But as these implementations continue, there are four major issues impacting both individual patient/taxpayers as well as state legislators.

First, under the Affordable Care Act, employers with at least one employee who chooses to purchase health insurance through healthcare exchanges will be penalized, up to $3,000 per employee. The penalty for many employers will be so burdensome, that many smaller businesses will not be able to survive based on the tax penalties assessed simply because one employee chose to shop around for health insurance. But without exchanges, there will be no burdensome penalties. Continue reading

Featured Health Freedom Minute:

Marketing Patient Privacy

I have long said privacy should become a marketing tool. Doctors should refuse to use an online electronic medical record. They should refuse to put your records into the National Health Information Network - the intrusive national system that will give 2.2 million entities access to your data. Doctors should use the promise of privacy to drive patients into their clinics. Continue reading

Twila Brase broadcasts a daily, 60-second radio feature, Health Freedom Minute, which brings health care issues to light for the American public. Health Freedom Minute airs on the entire American Family Radio Network, with more than 150 stations nationwide in addition to Bott Radio Network with over 80 stations nationwide.

Click here to listen to this week's features.


Citizens' Council for Health Freedom
161 St. Anthony Avenue, Ste 923
St. Paul, MN 55103
Phone: 651.646.8935 • Fax: 651.646.0100

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