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CCHF Health Freedom eNews

March 20, 2013

Swimming in Dependency

Let's talk about freedom and fish. I recently stopped at a restaurant. Inside was a small pool with white and orange koi fish. As I came close, they stopped swimming and came to the side of the pool and started to beg. Five swishing tails. Five wide-open mouths peering up at me, sucking the air, silently asking for food. 

It brought to mind the trouble with many government programs. Those on welfare find themselves swimming around and around the government's welfare pool dependent on welfare checks, welfare homes, welfare phones, welfare Internet, WIC discounts, Medicaid cards, cash cards, and food stamps. Sometimes they come directly to the legislature or Congress to ask the government for more. Many may not even realize that they're asking for more of their neighbor's paycheck.

Too many Americans are trapped like koi fish in a restrictive welfare pool, dependent on government handouts. Many don't even remember what it was like to be free. Children born into welfare don't know what freedom really is. For them, everything is free. The welfare pool is so warm and comfortable they barely feel the restrictive walls.

Welfare for the middle class beckons. Obamacare offers federal subsidies to individuals making $44,680 and families of four making $92,200 (400% 2012 FPL) for coverage bought through the government exchange. This is "Medicaid for the middle class" on a sliding fee scale for at least 24 million people (chart below designed by Cognizant). The government is inviting middle-class Americans to jump into the welfare pool.

In 2011, a record  70.4 million people were Medicaid recipients. This is 22 percent of America's population. Obamacare will expand it by at least 16 million (see chart above). Last December a record 47.8 million people were on food stamps. And two million households are living in Section 8 welfare homes. These numbers will likely increase. A demo of the Minnesota Exchange gives applicants an opportunity to apply for food stamps and welfare housing.

Free phones are also available. Individuals on one or more of the following welfare programs ...

Continue reading . . .


News to Know:

Will Obama's Exchanges Falter?

The feds still claim that everything is going smoothly with the "Federal Exchange" (for which they have no funding) and that there will be "marketplaces" offering coverage "in all 50 states." However, last week at a national health insurance exchange (HIX) conference in Washington, D.C., federal officials said they're working on contingency plans. Henry Chao, head of IT at the Medicare administration said in a bemused voice that he thinks he's already working the contingency plan "given what time we have." Gary Cohen, director of Obama's HIX office said of opening day on October 1, 2013: "Day one will not be perfect. We're striving for a second world experience."

CMS officials, Gary Cohen and Henry Chao, answer questions during Q & A at AHIP Exchange Conference in D.C.

Chao said in reference to the seven "partnership" exchanges: "Do we have 26 states that are in the Federal Exchange or 33?" The answer is 33. He said the partnerships are on the "Federally Facilitated platform." There are just two versions of Obama's exchange: the state-funded exchange (state name; built under state contracts) and the federally facilitated (and funded) exchange (federal name; built under federal contract if they get funding or through fees from "partner" states). To be clear, the only difference between a state and an federal exchange is who funds them - and signs the contracts to have them built according to federal specifications.

"This is a complete disruption of the world as you know it." said Christine Ferguson, director of the Rhode Island Exchange. Brian Haile from Jackson Hewitt said, "We've never had a program that imposed this level of cost on low income people...We're all one big happy marketplace now but we don't know how happy we'll be... If not enough healthy people sign up...premiums will go up." And that, dear eNews readers, is the government's big concern. That is the exchanges' Achilles' heel. If premiums go up, the exchanges implode. They will not be sustainable. Refuse to sign up.

Obituary for Solo Practice . . . Or Not

Two years ago, a New York Times reporter wrote a story about a physician's solo practice. It read like an  obituary. He wrote:

[I]n 2007, just 28 percent of doctors described themselves as self-employed, compared with 58 percent in 1970. Many of the provisions of the new health care law are likely to accelerate these trends. ...

Indeed, younger doctors   - half of whom are now women - are refusing to take over these small practices. They want better lifestyles, shorter work days, and weekends free of the beepers, cellphones and patient emergencies that have long defined doctors' lives. Weighed down with debt, they want regular paychecks instead of shopkeeper risks. ...

Dr. Sroka [whose practice is in Maryland] has not taken a sick day in 32 years. ... Handsome, silver-haired and likable, Dr. Sroka is indeed a modern-day Marcus Welby, his idol. He holds ailing patients' hands, pats their thickening bellies, and has a talent for diagnosing and explaining complex health problems. 

Dr. Sroka says of large medical practices: "We're going to have good medical care. The high blood pressure, the diabetes, the hypertension's going to be treated just as well, but the emotional components to these diseases will never be detected." In other words, they are high tech, low touch. He says, small practices struggle because of "low, low reimbursement and monopolistic control of the health care system by the private insurers." But Dr. Sroka was taking third party payment (insurance/Medicare). The upcoming batch of new solo practitioners are leaving health plan control behind. Read on...

Doctors Revolt

A Kansas doctor, Ryan Neuhofel, 31, has gone to an  online price list and a cash-based practice. As Reason reports, "A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house." He uses email and Skype with patients in exchange for a monthly fee of $20 - $30 dollars. This is called "direct primary care."  Dr. Lisa Davidson, in Denver Colorado, did the same thing. Her 6,000 patients dropped to 2,000 patients, her 15 minute visits turned to 45 minute visits, and now she says, "We're on track to make more money and take better care of our patients." 

"People want to escape the train before it derails. There are a lot of doctors who don't want to be trapped in the traditional system when it takes effect, and there are a lot of patients who don't want to be trapped there either," says  Dr. Brian Forrest, of Raleigh, NC. He thinks Obamacare will be a boon for doctors like him. Dr. Forrest charges patients $39 a month plus $20 per office visit. He accepts no insurance, because it's an expensive hassle.

Get your doctor now. Doctors who provide such patient-centered care will soon be highly valued as the cost and control realities of Obamacare emerge, but they won't see as many patients as doctors on tight production schedules today. This is how health freedom can be saved. Ask your doctor to join the revolt...and get ready to pull out your credit card.

Employer Mandate Penalty Chart

Medicare is More Expansive than Insurance - 3 Reasons

National health care supporters often claim that Medicare is less expensive than private insurance. Studies claim administrative cost for traditional, non-HMO, Medicare are only 2%  as compared to 12% for private health plans ( pg 46). It's not. Here are three reasons:

  1. The high cost of  fraud and waste has been excluded from studies, writes Yevgeniy Feyman at the Manhattan Institute. The GAO found that Medicare and Medicaid made around $70 billion in improper payments in 2010, close to 10 percent of the cost of the two programs; 
  2. Other government agencies  help administer the Medicare program: the IRS collects taxes to fund it, the Social Security Administration helps collect premiums, and HHS handles the accounting, conducting the marketing, and pays the bills. These costs are all off the books; 
  3. The Medicare administration  pays no taxes, while insurers must count their taxes as administration.

As Heritage Foundation's Robert A. Book, Ph.D. writes in his definitive report on the subject, "on a per-person basis Medicare's administrative costs are  actually higher than those of private insurance -- this despite the fact that private insurance companies do incur several categories of costs that do not apply to Medicare." In his chart, private insurers in 2005 spent $453 per beneficiary on administrative costs, compared to $509 for Medicare." Medicare currently has around  49.4 million beneficiaries. Using his figures, Medicare costs $3.1 billion more than private insurance.


Quotes of the Week:

"None of us are sleeping. None of us are comfortable. None of us are in a good place . . . None of you would undertake something in this time frame."
-- Christine Ferguson, Director, Rhode Island Health Benefits Exchange, on the October 1 deadline for implemention of the government's IT superstructures called health insurance exchanges, AHIP exchange conference, March 14, 2013.

"You're not the system of record. You're not the system of truth. The exchange is the system of truth." - Eugene Sayan, president and CEO, Softheon, Inc. during his presentation on exchange technology and need for notification management "push technology" that goes back to the exchange, AHIP Conference, Washington, D.C. March 15, 2013.


"No one escapes the Affordable Care Act." - Seth Perretta, JD, Crowell & Moring, speaking on employer requirements in the exchange environment, AHIP Conference, Washington, D.C., March 14, 2013.

"I'm pretty nervous. I don't know about you." - Henry Chao, Deputy Chief Information Officer, Centers for Medicare and Medicaid Services, about the October 1, 2013 opening day for Obama's government exchanges, AHIP Conference, Washington, D.C., March 14, 2013.

"They had tons of money to begin with. Now they're running out of money. That's another story." - Eugene Sayan, president and CEO, Softheon, Inc. on federal funding, during his presentation, AHIP Conference, Washington, D.C. March 15, 2013.

Stats of the Week:

$12.3 billion - Medicare and Medicaid incentive payments for electronic health records paid to 219,000 physicians and hospitals.

$6.2 trillion - what Obamacare will add to nation's deficit over next 75 years.

60 million - number of medical records stolen by 15 IRS agents without cause; lawsuit filed.

90% - portion of Obamacare exchange regulations completed (Gary Cohen, CCIIO, AHIP exchange conference, 3/14/13).

50+ million - small group members that may drop commercial coverage, enroll through exchanges (Softheon ppt, AHIP conference, 3/15/13).

Media Statement of the Week

Citizens' Council for Health Freedom States Senate Passage of MN Health Insurance Exchange Bill Damages Citizen Healthcare

STATEMENT by Twila Brase, President of the Citizens' Council for Health Freedom:

"This afternoon, the Minnesota Senate made the final vote to pass the Minnesota Health Insurance Exchange, or MN HIX, bill, which passed by a vote of 39 to 28. Not a single Republican Senator voted for the bill and one Democrat voted in opposition of it during the House vote last week.

Allowing the bill to pass the Legislature represents the federal takeover of healthcare in Minnesota and will do nothing but damage healthcare quality, and access, as well as increase costs. Continue reading

Featured Health Freedom Minute:

190% Premium Increases On The Way

Americans will soon be hit by the largest premium increases ever. A new survey says the young and healthy will see premiums increase 169 percent on average, but some will experience 190% increases - in other words, triple the cost. In short, the young and healthy will be forced to subsidize the old and unhealthy. 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.

Reading Now...

Next year's health care reform will be a "mess," experts predict, The Augusta Chronicle, March 15, 2013.

Lawmakers question robocalls opposing Idaho health exchange, Idaho Statesman, March 16, 2013 - seven freshman, including six Republicans and one Democrat ask Attorney General to inquire into violations of Idaho's telephone solicitation act by local Tea Party group.

Small-business health exchange mandate will go to D.C. Council, The Washington Post, March 13, 2013. - Although given a two year reprieve, all small employers will be forced to use the government exchange to buy employee coverage.

Deadline pressures could put more health exchanges in the federal government's handsNews Medical, March 16, 2013. 

What One Writer Got Wrong When Attacking An Obamacare Critic, Forbes, March 14, 2013. - explaining how Obamacare will add $6.2 trillion to the deficit over the next 75 years -- with some interesting stats on severe cuts to physicians and hospitals.

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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