Fact Checking Sen. Menendez ACA Diatribe

Dear Senator Menendez,

As a N.J. citizen, taxpayer, physician, husband and father, I must offer factual correction on your healthcare policy ACA diatribes.

You tweeted:

Nothing could be further from the truth in your partisan message:

1. Insurance coverage is not healthcare.
2. Forcing citizens into ACA Medicaid at taxpayer expense is foolhardy.
3. ACA through “guaranteed issue(preexisting conditions)” destroyed the risk pools that kept prices stable. Now ALL commercial plans premiums have doubled and tripled.
4. The individual insurance market was decimated by ACA, destroying any semblance of insurance competition.
5. ACA put most private practice independent physicians, that are more efficient and cheaper, out of business and working for hospitals. As you know, hospitals inflated pricing schemes also extorts taxpayer dollars
6. ACA also pushed insurers toward “narrow networks.” eliminated patients long-term relationships with physicians and further limited their choice of physician and facility.
7. ACA and forced government dependence will bankrupt the country and its citizens, as a whole and individually.
8. Remember the three big lies of Obamacare? Keep your doctor. Keep your insurance. Each family will save $2500. All proven false partisan narrative.
9. Attacking the president of the United States is a waste of time, money and energy when he would gladly work with you on these issues.

I would be glad to work with you and other legislators on competitive free-market plans and assure quality and give patients best choice and restore personal responsibility and freedom.

Sincerely
Craig M. Wax DO
Independent family physician, media host and healthcare policy expert

What is Healthcare? And How to Fund It.

Dear Chairman Alexander,

Thank you very much for asking America’s MD and DO Physicians to weigh in on solutions to improve Americans’ health and launch an efficient and sustainable path for the healthcare ecosystem.

The first critical step is educating your colleagues that there is a difference between medical care and health insurance. My recent article published in Medical Economics may help policymakers understand that the difference matters: https://www.medicaleconomics.com/med-ec-blog/what-healthcare

Solving the current healthcare policy disaster ultimately means less federal intervention and regulation, combined with more freedom and liberty.

Please consider:

1. Expanded universal HSA heath savings accounts for all, independent of insurance, and usable for every healthcare service, medication and device.

2. Remove ACA restrictions on insurance policies and stop multi-billion dollar bailouts of the insurance industry. Insurers have driven up costs. Instead allow a diversity of insurance plans to compete side by side: from catastrophic with high deductible to first dollar HMO-coverage. Unique individuals should be shopping for unique plans to suit their own needs.

3. Repeal the Group Purchasing Organization safe harbor to the Anti Kickback Statute that is also being abused by Pharmacy Benefits Managers. The federal government has permitted kickbacks disguised as “rebates“ for decades and it must stop. Make kickbacks illegal again. GPO and PBM middleman must compete legally and not extort manufacturers.

4. Innovative solutions like Direct Primary Care (DPC), and similar direct payment arrangements between specialists and their patients are must not be subject to over-regulation under insurance rules . These arrangements are not insurance but cut out the third party bureaucracy driving up the cost of care. DPC serves to strengthen patient-physician relationships not interfere in them. This healing relationship is critical for regaining health and health maintenance. It makes both patients and physicians responsible to each other directly, as it should be.

5. Allow physicians and patients to opt out of Medicare, MACRA, and other top-down government programs. They should be voluntary, not compulsory. Direct contracting between patient and physicians will save lives and tax dollars.

6. Consider legislation to protect patient access to physicians of their choice, even if they are not in their plan’s network. Narrow networks serve to trap patients into obtaining care in the most expensive settings instead of from higher quality and less expensive options like independent physicians.

Please feel free to contact me via letter, email, social media, phone, or any other mechanism for short and long-term planning. Together we can harness free market and personal individual responsibility to organically solve America’s healthcare crisis.

My article catalog: https://www.medicaleconomics.com/authors/craig-m-wax-do

Best wishes for good health,

Craig M. Wax, DO
Family Physician
VP Healthcare Policy, Practicing Physicians of America
National Physicians Council on Healthcare Policy member
Independent Physicians for Patient Independence
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
Twitter @drcraigwax
HealthIsNumberOne.com

Be There! New Jersey Doctor-Patient Alliance Inaugural Summit

You will not want to miss this summit on February 8-9, 2019!

IP4PI’s own Craig M. Wax, D.O. will join an all star lineup as a featured speaker. Dr. Wax will share reform priorities that will help put doctors and patients back in the driver’s seat. It is time to put and end to the shenanigans politicians pull to hand advantages to their crony buddies in the hospital industrial complex. Patients and their physicians must team up to reclaim their rights, increase the availability, and slash the cost of high quality care.

Aug. 30: Town Hall – Why Is Healthcare so Expensive?

The Healthcare Costs NJ 2018 Townhall with take place on Thursday, August 30th from 6:30pm ET to 8:30pm. It will be held at the Rastelli Market Fresh at Hill Creek Farms located  at 1631 State Hwy 45-S in beautiful Mullica Hill, NJ.

Contact: Craig M. Wax DO, office 856-478-4780 IP4PI@comcast.net

Why is Health Care so expensive?  This question is on nearly every American’s mind.  85% of Americans are more concerned about health care costs than other major expenses, and for good reason:  The average family of 4 will spend $28k on health care this year, $1200 more than last year. And even more concerning is that 44% of Americans skip care because of costs.

The Aug 30 event, featuring a word-class panel of experts on the drivers of medical costs, will explore and provide true solutions to this crucial problem, for both patients and policy makers. The townhall is held in conjunction with Practicing Physicians of America at PracticingPhysician.organd Independent Physicians for Patient Independence at IP4PI.wordpress.com. It is a free event and open to the public.

Speaker Bios:

David Hyman, MD, JD is an adjunct scholar at the Cato Institute and a Professor of Law at Georgetown University. A doctor as well as a lawyer, Hyman served as the Ross and Helen Workman Chair in Law and Professor of Medicine at the University of Illinois, where he directed the Epstein Program in Health Law and Policy. He focuses his research on the regulation and financing of health care and has taught insurance, medical malpractice, law and economics, professional responsibility and tax policy in addition to civil procedure. Hyman served as special counsel on the Federal Trade Commission, where he organized and led hearings on health care and competition – leading to the first joint report issued by the Federal Trade Commission and Department of Justice, “Improving Health Care: A Dose of Competition.” Earlier in his career, he was an associate at Mayer, Brown & Platt in Chicago, practicing tax litigation and health care law. He has been a visiting law professor at the University of Texas and George Washington University, a law professor at the University of Maryland and a lecturer at the University of Chicago. Hyman earned his BA, JD and MD degrees from the University of Chicago. Dr. Hyman recently published a book called Overcharged: Why Americans Pay Too Much For Healthcare. https://www.cato.org/overcharged

Kimberly Legg Corba,  DO is a family physician in private practice in Allentown, PA.  She is a 1993 graduate of the Philadelphia College of Osteopathic Medicine.

She has owned and operated her independent, solo practice since 2003 and transitioned the office to the model of Direct Primary Care in January of 2016.

Dr. Corba has been a speaker for Docs 4 Patient Care Foundation, the Free Market Medical Association, and will be speaking at the 75th Annual meeting of AAPS.

She testified about DPC in December 2017 for the PA Senate Banking and Insurance Committee in support of S. 926 and authored an policy for in-office medication dispensing for PA practices supported and approved by PA Med Society.  On a federal level, Dr. Corba has lobbied several times in Washington DC with the other national leaders for health care reform and most recently met with HHS, White House Administration, The Department of Treasury in support of Direct Primary Care and was present for the May 2018 rose garden speech concerning prescription costs by President Trump and Secretary Azar.   She is a founding member of the Direct Primary Care Alliance and the original founder of the Mid-Atlantic Direct Primary Care Alliance.  Dr. Corba has also authored and published The Manual of Policies and Procedures for Direct Primary Care which helps DPC practices maintain compliance.

Craig M. Wax, DO, is a family physician that practices family medicine and health through prevention in private practice in Mullica Hill, NJ. He is a tireless advocate for the patient-physician relationship and free-market health care. He has a bachelors degree in Food Science Research from Rutgers University in NJ, and a Doctorate in Osteopathic Medicine from the New York College of Osteopathic Medicine in 1994. Dr. Wax serves on the U. S. congressional subcommittee National Physicians Council for Health Care Policy at NPCHCP.org. He is the Vice President for health policy at Practicing Physicians of America at PracticingPhysician.org. Dr. Wax served on Medical Economics journal editorial board and frequently published articles on topics of free market medicine. He is the health talk show host and executive producer for “Your Health Matters ,” on Rowan Radio 89.7 WGLS – FM at RowanRadio.com since 2002. Dr. Wax was honored by the Society of Professional Journalists of Philadelphia with an SPJ award for his ability to make complicated matters simple to understand. He blogs at Independent Physicians for Patient Independence at IP4PI.wordpress.com. Dr Wax began HealthIsNumberOne.com, a free public information source on health in 1999.

Making American Medicine Great Again in 10 Simple Steps #MAGA

1. Price transparency for all healthcare services and supplies.
2. Site neutral payments (no hospital advantages).
3. Legislation to open and eliminate closed insurance networks. Networks are the third parties strangle-hold noose on healthcare.
4. Care must not be limited by insurance red-tape “referrals,” pre-certifications of imaging tests, and prior authorizations of medicines.
5. Reconsider tax exempt status of hospitals. They should have no advantage over physician offices or other services.
6. Patients should shop for all non emergent healthcare services and supplies and keep their savings.
7. Repeal 1987 GPO PBM anti-kickback safe harbor. Enable freemarket competition.
8. Define DPC as healthcare service contract between patient and facility or physician, not insurance. Keep DPC simple, direct, third party and government free, and patient empowered.
9. HSA expanded for DPC and OTC meds.
10. Legislation to permit physicians to see charity patients in return for either tax deduction or  malpractice insurance.
Two supplementary short editorials:
To solve U.S. healthcare crisis, think small, not big
The American hospital: from volunteer charity to tax-exempt patronage pit

AT RISK: Bill to Let Patients Use HSAs for DPC

Earlier this week we heard the good news that H.R. 365 was finally going to be considered by the House Committee on Ways and Means, bringing the use of Health Savings Accounts (HSAs) for Direct Patient Care (DPC) one step closer to reality.

Then we learned “a few small changes” had been made to the bill. Unfortunately the “few small changes” have greatly damaged the legislation.

You can read a copy of the latest bill here: https://goo.gl/B6imgQ.

Under the new language, DPC practices would have to comply with several federal requirements in order to become HSA-eligible. One provision limits the care provided under the agreement to specific CPT codes.  Another would prohibit DPC arrangements priced over a certain threshold from being HSA-eligible. Others further limit how the pricing can be structured and what care can and cannot be included. Specialists would be blocked from offering innovative HSA-eligible monthly membership payment arrangements.

To us, these changes are unacceptable and might be worse than no bill at all. If the bill passes in this form it would put practices that don’t comply with the federal rules at a competitive disadvantage to practices that align their model to satisfy DC instead of their patients.

One more problem:  these changes were tucked in at the last second barely a day ahead of Wednesday’s mark up session of the Bill in House Ways and Means.  That’s right, the new bill is headed to be pushed through committee with little chance for public input.

Today, AAPS sent a letter to every Ways and Means Committee member, and the committee staff, expressing our concerns about this bill and a few other bills the committee will consider on Wednesday, July 11.  Overall, we like a number of the bills under review, because they do expand HSA flexibility. But there are several key problems that tilt the playing field to the advantage of corporate medicine. Read more in our letter here: https://goo.gl/XYutr5.

What can you do?  Please send the committee a message ASAP before Wednesday at 2pm Eastern.  Here are the steps:

1) Copy the following text:

Dear Chairman Brady, Ranking Member Neal, and Members of the House Committee on Ways and Means,

Tomorrow you will be considering replacement language to H.R. 365, the Primary Care Enhancement Act. The addition of improper requirements means the new bill will not accomplish the goal of allowing patients to use their Health Savings Accounts to see the Direct Patient Care physicians of their choice.  I encourage the committee to consider adopting H.R. 365 as written, while rejecting the recent changes. In addition I encourage you to please consider AAPS recommendations about this bill and others you are considering today. The AAPS letter to the committee is available at https://goo.gl/XYutr5.

2) Visit https://waysandmeans.house.gov/contact/ and paste the comment in to the appropriate field and modify as desired.

2a) You can also fax your comment to the committee: (202) 225-2610

3) If your representative is on the Ways and Means Committee, email the note to the Health Legislative Assistant for your Member of Congress. A list of committee members and their health staff contact information, sorted by state, is available here: https://goo.gl/8iqw3u.

Thank you for speaking out!

Talking to Patients About Guns. A physician says “yes” and “no”

Should doctors routinely talk to patients about gun use?

That was a question my colleague Paul Hsieh MD addressed in the Wall Street Journal over the weekend.

Here’s another slant:

“Yes, physicians should ask about patient gun issues for their health and safety but No, no one should use EHR electronic health records or any data sharing mechanisms for that ultimately private discussion!” – Craig M. Wax DO

What do you think?