ALERT: Opportunity to Help ALL patients access Direct Care with latest Coronavirus aid bill

Update 3/22/2020: It appears that the flawed language has been removed from consideration! Now it is time to ask the Senate to ADD good language from S. 3112, the Personalized Care Act.

Please contact your Senators ASAP with the following request: Please include S. 3112, the Personalized Care Act in the upcoming bill to address the Coronavirus epidemic. Allow all patients to use Health Savings Accounts for direct care arrangements with their trusted doctors, without unnecessary red tape and limits on patients’ options.

Phone numbers for all Senators and the email addresses of their healthcare legislative staff can be found at: bit.ly/senfull2020

Empowering patients to access low cost, high quality medical care, from independent physicians is more urgent than ever!


Tell Congress to Remove Flawed Direct Primary Care Language from Emergency Legislation

Dear AAPS Members and Friends,

Earlier this week we alerted you to provisions in the House coronavirus relief bill that are harmful to small medical practices and all small businesses.  The bill was made slightly less bad before it ultimately passed and was signed by the President.

You can read more about the changes and impact for small businesses here:

https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/senate-to-vote-soon-on-coronavirus-paid-leave-mandate.aspx

Now the Senate is working on a third bill related to the ongoing situation with COVID-19. 

A 247-page draft of the bill is now online here:
https://www.republicanleader.senate.gov/imo/media/doc/CARES%20Act%20Final%20-%20Mar%202020.pdf

It has a number of health policy related items tucked into it, for instance a temporary suspension of Medicare sequestration payment reductions.  It also has provisions easing FDA regulations that may impede timely care, and requires that “each provider of a diagnostic test for COVID-19 shall make public the cash price for such test on a public internet website of such provider.”

One immediate concern about the latest bill is that it contains flawed language (Sec. 4403) intended to fix the incompatibility of Health Savings Accounts and Direct Primary Care caused by current IRS law and policy.

A solution for this problem is needed, but the Senate language mirrors problematic policies from past versions of related legislation.

For instance:

1. The bill caps patients’ “aggregate” direct primary care fees at $150/month. Most DPC fees are well under that amount but imposing price controls on care paid for from HSAs would be a dangerous precedent.  And the cap also limits the flexibility of physicians and patients to tailor agreements based on individual patient needs. 

2. The bill limits DPC agreements to “primary care practitioners as defined in section 1833(x)(2)(A) of the Social Security Act.” It also imposes other limits on the types of care that can be included in agreements. These limitations are unwise and also improperly limits the options of patients and physicians.

3. The bill adds DPC to the the section of IRS code that lists types of insurance eligible for payment from HSAs. Labeling DPC as a type of insurance, or type of coverage, is not the right way to correct the flaws in the IRS code and increases the risk of overregulation of innovative DPC practices.

Here’s what you can do:

1) Ask your Senators to remove Section 4403:

Please call your Senators ASAP and ask them to“Remove Sec. 4403 from the 3rd coronavirus bill and replace it with S. 3112, the Personalized Care Act.  Sec. 4403 overregulates innovative direct care arrangements that are increasing patient access to low cost, high quality medical care. This flawed language will do more harm than good. Congress instead should enact S. 3112 and allow all patients to use Health Savings Accounts for direct care arrangements without unnecessary limits on patients’ options.”  

You can find your Senators’ phone numbers at: 
https://www.senate.gov/general/contact_information/senators_cfm.cfm

Alternatively, you may phone the United States Capitol switchboard at (202) 224-3121. A switchboard operator will connect you directly with the Senate office you request.

2) Next call your House members and tell them the same thing!

Contact info at https://www.house.gov/representatives or Capitol switchboard at (202) 224-3121

3) Finally call President Trump to warn him about this bad provision and ask him to demand Congress remove it:

White House Phone #:  (202) 456-1111.

White House Contact Form: https://www.whitehouse.gov/contact/

Please share this alert and encourage others to call. Thank you!

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

CMS wants your comments on market-based Healthcare innovation. Deadline Nov. 20.

CMS has caused quite a stir this week by announcing they are shaking up their CMMI “Innovations” office.
They are looking for input on “Consumer-Directed Care & Market-Based Innovation Models”  that might be beneficial to Medicare and Medicaid patients.
“What options might exist beyond FFS and MA for paying for care delivery that incorporate price sensitivity and a consumer driven or directed focus and might be tested as a model and alternative to FFS and MA?”
Here’s a link to the full request:
The deadline for submitting comments is November 20 and the link to their webpage on this is here:
And the response form is here https://survey.max.gov/429625

I do not want a government “comprehensive replacement plan” for 1/6th of the private sector economy.

Friend of IP4PI and medical freedom warrior Jane L Hughes, MD writes in:

Greetings,

We need something that does not increase the cost to everyone! Approximately 50% of Americans don’t spend more than $1,000/yr on actual healthcare, and 89% don’t spend more than $5,000/year. Also, in my opinion, “Make America Healthy Again” is more a slogan for the public health department, not physicians per se. 100% of Americans who make it past 8th grade have had health class. They know obesity, smoking, drugs, sex, teen pregnancy all lead to problems. They persist in bad habits/lifestyles anyway. That is a societal problem that we all care about, and each of us in our own way influences as a physician. However, our primary job is screening, treating when necessary, managing chronic illnesses with our patients, and stressing behavioral changes that can impact future health issues with our patients. OK, on to what I think we need.

1. Repeal 100% of ObamaCare and start over with transparency regarding cost and sources of revenue for safety net on federal level. Continue reading

True Patient Centered Reform: Revisiting Dr. Paul Broun’s Patient OPTION Act

According to our friends at Freedom Works:

“Section 1 of his bold, principled plan repeals ObamaCare in its entirety. That alone would make it worth supporting, but he goes much farther. Inspired by the vision of a truly patient-centered system, his bill addresses the spiraling cost of health care and lack of consumer control in a number of commonsense ways.”

The OPTION Act eliminates the requirement that HSAs be attached to high-deductible health plans, allowing all Americans to save money for a rainy day tax-free. Continue reading

Key concepts as we work to restore patient freedom and Make American Medicine Great Again

Now that there’s a fighting chance to save patients from the disaster of ObamaCare, let’s keep focus on some of the pivotal ideas that will restore low-cost, high-quality care for the maximum number of Americans, i.e. Make American Medicine Great Again:

Health insurance was originally intended to be optional inexpensive stop-gap damage control against large financial losses for catastrophic disease or injury. It has become government #ACA mandated income redistribution through #ACO cronyism disguised as an entitlement program.

The “unaffordable careless act,” aka ACA, not only had high deductibles but the highest premiums in history as it was first dollar coverage driven by government fantasy. 

True low cost competitive rate high deductible plans (HDP) should only cover large expenditures as small ones should be paid out of pocket with consumers’ Health Savings Accounts (HSA).  

Patients will decide on the value mix of the services they desire with prices mutually agreed on between patient and doctor. Consumers can have choice of paying fee for service at their discretion or paying for direct primary care ongoing relationship services. When other entities like employers, special interests and government get involved, the relationship and value is put asunder. 

Insurance was never intended to cover every dollar out of pocket. Imagine how expensive your car insurance would be if it covered every scratch, ding, dent, oil change, and every other service and told you where to buy gas every day….

HSAs Need A Makeover: Meet the Health Empowerment Account

Comrades in arms,

Thank you for working to bring back true low premium high deductible health insurance that reimburses patient for catastrophic losses and health savings accounts. Current HSAs are fatally flawed as they are currently limited in use scope and inexorably tied to health insurance. Here are some principles to help. If the HSA is limited by definition, perhaps we can advocate for a new concept like “health empowerment accounts(HEA).”

1. HEA/HSA should be one to each individual from birth or whenever they are added on. They should belong only to that individual unless lawfully transferred to a family member(see 3). Continue reading

The Definitive Interview with Dr. Ben Carson – We Can Afford Good Health Care

Originally broadcast on January 13, 2016: Dr. Craig M Wax Interviews Ben Carson, MD on Your Health Matters, Rowan Radio, WGLS-FM.

 

It is NOT a Free Market

Guest Post from Dr. Claire Coco

We don’t have free market conditions:

  • Health insurance is required.
  • Insurers are required to cover certain levels of care.
  • Pricing is not transparent.

That is the formula for high prices. First we saw it with hospital and urgent care. Now we are seeing it with prescriptions and labs. Continue reading

United Healthcare’s Bank Enables Even More Data Mining About You

Guest Post From Barbara Duck, Proprietor of The Medical Quack Blog

How many people know that United-owned Optum has a bank?  They don’t offer any retail services outside of an Health Savings Account to the public but many companies offer this for people who have a high deductible health insurance policy.  You can read through Yelp and make your own opinions if you want to dive in a bit more.  The bank is located in Salt Lake City and most of what one would do with this “custodial” bank would be onlineimage of course.  There are other Health Savings Accounts around of course to choose from.  Well here we have MasterCard who we should all know by now are just marketing and mining your data to who ever seems to have the money to buy anymore.  Here’s a company names Argus, who buys credit card information and then continues on to “score” you.  We’re not talking credit scores here, but anything they can think of where they can take data, score you with some query some Rogue software engineer came up with to make money. Continue reading