The solution to healthcare is…

Most agree that we need a healthcare system that encourages people to take care of themselves and covers catastrophic injuries and disease for all people.

I trust the free-market more than government, and some trust the government more than the free market.

MACRA, ACA, HIPAA, HMO act, Medicare and Medicaid were supposed to reduce costs and expenditures. Obviously government only makes it all worse. Looks like a job for the freemarket!

Either way, whichever philosophical system is selected by the people, individuals must freedom of choice and bear their own responsibility to the extent that is humanly possible.

Craig M. Wax DO

CNBC reports:

Medical emergency: ER costs skyrocket, leaving patients in shock

  • Americans are being overcharged by more than $3 billion a year for ER services, according to data from Johns Hopkins School of Medicine.
  • Bills can be nearly 13 times the rates paid by Medicare for the same services.
  • Americans in the Southeast and Midwest, and poor and minority patients, are the most exploited by emergency-room billing practices, especially at for-profit hospitals.

Read full story:

https://www.cnbc.com/2017/08/10/medical-emergency-er-costs-skyrocket-leaving-patients-in-shock.html

A Conversation: Can Free Markets Save American Medicine?

A recent article from the Mises Institute. “Under Socialized Medicine, The State Owns You,” sparked a conversation between Mr. Bob Wells and IP4PI founder Dr. Craig M. Wax.

Bob

I appreciate your assessment of the solutions presented like VA, Medicare and Medicaid being awkward, too expensive, and failing in large demonstrable ways. We haven’t had true market based medicine since World War II. Prior to that, it was relatively inexpensive cash and Barter based services. I argue this is the most efficient as it cuts out insurance, pharmacy benefits managers, all levels of administration, and last but not least, all aspects of government regulation compliance and taxation.

In the last six years there have been at least 12 plans on the table to repeal Obamacare. And, there have been six in the last 12 months. There was no sparsity of plans, just no palpable consensus.

I assert that inexpensive primary care, labs, low-end studies, cheap generic medications, will allow for most needs to be met by most people. And expanded health savings account HSA would be used for each citizen to use pretax dollars to buy anything health related from gym memberships to over the counter medications to actual care necessities. Further, inexpensive catastrophic insurance for the big ticket items would be also affordable by most. There could be community, charity, and state programs to provide for the neediest, while keeping the federal government taxation hands to itself.

Unless the Congress and President act soon to repeal Obamacare, just rearranging the deck chairs, will not prevent its fate. Already 19 out of 23 taxpayer-funded co-ops have gone bankrupt taking billions of taxpayer dollars with it. And for the phony federal mandates state exchanges, many have only one high price insurer participating, while still others have none. Leave it to the government to mandate you buy something very expensive and then there’s no opportunity to even comply!

Best wishes for good health,
Craig M. Wax, DO

—————

Dr. Wax,

The deficiencies of state-sponsored health care are widely known. What is difficult to figure out is an alternative — market-based — that is universally accessible and affordable (with affordability being as elastic as elastic can be), while still offering high quality. If there is a model in this world, I am unaware of it.

All efforts America has made to provide public support for health care since World War II, from the VA system to Medicare and Medicaid to Obamacare, have been awkward and grossly inefficient (if somewhat effective, overall). Unfortunately, blowing these systems up and starting a new system based solely on market forces would be catastrophic in the short term. And since politicians think in the short term, such a radical transformation is impossible.

Today’s Republicans realize there is reward in trashing Obamacare, but they also know that they do not have a better plan to replace it. If they really had a better plan they would have introduced it by now, and it would be on President Donald Trump’s desk for signature. The fact that they cannot agree among themselves on a replacement is testimony to how difficult a problem this is. (This does not excuse the Democrats, either.  They’d rather let the Republicans look foolish than offer their own “solutions.”)

Regards,

Bob Wells

Even a Seventh Grader Can Understand the Root Failure of Government-Run Care

From Steven Dailey FACHE:

The first term paper that I ever wrote was titled “Should Medicare and Medicaid Survive?” and was handed in to my seventh grade teach in the spring of 1967. She gave me a “B” because she did not believe that I had interviewed the local hospital administrator whom I quoted extensively in the term paper.

She also marked me down because in her mind, “our government never takes something away that they have already given away. That is just too hard to do.” Maybe she was right about never taking something away -. She was wrong about the interview with the hospital administrator – he was my Dad…. He ran a 500 bed hospital and he absolutely railed against the involvement of government in healthcare.

Many, many hospital administrators did not want Medicare and Medicaid back then. They knew all too well what would happen – regulation and cost increases year after year…. Isn’t it amazing that our public trusted our physicians and hospitals back in the 1960’s and after decades of increasing governmental regulation and trillions of government expenditures healthcare suddenly fails to meet public expectations? It isn’t amazing that when you add insurance coverage to tens of millions that costs will increase? Not really….

Principles for individual healthcare freedom

IP4PI Physicians support the following resolutions for the legislative, executive and judicial branches of the US:

1.  The full repeal, nullification or reconciliation of ACA/Obamacare as it was:

A. ACA passed by a partisan Congress (one party) by reconciliation. B. Changed by the executive branch 43 times without appropriate congressional action. C. Changed by SCOTUS to be a tax bill. D. Tax bills must originate in the House and ACA originated in the Senate. E. ACA has changed healthcare from a professional physician-patient interaction into merely an act of government HHS/CMS unelected bureaucratic compliance. F. ACA lead to an uncontrolled rise in costs for all citizens through increased taxes, insurance costs, hospital costs, physician costs, use of narrow networks and severely limited ACA approved options. G. IRS and tax penalties for any American citizens violate the US Constitution. H. Mutually accepted individual customer-vendor purchases are the ideal way to allow personal choice, encourage excellence and establish price competition for best citizen consumer value. Continue reading

Obamacare cost us trillions to save us millions.

Think about the math; Obamacare cost trillions to save us millions . It has taken over our the healthcare system, insurance system, funneling money to the hospitals and special interests, and stolen everybody’s right to choose to buy or not buy and insurance product. It is the biggest tax increase, biggest taxpayer funded entitlement and biggest theft of out rights in the history of our country. Obamacare Medicaid is not actual care, but a phony entitlement to enslave a population to vote for Washington cartel into perpetuity. I’m no fan of either party and their centralized power and money. We must repeal ACA and change DC now!

Best wishes for good health,

Craig M. Wax, DO
Family Physician
National Physicians Council on Healthcare Policy member

Eliminating the six degrees of patient-physician separation

By Craig M. Wax, DO

Parties and special interests within the US federal government have been trying to passively and actively control the health and welfare of its citizens for a century. With the War Labor Board’s wage and price controls instituted in 1943 during WWII, the US federal government first warped both the employer/employee workplace and healthcare by firmly establishing health insurance as a employee “benefit” in lieu of salary. The premiums were paid with pretax dollars by a combination of the employer and employee.

This gave the employer the power to choose the coverage based on the employer’s needs and wants, not the end user employees needs and wants. This was the first degree of separation.

The insurance premium was used as a bet against the employee getting sick. Today, the insurance companies and other third parties make money by denying the healthcare payment for services, studies, tests and medications. After the insurance company processes healthcare provider claims, they make restrictive and sometimes arbitrary decisions about whether to fund the care, tests and medications. This leaves the patient on the hook for associated costs, despite the insurance premium already paid. This is the second degree of separation. Continue reading

Saving the Principle Upon Which the Country Was Founded – Liberty

I’m not really trying to save the country…trying to save the principle upon which the country was founded…Liberty

The Federal Government should be removed from every aspect of interference it has unconstitutionally grabbed in the last 100 years: Social Security, Medicare, Medicaid, Income Tax, Federal Reserve, education funding , litany of Federal Agencies etc. etc., etc.,

Never was there a country on Earth (and there will never be one) with massive central government programs that are not either bankrupt and/or corrupted morally and politically, We indeed see that in our face after 100 years of creeping socialism….

Complete decentralization means living within your means locally …health care, education….everything!

Short of this the country will break up soon.

Jack Iannantuono, CFP®, ChFC®, MSFS, AIF® | Indicon, Inc.
Chief Executive Officer

Ayn Rand’s speech against socialized medicine in 1963; 100% relevance today.

https://ari.aynrand.org/issues/government-and-business/health-care/How-not-to-fight-socialized-medicine

A Physicians’ Template for HealthCare Reform: An Eleven Point Plan

via AmericanDoctors4Truth

Revised Edition, September 1, 2015

There are those who say that ObamaCare is now the law of the land and citizens should accept it and proceed with compliance. However, the overt bribery with cloistered deliberations and the failure of Congress to read the bill before passage is an affront to every American citizen regardless of political persuasion. As we now begin to understand this takeover of one sixth of the private sector economy, we see a fundamental transformation of the relationship between the individual and the federal government. The profession of medicine has been politically commandeered to accomplish centralized power in bureaucrats who now have increasing potential to intercede in some of life’s most critical and intimate affairs. This has the potential to erode the personal dignity and worth of every individual and strip individuals of personal freedom in healthcare choices. Our healthcare system needed reform, not the further distortions to the system in the ACA.

These ideological considerations aside, many promises of ObamaCare have been shown to be false. Health insurance costs have already risen and individuals have lost their insurance, hospital access, and physicians with whom they were happy. Individuals now have an insurance card, but with the high deductibles and narrow networks they are unable to access care. Medicare, Medicaid, and the VA are existing examples of government medicine. Medicaid pays less than the cost of delivery of care for many services, and the VA scheduling delay scandal actually cost lives. The bureaucratic nightmare of compliance with Medicare mandates, not to mention the approaching ACA mandates, has prompted many physicians to restrict the number of these patients or opt out of participation completely.

Thirty-six states wisely rejected ObamaCare by not setting up state run exchanges. Of the fourteen that did, at least seven are now insolvent after over a billion dollars of federal tax dollars were spent to help set them up. ObamaCare has never been implemented. Rather, it has been changed by administrative or executive fiat at least thirty-five times. After the 2014 elections, there continues to be a window of opportunity for alternative solutions to fix our American healthcare system without destroying arguably the finest medical and surgical care in the world. Across the country physicians are joining forces to craft viable alternatives that fulfill the false promises of ObamaCare. Although the AMA has name recognition, it represents only about 12% of practicing physicians. In fact, the AMA supported ObamaCare because it has a monopoly on the coding books necessary for business with government insurers, an estimate $80 million a year revenue for them. Currently Docs4PatientCareFoundation, The American Association of Physicians and Surgeons, AmericanDoctors4Truth, The Physician’s Council for Healthcare Policy, and The National Coalition of Physicians for Healthcare Freedom, and United Physicians and Surgeons of America are leading activists in these endeavors. Most of the reform ideas share a common philosophy. Our system should be patient centered, physician guided, and free market driven leading to healthy competition, transparency, and free patient choice. Perhaps those in Congress and the presidential candidates who truly care about enduring reform will consider listening to the experts in healthcare, the boots-on-the-ground practicing physicians who take care of you and your family. The eleven points for reform are as follows:

  1. Get employers out of the health insurance business. Shift insurance purchase for the employee to defined contributions for healthcare purchases or to increased wages to place individuals in the driver’s seat selecting insurance options that fit their needs. Massive administrative costs for business would be saved and disruptions to existing physician relationships would be stopped. Insurance would be non-job specific, stable, and portable. The insurance industry would be forced to respond with a robust offering of individual policies that would form the risk pools. They would compete by virtue of their product, not contracts with third parties, i.e. employers or the federal government.
  2. Purchase of health insurance, health savings accounts, or cash payment for care should be with pre-tax dollars regardless of who makes the purchase.
  3. Once a robust individual market is established, liberate Medicare aged individuals by allowing them to opt out of Medicare without penalty. A defined contribution, like their social security check, would allow them to purchase insurance of their choosing like the rest of the population.  Retain Medicaid for the truly indigent or incapacitated of all ages.
  4. Medicaid would emerge as the only federal government health insurance program, except for the Military and the VA System. (Their reform is for a different discussion.) It could be also used as a stop-gap insurance for those between jobs who could not afford continuation of their insurance, as well as a “rider” for pre-existing disease added to conventional insurance for a specified time. States should receive block grants without mandates to decrease the perverse incentives to increase enrollment. This also promotes innovative ways to ensure access to quality care in cost effective ways.
  5. Return to indemnity insurance where there is shared risk for unanticipated medical or surgical expenses related to injury or illness. The notion that insurance is pre-paid routine healthcare cannot be fiscally sustained. Health Savings Accounts with a catastrophic insurance policy paid for with pre-tax dollars would transition to paying health care dollars, not insurance dollars. Many current insurance payments exceed the cost of routine care and a catastrophic policy. Patient controlled HSAs promote good stewardship of healthcare dollars.
  6. Encourage states to eliminate insurance coverage mandates, like acupuncture and message, to allow a cost effective catastrophic policy and HSA’s. Pre-existing could be covered with time-limited riders.
  7. Allow purchase and portability across state lines. States are the places for innovative healthcare solutions, not one size fits all central planning. Mistakes are more readily remedied as well.
  8. Total transparency across all health care entities is essential. No more third party contracts. There could be a state sponsored portal where hospitals, pharmacies, physicians, etc could post their individual fee schedules regardless of the insurance the individual carries. The insurance contract then becomes one between the patient and the insurance company. Insurance companies then could list what they will pay, not dictate what the physician can charge. This allows patients free access to whatever provider they chose. Cost shifting and horrendous administrative burdens would be eliminated. Hospitals would no longer have inflated “charge master” fees. Prices would fall as competitive markets emerge. We don’t walk into a grocery store and get charged different prices depending on what credit card we use and what deal that credit card has with the grocer.
  9. Fees and costs of all entities, like pharmaceuticals, surgery, devices, physician services, should reflect the cost of resources used and services rendered, not an inflated price upon which third party contracts base their “discounts” for individuals in their “network” nor the Medicare arbitrary price controls. This allows patients and physicians to make informed decisions regarding health care expenditures and choices, and helps to ensure adequate access to care.
  10. Encourage torte reform to save the estimated 30% cost of litigation avoidance for pain and suffering. Lost wages and disability compensation would still be recoverable.
  11. Allow charitable care delivered by the physician to be a tax deductible item with a yearly limit.

Jane Lindell Hughes, MD, FACS

Edited and Approved By:
AmericanDoctors4Truth

Co-Founders:
Kristen Story Held, MD
Jane Lindell Hughes, MD, FACS

A Physician Overcomes His Addiction to Third-Party Money

Guest post from Steven Horvitz, DO

I am solo Family practice in southern New Jersey.

Back in 2006 I saw the writing on the wall that solo docs were in trouble. Revenues were stagnant due to insurer fee schedule reduction, yet expenses kept rising. My practice style does not fare well with quick visits so adjusting my practice to a treat-em and street-em quickly was not in my plans.

In 2005 United Healthcare and First Health insurers were creating issues with referrals and formularies and since I did not have a large percentage of those patients I dropped those plans. Most of those patients either switched insurance to remain with me or paid me my cash fee. Continue reading