DAY IN DC FOR THE GOOD OF PATIENTS-empowering physicians to put patients first.

In the Oath of Hippocrates, physicians promise to work for the good of their patients, according to the best of their ability and judgment, and to do no harm. We support a return to this ethic in American medicine, and oppose policies that harm patients by subjugating care to the interest of the government and third parties.

Reform Issues:

• Overregulation and mandates restrict access, stifle innovation, impede transparency, block competition & raise costs.
• Fraud, waste, and shortages are rampant because special favors to middlemen.
• Employer-based and government-run insurance discourages rational insurance practices.
• Medicare and Medicaid are bankrupting the federal government, states, and doctors.
• In the era of COVID, the consequences of usurping of patient and physician autonomy and freedoms are becoming increasingly apparent and dangerous.

Proposed Solutions: to protect freedom, increase options, encourage competition, and unwind unsustainable spending.

1. End mask, vaccine, and other mandates and policies that intrude on patient autonomy. This also includes protecting Americans from World Health Organization policies that too often become mandates.
2. Protect physician and patient freedom of speech in all venues, including the Internet. The government and media must not limit legal speech and must be transparent about their sources of funding and control. (See Texas HB 20.)
3. Protect physician and patient autonomy in treatment and vaccination decisions. Early treatment for COVID saves lives and should not be improperly blocked by government or other bureaucrats. See AZ SB 1416 and MO HB 2149). Vaccine mandates are hurting vulnerable patients at low risk for COVID and must end. (See FL HB 1B, 3B, 5B, 7B).
4. Protect due process rights of physicians who too often face retaliation, simply for advocating for patients, by employers, hospital administrators, licensing boards, and others who control their ability to practice. Needed reforms include repealing HCQIA’s qualified immunity for sham peer review, reform of the National Practitioner Databank, and rights for physicians employed by private equity controlled corporations.
5. Work toward independence from China CCP medications, tech, manufacturing, goods and WHO influence.
6. End regulations blocking alternatives to ACA, employment-based, Medicare, and Medicaid plans, while allowing those who wish to keep their current government plan to do so.
7. End ACA’s ban on physician owned hospitals. Section 6001 of the Affordable Care Act of amended section 1877 of the Social Security Act to generally prohibited those who know best how to care for patients from running the facilities where care for the most seriously ill and injured often takes place.
8. Encourage transparency. Health care entities receiving taxpayer-subsidized funds from any source must disclose all prices that are accepted as payment in full for products and services furnished to individual consumers. Transparency by agencies (FDA, CDC, NIH, etc.) that control and influence health policy and treatment guidelines is also paramount. Transparency in training, so that patients know the qualifications of the clinicians caring for them, is also needed as patients are increasingly pushed to obtain care from individuals with significantly less training than physicians. Databases disclosing potential conflicts of interest must include all entities receiving or offering payments (e.g. device and pharmaceutical manufacturers, PBMs, GPOs, hospitals, insurers) not just physicians.
9. Remove legal protection for kickbacks. Remedy GPO and PBM abuse of safe harbors by encouraging Congress to repeal 42 U.S.C. § 1320a-7b(b)(3)(C) and amplifying HHS-OIG efforts to stop exploitation of 42 C.F.R. § 1001.952(j) and related regulations. Ending kickbacks is a crucial aspect of ending America’s reliance on China for drugs and supplies.
10. Decouple Social Security benefits from Medicare Part A. Citizens should be permitted to disenroll from Medicare Part A without forgoing Social Security payments. This would immediately decrease government spending and open the potential for a true insurance market for the over-65 population.
11. Repeal Medicaid rules that decrease Medicaid patients’ access to independent physicians. ACA requires physicians ordering and prescribing for Medicaid patients to be enrolled in Medicaid. This creates barriers for Medicaid patients who seek care from independent physicians but wish to use Medicaid benefits for prescriptions, diagnostics, and hospital fees. This is a particular problem for Medicaid patients seeking treatment for opioid addiction.
12. Explicitly define direct patient care (DPC) agreements as medical care (instead of insurance) so patients can use their HSAs, HRAs and FSAs for DPC.
13. Expand Health Savings Accounts (HSAs).  Examples of needed reform include repealing the requirement that an individual making a tax-deductible contribution to an HSA be covered by a high deductible health care plan; increasing the maximum HSA contribution level; allowing Medicare eligible individuals to contribute to an HSA. HSA reform will help end tax discrimination. Individual’s payments for medical care should not be taxed differently than payments made by employers.
14. End Restrictions on Health Sharing Ministries. Open the door for secular charitable sharing plans. Health Care Sharing Plans engage in voluntary sharing and are not a contractual transfer of risk.
15. Encourage indemnity insurance and competition instead of managed care HMO plans. No limited networks of physicians and facilities.
16. Address shortcomings of the No Surprises Act, that unfairly increase insurance company control over the ability of patients’ to access care from the physicians of their choice on mutually agreeable terms and that increase red tape for physicians.
17. Increase options for addressing pre-existing conditions. Invigoration of competition, by implementing the above changes, would bring a variety of products for patients with pre-existing conditions, including reinsurance, and inexpensive guaranteed issue and renewability protections, and most importantly, lower overall cost of care.

Conclusion: Congress has passed law after law that disrupts the patient-physician relationship, corrupts medical decision making, and increases costs. During the COVID era, overregulation and regulatory capture is a greater threat to our nation than ever.   Harmful laws and policies cannot be fixed by adding new regulatory burdens or further usurping patient and physician autonomy. True reform starts with repealing laws and correcting errors, restoring the freedom, under constitutionally limited government, that made America great.

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

If anyone asks about preserving “good” portions of Obamacare, you can respond:

“You can’t fix a turd.”

“And like a turd,” explained one physician a few years ago, “we had to pass ObamaCare before we could find out what was in it.” Remember Congresswoman Pelosi’s infamous quote?

Sorry to be so blunt but ACA Obamacare is so filled with theft by taxes, giveaways to hospitals and insurance industries, and theft of patient rights and physician autonomy, that it would be unwise to leave any of it on the books.  If it were re-activated and funded at sometime in the future, because we failed to repeal it on total, we would be at fault. Will our children face the true consequences of paying for it and being bound by it?

Best wishes for good health,

Craig M. Wax, DO

Family Physician

National Physicians Council on Healthcare Policy member

Real Stories of the ACA nightmare # 13 – Year and a half waits in Canada

“45 year old man. Known ophthalmic ICA aneurysm. Presents in 2014 with worsening headaches and blurred vision. Neurologist orders MRI March 2015. Neurologist RETIRES. Patient gets MRI November 2016. Canada.”

Real Stories of the ACA nightmare # 12- “Two out of three ain’t bad” – Meatloaf

A Canadian physician writes: “54 year old woman. Diabetic, hypertensive, high cholesterol. On Atorvastatin, Ramipril, Metformin. Presents to me with HbA1C of 8.9 – I adjust Metformin. Next visit, HbA1c is better, closer to 7.8. But BP is 190/100. I adjust the Ramipril. Next visit A1C is 7, BP is 135/80. Patient tells me not to check cholesterol. Because, she finally admits, she can only afford 2 out of 3 medications at a time, and she’s picking and choosing which ones to take depending on how horrified I am at the visit. But the cholesterol drugs are so expensive and her heater broke, so she needs a new heater, and she doesn’t want to know my reaction if she stops her statin.”

Posted with permission from the across the border

Real Stories of the ACA nightmare # 10 – “Free” care is awfully expensive

“I saw a patient that I met for the first time three months ago who is originally from Canada. She was in for her pre-op visit. She is in awe of the fact that she got surgery in three months. In Canada under a single payer system it would have taken at least three years she said. And her income tax rate was at about 50% to cover the programs.”

Posted with permission

Real Stories of the ACA nightmare #9 – A Tale of Two Patients

“Whereas Mr. Clinton has accurately diagnosed Obamacare’s fundamental problem, Mrs. Clinton has spent the past year either defending it or calling for even greater intervention in health care. Now momentum is building among her supporters and allies for a full-blown, single-payer system in which the government, using tax dollars, pays for all medical care of its choosing. Medicaid, Medicare and the Veterans Affairs hospital system operate on this model, and each provides sub-par care to their intended beneficiaries in many key ways…I have patients who show the dangers of going in this direction.

One patient comes from the VA. He requires very high doses of concentrated insulin to control his blood sugars. At my practice, we provided him with treatment quite effectively until he retired. Now the VA has been giving him the runaround for over six months. It has yet to even accept his application for the concentrated insulin he needs, which has driven his blood sugar to dangerous levels. It’s unclear when, or even if, the agency will get him the treatment he needs. His health is failing fast under the single-payer system.

The second patient is on Medicare. He has had type-1 diabetes for over 40 years, but thanks to advances in medicine he has been able to continue working on a consistent basis. When he turned 65 and went under Medicare, however, he lost his coverage for the specific treatment he needs. He has appealed this all the way up to a federal administrative law judge, but six months after the hearing he still hasn’t heard of a decision. His health, too, is failing fast.

Wouldn’t it have been better for these two men to keep their private insurance plans, which fit their needs and improved their health…My patients experience shows the danger of heading toward even greater government intervention in our health care system. If we empower bureaucrats to wield ever more power over patients’ health and well-being, the end result will be higher costs, fewer choices, worse care and even lost lives….For the sake of my patients, to say nothing of millions of other Americans, it’s critical that we get this one right.”

Real Stories of the ACA nightmare # 8 – From those who sacrifice for our freedom

“We’re on military insurance. When the first round of ACA went into effect, our premium jumped about $20. Which wasn’t horrible. Then we realized our coverage dropped. We used to pay $10-15 for the office visit co-pay. Now we’re paying $50-80 depending on the Doctor we visit. And getting approval for procedures (i.e. Gallbladder surgery) was horrible.”

Real Stories of the ACA nightmare # 7 – Bill Clinton was Right

“Bill Clinton has a point. Specifically, he was right when he said the Affordable Care Act is “a crazy system where you’re paying double and getting half the care.”

I realized this when I welcomed back a patient into my office after a gap of 18 months. This gentleman had stopped coming to my office when he purchased a health insurance plan on Pennsylvania’s Affordable Care Act exchange. His plan didn’t include me in its network. Nor did it include much of anything for that matter.

After struggling to find care for his condition for a year and a half, he and his wife decided to come to my office and just pay cash. When I asked why they had chosen their plan — it had a $10,000 deductible — I was told it was all they could afford and, if they didn’t buy it, they’d have to pay a fine.

Bill Clinton calls this crazy, which it is. My patient was essentially forced to purchase government-mandated insurance that covers little, disconnects him from his doctor and costs him an arm and a leg. “Obamacare” has undeniably made his life worse — and it was supposed to help him.”

ObamaCare: CBO report shows full repeal is better than partial repeal

The Hill reports:

“ObamaCare’s regulations would cause premiums to rise an additional 20-25 percent next year and to double over the next decade. … Those costs would be due to ObamaCare itself, not a partial-repeal bill. ObamaCare architect Jonathan Gruber explains ObamaCare’s mandates and subsidies exist to hide the costs of the law’s health-insurance regulations. Repealing them merely makes those staggering costs transparent. Nevertheless, the public would blame Republicans for failing to repeal those regulations when they had the chance.

The reason Republicans are entertaining a partial-repeal is because they mistakenly believe Senate rules don’t allow them to repeal the regulations with a simple majority.

With a 52-seat majority, Republicans don’t have the 60 votes necessary to overcome a Democratic filibuster of a repeal bill. But Senate rules do, in fact, allow repeal of ObamaCare’s insurance regulationsthrough the special “budget reconciliation” process that requires only 51 votes to approve legislation. Even if the Senate parliamentarian misinterprets those rules — and this would be an egregious misinterpretation — a majority of the Senate can overrule that misinterpretation.

In short, the question is not whether Republicans can repeal the regulations. It is whether they have the will.”

http://thehill.com/blogs/pundits-blog/healthcare/317269-obamacare-cbo-report-shows-full-repeal-is-better-than-partial