Join the discussion on how we can fix healthcare.

The U.S.A. was founded on an act of rebellion against authority. It is our cultural norm to question those in power. With the Vietnam War and Watergate, questioning became doubting. We began to ask if those in authority were regularly lying to us.

Now the veracity of elected officials, especially those in Congress, has reached an all-time low. It is the general feeling that all incumbents, of either Party, lie, cheat and represent only themselves, not us. Everything they do is partisan and bluntly, if their lips are moving, they are lying. They seem to talk only in newspeak.

“Newspeak” is the word coined by George Orwell in his book 1984, warning us in his 1948 novel about what Big Brother could and will do to us. Using newspeak, a word or phrase means exactly the opposite of what you think it means. Bad is good. Black is white. Reforming healthcare makes it worse.

President Obama raised the issue of healthcare to national prominence by emphasizing its unsupportable cost spiral. His “Reform” Act, H.R. 3590 or the PPAHCA, spends over $1 trillion. This is classic newspeak. You call something “reform”–making things better, i.e., reducing costs–while you actually increase spending.

Consider the title of the PPAHCA: Patient Protection and Affordable Health Care Act of 2010. This is another demonstration of Congressional mendacity or disingenuousness. It is a WMDc (weapon of mass deception). It is classic newspeak.

“Patient Protection…”
Does PPAHCA protect patients? In fact, it creates the infamous Death Panels the Republicans tried to scare us with in 2009. The Act creates cost/effectiveness Commissions similar to what Great Britain calls the National Institutes For Clinical Excellence. These decide what is “cost/effective” for the national population, not the individual. If a treatment is deemed not cost/effective, it is not funded and therefore not available. In simple terms, if you need an unusual treatment or something that is very expensive, it is denied, you don’t get the care you need, and…guess what happens. That is a strange way to “protect” patients.

“…Affordable…”
“Affordable” for whom? Certainly not for our nation. The minimum cost estimate is $690 billion and the maximum I have read so far is $2.7 trillion. The fact that no one knows should itself scare you. Would you give a blank check to an inveterate overspender? You just did!

Worse, every entitlement program ever enacted has cost much more than projected. By 1990, Medicare had cost 854% over the original 1964 estimate and will be bankrupt in less than seven years.

Testifying before the Senate Budget Committee, the Director of the CBO (Congressional Budget Office) said that PPAHCA will accelerate not dampen the healthcare cost spiral. Recall that the President started the healthcare ‘reform’ movement because the upward cost spiral was unsupportable. The only way that accelerating the spiral would be considered “reform” is using newspeak.

No one in their right mind calls something affordable when you have to borrow the money to spend, then print dollars, and add to the national deficit.

Finally, where does all that money go? Did you know that before the PPAHCA almost forty percent (!) of all healthcare spending went to the Government? I termed this the “waste of the middle.” After this “Affordable” Act, close to 50% will go to the bureaucrats and not to hospitals, doctors and nurses, pharmaceutical companies, or wheelchair makers.

“…Health…”
Always bear in mind that “Healthcare” is a sickness treatment system. It does not reward health or wellness. Neither the Government nor the providers can deliver ‘health’ to the Public. This is particularly true when Cost/Effectiveness Commissions will prevent you from getting the care you need. Read Daniel Putkowski’s (temporarily fictional) novel “Universal Coverage” to see what it will be like for the average citizen under PPAHCA.

“…Care”
PPAHCA implicitly promises you health CARE but offers health insurance. They let you believe that having insurance automatically gets you care. This is probably the cruelest lie built in to the PPAHCA. Here is a dose of reality.

We currently have a shortage of nurses and doctors: we do not have enough providers to deliver the care needed right now. Further, our provider shortage has been getting worse. What will happen when 30 million additional Americans acquire health insurance and start demanding care? Where will they find doctors, especially since PPAHCA reduced Medicare payments? And while PPAHCA is hiring thousands of new bureaucrats, there is not one single dollar in PPAHCA for a new nurse or doctor.

If you think that I exaggerate, please check my facts and assertions. Unfortunately, you will find they hold up. It is just as bad as I describe.

PPAHCA or Obamacare is a superb example of newspeak.
It exacerbates healthcare rather than reforming it.
Good medicine for healthcare starts with the repeal of PPAHCA.

System MD

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Last year, all our nation could talk about was the crisis in U.S. healthcare. Now there is an eerie silence. The quiet is…unnerving. Is something happening? Is everything fixed?

Hopefully, you knew those were rhetorical questions with answers: YES and NO!

HR 3590, also known as the Patient Protection and Affordable Health Care Act (PPAHCA) or colloquially and derisively called Obamacare, is moving the Democrat Party agenda forward but not the welfare of our nation and its citizens. It will exacerbate, not “Reform,” our healthcare system.

While the Public experiences nothing good and hears little, the healthcare bureaucracy is massively expanding. HR 3590 creates 68 new grant Programs, 47 bureaucratic entities, 29 demonstration projects, six whole new regulatory agencies, six compliance standards, two new entitlements and a very large expansion of the IRS. All this reputedly to solve the healthcare [fiscal] crisis and provide care for uninsured Americans.

The Public has been sold a bill of goods, a basket of goodies that delivers exactly the opposite of what was advertised. This is also known as bait-and-switch. Four months ago, I asked, “Is ‘Credible Congress’ an oxymoron?” I think you will have to agree that the answer is a resounding YES!

Every fact reported below has quantified, documented proof.

Advertised: ‘We must reduce the unsupportable cost of U.S. healthcare.’ (President Obama, January 20, 2009)
Fact: Originally estimated by the GAO to cost only $1 trillion, HR 3590 will spend over $2.7 trillion dollars according to the Society of Financial Service Professionals. That is money we do not have and must borrow. The largest portion of these trillions goes to the government itself.

Advertised: ‘The PPAHCA will provide care for 30 million uninsured Americans.’ (Nancy Pelosi on Charlie Rose)
Fact #1: In January 2010, the GAO reported there were over 45 million uninsured Americans: roughly 12-15 million were illegal residents. Note how the number of uninsured touted by the White House and Congress dis-includes illegal residents. The Federal Government is silent, ambiguous, or self-contradictory on whether or not illegal residents will be covered under HR 3590. They know this is political plutonium.
The Government also ‘forgot’ to tell the Public that 25% of the 45 million “uninsured” Americans qualified for aid Programs that existed before PPAHCA was passed, and refused to apply.
Fact #2: Neither Congress nor any legislation can provide “care” (the “C” in PPAHCA stands for care). Only people called providers can do that.
Fact #3: We do not have enough providers to care for patients right now. Where will 30 million additional newly insured people get care in the face of nurse and doctor shortages?
Even before Healthcare Exacerbation of 2010, these shortages were getting worse. Since 1995, applications to U.S. medical schools have decreased by 20%. Professional satisfaction was 95% in 1972, and in 2004, it was 26%. Forty percent of doctors over age 50 are considering early retirement. Over 500,000 nursing positions are currently unfilled. Who is going to provide the care guaranteed by Congress?

Advertised: ‘If you like your doctor, you can keep him or her.’ (President Obama, multiple times)
Fact: The PPAHCA has cut already low Medicare reimbursements by an additional 21%. Physicians can no longer afford to accept Medicare patients. If you have Medicare (or any insurance plan that follows the Medicare reimbursement schedule), you will no longer have a doctor to “keep.”

Advertised: HR 3590 will determine what works and what does not work. The government will offer only what works. (Every official supporter of the Bill)
Fact: HR 3590 creates cost/effectiveness Commissions to decide what is “cost/effective” for the nation, not for the individual. That is what the British NHS does now and what Dr. Don Berwick, White House-designated Director of Medicare, wants to emulate here.
Treatments deemed to be “not cost/effective” would not be covered and therefore not available. If you are over 55 and need kidney dialysis, or have an atypical cancer and need an unusual drug, you cannot get the treatment. Guess what will happen to you? No one in government would dare name the Commissions as “Death Panels,” but that is what they are.

Advertised: ‘During this recession, HR 3590 will help business by cutting costs.’ (Nancy Pelosi on Charlie Rose)
Fact: Numerous large corporations have publicly shared their estimates of the effects of HR 3590 on their bottom lines. Their calculations showed cost increases just for 2010 as follows: Deere Farm Machinery ($150 million), Caterpillar ($400 million), and AT&T (over $1 billion). Medtronik, the world’s acknowledged leader in heart pacemakers, has already begun to do what the others say they must do: lay off workers to compensate for their increased costs. These costs are generated by a Bill that was advertised to reduce costs.

Have you heard about any of this? I think not. The quiet is unnerving. Actually, it is terrifying. The quiet on the surface is deceptive. Under the radar, there is tremendous activity, all at our expense and NOT to our benefit.
• The governmental bureaucracy is following its own mandate–to expand infinitely.
• Costs are skyrocketing instead of decreasing.
• The deficit is exploding.
• Business is being shackled even further.
• Providers are giving up, making shortages even worse. Meanwhile,
• We are told ‘they know best,’ just keep quiet, accept what they are giving us, while our grandchildren will have to pay the bill for the Bill.

System MD

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If you read British newspapers, you know their universal health care system is cutting more and more services. There, everyone’s right to health care is becoming the right to NO care. Do we want that in the U.S.A?

Health care as a right means that people are entitled to medical care services just like free speech and the right to assembly. We do not have to do anything to get them. They are ours by right and they are free. We have no responsibility and therefore no personal control and or need to make decisions.

In all societies without exception, supply must equal demand. This may be done by nature as in hunter-gatherer societies, by the free market in capitalist nations, or by the government in socialist or communist countries. But someone or something must balance the two. Another word for balancing supply and demand is rationing.

Ration comes from latin ratio (to reason or think) and can be defined as “allowing an individual a fixed amount of a commodity.” If health care is a right, the “allower” or balancer of supply and demand is the government, which must and will ration health care. That is what occurs in all ‘universal health care’ countries including France, Germany, Scandinavian nations, Taiwan, and Japan. Consider Great Britain with its National Health Service (NHS).

Because Great Britain cannot afford its current level of demand for health care, the NHS is cutting services. Services already deleted or to be cut include: heart surgery over the age of 65; kidney dialysis over 55; much hospice care; many cancer treatments; and most nursing homes.

The NHS has a Commission (Department) called NICE, the National Institute for Health and Clinical Excellence. As an aside, note that the President’s choice for Director of Medicare, Dr. Don Berwick, is an admirer of the NICE and wants to import to the U.S.A.

The responsibility of NICE is to determine which medical treatments have the best cost/benefit ratios for the nation, to approve payment for those, and to deny payment for all others. Note what the underlined words mean (to them). Cost considers only the immediate outlay and does not calculate avoided costs or productivity gains or losses. The benefit is national: based on the entire population and not the individual’s best interest. If a specific patient needs something that does not work in the majority, the specific patient doesn’t get it.

The non-payment for specific treatments either because of age or based on NICE criteria (talk about a acronym that means its opposite!) is effectively a Death Panel. Remember the fierce denial of the Democrats that Obamacare (HR 3590 or PPAHCA) would have any such thing? Read the Patient Protection and Affordable Health Care Act: it assigns $650 million for cost/benefit analyses. What happens when the answer is negative? Answer: no payment for that care and therefore, NO care, just like Great Britain.

Nations with ‘universal health care’ have a dirty little secret that is highly relevant to those in the USA who want to import their systems: they are not ‘universal.’ Non-citizens are excluded. If you are an illegal resident, you are not part of the ‘universal care’ and have No right to health care. Recall that the White House said that ALL Americans were entitled to health care and that HR 3590 will cover the “30 million uninsured Americans.” The quote is another WMDc (weapon of mass deception).

Check out the GAO report from January 2010 that clearly and publicly shows there are over 45 million uninsured people in the USA, 12-15 million of whom are illegal residents. Should they be included in the “health coverage for all Americans” or not? Note how smoothly the President sidestepped this political third rail by cutting their millions out of the number of “uninsured Americans.” The issue of health care for non-residents remains our dirty little unresolved secret.

The conclusion is clear and inescapable: health care as a right leads to government rationing of health care. If that is what you want, fine. But do not be fooled by snake oil salesmen in Congress or the White House who says otherwise. If you believe that health care is a right, you cannot and will not have the care you want or need.

Finally, what happens to your right to health care–rationed or without limit–if there are no doctors or nurses? Since 1995, applications to U.S. medical have fallen off 20%. At present, over 500,000 nursing positions are unfilled. A right to health care is meaningless if no one chooses to be or stay a care provider.

DO YOU STILL WANT HEALTH CARE AS A RIGHT?

System MD

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A recent newspaper article reported that, instead of reducing Emergency Room visits, the self-styled Healthcare ‘Reform’ Act (HR 3590), will increase visits to these already over-burdened facilities. Washington’s prediction of reduced ER visits was another demonstration of magical thinking.

Small children are magical thinkers. Ask any psychologist, pediatrician or parent. Magical thinkers believe that because they want it or can conceive of it, “it” is so or will be so. The magically thinking child ties a cape on his back and KNOWS he can fly. When he jumps off the roof, he will of course fall, not soar like Superman.

Those in Washington – both Congressional leaders and the White House – are magical thinkers. Because they say it, “it” will be. If House Speaker Pelosi says that HR 3590 will save money, it must save money. If President Obama says that the Bill will increase care, reduce errors and improve quality, it will happen (because he said so).

The reason most adults do not don capes and jump off roofs is evidence. They may have tried it as a child and have the painful evidence in memory of a broken leg. They may read in the newspaper or see on TV the evidence of what happened to a child who tried it. They may simply consider the centuries old evidence about gravity and deceleration injury.

Is there evidence about healthcare, evidence that Washington ignored? Absolutely!

“HR 3590 will save money.” Every entitlement Program ever enacted has: a) cost more than projected, and b) spent money we did not have or do not have. No entitlement Program EVER saved money. There is overwhelming evidence to prove this.

“HR 3590 will provide care for 30 million uninsured Americans.” Is there evidence to confirm or refute this? Again, yes. Take the experience with Medicare, Medicaid and all other government health insurance programs.

If Medicare pays less than the doctor’s cost-of-staying-in-business (which it does), then the doctor CAN NOT (this is not a question of will not) accept a Medicare patient. If having Medicare insurance guarantees the doctor will not see you, then having government insurance guarantees that you will NOT GET CARE: the opposite of what was promised. Unfortunately, things are even worse than that.

Having any kind of insurance – government or private – may not guarantee getting care. Evidence shows a 20% fall-off in applications to U.S. medical schools. Forty percent of physicians in their prime are considering early retirement. There is hard evidence about our nursing shortage: over 500,000 positions are presently unfilled. So even if you had insurance and even if it paid well, you cannot get care if there are no nurses or doctors. Having insurance does not equal receiving care, and magical thinking will not make it so.

“HR 3590 will reduce errors and improve quality.” This is more magical thinking or worse, a WMDc (weapon of mass deception). To do either – reduce errors or improve quality – providers must learn. That means taking risks and easy access to lots of data, including bad outcomes. Evidence shows that the tort system, the security tightening of HR 3590, and FDA draconian regulations are killing healthcare’s ability to try new things and learn.

Magical thinking by children can harm them. Magical thinking by Washington can kill us. Those with power in Washington are not children, but they think like children, magically, and ignore the evidence.

We tolerate magical thinking by children: that is part of childhood.
Why do we tolerate such behavior in our ‘Representatives?’

System MD

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There are several types of tapeworms (Cestoda) that infect humans. They latch on to the host’s intestinal wall and absorb nutrients that are supposed to feed the host. Tapeworms survive and thrive at the expense of their host. Typically, they release their hold, fall off the intestinal wall and are excreted before the host dies of starvation.

Healthcare has a tapeworm but it won’t let go. It keeps growing as the host consumes more but gets less nourishment. The worm’s full technical name is Bureaucrator defensis uber alles (BDUA) or bureaucracy for short. Because it won’t let go, the host called Healthcare is starving to death.

According to Darwin (“On the Origin of Species,” 1859), biological organisms survive in order to procreate. BDUA is different. It survives and defends itself solely for the purpose of expanding or enlarging and does so at the expense of everything, including its host.

Host healthcare is gorging itself…on money. The U.S. consumes more healthcare dollars per capita than any other nation. Since money is the energy source by which systems do whatever they do, one expects that the system that uses the most energy (consumes the most money) gets the most benefit. Not so!

The U.S. spends more of its gross domestic product on healthcare than Canada (50% more in USA), Japan (48%), United Kingdom (46%), Germany (35%) and Switzerland (24%). The U.S. ranks behind every one of them in how long we live and infant mortality.

To paraphrase a beer commercial, we are spending more and getting less. Plagiarizing Peter, Paul & Mary, “Where has all the money gone?” Answer: the “waste of the middle,” consumed by BDUA. Roughly 40% of all the dollars that go in to the U.S. healthcare system never come out. When you are talking about $2.5 trillion, even Senator (deceased) Everett Dirkson would call $1 trillion [40% of 2.5 trillion] some “real money.”

Imagine what the nurses and doctors could do for us if they had a $1 trillion more than what is available now!

There is one huge difference between BDUA and the more common human tapeworms (Cestoda). When an individual human is infected with Cestoda, the person cannot decide what the tapeworm eats versus what goes to the host.

For BDUA, we can say how much [money] goes to it and how much goes to us [patients]. By requiring cost/benefit analysis for all food [money] going to the bureaucracy (BDUA), we can reduce its obscene, life-threatening eating habits and have more health care for people.

I often repeat Dennis Miller’s famous closing line, “That’s just my opinion. I could be wrong.” Not this time – I know I am right. In a choice between our welfare and the tapeworm, we must choose us.

System MD

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