Blog and News

The ACA fails to fix the basic problems that were promised if passed- high costs and access to care. It actually exacerbates these problems. There is little disagreement that America’s health care “system” was in need of reform, however, many of the “solutions” embedded in the ACA are concepts that are untested or have failed historically and in recent CMS demonstration projects.

Governor Romney can distance himself from President Obama on healthcare by developing a health system reform platform that relies on trust of the American consumers and their physicians, instead of erecting artificial barriers and obstacles that further erode the physician-patient relationship. A leader like Governor Romney with a lifetime of business experience is poised to collaborate with the working physicians of America to set a more hopeful and constructive healthcare course for the future. 

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Despite years of government intrusion in the healthcare market with dozens of schemes to allegedly "save money and improve care" the president, congress and healthcare policy "experts" continue to meddle with complicated proposals that invariably fail on delivering the promised savings and quality.

More troubling is the fact that these new payment methods place hospital administrators in primary control of healthcare and actually make the current situation even worse. Physicians, the most fundamental component of the American healthcare system are relegated to "employee' status and continue to be excluded from the discussion on how to improve quality of care while saving costs.  

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A key technocratic gimmick of ObamaCare, the Accountable Care Organization, is rolling out now — but the wheels are already starting to come off. Critics warn that, instead of helping doctors and patients to make individualized treatment decisions, ACOs will empower government bureaucrats to consolidate health-care providers into top-down organizations and dictate how care is delivered — at greater cost. 

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When the Obama Administration released their proposed regulations for Accountable Care Organizations (ACO), the response was muted particularly by organizations that already exists and served as the model when Congress dreamed up the ACO provisions of ObamaCare. Existing ACOs, such as Mayo Clinic, the Cleveland Clinic, Geisinger Health System and Intermountain Healthcare were hailed as the paradigm of what healthcare would like under the ACO pilot program in ObamaCare. 

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A newspaper in the United Kingdom is reporting that Britain's national healthcare system is rationing cancer screenings by instructing general practitioners to "slash the number they refer to hospital for tests including ultrasounds, MRIs and CT scans commonly used to spot tumours. Last night experts warned the cost-saving measures increased the risk of patients being diagnosed too late and dying unnecessarily." 

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From Kaiser Health News...

"...two of the nation’s top health care economists are expressing doubts that accountable care organizations -- one of Obama administration’s most-hyped mechanisms to save money -- will be able to overcome the medical system’s lust for the new new thing...

"In a paper delivered last week at a Federal Reserve Bank of Kansas City symposium in Jackson Hole, Wyo., Harvard’s Katherine Baicker and Amitabh Chandra warned that ACOs may not want to rein in the use of expensive technologies that haven’t been proved superior to old-fashioned approaches, since the new stuff is often a major lure for patients." 

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Pajamas Media has published Dr. Paul Hsieh's article entitled: "How ObamaCare Plays Games With Your Life."  The article details the numerous ways that favored groups are receiving special treatment in the form of waivers and that special interest consultants and lobbyists are receiving a financial windfall providing expertise to doctors and hospitals struggling to understand how the law will impact the practice of medicine. 

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Writing for Physician News, Docs4PatientCare's Dr. Hal Scherz suggests doctors will continue to be a target unless they wake up and understand how policies coming from Washington, D.C. will affect doctors, their practice and their ability to properly care for their patients. 

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Welcome to D4PC "Morning Rounds", your daily review of healthcare news and information from Washington, DC and around the nation. These briefings will keep you up to date on recent developments and our effort to replace the PPACA with patient-centered reforms that protect the doctor-patient relationship and preserve individual freedom of choice. 

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Dr. Paul Hsieh has a new article on Pajamas Media that explains the real purposes and intended outcome of Accountable Care Organizations: it will lead to the elimination of small private medical practices in favor of large collective practices. The large practices will be much more bureaucratic, less personal when it comes to the delivery of care, and far easier for the government leviathan to control. The bottom line is that, as Dr. Hsieh writes, ACOs "threaten to corrupt the doctor-patient relationship." 

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Welcome to D4PC "Morning Rounds", your daily review of healthcare news and information from Washington, DC and around the nation. These briefings will keep you up to date on recent developments and our effort to replace the PPACA with patient-centered reforms that protect the doctor-patient relationship and preserve individual freedom of choice.

"A Report Card for Doctors", Pauline Chen, MD in the NYT

D4PC Opinion:

Good article which starts to get at the importance of the unintended consequences of "pay-for-performance". The distinction the article fails to make is that while financial reward for quality is a good idea---it needs to come via the recipient of the service, not from a centrally controlled 'big-brother" who determines what quality is. We contend that until the recipient of the service is also the one financially responsible, "value and quality" calculations are going to continued to be distorted.

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"A Doctor Exposes Obama's Healthcare Fallacy", Paul Hsieh, MD in Townhall.com

"At root, ACO supporters presume that government bureaucrats are better at determining best medical and business practices than the physicians and hospitals whose own reputations and profitability are at stake...Premier medical centers such as the Mayo Clinic excel because their doctors and administrators are constantly striving to innovate. To succeed, they require the freedom to adopt successful new methods (and reject unsuccessful ones) based on their particular requirements and goals. They—not the government—must decide whether and when to offer new medical procedures such as PET-CT scans for detecting early cancers or to invest in new electronic medical records systems. Smaller medical practices require the same freedom to prosper and thrive."

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"Death by Regulation", NCPA.org

"As early as 2005, hospitals and clinics complained to Health and Human Services Secretary Michael Leavitt that drug manufacturers and distributors were often out of certain drugs. The problem has been getting progressively worse ever since. Industry insiders point to numerous causes of the problem, including the fact that the generic drug market may be inherently more volatile than the market for brand-name drugs. Imperfect competition may also be a factor. Others point to supply chain problems. Then there is government regulatory policy".

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"Why Can't We Fix Medicare Once and For All?, Geoff Colvin in money.cnn.com

"We can try to fix Medicare in two ways. One is a proven winner, the other a proven loser. The stakes could scarcely be higher -- and right now we're betting on the loser". 

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Minnesota's Star Tribune reports that the Mayo Clinic opposes the proposed Accountable Care Organizations (ACO) rules contained in the PPACA and will not participate in the ACO program.

The Rochester-based clinic, according to the paper, "is raising questions about accountable care organizations, or ACOs, which are supposed to be updated -- and better -- versions of health maintenance organizations. Approved as part of the 2010 health care law, they are designed to improve care and cuts costs by over half a billion dollars a year."

Dr. Douglas Wood, Mayo's chairman of health care policy and research, said that the Mayo Clinic does not want to significantly change from its current practices which they believes is already able to provide care in an efficient, patient-friendly manner. Wood said that Mayo would not "participate in a Medicare accountable care organization under the circumstances proposed."

Read the Full Article Here.....  

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Health Insurance Reform: Frequently Asked Questions (FAQs)

"Explanation of How the 3.8 Percent Medicare "unearned " Income Tax Works"

This new tax is created to help pay for the massive entitlement program known as the PPACA (Affordable Care Act, Obamacare) since the law diverts taxpayer money out of financially strapped Medicare. It is obvious from the following explanation how this tax will affect more Americans over time as currently written.

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"Medicare's Actuary Paints A Darker Picture Than Trustees", National Review

Under current law, Medicare would spend $220 billion on physicians in 2012. But that assumes the 29 percent cut goes into effect--something that is considered unlikely. So under the alternative scenario, Medicare would spend $248 billion in 2012 on physicians, or about 12.6 percent more. At the same time, Medicare physician payment rates would decline to 57 percent of what private insurers pay in 2012, and eventually to 27 percent by 2085. With the debate over Medicare heating up, this report illustrates that the PPACA does nothing to save Medicare. In fact, it drives the nation over the national debt cliff by continuing the failed policies of this government program.

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"GOP Senators Demand Withdrawal of ACO Rule", Politico Pro

Seven Republican senators are demanding that the Obama administration withdraw the embattled ACO proposed rule, saying the criticism from providers shows that the rule is unworkable. The letter, sent Tuesday to HHS Secretary Kathleen Sebelius and CMS Administrator Don Berwick, was signed by Tom Coburn (Okla.), Jon Kyl (Ariz.), Mike Crapo (Idaho), Mike Enzi (Wyo.), John Cornyn (Texas), Pat Roberts (Kan.), and Richard Burr (N.C.).

“The concerns over the ACO regulation from some of our nation’s most knowledgeable and innovative health care providers are clear,” they wrote, pointing to an imbalance between incentives and accountability and the expense of investing in quality measures. “Unfortunately, based on the feedback we have from providers around the country, we conclude that the proposed ACO regulation will fail to accomplish its purpose.”

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"Albany Out to Boost Malpractice Lawyers", New York Post

A package of bills moving through Albany could mean big paydays for medical-malpractice attorneys -- proving the case for greater ethics disclosure among the state's elected officials, good-government advocates say.
The legislation, backed by lawmakers who moonlight as attorneys, would include increasing lawyers' fees on malpractice cases and extending the cutoff date for filing suit.

Not surprising, there is a conspicuous lack of effort on medical liability reform in the president's healthcare law.

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Government Entitlements and Economic Growth

A key argument in favor of the PPACA is that our economy is less competitive because of soaring health care costs. If this is true, increasing government entitlements will not help. The paper below demonstrates that government entitlements have a negative impact on economic growth--which is the only means we have of enlarging the economic pie for everyone.

Policy Research working Paper by Jean-Pierre Chauffour, Lead Economist International Trade Dept. world Bank. "On the Relevance of Freedom and entitlement in Development: New Empirical Evidence" (1975-2007) May 2011

Summary:

Reviewing the economic performance -- good and bad -- of more than 100 countries over the past 30 years, this paper finds new empirical evidence supporting the idea that economic freedom and civil and political liberties are the root causes of why some countries achieve and sustain better economic outcomes. For instance, a one unit change in the initial level of economic freedom between two countries (on a scale of 1 to 10) is associated with an almost 1 percentage point differential in their average long-run economic growth rates. In the case of civil and political liberties, the long-term effect is also positive and significant with a differential of 0.3 percentage point. In addition to the initial conditions, the expansion of freedom conditions over time (economic, civil, and political) also positively influences long-run economic growth. In contrast, no evidence was found that the initial level of entitlement rights or their change over time had any significant effects on long-term per capita income, except for a negative effect in some specifications of the model. These results tend to support earlier findings that beyond core functions of government responsibility -- including the protection of liberty itself -- the expansion of the state to provide for various entitlements, including so-called economic, social, and cultural rights, may not make people richer in the long run and may even make them poorer. 

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From the Washington Post...

"Just over a month ago, the administration released long-awaited draft regulations for “accountable care organizations,” networks of doctors and hospitals that would collaborate to keep Medicare patients healthier and share in the savings with taxpayers. Obama’s health care overhaul law envisioned quickly setting up hundreds of such networks around the county to lead a bottom-up reform of America’s bloated health care system.

"But in an unusual rebuke, an umbrella group representing premier organizations such as the Mayo Clinic wrote the administration Wednesday saying that more than 90 percent of its members would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed..."

Read the full article here. Also, view the AMGA's letter here. 

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Dr. Hal Scherz, founder and president of Docs4PatientCare, and Sally Pipes, president of the Pacific Research Institute, penned an op-ed that appeared in Wednesday's Washington Examiner. The piece focused on the increasing role of government in the doctor-patient relationship, and the negative impact that intrusion is having on care, as well as the quality of training new physicians receive.

"Physicians increasingly worry that a combination of government regulations and plummeting reimbursements for their services will force them out of business. Hospitals have seized upon this widespread fear and are buying up physician practices, placing the practice of medicine nationwide under their institutional control.

As a result, private practice as we know it could be extinct within a decade..." 

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Sally Pipes, president of the Pacific Research Institute, recently brought light to Obamacare's plan to implement "Accountable Care Organizations" (ACOs):

"ACOs amount to little more than the old HMOs of the 1990s--which Americans detested--and will yield lower-quality, centralized care that ends up costing patients more.

At present, ACOs are more of a concept than a reality. Kaiser Health News compares them to a unicorn: 'Everyone seems to know what it looks like, but nobody's actually seen one.'"

Read her full column here.  

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