Go Smile at Democrats’ Lame Efforts to Blast Republicans’ Plans to Repeal ObamaCare

According to The Hill’s Healthwatch Blog,http://thehill.com/blogs/healthwatch/other/128585-democrats-tout-new-report-on-uninsured-to-blast-repeal-efforts,  the Senate Democratic Communications Center is arguing that, based on a new report from the CDC,http://www.cdc.gov/mmwr/preview/mmwrhtml/mm59e1109a1.htm,  Democrats will continue to fight to protect American families who deserve quality health care, while the GOP leaders fight to protect insurance companies. The new report shows that in the first quarter of 2010, an estimated 59.1 million persons had no health insurance for at least part of the year before their interview. HOW NOBLE THOSE WONDERFUL DEMOCRATS ARE!

If they care so much about individuals’ health care, why didn’t the Affordable Care Act (ACA) directly offer a public option? The Democrats couldn’t muster enough votes for this? I wonder why?

Creating a huge increase in the Medicaid population, which the ACA will do, is entirely different than creating a public option. The low levels of payment associated with Medicaid allow the hospitals and insurance companies to engage in the game of increasing premiums and deductibles via the cost shift argument. So, those, who pay taxes and purchase health insurance, will see both payments increase: Good old redistribution of wealth, while leaving in place the resentment for Entitlement populations and thus replanting  the seeds for continued socio-economic discrimination. Oh! those WONDERFUL NOBLE DEMOCRATS! They created a bonanza for the health insurance companies. The insurance premiums and deductibles have already started to increase.

Creating a public option with payments set at Medicare payment rates (higher than those of Medicaid) would probably have been the beginning of the end for the insurance companies. I believe that Medicare payment rates are quite adequate for true hospital costs, if these are examined closely and if there is a standardized, appropriate overhead structure in place for all hospitals, as opposed to the entrepreneurship, currently in place, which allows hospitals (for profit and not for profit) to become independent, dollar-driven, business fiefdoms. Oh goodness, we can’t have that! That would be Socialism! Wait a minute! That’s what I thought the Obama Administration and the Obama Congress stand for! So, just why is it that they did not create a direct public option in the ACA?

Those wonderful Democrats are every bit as phony as the Republicans. They don’t want to create true healthcare reform. What they want to do is to make great argument about it, while diverting the public’s attention from their real agendas:

  1. Maximize the revenues and profit for the companies which finance their campaigns and which lobby them,
  2. Create a voting block, the Entitlement Population, to enhance their chances for re-election,
  3. Pay tribute to their puppet-masters’ ideals, redistribution of wealth and others, except those which interfere with their own personal goals.

The Republians are no better. What have they done over the last 50 years , which really benefits the individual person, who just wants to be able to go to the doctor without fearing bankruptcy in the process? If the Republicans are so great, why do we have this healthcare mess? The answer is GREED  and POLITICAL RE-ELECTION.

And, I will make a prediction: The Tea Party politicians, whoever they are, will dive head first into the same swamp.

R. Garth Kirkwood, MD

Current Time: Tea Party, FreedomWorks, Dick Armey, Libertarians, and Socialized Medicine

It is not enough for you to say that you will repeal ObamaCare. Many agree that it’s a noxious legislation that needs to be undone.

But what will you replace it with? Mr. Armey, during your time in the Congress, what did you accomplish towards creating a healthcare system in America that works for everyone? The Tea Party and FreedomWorks, do you have a forward looking plan, which will provide clear and equal access to sound, ongoing, non-conflicted health care for everyone living in America; which will simultaneously decrease our national healthcare expenditure, end discimination in health care, and break the nexus between politicians and healthcare business corporations; which will place the medicine of medicine as a primary goal to be accomplished for everyone and the business of medicine as a secondary goal; and which will save our employers and individuals from going broke?

Your urgent calls for conservatives and libertarians to stop Socialized Medicine are a ruse. Medicine is socialized, when the functioning of the doctorpatient relationship is conflicted by a payer, generally thought of as government-run health care. I agree that the government shouldn’t be in that position. However, neither should the health insurance companies nor other puppeteers, empowered by the nexus of intertwined tendrils of greed, power, ideology, and re-election aspiration, which exists because of conflicted, compromised politicians in league with healthcare businesses.

It is time for libertarians to tear asunder this nexus. If you cannot accomplish that, then wonderful healthcare reform will not ensue and your newly elected Tea Party candidates will go the way of the politicians of the last several decades: Sucking off the government teat to satisfy their own needs and those of the businesses, which lobby them.

R. Garth Kirkwood, MD

Fox News, Congressman Boehner, Senator Graham, and ObamaCare

I have listened to Congressman Boehner’s and Senator Graham’s recent commentary on Fox News regarding ObamaCare. They said that they want to repeal ObamaCare before it becomes entrenched, before it really gets implemented. I agree. It is a noxious legislation that was forced onto the American people; it should be repealed completely; and efforts at true healthcare reform should start fresh.

However, do Congressman Boehner, Senator Graham, or any of the Republican politicians in Congress over the last several decades recognize their role in creating the angry substrate upon which this bill had its birth?

This substrate is: 1. Mega healthcare business empires including insurance companies, drug companies, hospitals, and others, which are operated for max dollar profit as a primary goal and good health care, open to everyone, as a secondary goal with little concern over whether the latter is actually achieved.
2. That the operation of these business empires is bankrupting the American people and our country.
3. That politicians are in league with these business empires and thus, they have acted in accord with their financial interests and not in accord with the well being of the individual American.
4. That politicians have left in place the concept of Entitlement populations in our healthcare system, which raises not only our taxes to support their public funding but also increases our insurance premiums and deductibles via the purported cost shift mechanism.
5. That health care is not open to everyone, not based on clinical need but rather ability to pay, and not free at the point of delivery. The latter concept then causes the funding of our health care system to become an obstruction to accessing it as opposed to a mechanism for guaranteeing its existence.
6. That insurance companies; managed care; and medical, pseudo-righteous, businesses and groups are interfering with the practice of medicine like the government payers do in formally ‘socialized’ systems and therefore, that our system is, in effect, socialized; the control simply comes from another source.

So, while you Republicans are delivering all of this rhetoric about repealing ObamaCare and listening to the American people, understand that wonderful healthcare reform will not ensue until you understand what the medicine of medicine is; distinguish it from the business of medicine; stop paying dues to the business of medicine, i.e., the corporations, which financed your campaigns; start your healthcare reform efforts with an understanding that whatever you create must have the medicine of medicine as its primary goal for everyone and that healthcare businesses exist to support that goal with their own profit being placed in a secondary position; and finally, that your own political re-election has no place at all in deliberations about healthcare reform. You must yourselves tear asunder the nexus between healthcare business empires and Congress. If you accomplish this, there is a good chance that commonsense healthcare reform will follow and that we will not see in 2012 the reverse of what happened November 2nd 2010.

R. Garth Kirkwood, MD

Contrary to Former HHS Chief’s, Tommy Thompson, Advice, Repeal ObamaCare

On Healthwatch, The Hill’s Healthcare Blog, it has been reported that Tommy Thompson, former HHS chief under President George W. Bush, has suggested that repealing the new healthcare reform law is a futile exercise because the Republicans do not have enough votes to override President Obama’s certain veto. (1.http://thehill.com/blogs/healthwatch/health-reform-implementation/127007-former-hhs-chief-gop-shouldn’t-try-to-repeal-health-reform )

Couldn’t the Republican controlled House defund this poorly prepared, nebulous, bewildering legislation, while its Republican members go about garnering support for a repeal and simultaneously reporting to the American people those remaining Democrats, who are not cooperating? The latter could then be removed at the 2012 elections.

I wonder why Mr. Thompson seems to have developed such compliant resignation to this poorly prepared, bewildering, noxious legislation. Is it related to his appointment as Special Advisor to Tamir Biotechnology, Inc.? (2. http://www.fiercebiotech.com/node/85930/print  )

The “Healthcare Reform Gave Biotech Everything It Wanted and More,” including a 12 year period of market exclusivity after FDA approval of the product, which period is independent of patent time frames. (3.http://www.xconomy.com/national/2010/03/24/healthcare-reform-gave-biotech-everything-it-wanted-and-more/ ) Also, there are significant barriers that will limit the entry of large numbers of follow-on biologics (biologic copycat molecules made by generic companies) into the marketplace. (4. Ibid 3.) Biotechnology companies developing reference therapeutics should be ecstatic with the legislation. (5. Ibid 3.)

Is there a connection between Mr. Thompson’s advisory position to a Biotech firm, the new legislation’s favorable stance towards biotech firms, and Mr. Thompson’s advice for the GOP? If there is a connection, I can understand it; Mr. Thompson is trying to do the best he can for the company, which he advises.

But what about the effect of this new legislation on the country as a whole? It creates a huge increase in an Entitlement population (Medicaid) beginning in 2014. This increase in a publicly funded program will not only raise our taxes, it will also significantly increase insurance premiums and deductibles via the purported cost shift mechanism. I am one of the people, who is fed up with the insurance companies’ continued greed-driven gouging of the American people. Moreover, I believe the existence of large entitlement populations is one of the reasons for ongoing socio-economic discrimination in the USA. This attitude needs to be and can be removed from our healthcare system by changes, which effectively remove the words, indigent; poor; entitlement; etc. from our healthcare lexicon. For these reasons, which I believe are more important than the profitability of the biotechnology industry, I believe the new healthcare legislation should be definitively repealed.

Other realities, such as, “many specifics of the healthcare law remaining unknown because Congress punted so many decisions to HHS officials”; that “health care is still being written” and “Secretary Sebelius still has so much to put together in the rules”; “that most people are just bewildered by the magnitude of healthcare and how it’s going to play out” (6. Ibid 1.), lead to the commonsense demand that the entire thing be repealed and that this new Congress start the process over, clearly think it through, and write a completely different, understandable healthcare legislation reform, free of political ideology and beneficial for everyone living in America. It can be done.

R. Garth Kirkwood, MD

Rich Man Poor Man Healthcare Reform Principles: Clinical Need Not Ability To Pay

That medical care is based on clinical need not on ability to pay is the third core principle for sound healthcare reform for the USA. If a rich man and a poor man have the same illness but the poor man has no insurance, is it right that the rich man can easily receive advanced medical evaluation and treatment, since he has good insurance and plenty of cash to spend, while the poor man can’t even contemplate going to the doctor? The poor man may wind up going to the emergency room, from which he can’t be turned away, but this is totally different than an ongoing doctorpatient relationship with an experienced specialist.

It is certainly right that the rich man can avail himself of the best diagnostic and treatment modality available through a sound, ongoing, non-conflicted doctorpatient relationship. But, in my view, it is not right that the poor man cannot, because of lack of financing. Becoming part of an entitlement population, whose medical care is paid by public funding (e.g., Medicaid), does not change this fundamental inequity. Entitlement populations become quickly disenfranchised because public funding for payment is less than private payment.

Can healthcare reform change this fundamental human behavior? I don’t know. But it can completely remove the economic reasons for its existence by creating a payment mechanism, which yields the same (fair and adequate) dollar amount paid regardless of whether the patient is rich or poor. Thus, doctors would have no economic excuse for not seeing patients, who, in the current system, couldn’t come close to paying the bill. The reality of huge overhead expense in private practice, not under doctors’ control and put into place by administrative paperwork from both private and public payers and by American society itself, because of its need to blame somebody, its need to be litigious, causes significant financial struggle. When a large proportion of patients in a practice come from an entitlement population, these financial pressures can become overwhelming.

America’s healthcare reform should absolutely end this financial dichotomy, created by the business of medicine’s quest for the dollar bill. In that way, the system can fulfill this third core principle: Based on clinical need not on ability to pay, which would make the business of medicine subservient to the medicine of medicine, the absolutely correct pecking order for our healthcare system.

R. Garth Kirkwood, MD

Core Principle for American Healthcare System Reform: Free at the Point of Delivery–YES; and Everyone Contributes to Its Financing

Free at the Point of Delivery is a good concept. It simply means that there is no exchange of money or other forms of payment at the doctor’s office, hospital, or pharmacy. The dollar bill or lack thereof should no longer be an obstruction to anyone going to the doctor, when they decide that this is necessary, or going for specialty diagnosis and treatment including surgery, when this clinical decision has been made within the context of the individual’s doctorpatient relationship.

For effective healthcare reform, the dollar bill must not be an obstruction, a hurdle to be cleared, before we can avail ourselves of the wonderful strengths of American health care. Thus, the concept of deductibles, co-pays, and cash out of pocket need to disappear from our healthcare thinking and lexicon.

This does not mean that health care is free. Nothing is free in America. I believe that everyone should contribute to the financing of our American healthcare system. If the system is to meet the needs of everyone, then everyone should have a financial stake in it. I will discuss ideas for this financing in future posts. But it is my view that this financing should not occur at the point of delivery. That makes financing our system an obstruction to accessing it as opposed to an appropriate vehicle for guaranteeing its existence and quality.

R. Garth Kirkwood, MD