Brooklyn doctor says NO to Obamacare

Dr. Vladimir Gressel, MD

Recently, people began to ask my opinion on the “affordable” healthcare reform, also widely known as “Obamacare”. Strangely enough, nobody bother to ask us, practicing doctors, prior to the congressional vote on this “reform”, before it became a law. Well – these are my points on Obamacare:

 Ponzi-Madoff Scheme:

 America is a “dream comes true” country for every immigrant for the last 200 years, regardless of the period they immigrated. You should remember those Irish and Germans of the late 18^th century, Eastern European Jews of the  19^th, Cubans fleeing Fidel’s “paradise ” island, and, of course, the latest waves of Mexicans, Dominicans, Pakistanis, and let’s not forget us, Russian Jews in the 1970-1990. We all came here for a dream, and we all got one. Yes, it was the same dream for everybody: we all choose the prosperous life, not miserable sub-standard survival and constant struggle with poverty in our native countries. Sure enough, some of us achieved this dream very soon by working hard in a tradition this country was built upon, but lately we can see that more and more of the recent immigrants manage to obtain their dream in the totally different fashion. They work hard milking “The System”, actively pursuing the “free stuff”. Well, you can ask me about nature of this mysterious “System”. Our country is well-known for its free-market capitalist economic system, which made it so great. How can you “milk” this capitalist system, which supposed to promote hard work and innovations, support taking risks and individual responsibilities?

Unfortunately, the other system was born and grew in our country since early 1900’s. The system which offers wonderful American Dream to everybody disregarding their talents, hard work, ethics or even respect to the law.

This system was sold (and still selling) to us by the politicians the same way Mr. Ponzi did it in the early 1920s: promise the great returns for the small investment in your future. More than that, according to the promises, this future is GUARANTEED by the government!

Social Security - failed, almost bankrupt, Medicare - already bankrupt, Medicaid - all in red ink. There is none, repeat, not a single one federal program currently in existence which is financially solvent and is delivering what it was designed to do. And results of these experiments in the “progressive” capitalism are devastating for our children’s future: almost 100 trillion dollars in the unfunded liabilities for bankrupt programs mentioned above and tens of millions of the people who became dependent on these programs. I should mention also the food stamps, the “affordable“ housing programs, “free” education, forever extended unemployment benefits, innumerous welfare programs and on, and on, and on…..

It is all done with one purpose only. Government can grow only if it controls your life as much as possible, through taxes, regulations and…benefits, the notorious “free stuff”. When you become addicted to this “free stuff”, you will beg your government as an alcoholic to give you more and more…. in exchange for more and more of your freedom.

If you think that Obamacare will be somewhat different, please, don’t fool yourselves. It is not simply another Ponzi-Madoff style “progressive” lie. This time it is much more dangerous than you think.

 Myth No 1: “New law will decrease cost of private medical insurance.”

 False. Last year, even though the main components of Obamacare will begin only in 2013, average cost of the private insurance increased dramatically, by average of 12-15%. Why? Because insurance companies were forced to hire the large legal teams desperately trying to figure out how to comply with this new, more than 2400 pages, monstrosity. You got that right, the only people who will benefit from Obamacare are lawyers. And again, you’re right if you guessed that the major supporters who lobbied this law in Congress were LAWYERS, not doctors. According to the new law, if you failed just a few from the myriads of the new regulations, your insurance company could be kicked out of business. Also, last year all insurances were forced to insure the so called “kids” until the age of 26 for free (before the age limit was 21). They also will be forced to insure everybody regardless of their prior medical history for the same price. Would you like as a business owner to run your business without profit? Well, of course, not! It is against the nature of any private business and you will increase the prices for the premiums across the board just to cover your losses. Equal prices for the newly insured sick people would force you to spread the risk (and prices). Even my teenage son understands it, but our politicians pretend that they are not.

Myth No 2: “New law will provide medical coverage (via mandatory insurance) to everybody, which will in turn put control on overall cost of healthcare, at least theoretically. The argument was, that by insuring everybody we would dramatically decrease number of ER visits; that these people will have general access to the regular checkups and by the early prevention we would save tons of money on hospitalizations.”

False. Besides the fact, that it is unconstitutional for the federal government to force somebody to buy any product (like insurance), insuring everybody could mean the only one thing: now the patient could see a doctor without paying out of pocket. Those 32 million uninsured Americans consist of two separate groups: the ones who obtained the coverage as a free gift from the government and others who must buy it since they have sufficient income. Latter group mostly consists of the young working people who didn’t have to spend money on insurance before since they didn’t feel this necessity being young and healthy. Now, since they must invest their hard earned money in the health insurance, they would be able to visit doctors as often as possible, and demand expensive services, just to make sure their good health is still “very good”. Some of them probably would agree to pay penalties for not buying insurance, if it would appear cheaper for them, while consider that they could always go to ER anyway, the same old way. But the first group attitude will make things even worse. They could do anything they want with “free” healthcare services since it doesn’t cost them anything. This will drastically increase taxpayers’ burden, as we see it with Medicaid.

Myth No 3: “New law will dramatically improve quality of medical care”

 You got to be kidding! How in the world we can improve it with sudden influx of 32 million new customers and no new service providers. Actually, we have significant shortage of doctors in this country now. More than that, 46% (sic!) of physicians consider leaving private practice in medicine or work part time only, if Obamacare will be implemented. Do you really want to be seen by the doctor, who doesn’t have time to look at you, being busy writing filing on his computer your visit’s note to your EMR (electronic medical record). By the way this is another news for you: your EMR should (and will!) be available for the governmental agencies reviews without your consent. And don’t forget about computer hackers: if they can get into the Pentagon’s files, stealing your medical record from the government’s sites is for sure a piece of cake for them.

 Myth No 4: “Our senior’s Medicare program will not be affected, it will only improve.”

 I wonder how this miracle would happen? May be, by cutting its funding by 500 billion dollars? Or by cutting doctor’s fees by average 25% in 2013? In 10 short years we’re expecting 30% more Medicare recipients due to the demographic changes (people generally live longer, in addition to the growing number of the retiring “baby boomers”). Who is going to take care of them? More and more doctors thinking to opt out from Medicare, since it pays less and less while they have to spend more time with those patients as they get older to provide quality care.

Myth No 5: “Nobody will be telling your doctor how to treat you.”

 Another lie. Actually, the very scary one. Most of you don’t know yet that Obamacare is in fact a part two of the healthcare reform. The first part was sneaked in as a part of the near 1 trillion dollars stimulus bill early in 2009. In this bill 1,1 billion dollars were allocated to create Federal Coordinating Council for Comparative Effectiveness Research. Just three days after passage of the Stimulus Bill, Obama appointed all 15 members of this Council.

The Federal Council is modeled after one particular British committee, UK Health board. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit from the treatment. Naturally, treatments for the younger patients are more often approved than the treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with the macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.

Later, in Obamacare bill, another new bureaucracy, the National Coordinator of Health Information Technology, was created with the purpose to monitor patient’s treatments to ensure that your doctor is doing whatever the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions.

Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far. More than that, hospitals and doctors neglected to be the “meaningful users” of the new system will face penalties. However, term “meaningful user” isn’t clearly defined in the bill. It will be left to the bureaucrats at Health and Human Services Department, who will be empowered to impose “more stringent measures of meaningful use over time”. This vagueness is intentional : what penalties would not deter your doctor to go beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? Anyway we’ll have another appointed body with vast powers to make the “tough” decisions our politicians refuse to make.

Myth No 6: “Doctors support Obamacare.”

 Simply, not true. Obama’s administration singled out the American Medical Association, who endorsed Obamacare, but membership of this organization dropped dramatically in the last 10 years. AMA does not represent physicians for a long time; it became another political lobbying entity for the special interests.

You might ask me about solutions, what would I do to improve healthcare and make it more affordable. The answer is always in the free market, not in the governmental bureaucracy. About 60 years ago when there were very few healthcare insurances, no Medicare or Medicaid and 85% of all Americans were able to afford their doctor and hospital admissions. People understood then that they had to prioritize their budget: how much to save for the medical care and how much – for the entertainment, travel, extra clothing etc. Personal responsibilities were taught by parents and in the schools. Now our economy and government experience serious financial troubles and yet we hear from progressive school of thought about “right to have free medical care”. I am aware of only three unalienable rights: right for Life, right for Liberty and right to pursue Happiness. Give consumers (patients) power to choose the doctor or the hospital they would like to attend and let the service’s providers (doctors and hospitals) have freedom to decide how much they want to charge. Remove thousands of regulations and inefficient policies and these charges will drop dramatically… You can argue that the straight road back to the good old times when nobody was standing between doctor and patient is unrealistic. Sadly, I agree with you.

But nothing is preventing us from the common sense healthcare policies’ changes which don’t require spending of the single taxpayer’s penny, yet must be implemented immediately to avoid disaster.

Suggestions:

First: Obamacare must be repealed RIGHT NOW

Second: Healthcare insurance should be available for purchase across state lines

Third: Stop the threat of unscrupulous lawyers, suing everybody for everything, hanging over every single doctor in this country (Doctors are forced to order multiple expensive and sometimes unnecessary tests just to protect themselves from the lawsuits; malpractice insurance for OB/GYN specialist in NYC is approximately $180,000.00 a year!)

Forth: Reform Medicare ASAP, before it completely collapsed.

Prediction:

 If Obamacare is here to stay with us, my predictions for the next 10-15 years are very pessimistic:

 1. Most of the specialists will stop seeing patients with any insurance, including Medicare, and accept only private payments plans.

 2. Most of the primary care doctors will be forced out from the private practice and compel to work only for the big hospitals or government-sponsored clinics.

 3. In about 15-20 years public will demand from government access to specialists and doctors in general, due to the tremendous shortage of physicians.

 In response, as the only way out, government will employ all doctors (and all other licensed medical professionals) in order to provide promised medical care to the population. If you, as a physician, disagree to work for them, you license will be suspended. Do not forget, that it is the State who granted medical licenses for the physicians.

 Advice:

 My advice for everybody: let’s hope for the best in 2012 elections, but prepare for the worst as your American dream could become another socialist nightmare.