Obamacare Versus Physician’s Hippocratic Oath

By Joanne Moudy

John Ammon

Dr. John Ammon

When John R. Ammon, M.D. finished his rigorous training at Harvard and Stanford 36 years ago, he swore to uphold the all important Hippocratic Oath – which proclaims – “Do No Harm.” Looking forward to working as an anesthesiologist, he believed he would never have to compromise that solemn promise. Yet, for Dr. Ammon, as for so many hundreds of thousands of physicians, that oath is progressively more difficult to keep.

Dr. Ammon has spent a lifetime of serving and healing his patients. More than just participating in a practice, his personal belief systems made him keenly aware of – and sensitive to – his patient’s individual needs. As a former Director and President of the American Board of Anesthesiology, as well as a Senior Lecturer in the Department of Anesthesiology at the University of Arizona School of Medicine, and the founder and former President of the Arizona Chapter of Docs4PatientCare, he has a keen insight into the entire healthcare system in the United States. And he is deeply concerned.

During a recent event in Phoenix Dr. Ammon kindly sat down with me and shared his thoughts on Obamacare and why he believes it will ravage our country like a plague of the worst magnitude.

“The way I see it,” Dr. Ammon said, “is that today Obamacare is the greatest threat to our freedom America has ever faced. People are already upset about the insurance issues with the new law, but the truth is we’ve only seen the tip of the iceberg. The full force and effect of the horrifying legislation will impact and diminish the quality of American healthcare both now and into the distant future and severely restrict a doctor’s ability to help patients.

“Obamacare was advertised to the American people as a fix for two healthcare problems. The first was reining in the runaway cost of healthcare and the second was extending health insurance to the uninsured.

“But what the left failed to explain to the American public,” Dr. Ammon continued, “is that long before the law was written, physicians had already agreed that major reforms were necessary, especially in the realms of healthcare financing, taxation and insurance. Had those underlying areas been addressed, the law would have been unnecessary.

“Physicians already knew that the cost of healthcare had ballooned from coast to coast. The steady increase in costs made it harder for many to afford healthcare or insurance for their families. And that drove up the number of uninsured.

Obamacare“And what’s really amazing to most physicians is that Obamacare did not address any of these issues. It did not address the runaway costs nor did it extend insurance to the uninsured,” Dr. Ammon said. “Quite the contrary, the law has had the opposite effect.

“Take a look at the estimates from the experts at Harvard University and Dartmouth College,” he said. “They anticipate that healthcare costs will continue to grow faster than the economy for at least 20 years. And even more troubling is that the federal government estimates that 31 million Americans will still be uninsured by 2024. So in effect, Obamacare made things much worse.

“And instead of improving the situation, the president’s law has placed unprecedented regulatory and financial burdens on physicians and hospitals. Now, instead of focusing on patient healing and their well-being, practitioners in all specialties are increasingly focused on paperwork and checking statute-driven boxes. It’s exactly the opposite of what was needed.

“But aside from all this, a major problem with Obamacare is the Accountable Care Organizations, or ACOs,” Dr. Ammon continues. “Most people aren’t even aware of the term ACO. Yet, it will be the downfall of our healthcare system as we know it today.

“Here’s how it works. ACOs collectivize hospitals and many physicians together into single units. These units are then paid by the federal government for the specific services and treatments they provide under federal guidelines, in a one-size-fits-all regimen.

“Although this currently applies only to Medicare patients, the model is already being adopted for all patients. One of Obamacare’s main architects was Dr. Ezekiel Emanuel, who brags that the law’s main goal all along was to shift the focus of healthcare from individual patients – to society as a whole, i.e., a European socialized medicine model.

“ACOs are not about the doctor-patient relationship at all,” Dr. Ammon said, “because ultimately the federal government will dictate all treatments, procedures, and payment schedules. And the Independent Payment Advisory Board (IPAB), made up of 15 people appointed by the president, will determine which medical services will or will not be reimbursed – and for how much.

“No matter how obfuscated the truth is, this is truly ‘rationing’ and it should terrify all Americans. According to Obamacare, providers must stay within the mandated guidelines or – at a minimum – Washington will refuse to reimburse them, and at a maximum, providers can face criminal liability.

“Thus, instead of physicians caring for each individual patient and working to achieve the best healthcare outcomes, doctors become professional assembly-line workers. The federal bureaucracy increasingly sits in the middle of the examination room, like Big Brother overseeing our every move and dictating our behavior.

“This is a dagger aimed at the heart of physician’s commitment to the Hippocratic Oath,” Dr. Ammon said. “In too many cases, doctors will have to choose between what is medically appropriate for their patients versus what they are ordered to do (or not do) as mandated by the feds. There is no question that this represent a moral crisis for physicians – follow the Hippocratic ethic or the Obamacare regulations.”

As we ended our conversation, Dr. Ammon had these rather haunting, parting words.

“When I ask pre-med and medical students why they want to become doctors, they invariably say they want to help people. Although I praise and encourage that sentiment, today I have to couch my comments with warnings that they won’t be able to achieve their altruistic goals without the freedom of an unwavering commitment to each individual patient, which will be more and more difficult to attain under the Obamacare.

“Nothing threatens our American way of life or the ability of a physician to care for individuals more than Obamacare. It is an abomination which must be entirely repealed and replaced with real reform, less physicians be forced into an untenable moral crisis.”

Will The “Keep Your Health Plan Act” Save Us From Obamacare?

by Bob Quasius – I was content to learn this morning from The Hill that the House will schedule a vote  on the Keep Your Health Plan Act (H.R. 3350) for next week! Without this legislation, tens of millions of Americans seem destined to lose their pre-Obamacare individual or employer-based health insurance, through Obama’s administrative chicanery.

The Obama Administration Circumvented the Will of Congress with Administrative Regulations

In all the hoopla leading up to passage of the Patient Protection and Affordable Care Act, also known as Obamacare, or the “Unaffordable Don’t Care Act” Obama repeatedly made promises like these through 2012:

“We will keep this promise to the American people. If you like your doctor you will be able to keep your doctor. Period. If you like your healthcare plan, you will be able to keep your healthcare plan. Period.” – Barack Obama, June 15, 2009

“Nothing in our plan requires you to change what you have.” – Barack Obama, September 9, 2009

A video from New York Magazine compiles video clips of Obama making this same “keep your health plan” promise 23 times from from 2008 to 2010, even as his administration crafted rules that all but precluded Americans from keeping their existing health plan!

Existing employer and individual healthcare plans were to be grandfathered, per the law passed by Congress.

However, insurance plans change constantly, often in response to regulatory changes at both state and federal levels. The Obama administration promptly wrote Obamacare rules that are tightly written so even the slightest change in an insurance policy makes it ineligible for grandfathering under Obamacare.

Around 19 million Americans are covered under individual insurance policies, and it appears the vast majority of these plans will be cancelled.

keep your health plan actThose unlucky enough to lose the insurance most are satisfied with are forced to purchase insurance that meets the high standards of Obamacare, including coverage for maternity, contraception, etc. If you’re a post menopausal woman who has an individual insurance plan without maternity coverage, you’re in for an unpleasant surprise because you’ll have to buy new insurance that includes coverage you don’t need!

Some employers with strong religious convictions, such as Hobby Lobby, are suing over the contraception mandate of Obamacare, and seem likely to drop health insurance rather than violate their religious convictions.

There are widespread reports that most covered by individual plans will now be forced to pay much higher premiums with much higher deductibles.

The Other Shoe Drops – Most Existing Employer Plans Are Not Grandfathered Either

Kathleen Sebelius keep your health plan act

Kathleen Sebelius tells Congress employer health plans are subject to the same grandfathering restrictions that forced cancellation of millions of individual health plans

Kathleen Sebelius recently told Congress that the same regulations that essentially block grandfathering for individual plans also apply to employer-based plans. Since the vast majority of health insurance not provided by government is through employers, we can expect employers to pay substantially higher premiums. Many employers will simply decide to drop health insurance rather than pay much higher premiums, incurring the Obamacare penalties.

The Obama administration, despite the explicit language of Obamacare, has also decided to defer employer penalties for a year, further incentivizing employers to simply drop health insurance, which confirms the suspicions of many critics that Obama’s real agenda is replacing employer provided health insurance with single-payer, and that Obamacare is designed to fail, setting the stage for single-payer.

Single-payer is like “the holy grail” of liberalism, based on the deeply flawed notion that government can always make things better for us.

The Keep Your Health Plan Act

The Keep Your Health Plan Act, H.R. 3350, was introduced last week by Fred Upton (R-Mich.), Chairman of the House Energy & Commerce Committee Chairman. As of today, co-sponsorship has grown to 88 members, but not a single co-sponsor has a “D” for Democrat after their name. It seems Democrats in Congress are ready and willing to follow Obama off a political cliff next November in mid-term elections. Like so many other worthwhile bills addressing Obamacare, it seems likely to pass the House, but will be ‘dead on arrival’ at the Democrat controlled Senate.

Millions more Americans will lose their health insurance, and given the deeply flawed rollout of Obamacare, it seems likely we will have more uninsured Americans next year than this year. There’s nothing affordable about the Affordable Care Act. Many Americans will simply decide its more economical to do without health insurance than pay much higher premiums, with deductibles so high they likely won’t benefit from having insurance unless they have high medical costs.

Guess what happens when health insurance is too costly for healthy people? They stop buying health insurance, leaving the insurance pool with more unhealthy people! Obamacare is predicated upon getting more healthy Americans insured, to help drive down costs for less healthy Americans, and particularly older Americans who naturally have more health issues!

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Bob Quasius is the founder and president of Cafe Con Leche Republicans

Obamacare Lie: “keep your healthcare plan.”

by Bob Quasius – Until at least 2012, Obama has been promising that under Obamacare, Americans can keep their health insurance, their doctors, etc.

The Big Obamacare Lies

“We will keep this promise to the American people. If you like your doctor you will be able to keep your doctor. Period. If you like your healthcare plan, you will be able to keep your healthcare plan. Period.” – Barack Obama, June 15, 2009

“Nothing in our plan requires you to change what you have.” – Barack Obama, September 9, 2009

Hear it direct from Obama’s own lips:

Obamacare Lies Exposed

Now, Fox News and other media outlets report the White House knew at least as early as 2010 that ten million or so Americans with individual policies would lose their health insurance, not to mention millions more losing their health insurance when businesses dropped spouses, dropped insurance altogether because the penalty for not providing insurance is less than the cost of the insurance itself, etc.

From the July 19, 2010 IRS 2010 Obamacare regulations:

In the individual market, one study estimated that 40 percent to 67 percent of individual policies terminate each year. Because all newly purchased individual policies are not grandfathered, the Departments expect that a large proportion of individual policies will not be grandfathered, covering up to and perhaps exceeding 10 million individuals.

Obama Obamacare

President Obama – Lied to Americans about keeping doctors and health insurance plans

More than likely, Obama knew from the very beginning, in 2008, that millions of Americans would lose their health insurance. Note the the IRS regulations cited a May 2008 study sponsored by the reputable Robert Wood Johnson Foundation, which surely was available to Obama and HHS Secretary Kathleen Sebelius in 2008.

Source: Adele M. Kirk. The Individual Insurance Market: A Building Block for Health Care Reform? Health Care Financing Organization Research Synthesis. May 2008. (Robert Wood Johnson Foundation)

It’s implausible that Obama didn’t know about this massive loss of health insurance coverage all along. In other words, Obama has lied to the American people for years, in order to push his agenda.

Kathleen Sebelius obamacare train wreck

Kathleen Sebelius, HHS Secretary Responsible for Obamacare train wreck

Kathleen Sebelius should resign, not just for lying, but the sheer incompetence evident in rolling out Obamacare.

The Obamacare train is rapidly turning into a train wreck, from the broken promises to the failed web site. While it’s fair to say that not everything in Obamacare is bad, it’s clear major surgery is needed. The individual mandate should be delayed for at least a year while the program is overhauled, if not repealed outright. Government should never be in the business of forcing consumers to buy a product!

Repeal Obamacare or Overhaul?

There are parts of Obamacare that I believe should be retained, though in some cases modified:

  • Removing barriers to insurance for treatment of pre-existing conditions.
  • Grants to community health centers, 501(c)3 organizations that often rely on volunteers, private grant funds, etc., which in my opinion to a particularly good job of providing health coverage in under-served communities and groups, such as migrant workers, immigrants, etc.

Congress should start from the position of total repeal, then retain the few good parts, rather than attempt to fine tune Obamacare.

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Bob Quasius is the founder and president of Cafe Con Leche Republicans.

Obamacare – The Audacity of Nope

Obamacare Affordable Care Act

Obamacare

 

by Manny Fernandez – It has cost the American taxpayer $634 million to launch the Obamacare web site. I am sorry, but that as a reckless and misleading statement. The truth of the matter is that it has cost the American taxpayer $634 million to launch the Obamacare WEBSITE. The website plagued with major glitches has cost the American taxpayer six times as much as the bid from the private contractor bid for the contract to create the website.

Now, let me ask you something. How come Mark Zuckerberg can make billions launching a website that has hundreds of millions of subscribers without charging them a cent, but the federal government is 600 PERCENT OVER BUDGET launching the portal that is supposed to take Americans that do not have health insurance or are losing their health insurance because their employers have dropped insurance coverage in response to Obamacare? That is correct. The cost to date for a website that does not work is $540 MILLION MORE than the contractor agreed the website would cost.

If you think about it, the Obamacare website is the portal or front porch for Obamacare. So, let’s say you were having a contractor build a $250,000 home for you. Let’s assume that the soft cost line item for the plans was $5,000. Let’s say that the hard cost line items for the front door and the porch you decided would make a nice feature for the home totaled $10,000. What would you do if the contractor who was building the house for you came back to you and said that those line items — which your construction contract provides will cost $15,000 — will cost $90,000 instead. Do you still think your contractor is going to bring the job in on budget?

I think the GOP needs to go all in. I would rather bet the farm on a bold new strategy and give the country an opportunity to recover if a Obama does not play ball than allow Obamacare, as presently enacted, to bankrupt the treasury. John Boehner and Mitch McConnell should agree to end the shutdown and draft a clean continuing resolution that will raise the debt ceiling for six months. They should publicly lobby for the roll-out of Obamacare to be delayed until all of the bugs are fixed. They should also lobby for the assembly of a non-partisan blue ribbon panel of business people and computer nerds who will work together to make recommendations on how to fix Obamacare so that the program:

  1. Provides affordable healthcare for Americans who do not have and cannot currently get healthcare insurance;
  2. Incentivizes Americans to buy healthcare and incentivizes businesses to offer healthcare to their employees; and
  3. Does not create an incentive for businesses to fire employees, cut back their hours or stop hiring them.

I firmly believe that American business people have the ingenuity to make recommendations that will accomplish the laudable goal of providing affordable healthcare for those who cannot currently obtain it without creating a healthcare brothel where the government is the pimp, insurance companies are the hookers and the American taxpayer is getting royally screwed. Instead of using all of the obvious problems with the ACA to make the President look bad, John Boehner should ask for one concession to the end of the shutdown. He should ask for the President to go on national television and promise the American people that he is going to work with Republicans and Democrats to fix the law and agree that the discussions of the blue ribbon panel will be televised. In turn, Boehner and McConnell should promise the American people that they will stand up to both the left and the right in order to do whatever is necessary to fix the glitches in the law.

Like it or lump it, Obamacare is the law of the land. All we can do in a divided government is work together to fix it. The notion that a political party completely devoid of leadership like the GOP — or where what passes for leadership is the Audacity of Nope — is going to be able to overturn a piece of legislation that the President regards as the signature achievement of his administration without a majority in the Senate, absolutely no chance of acquiring veto proof majorities in Congress in 2014, no currently viable Presidential candidate for 2016 and dwindling support for the intransigent ideologues it sent to Congress in 2010 and 2012 is just plain silly. On the other hand, if the GOP demonstrates a willingness to work with the President to fix Obamacare, it will acquire the credibility it needs in order to convince the American public that there is more to this once Grand Old Party than the Audacity of Nope.

Editor’s Note: reposted with permission from Cafe Con Leche Republicans – original link.

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Manny Fernandez is the Florida Director for Cafe Con Leche Republicans

Hospital Admissions Restrictions: The Statist Mentality

By Thomas Salazar

ArizonaA new bill proposed in the Arizona state legislature (HB 2293 or Hospital Admissions Restrictions) would require the “hospital admissions officer or representative” to be held responsible to the State of Arizona for seeking out whether or not a patient is legally present in the United States, if the patient does not have valid insurance. The problem is that immigration is the job of the federal government. The onus should not be on the state to insist that hospitals and their staff do the job of immigration officers. Hospitals are already burdened down by the overbearing regulations imposed by the Affordable Care Act. The last thing they need is to be inundated with more regulations.

Unfortunately, legislatures and bureaucrats do not consider this before they pass a bill. As Thomas Sowell states:

“The fatal attraction of government is that it allows busybodies to impose decisions on others without paying any price themselves. That enables them to act as if there were no price, even when there are ruinous prices — paid by others.”

That price could be the need to hire new staff to meet these regulations if it becomes law. It could divert funds for staff and resources that could be going to help cover the cost of medical treatments. Moreover, this legislation could reduce the hospitals staff’s time and ability to efficiently help patients obtain the medical attention they need, because the staff will be wasting time probing patients for documentation to prove whether the patient is legally here in the United States.

This legislation also requires the hospitals to keep records. The proposed bill states,

“A HOSPITAL MUST SUBMIT AN ANNUAL REPORT TO THE DEPARTMENT TO DOCUMENT ITS COMPLIANCE WITH THE REQUIREMENTS OF THIS SECTION IN A MANNER AND FORM PRESCRIBED BY THE DEPARTMENT.  EACH REPORT MUST INCLUDE DOCUMENTATION REGARDING THE NUMBER OF PERSONS WHO DID NOT SHOW PROPER OR VALID INFORMATION AND THE NUMBER OF REFERRALS TO IMMIGRATION OR LAW ENFORCEMENT, OR BOTH, PURSUANT TO SUBSECTION B OF THIS SECTION.  THE DEPARTMENT SHALL TAKE ALL REASONABLE ACTION TO COLLECT THE DATA AND SUBMIT A REPORT ON OR BEFORE NOVEMBER 15 OF EACH YEAR TO THE GOVERNOR, THE PRESIDENT OF THE SENATE, THE SPEAKER OF THE HOUSE OF REPRESENTATIVES AND THE CHAIRPERSONS OF THE APPROPRIATIONS COMMITTEES OF THE SENATE AND THE HOUSE OF REPRESENTATIVES.”

This to me is an overreach and beyond reasonable. The fact is that this does nothing to stop or curb illegal immigration. No one comes here to get sick or injured just to become treated in an American hospital.

Whose job is it, anyway, to enforce immigration? The resounding answer should be that it is not Banner, Integrity Health Care, nor any other hospital’s responsibility. These hospitals have trained staff who are there to help patients. Their staff members are not state or federal officers who are trained to enforce state or federal laws nor should they be treated or thought of as such. The goal of the legislature should not involve punishing hospitals by coercing them to modify their procedures and incur added cost, due to the failures of the federal government. More government regulation on business, nonprofits and individual citizens is not the answer to illegal immigration. Until the Federal government enforces our borders and passes immigration reform enabling more people to come here legally to work, there will be no real change.

These petty measures by our legislature do nothing more than cause problems and over regulate our businesses and organizations. In the end, this amendment hopefully will not pass because it sets a shameful precedent where the government can coercively demand private organizations to report on those who use their services. Therefore, let’s look beyond demagoguery and band aid bills that do nothing to fix the issue and oppose this bill.

Editors note: as with all blog postings that appear with a by-line, the opinions presented are the author’s and not necessarily the positions of Cafe Con Leche Republicans.

Thomas Martin Salazar is an Arizona leader of the Café con Leche Republicans. Thomas was born and raised in Arizona. He holds a Bachelor’s degree in History from Grand Canyon University and is currently working on obtaining a MDiv in Biblical Communication from Phoenix Seminary. Thomas has also served as the Grand Canyon University College Republicans Vice President and interim President (February 2007-April 2008) and as a Maricopa County Republican Precinct committeeman (August 2009 – August 2012).

A Responsible Doctor Confirms: Obamacare Won’t Work — It’s Just Too Complicated

A few days ago, I posted an article titled “Obamacare’s Fatal Flaws: Complexity and Central Control.”  I argued that the whole Obamacare system was too complex to deliver on its promises, especially when operated by political appointees from a Washington-based central control bureaucracy.

I know virtually nothing about the practice of medicine.  I based my argument on four decades in the engineering business, where complex systems designed from scratch never work, especially when they are pressed into service under full load, with high expectations, much too soon.

And now from the US House of Representatives Oversight Committee comes the testimony of Richard A. Armstrong, MD, Chief Operating Officer of Docs4PatientCare.  His clear and compelling testimony, at this link, is worth reading in its entirety, but the key paragraphs for this brief post are (my emphasis added):

Although the ACA attempts to address many of the perceived problems with our health care system, it ignores the fact that enormously complex systems cannot be successfully centrally designed or controlled. We have been attempting that with Medicare and Medicaid for almost five decades. Any honest and objective appraisal would conclude that we are failing with those programs. The ACA will fail as well, for the same reasons.

[Some ACA supporters have claimed] that the ACA will remove the burdens of bureaucracy and overhead that currently plague our nation’s practicing physicians. How can we possibly take this seriously? It creates an estimated 159 new agencies, boards and committees governing in detail how physicians are to care for their patients and run their practices. In a time of decreasing reimbursement and the lack of an alternative for the Sustainable Growth Rate formula in Medicare, these claims of bureaucratic simplification ring hollow with experienced physicians.

Shifting to electronic medical records has been touted as a means to improve patient care. Even though the HITECH portion of the Stimulus Bill provides financial support for the adoption of electronic medical records and the ACA provides incentives for those who meet federally defined meaningful use, only a minority of physician practices have adopted EMR systems. A majority of those who have attempted have been met with major frustrations and financial burdens. This is because the existing systems are not designed to enhance patient care. They are business systems designed for medical coding and billing. They are cumbersome in design, difficult to use and detract from the already limited time most physicians have to spend with patients.

Quite apart from all the politics, the fatal flaw of the Affordable Care Act (ACA, Obamacare) is that it simply won’t work.  How many people will suffer and how many lives will be lost as Washington feeds our life savings into this bottomless sink hole, this mother of all white elephants?

Picture yourself pleading for a loved-one’s life with an uncaring bureaucracy of blame-shifters and formerly fine doctors who must now slavishly follow rules issued from Washington.  From those bureaucrats and hapless doctors, you can almost hear the responses now:

The voice mailbox for this department is full.  Please call back later.

I don’t make these rules, ma’am — I just follow them.

You’ll have to get in line like everyone else.  We’ll call you back when it’s your turn.

If I made an exception for you, I’d have to do it for everyone.  It’s illegal.  I could lose my job.

I’m sorry, I can’t help you … I could lose my license to practice medicine

I’m sorry, the doctor is not accepting new patients.

You’re yelling at the wrong person … try yelling at your Congressman!

In the meantime, you can be sure that Washington politicians will enjoy first-rate medical care with no waiting.

In the engineering business, when a system can no longer be patched or tuned, it has to be scrapped.  That’s where we are now with the whole gang in Washington that brought us to the edge of this national health care nightmare.

The Supreme Court has abdicated, and now there’s only We-the-People who can change things this November.  Surely America’s voters can be forgiven for being fooled once.  But to be blunt about it —

Anyone who votes again for Barack Obama or for any politician who has supported Obamacare should understand one thing:  the pending national disaster in healthcare is on YOU !