Brook: "You Are Not Your Neighbor's Health Care Provider"

The Ayn Rand Center for Individual Rights now has the full video of Yaron Brook's lecture, "You Are Not Your Neighbor's Health Care Provider":

This talk by Yaron Brook was recorded at the University of Pennsylvania on May 11, 2010 as part of the ARC Speaker Series.

Despite overwhelming evidence that government intervention wrecks health care, government control over American medicine keeps growing. Why?

Because, Dr. Brook argues, virtually everyone today believes that a person’s need morally entitles him to have it fulfilled at others’ expense. This morality of need is at the root of every government health care entitlement, from Medicaid to ObamaCare .

In this provocative talk, Dr. Brook attacks the morality of need , and proposes a revolutionary alternative: the moral right of each individual to live for his own sake, taking responsibility for his own life and needs—including his health care needs—on a free market.

Watch the talk here.

Parkinson on Paying Cash

Dr. Jay Parkinson explains how working out a cash-pay arrangement with his own physician saved him money, and improved his care.

Read the details at, "Paying cash to doctors affects the treatment plan".

This is one of the strategies I discuss in my article, "How To Protect Yourself From ObamaCare" in the Summer 2010 issue of The Objective Standard.

Who's Lying Now?

The July 23, 2010 Las Vegas Review-Journal has a nice summary of President Obama's flip-flopping on whether the individual mandate is a tax or not.

Here's an excerpt from "Health Care Lies":

...[W]hile Congress was working on the health care legislation, Mr. Obama refused to accept the argument that a mandate to buy insurance, enforced by financial penalties, was equivalent to a tax. "I absolutely reject that notion," he said emphatically.

Why? Because Mr. Obama was loathe to admit he'd massively violated his campaign pledge not to raise taxes on anyone but the rich, presumably...

In a brief defending the law, the Justice Department says the requirement for people to carry insurance or pay the penalty is "a valid exercise" of Congress's power "to impose taxes."

...One of two things is true, here.

Either the mandate is a tax, as the Obama Justice Department now asserts in court, and President Barack Obama lied to the American people -- loudly, firmly, repeatedly, as he worked to get this massive federal power grab enacted -- or else Barack Obama was telling the truth last year, the penalty is not a tax, and the Justice Department (directly answerable to the president) is lying in court today when it asserts no one can challenge the mandate because it falls under the wide-ranging "taxing authority" ... that it's a tax.

Someone's lying: either Barack Obama or Barack Obama.

(Via @TOSjournal.)

Quick Links: Samuelson, Barnett, NHS

In the July 19, 2010 Washington Post, Robert Samuelson warns, "As Massachusetts health 'reform' goes, so could go Obamacare".

The July 23, 2010 Wall Street Journal has an interview with Randy Barnett over the constitutionality of ObamaCare.

The July 24, 2010 Telegraph described the next round of "astonishingly brutal" rationing planned for the British National Health Service.

Pledge for an Op-Ed by Paul Hsieh in Top-Tier Newspaper

Note: I'm Diana Hsieh, posting with Paul's permission.

As you likely know, Dr. Paul Hsieh is an op-ed writing machine. He published a handful of op-eds in 2007 and 2008, then 13 in 2009. This year, in just seven months, he's published 18 op-eds. That's an impressive output, to say the least. It's in addition to five articles published in The Objective Standard. Perhaps most remarkably, Paul does that work purely in his scarce free time -- in evenings and weekends, often after long days in a very busy radiology practice.

Since early 2009, Pajamas Media has become Paul's favorite outlet, such that most of his op-eds this year were published by them. That makes sense. Pajamas Media is eager for his work, they're great to work with, and his op-eds get widely circulated and discussed on the internet.

Paul speaks about trying to publish in the top-tier national newspapers on occasion. By that, he means:

• Wall Street Journal (#1, with circulation of 2,092,523)
  
• USA Today (#2, with circulation of 1,826,622)
  
• New York Times (#3, with circulation of 951,063)
  
• Washington Post (#5, with circulation of 578,482)

For Paul to publish an op-ed in one of those venues would mean so much more exposure for his ideas than any online outlet or regional paper. He's experienced a taste of that with his two op-eds in the smaller but well-respected Christian Science Monitor, and even with his letters published in the New York Times and the Wall Street Journal.

However, any serious attempt to publish an op-ed in any of those four top-tier venues would require much additional work for Paul. The op-ed couldn't just be solid: it would have to be a work of art. The submission process would be far more cumbersome than with Pajamas Media too. Consequently, he's not pursued it seriously.

Here's my proposal... Let's help motivate Paul to publish in one of those top-tier national newspapers!

I'm asking you to join me in pledging to pay Paul Hsieh a bonus if he publishes an op-ed in the print edition of any of those four top-tier papers by the end of 2010. The topic -- and what he says about it -- will be entirely up to him.

Paul needs to start his work on this project as soon as possible. However, he'll be extra-busy with work through August 6th. That gives us some time to gather pledges. If we've raised enough funds by noon on August 6th to justify the additional work required for him, then he promises to make a serious effort to publish in one of those top-tier papers. (The more money that's pledged, the more serious his effort, I suspect!) So on August 6th, I'll announce whether the project is moving forward or not.

Publishing an op-ed in a top-tier paper is no small feat. Paul knows that, and he's not sure that he'll be able to do it by the end of 2010. You're not pledging for effort; you're pledging for results. So if he's successful, then you'll owe him your pledge when he publishes. But if he's not, you'll owe him nothing.

If you value Paul's work -- if you want to inspire him to new heights -- please pledge!

In your comment, I'd love if you would say something about why you've decided to pledge. In other words, what does Paul's work mean to you? I might post some of those, but I'll do so anonymously, unless you request otherwise. Your pledge amount will remain private no matter what.

Here's the form to pledge:



If you have any questions, please e-mail me at diana@dianahsieh.com. And thank you!

A Picture Is Worth A Thousand Words

Here's a must-see visual wallchart of the ObamaCare implementation timeline.

(Via Medical Progress Today.)

Hsieh PJM OpEd: Berwick, Gun Control, and Paternalism

The July 23, 2010 PajamasMedia has published my latest OpEd, "Donald Berwick, the Pro-Gun Control Lobby, and Paternalism".

My theme is that both Donald Berwick and gun control advocates share a flawed view of human nature and a disdain for the rationality of ordinary men. This explains their paternalistic desire to restrict our freedoms.

Here is the introduction:

Q: What do Donald Berwick and gun control advocates have in common?

A: Both distrust ordinary Americans' ability to exercise individual rationality and responsibility. Instead, they believe that the government should restrict our freedoms for our own good. And if they have their way, we'll end up paying the price.

Dr. Donald Berwick is President Obama's newly appointed head of Medicare and an unabashed supporter of socialized medicine. He has repeatedly praised the British National Health Service as a model for the United States to emulate.

The Wall Street Journal recently published a selection of Berwick's public statements on health policy. Two in particular stand out because they are such naked attacks on the efficacy of individual choice and rationality:

1) I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.

2) The unaided human mind, and the acts of the individual, cannot assure excellence. Health care is a system, and its performance is a systemic property.

Hence, Berwick has explicitly called for doctors to relinquish their "clinician autonomy" and instead follow standardized government treatment guidelines. Patients should forgo using their "unaided human minds" and instead let their "leaders" decide what kind of medical care they should receive.

Many gun control advocates display a similar disdain for the rationality of ordinary Americans. This can be seen most clearly whenever a state considers allowing law-abiding citizens to carry concealed firearms...

(Read the full text of "Donald Berwick, the Pro-Gun Control Lobby, and Paternalism".)

Update: Thank you, Instapundit!

Schwartz at PJM: Exploitation, Not "Reform"

Brian Schwartz of PatientPower has a new OpEd at PajamasMedia, "It's Not Health Care 'Reform'; It's Exploitation".

Here's the introduction:

Scratch a health care "reformer" and you're likely to find a health care exploiter. As ObamaCare's provisions and taxes begin and resistance builds through lawsuits and state-level measures, it's important to see the exploitative motives driving increased political control of your medical care. Health control advocates won't stop with ObamaCare (HR 3590). "Once we kick through this door, there'll be more legislation to follow," said House Speaker Nancy Pelosi.

Whether health control supporters demand that all policies include certain benefits or that everyone must buy government-approved insurance or something like "Medicare for all," the policies don't follow from the alleged justifications for them. But they do follow from one motive: charity at gunpoint. That is, forcing you to finance other people's medical care. This is exploitation. It's about time freedom advocates reclaim this term often misused by the left, as so-called health care "reform" is a clear case of exploitation...

(Read the full text of "It's Not Health Care 'Reform'; It's Exploitation".)

The Two Types of FDA Errors

Dr. Henry Miller (a former FDA official) explains the two types of FDA errors. And why the lesser-known Type 2 errors are strangling innovation.

Private Insurance Death Spiral

The private insurance death spiral is accelerating as private carriers and small businesses are being squeezed by government regulations.

The July 17, 2010 New York Times reports "Insurers Push Plans That Limit Choice of Doctor".

The July 18, 2010 Boston Globe reports "Firms cancel health coverage".

If the trend continues, the government option will be the only left -- thus backing Americans into a "single-payer" system against their will.

OCR Reviews ObamaCare

The July 8, 2010 Orange County Register posted some interesting information about ObamaCare and popular response. In "The future of health care under Obamacare", Brian Calle noted two tidbits:

After Whole Foods CEO John Mackey wrote an OpEd against ObamaCare, his sales went up rather than down. In other words, his willingness to speak out attracted more customers than left due to ineffectual boycotts.

And Wall Street Journal writer Stephen Moore gives several reasons why the only solution to ObamaCare's problems is "repeal, repeal, repeal".

Let's hope more Americans start paying attention!

(Via @Lucidicus.)

Quick Links: Doctors' Code, Exodus, UK, FDA

Dr. Michael Kirsch explains what "will discuss with you" and "for completeness" in a medical chart really mean.

In the July 19, 2010 Boston Herald, Grace-Marie Turner describes how new government rules are accelerating the exodus of physicians from Medicare.

The British Medical Journal reports that "UK is ranked top out of 40 countries on quality of death". As one of my physician colleagues notes, "The NHS is really good at killing people."

David Catron discusses more inane FDA mission creep.

Punishing Doctors For Quality Care

Here's the latest example of how new ObamaCare rules could punish doctors who take better care of their patients:

...[F]inancial incentives could actually punish physicians for doing the right thing.

A recent study from Cleveland Clinic shows how this could happen. The Clinic studied hospital readmission rates for patients with heart failure. It is often considered a sign of poor quality care when a heart patient, once released from a hospital, must be readmitted for further treatment. Turns out, this may not be the case at all.

Writes Karen Pallarito for the HealthDay Reporter, the Clinic reasons that “[k]eeping more patients alive for a month in the first place means there are more patients eligible for readmission... They also suspect that assuring appropriate care for these patients, including any necessary procedures or surgery, may necessitate readmission to the hospital -- which would drive up readmission rates.”

The results of the study showed that high readmission rates actually corresponded to lower 30-day death rates. The Cleveland Clinic's 30-day readmission rate for heart failure was 28 percent, 3.3 points higher than the national average. But their 30-day death rate of 8.8 percent was 2.4 points below the national average.

Starting on Oct. 1, 2012, Medicare payments for hospitals with high readmission rates for certain conditions, including heart failure, will be reduced. This means Obamacare may actually punish hospitals and physicians for providing better quality care.

What will happen to American medical care when doctors are punished for keeping patients alive longer (and thus surviving for followup admissions), whereas they get rewarded for having fewer readmissions?

Do you want to be the patient who gets denied care in order to keep a hospital's readmission statistics down?

(Via Dr. Milton Wolf.)

Catron at PJM on Berwick and Rationing

PajamasMedia has just published an OpEd by David Catron entitled, "Donald Berwick's Motto? Rationing for Thee, but not for Me".

Here is the intro:

If you're like most Americans, you had probably never heard of Donald Berwick before July 7, when President Obama installed him as Administrator of the Centers for Medicare & Medicaid Services (CMS). And, unless you're a health policy wonk, the news that Obama circumvented the normal Senate confirmation process with a recess appointment probably elicited no response beyond a briefly raised eyebrow and a stifled yawn.

But this CMS decision deserves another look. Dr. Berwick has been granted the power to reach out and touch you in ways undreamed of by higher profile appointees like Elena Kagan. Whether you're paying attention or not, he will have a profound impact on the quality of your life...

(Read the full text of "Donald Berwick's Motto? Rationing for Thee, but not for Me".)

The arrogance of government officials like Berwick is astounding in a two-fold way.

First, they believe they are qualified to set draconian rules over the lives of the citizenry, because we are unable to make such decisions for ourselves. The typical excuse given is that it's for our own good or for some nebulous "common good".

But by exempting themselves from their own rules, they recognize (at some level) that these rules are actually bad for the individuals involved -- but they don't care.

This isn't just isolated to health care. We've seen this in the global warming debate, where officials lecture us about our "carbon footprints", while jetsetting around the globe to conferences, sanctimoniously criticizing the industrial society that makes their luxury plans possible.

Or officials who have tried to deny citizens 2nd Amendment rights, while using their positions in government to make sure they (or their bodyguards) can carry weapons for self-defense.

Such men view themselves as special -- and the rest of us as merely subjects to be ruled. This runs antithetical to the American ideal of the government being our servants, to protect our individual rights -- not our masters.

The more quickly Americans wake up to this fact, the more quickly we can remove them from power before it's too late. Catron's OpEd is another much-needed alarm bell for our country. Let's hope Americans are listening.

Quick Links: North Korea, Berwick

How's that government-run health care in North Korea working out? (Via Dr. Milton Wolf.)

David Catron notes that Donald Berwick (the new Medicare czar) has managed to exempt himself from his own program.

The July 15, 2010 Wall Street Journal shows how scary Berwick is by letting him damn himself with his own quotes. (Via @TOSjournal.)

Hsieh PJM OpEd: "Should You Be Allowed to Know What's In Your DNA?"

PajamasMedia has just published my latest OpEd, "Should You Be Allowed to Know What's In Your DNA?"

My theme is that you should be free to acquire knowledge about yourself that will help you act according to your best judgment for your benefit -- in particular, by helping you treat, mitigate, or prevent bad diseases through knowledge of your own genome.

Although this piece focuses on a seemingly narrow concrete (i.e., the FDA's new restrictions on direct-to-consumer genetic testing), I attempted to use this concrete to show how apparently small regulations can have a major impact on Americans' lives -- as well using it as a springboard to discuss broader themes of free markets vs. government regulations, paternalism vs. individual responsibility, and the virtue of pursuing one's rational self-interest.

Here is the introduction:

"You can’t handle the truth!"

That's the federal government’s latest message to Americans seeking to learn the content of their own DNA.

Recent advances in biotechnology have allowed private companies to offer affordable genetic testing directly to consumers, to help them determine their risks of developing problems such as diabetes, heart disease, and various forms of cancer. In response, the U.S. government has told these companies that their tests must be approved by FDA regulators before they can be sold because, in the government's words, "consumers may make medical decisions in reliance on this information."

These restrictions thus represent a new level of government paternalism over the citizenry. In the name of "protecting" us, the government seeks to prevent willing consumers from learning medically useful information about their own bodies that could tell them which diseases they may develop -- and help them make important treatment, prevention, and lifestyle decisions...

(Read the full text of "Should You Be Allowed to Know What's In Your DNA?")

The Perils of Indiscriminate Screening Tests

In a discussion thread on diet and blood tests, Dr. Doug McGuff made a very important observation about the dangers of government-driven practice guidelines and various "screening tests":

My major thesis is one against "screening". Unless you are feeling poorly and have a reason to check on a given body system (thyroid, kidney, adrenals or whatever) you should not do it. Without an increased pre-test probablility the risk of a false positive goes up.

These tests are not just "right or wrong", whether they are right or depends on whether the test "sets its sights" toward picking up positives (sensitivity) or negatives (specificity). No matter which way you set your sights, the more you get of one, the less you get of the other AND whether the test is going to give you information actually depends on if you have an elevated risk of having disease (pre-test probability).

If you have a false positive test result, and then go chasing after it (or worse, treating it) you can incur more morbidity and mortality than if you had never checked on it. For most tests and treatments in medicine the number needed to harm is lower than the number needed to treat.

When I order a Chem 18 (comprehensive metabolic panel) in the ER for an elderly person that has been vomiting for 4 days and is clinically dehydrated with jaundiced eyes, that has an elevated pre-test probability. Ordering a Chem 18 in a doctors office on a patient that is feeling well and is there for a yearly physical is just stupid.

Government health care is driving this herd mentality [emphasis mine - PSH], and most doctors I know simply do not understand this concept. It is a positively reinforced loop that is now withholding payments to doctors unless they do ridiculous stuff that the literature (and common sense) say is stupid.

Many doctors today (especially the more recently minted ones) cannot practice without referring to the i-phone to follow some government-mandated template. When residents rotate with me I collect all i-phones and digital technology at the beginning of the shift and smile as almost all become paralyzed with fear because they have not memorized anything useful.

Get yourself a concierge doctor that does not participate with government payors. Most are cheap ($35 bucks per visit) and are free to practice as they see fit. Force and threats really do paralyze the mind, especially in medicine.

Doug McGuff, MD

Bowdlerizing Berwick

David Catron discusses the latest mainstream media attempts to sanitize Donald Berwick's radical views.

Here's the opening of "Bowdlerizing Berwick":

Thomas Bowdler was an English physician whose desire to publish an edition of Shakespeare amenable to 19th-century sensibilities led him to sanitize many of the Bard's juiciest passages. The result was predictably risible. One of his most hilarious revisions was to change Lady Macbeth's cri de coeur, "Out, damned spot," to "Out, crimson spot!"

As absurd as it was, this project did preserve the good doctor's name for posterity in the verb "bowdlerize." And it would be difficult to come up with a better term to describe what the establishment media have attempted to do with the record of Donald Berwick, the Harvard pediatrician whom our President just appointed Administrator of the Centers for Medicare & Medicaid Services (CMS)...

More than ever, America needs journalists to shed some light on our elected (and unelected) officials. If the mainstream media aren't doing their jobs, I'm very glad that independent writers and journalists like Catron are stepping up.

Brook Interviews at ToFindHealth.Com

Yaron Brook of the Ayn Rand Institute recently gave a series of interviews to ToFindHealth.com.

Part 1 (Mind and Health):



Part 2 (Politics):



Part 3 (Rapid Fire):



(Via Dr. Brian Panik.)

Pournelle on Berwick

Writer Jerry Pournelle has a nice short analysis of what President Obama's recess appointment of Donald Berwick to head Medicare means:

There are a number of reasons for this recess appointment. The most obvious is that President Obama doesn't want debates on his Obamacare in the months leading up to the election, and since Berwick is an unashamed advocate of single-payer (government) health insurance in general and the British national health care system in particular, his hearing confirmations would make it pretty clear that Obamacare moves us inexorably toward that.

The latest reports from Massachusetts show that pretty clearly. Obama has said that his system is similar to the Massachusetts system, and that system is going broke. The premiums keep rising, and the private insurance companies can't stay in business the way things are. The Massachusetts health care experiment has been a train wreck.

Berwick is certainly qualified to head a national health care system (for a pro-Berwick piece see the Washington Post). He's also a realist about what that implies. A few years ago he said that sick people tend to be poorer, and poor people tend to be sicker, and if you want an excellent, humane, and rational health care system it is going to be redistributive. It has to be. An excellent national health care system requires redistributing the wealth.

Of course that's true. It's also the last thing Obama wants debated this summer and fall.

Pournelle is on target here.

And one of the important points that ObamaCare opponents will need to be emphasize is that in because any national health care system will necessarily redistribute wealth in a massive fashion, it will be anything but "excellent" in both the moral and practical senses.

Instead, it will be unjust (in the sense of depriving some people of their rights to attempt to guarantee others' bogus entitlement "rights") and it will destroy the quality of American health care.

(Pournelle link via Instapundit.)

10 Ways Patients Can Save On Health Care Costs

Dr. Richard Reece offers, "10 ways patients can save on health care costs".

Prudent patients may wish to take advantage of these options while they can, before ObamaCare restricts access to them in the near future.

Quick Links: SCOTUS, MA ER, FDA

The July 6, 2010 LA Times reports that "Obama and Supreme Court may be on collision course" on health care.

The July 4, 2010 Boston Globe reports that ER visits increased in Masschusetts because of the state's universal health care law. (State lawmakers had promised the law would do the opposite, of course).

Freedom From the FDA covers the critical issue of how the FDA threatens (or does real harm) to patient health:

Our objective is to provide a resource for all of those concerned about the power of the Food and Drug Administration to damage the free practice of medicine in the United States and to restrict the individual rights of physicians and patients to seek the medical care that they consider most appropriate for their practices and good health.

This Web site is presented by Americans for Free Choice in Medicine.

More Massachusetts Gaming

The June 30, 2010 Boston Globe reports that as a results of the MA mandatory insurance system, more people are "gaming the system" and purchasing insurance only when they are ill. Then they drop the coverage (and pay the penalty) when they don't need insurance.

Hence, the combination of laws (including "mandatory" insurance and guaranteed issue) drives up insurance prices for others who don't game the system. Or as the article notes, "The result is that insured residents of Massachusetts wind up paying more for health care".

Americans in the other 49 states should be prepared for a similar phenomenon as ObamaCare is phased in nationally.

As with the housing crisis, those who are honest and attempt to "play by the rules" (and purchase insurance) will subsidize those who violate the irrational government rules by gaming the system. Whenever the law perversely pit people's sense of morality and fairness against their economic self-interest, this is a recipe for disaster.

Resendes on ObamaCare

In the June 29, 2010 RealClearMarkets, Dr. Maria Resendes lays out "A Doctor's Take On Health Care".

Dr. Resendes notes the following:

"Obamacare", as it is colloquially termed, is financially a disaster for doctors, hospitals, insurers, and will ultimately be a disaster for our nation's budget. It is also unfortunate for patients needing care.

She then proceeds to show how perverse economic incentives will drive doctors out of private practice and into "foundation" practices. And how it will also strangle private insurance.

The end result:

Looking ahead, it is increasingly apparent that by 2020 we will have severe cuts in service thanks to rising retirement among doctors, a decrease in the number of private insurers, and a reduction in the number of hospitals due to federal mandates that fail to marry costs with services. The end result will be rationing and delay of elective procedures, denial of expensive but effective treatments a la England, and most likely a single-payer system the likes of which is seen in other, less advanced health care systems around the world.

(Read the full text of "A Doctor's Take On Health Care".)

This will be the inevitable consequence of the continued government take-over of medicine. Fortunately, it's not too late to prevent this -- if we insist on repealing ObamaCare and replacing it with genuine free market reforms.

(Via @TOSjournal.)

Motivational Posters: Founding Fathers Edition

In honor of July 4th, I'd like to point readers to these "Motivational Posters: Founding Fathers Edition"!

Here are a few of my favorites (click on the image to see it full size):







(Via @susanwake.)

Tan Tax Blues

In in the July 1, 2010 PajamasMedia, John Kartch of Americans for Tax Reform writes, "Small Business Owners Furious as 'Tan Tax' Begins".

Here's an excerpt:

When ObamaCare was making its way through the House, it included the much-ridiculed "BoTax" -- a five percent tax on cosmetic surgery. But when the Senate Managers Amendment was released on December 19, suddenly the BoTax was nowhere to be found. In its place was the tanning tax -- slipped into the bill behind closed doors late at night, with no discussion or input from those affected.

Indeed, the tanning tax is a metaphor for ObamaCare in general -- burdensome, expensive, petty, thrown together behind closed doors, and blind to the actual impact the legislation would have on people.

President Obama saw fit to crack wise about the tanning tax during his remarks to the White House Correspondents Association annual dinner. Meanwhile, out in the real world, small business owners were trying to figure out how they were going to be able to comply with the paperwork and cost burden the new tax would impose. This was a tax that came out of nowhere and came with little helpful guidance from the IRS. Dave Morris, owner of Sunrise Tanning in Mishawaka, Indiana, summed it up this way:

I work 65 hours here just to make ends meet. They take 10 percent off of that. It’s going to be really hard.

In the same city, Jillian Frank, one of the 40 employees at Fun Tan, said:

If business really starts to slow down, I could lose my job.

The owner of two tanning salons in Virginia had this to say:

It is very emotional to see your dream being literally shattered by someone in Washington.

(Read the full text of "Small Business Owners Furious as 'Tan Tax' Begins".)

The Obama administration seems pretty well-practiced in shattering dreams...

Mayo Vs. Medicare and Medicaid

The Mayo Clinic is reducing services to Medicare and Medicaid patients due to goverment payment cuts.

The Heartland Institute reports:

The controversy over below-market government reimbursement rates has led the famed Mayo Clinic to close off access for many Medicare and Medicaid patients.

According to Mayo, Medicare was reimbursing doctors at the Mayo Clinic in Arizona for only about 50 percent of the cost of the primary care treatment they were providing, leading Mayo to make the decision to opt out of Medicare.

The clinic will continue to accept Medicare patients at the facility for primary care treatment, but only if they pay cash.

Amy Ridenour, president of the National Center for Public Policy Research, noted this natural consequence:

Ridenour says the situation will only worsen if President Obama's health care law is not repealed.

"It is so difficult for Medicaid recipients to find doctors that Medicaid enrollees already have been utilizing emergency room care at twice the rate of uninsured patients," she said. "We can expect it to be increasingly difficult for Medicaid and Medicare patients to find doctors and other providers."

This shunting of patients into the ER for non-emergency problems was one of the problems that "universal health care" was supposed to eliminate.

What additional failures of ObamaCare will we see soon?