Wolf: "Not Obamacare, but Patientcare"

Dr. Milton Wolf offers some good ideas to move America's health care system in the right direction in his latest Washington Times OpEd, "Not Obamacare, but Patientcare".

I'm an especially big fan of #1, 2, 4 and 5:

Tax fairness
Insurance portability 
Health savings accounts
End government monopolies 

Read the full text of "Not Obamacare, but Patientcare" for more details.

(As a side note, ultimately I believe programs like Medicare, Medicare Advantage, and Medicaid should be fully privatized. The government's job is to protect individual rights and freedoms, not provide entitlement programs. But these programs cannot and should not eliminated overnight. And there's ample room for debate on the precise timing/method for such privatization.)

Catron: "Can One Iraq Vet Stop Obamacare?"

David Catron has a nice article on Matthew Sissel's legal challenge to ObamaCare based on the Origination Clause, "Can One Iraq Vet Stop Obamacare?"

A couple of excerpts:

This 32-year-old artist, businessman, and holder of the Bronze Star is the plaintiff in Sissel v. U.S. Department of Health & Human Services, which Sissel sees as “a battle for my liberty — my freedom to live out my life to the fullest.” This is the only remaining lawsuit that has any chance of bringing down the entire health care law. His lawsuit, which was filed in July of 2010, was put on hold during the run-up to last June’s Supreme Court decision to uphold most of Obamacare. Ironically, that controversial ruling gave his case a new lease on life. 

And:

A variety of constitutional scholars have of course weighed in on the Sissel case. Last September Georgetown Professor Randy Barnett wrote, “If any act violates the Origination Clause, it would seem to be the Affordable Care Act. The Supreme Court has never approved the ‘strike-and-replace’ procedure the Congress employed here. This challenge might be a good opportunity to discover whether the Origination Clause is part of the ‘Lost Constitution,’ or whether it is still a part of the written Constitution that Congress must obey.”

(For more details, read the full text of "Can One Iraq Vet Stop Obamacare?")

Sissel also discusses his reasons in his earlier OpEd in the Christian Science Monitor:

I proudly served our country in the Iowa Army National Guard as a combat medic, spending two years in Iraq and eventually being awarded the Bronze Star. I mention that experience in order to drive home this point: While I am proud to have served my state and my country as a volunteer, I object to being conscripted into a federal health-care program that is at odds with basic constitutional principles of individual rights and limited government.

I see my lawsuit as a battle for my liberty – my freedom to live out my life to the fullest without costly, one-size-fits-all dictates from the government. I am fighting the command-and-control health-care plan in order to safeguard the health of our Constitution and the freedoms it protects for me and for all Americans.

Lewis On ObamaCare and Business Strategy

Certified financial consultant David Lewis asks small business owners, "Is Your 'Obamacare Strategy' A One-Way Ticket To Audit Hell?"

The IRS will be looking hard at businessmen trying to evade their ObamaCare requirements.

I've done a lot of reading about the health law's effects on doctors and patients, but know relatively less about how it affects the business community. Given that the law is expected to reach 1/6th of the US economy, I'm glad to read material from those with knowledge in this area.

Hsieh Forbes OpEd: Big Brother Has A New Face, And It's Your Boss

Forbes has just published my latest OpEd, "Big Brother Has A New Face, And It's Your Boss".

I discuss how government policies linking employment to health insurance create a powerful incentive for your boss to control his costs by controlling your lifestyle.

My takehome point:

...[I]t’s wrong for the government to use economic carrots and sticks to induce private employers to become enforcers of healthy behavior. This is just a subtler form of “nanny state” controls, such as NYC mayor Michael Bloomberg outlawing soft drinks he considers unhealthy.

And once employers start monitoring employee behavior on the grounds of “health costs,” there’s no end to the potential meddling. Who will be the next politically disfavored group after smokers or the obese? Do we want bosses discouraging their employees from owning guns or enjoying mountain biking on the weekends? This is a dangerous road.

(Read the full text of "Big Brother Has A New Face, And It's Your Boss".)

Haynes on MOC

Dr. Beth Haynes is quoted in this article, "Maintenance of Certification: A New Way to Control Docs?"

Many physicians worry that requirements like that are just thinly veiled attempts by hospitals, academics, and associations — what Kunkle calls healthcare’s “artificial aristocracy” — to control the way doctors work and interact with the healthcare system, not just how effectively they treat patients.

“If you think about lawyers, they pass the board once, that’s it,” says Beth Haynes, a family doctor in San Francisco and executive director of the Benjamin Rush Society, the physicians’ group that’s putting on the debate at the University of Pennsylania... Haynes is referring to the bar exam, of course. “That’s what we used to with board certification. It was a lifetime mark of achievement, period. But now it’s becoming this very intrusive way of trying to tell people how to practice. … It’s just complete micromanaging of physicians.”

$800 Heart Surgery

AFP: "In India, 'no frills' hospitals offer $800 heart surgery"

Using pre-fabricated buildings, stripping out air-conditioning and even training visitors to help with post-operative care, the group believes it can cut the cost of heart surgery to an astonishing 800 dollars.

Quick Reads: Catron, Held

I'm on the road for a few days and won't be blogging much. In the meantime, check out:

David Catron: "GOP at Fault for Obamacare Train Wreck?"

Twitchy: "Ophthalmologists walk out of Obamacare talk at national medical meeting"

Catron: Wheels Come Off Obamacare

David Catron discusses the growing recognition of serious ObamaCare implementation problems in his latest American Spectator piece, "Wheels Come Off Obamacare".

He discusses the problems in several arenas including the state "exchanges", the CLASS act, the "basic health plan", and the medical device tax.

Read the full text of "Wheels Come Off Obamacare" for more details.

Scherz on Circumnavigating Obamacare

Dr. Hal Scherz of Docs4PatientCare has a new OpEd, "Circumnavigating Obamacare".

He discusses how new ObamaCare "navigators" will be displacing independent insurance agents. Of course, these navigators will not necessarily be working for the customer, but will be beholden to the government that pays their salaries.

For more details, read the full text of "Circumnavigating Obamacare".

Medicare and Longevity

At Forbes.com, Christopher Conover asks an interesting question: "If Ray Kurzweil Lives Forever, Should Medicare Pay for His Health Care?"

Vecchio Policy Brief

Dr. Jill Vecchio is now a Healthcare Policy Fellow for tge Centennial Institute in Colorado.

She's written a health policy brief aimed at the general public entitled, "So You Want Affordable Care? Common Sense from a Practicing Physician".

I haven't read it yet, but I look forward to doing so!

BRS Debate on MOC

The Benjamin Rush Society has announced its next debate on health policy, scheduled April 20th in Philadelphia on maintenance of certification (MOC).

Here's the text of their announcement:

BE IT RESOLVED THAT

“Maintenance of Certification requirements fail to improve the quality of medical care while placing unnecessary burdens on physicians.”
 

IN FAVOR

Paul Kempen, MD, PhD (Cleveland, OH) Anesthesiologist; alternate delegate, Ohio State Medical Association; Board member, Academy of Medicine of Cleveland and Northern Ohio

Andrew Schlafly, Esq. (Far Hills, NJ)
Attorney at Law; General Council, AAPS 

OPPOSED
Martin Levine, DO, MPH (Bayonne, NJ)
Family Practice
Former president, American Osteopathic Association 

TBA

MODERATOR: Dr. Stanley Goldfarb, MD, Assoc. Dean, Perelman School of Medicine 

Saturday, April 20, 2013, 6:00 p.m.
Pre-Debate Reception at 5:30 p.m.

Perelman School of Medicine, University of Pennsylvania
Smilow Center for Translational Research - Arthur H Rubenstein Auditorium  
3400 Civic Center Blvd., Philadelphia, PA 19104

Parking is available at Penn Tower Garage 1 Convention Boulevard
Google Map: http://tinyurl.com/DebatePkngUPenn

Event is Free but seating is limited. Please reserve your seat at

http://tinyurl.com/BRSdebate-UPenn

For more information or to volunteer, contact Perry Evangelista, at perryev@mail.med.upenn.edu

Beth Haynes, MD
Executive Director, Benjamin Rush Society

Mitchell's Case For Optimism

Blogger Dan Mitchell offers a little bit of hope in his piece, "Why We Should Be Optimistic about Repealing Obamacare and Fixing the Healthcare System".

Here's the opening:

I’m going to make an assertion that seems utterly absurd.

The enactment of Obamacare may have been good news.

Before sending a team of medical attendants to cart me off to a sanitarium, allow me to elaborate. I’m not saying Obamacare is good policy. After all, I’ve written over and over again that it is a budget-busting boondoggle that will exacerbate our real healthcare crisis of third-party payer.

What I am saying, though, is that Obamacare may turn out to be a major political mistake for the left, one that sets the stage for sweeping free market reforms.

Basically, he argues that as ObamaCare problems unfold, we stand a chance at rolling back bad legislation -- if we can persuade voters that the problems are due to government interference in the marketplace (and not because of the "free market").

I basically agree with him. Our work won't be easy.  But it is an achievable goal, if we're willing to exert the necessary effort.

For more details, read the full text of "Why We Should Be Optimistic about Repealing Obamacare and Fixing the Healthcare System".

(Related: "The Battle Of The Narrative: How Ordinary Americans Can Fight ObamaCare".)

Quick Links: Vermont, Scherz

Vermont update: "Vermont doctors say health care reform will take away private practice". (Via Dr. Art Fougner.)

Dr. Hal Scherz on "Unintended Consequences" in medical training and in health legislation.

Medical Emergencies at 40,000 Feet

As a change of pace from health policy, I thought I'd blog about this interesting article from The Atlantic on "Medical Emergencies at 40,000 Feet".

A few excerpts:

Studies by the airlines and ground-based medical support services have found that a health care provider is available and responds in upwards of 80 percent of in-flight medical events. The truth is, though, that many health care providers find themselves attending to issues they don't see in their medical practices, and most have no specialist knowledge about aviation medicine or the medical resources aboard the plane. If asked, many health care providers will volunteer to help, especially if no one else is available, and this can lead to problems...

In addition to the goodwill of travelling physicians, all the major carriers in the U.S. have, for at least the past decade, also relied on ground-based physicians and nurses with experience in emergency care and additional training in aviation medicine. Based at centers including MedAire in Phoenix, the University of Pittsburgh Medical Center's STAT-MD program, the Mayo Clinic Aerospace Medicine program, and sometimes an airline's internal medical department, these experts work with the flight crew and volunteer health care providers on board over radio or satellite telephone to assess and stabilize sick passengers, to guide the decision whether to divert the airplane, and to organize the medical response on the ground...

According to Dr. Claude Thibeault, medical advisor to the IATA, "If you are caught in a medical emergency on-board, the first thing you should do is to ask if the airline has access to ground medical support. If so, then ask the flight attendant to call them immediately."

I've never been asked to respond to a medical emergency while flying.  But my brother (also a physician) has, and he said it was a bit nerve-wracking having to decide whether or not to divert the plane to the nearest airport.

(Read the full text of "Medical Emergencies at 40,000 Feet".)

CO Exchanges in Trouble

Katie Kerwin McCrimmon: "Tech troubles could hobble health exchange"

From the article:

Colorado’s health exchange is supposed to debut in just six months, but having the technology ready by Oct. 1 may be an impossible task.

Critical problems threaten the system, ranging from a lack of coordination with the state’s technology office and historic problems with state IT systems to poor oversight by exchange managers and contractors and the potential for serious conflicts of interest among those charged with creating the complex multi-million dollar exchange system...

Read the full text of "Tech troubles could hobble health exchange" for more details.

(Via Scott K.)

Quick Links: Doctors Retiring or Opting Out

MedPageToday: "More Docs Plan to Retire Early".

And what about those doctors remaining?

Sally Pipes notes in Forbes:"Fed Up With Obamacare, Doctors Increasingly Prefer Cash For Care"

HSAs Survive For Now

Merrill Matthews notes, "Health Savings Accounts Will Survive ObamaCare -- At Least For Now" (Forbes, 3/27/2013).

This is a little bit of good news!