Dr. Deane Waldman brings clarity, understanding and a workable solution to our sick U.S. healthcare system
We can fix healthcare
Our recent presidents, along with multiple Congresses, both Republican and Democrat, have all used the same, ludicrous approach on our sick healthcare system. It's what I call “Trust Me!”
Albert Einstein’s famous definition of "insanity" aptly describes Washington’s attempts to fix U.S. healthcare as: “Doing the same thing over and over again and expecting different results.”
By President Obama's own admission, Medicare will be insolvent before 2030. This means for all the current fifty-year-olds, Medicare will not be able to pay your medical bills when you qualify for Medicare coverage.
Why are both Medicare and Medicaid going broke? Because they are spending more money (on Washington’s healthcare bureaucracy and the increasing regulatory burden) than they are taking in.
Combined spending on our three major entitlements — Social Security, Medicare and Medicaid — amounted to 8.4% of GDP in 2007, or about $1.1 trillion. Under the Congressional Budget Office's extended baseline, the three programs will claim 25% of GDP by 2082, or almost triple their present share.
Because Medicaid is spending more than it can afford, just like Medicare, it must cut its spending and has decided to reduce payments to doctors. So there are fewer and fewer doctors to see more and more patients. Wait times to see a doctor or to get care will get even worse. Just ask an American veteran waiting forever for what they need. So much for “Trust me!”.
Even before Obamacare, over 30 percent of U.S. doctors couldn't afford to take care of Medicaid patients.  Obamacare reduces Medicaid payment schedules, so that number will be going UP. Similarly, the number of doctors opting out of seeing new Medicare patients tripled between 2009 and 2012,  and Obamacare cuts had not yet been implemented in 2012. By 2020, it may be impossible for a newly eligible Medicare patient to find a doctor.
EMTALA is a good example of how meaning well can do harm. It was passed to prevent hospital Emergency Rooms from transferring out patients who had no health insurance. Hence its nickname, the "anti-dumping law."
EMTALA requires a hospital to provide whatever care is needed regardless of whether the patient has insurance or not. This means the patient who needs a hernia repair or a heart transplant will get it and the hospital must either find some “other funding source” to cover its expenses or close its doors.
As a consequence of EMTALA, Washington created the unfunded mandate — that you and I pay for every day without knowing it. Want to know why an aspirin costs $2/pill when you’re in the hospital? The reason is the unfunded mandate: hospitals shift the un-reimbursed costs of caring for the uninsured onto the shoulders of those who have insurance. Otherwise, the hospital goes out of business.
The unfunded mandate annually costs my own hospital 25 percent of the total annual operating budget. This means our hospital must “find” a quarter of a billion dollars every year or it won’t cover its nursing payroll.
HIPAA stands for Health Insurance Portability and Accountability Act of 1996. It was supposed to solve the problem of people losing their their employer-supported health insurance when they lose their jobs. It did not fix the problem but it did elevate security of medical information to a level where doctors cannot communicate with each other. In other words, another of Washington’s “Trust me” approaches actually hurt us when it was supposed to help us.
As you can see from the Table above, Obamacare, the Affordable Care Act, delivered the opposite of what it promised it would do. In reality, it made “patient” Healthcare System sicker, not better.
I wrote above that the “Trust me” approach seems insane because of the chart below. The American people DON’T TRUST WASHINGTON and haven’t for a long time. Since Obama took office, Congressional job approval has been consistently below 20 percent, meaning more than 80 percent of We The People don’t trust Congress to get things right.
Congress' Job Approval Ratings, Yearly Averages
Do you approve or disapprove of the way Congress is handling its job? Note: Gallup did not measure congressional job approval in 1984/85.
The Republicans have tried to repeal Obamacare more than fifty times, all without success, yet their strategy for healthcare is called, “Repeal and replace.”
Dr. Waldman's new
eye-opening book lays bare the disaster that has befallen both patients and doctors over the last 50 years due to government and administrative involvement into health care. Today close to 50% of healthcare spending goes NOT to doctors to pay for care, but to administrators who manage the miles of red tape introduced by ever increasing number of government regulations.
Dr. Deane Waldman was Chief of Pediatric Cardiology at: the Children’s Hospital of San Diego, the University of Chicago, and the University of New Mexico. Responsible for budgets in excess of $20 million, he has seen all aspects of our floundering medical care system. His proposal for a simple Direct-Pay USA system has the potential to revolutionize health care in the U.S. and save us from imminent financial catastrophe.
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