Beyond the Cusp

September 19, 2017

The Grand Healthcare Fiasco

 

Has anybody honestly thought the concept of “Single Payer Government Healthcare” through completely? Senators Bernie Sanders and Elizabeth Warren claim they have the entire thing sorted out. What is their solution, you ask? They will tell everybody that it is easy-peasy-lemon-squeezy. The answer is to simply give everybody a Medicare Card and presto-chango and you have universal healthcare. Nothing will change other than the government will now pay all your healthcare expenses. You actually do get to keep your doctor. Of course, you do not get to keep your healthcare insurance because the government will become your health insurance provider. Now, what could be any more simple? When you go to your doctor, you just show them your Medicare card, they take down the number, you sign that you received the care listed and the government pays your doctor. Well, you will need to press down when signing the paperwork because there are tons of copies being produced, at least five with an unknown upper end. Well, there will be a little more to your doctor getting his money, but your work will be finished. Your physician will then be required to also complete some additional forms further describing the services delivered and the resources used and any testing which was required and any other incidentals which might be required to satisfy the government regulations and specific other essential requirements to complete and satisfy every criteria which the government and Medicare requires. Then the entire package is wrapped-up and mailed using Fed Ex, UPS, DHL, USPS or other mode of delivery of your physician’s choice and after the government Medicare workers complete processing and approving the claim, then the check is in the mail. Well, actually, not necessarily.

 

Medicare requirements are very particular and it will probably take some adjustment in meeting their standards and style requirements as well as quantitative and qualitative requirements as well as making sure that you utilize the perfect and correct forms for each specific set of procedures as well as the right entries for items utilized and which form for each procedure and a million other vitally important minutia; all of which will take a little period for adjustments. Then, and only then, things will move along smoothly for you, your physician and everyone involved. Of course, there is a faster means your physician might consider in order to make their reimbursement less painful and less time consuming, they might actually consider trying hiring somebody with experience in government forms and government lingo with a specialty in Medicare forms and formulations. Once the wrinkles have been ironed out, then will come the initial shock for your physician, the fact that he will be receiving less for each visit and delivered medical services than he may have become accustomed. With some fine-tuning of how he represents each service rendered and supplemental services required and other technicalities, your physician will be able to rectify some of the deficit he first encountered. The one thing he should be forewarned is that the government may decide to audit his practice if they suspect they might be cheating the government to increase his profit margin by cheating the government by charging for things either he did not provide or for items he did not use. What adds to the overall confusion is that government processing of claims and auditing of these same claims are actually somewhat subjective just as much as objective. That leaves some wiggle room, often some very noticeable wiggle room. Much of that is due to regulations written in order to protect, favor or punish specific items, procedures and a variety of other items and even people which often lead to regulations which are all too often contradictory with all too often vague wording such that things depend upon the person reviewing the same procedural sequence coming out with very different results. This also means that what applied one time might not be acceptable the next which makes for some difficulty complying with every regulation and requirement.

 

Senators Bernie Sanders and Elizabeth Warren

Senators Bernie Sanders and Elizabeth Warren

 

But let us leave all this aside and pretend that every provider is fully capable of meeting every wrinkle and requirement in the paper jungle which is government forms and requirements and understand and interpret every regulation with the greatest of ability. So, your physician is now a professional at all things government requirements, what could be the problem now? But what about these HMO, PPO and the rest of the alphabet soup of group coverage? Well, their problem will be to completely standardize treatments for every scenario and also make sure that the physicians itemize and document with great accuracy such that their administrative professionals can accurately file with the government. Our bet is that very quickly the idea of having your own private physician will very quickly become a thing of the past and most physicians will run and hide behind the bureaucracy of some group healthcare facility be it a hospital, clinic or HMO, PPO styled health provider. Yes, there will always be the pay for service providers who will be required to at the least file the Medicare paperwork despite taking an additional fee from their patients. Whether such will be theoretically permissible under the single payer government Medicare for all healthcare packages which the law suggested by Senators Saunders and Warren are suggesting is debatable because, as we all know, the government hates competition when taking over an industry. But there is another item which might allow for such care to exist, the wealthy are unlikely to be kind to having to accept the same level of care as the average person. As the wealthy are the meat behind campaign financing, our government representatives are extremely sensitive to their desires, wishes and comfort, and that means that the wealthy will be permitted their own better healthcare, thus, paying an additional fee to your personal physician will very likely be permitted or opting to go your own way and paying your physician as long as you also pay for government healthcare despite not taking full advantage of their wonderful services. But even all of this is not going to be the biggest problem because to assure that the majority of people end up in the government healthcare system, private health insurance will need to be made illegal across the board, which is why the wealthy will be paying directly to the physician for services and not purchasing an insurance plan. Further, the government will very likely allow membership hospitals charge their flat entrance fee either monthly or annually and any additional fees per service as required to continue to provide their services as long, again, as their members pay their Medicare fees to the government plan.

 

Finally, the people who will be hurt by any government healthcare system, where all health insurance is replaced by government payment of healthcare fees, is the health insurance company employees and the independent health insurance agents. From what we have read, this would include somewhere from two and a half million to three million people losing their employment. I can hear your claim that most of these people would be required to be hired by the government to do pretty much the same jobs they perform now. Well, that might be true if the only thing that health insurance employees ever did was process insurance claims. But there are also the salespeople, accountants, executives and likely dozens of other positions other than claims processing. Further, as the government will be the sole provider, and there being a number of healthcare insurance providers, the majority of these people employed by these companies will be out of work. There will be some new employees, enforcement investigators who will be sent to investigate fraud, and there will inevitably be fraud just as there is fraud now in Medicare and Medicaid. Then there are the last two and most frightening truths. With time, this care system will run into the same problems the other government healthcare systems already in use in the United States have, namely the “Veterans’’ hospitals and the healthcare system providing care of Native Americans in the various Reservations. This may be the absolutely most frightening reality of the entire healthcare prospects. There has to be a better system than using Medicare for all or any of the other European systems plus Canada, Australia and New Zealand.

 

We might suggest the Israeli system where everybody is required to have coverage and pay the healthcare tax. Here is where the Israeli system diverts from the others. There are four separate healthcare systems which are required to provide basic services by the government. Each of the four offers this basic set of services plus each choose a few additional services for their basic coverage. They each offer additional levels of service, say bronze, silver, gold and platinum (used for example only) which each provide additional services and prescription and other service coverages each for an additional fee to your provider. Physicians are required to provide a set number of hours of their practice to one of the national providers. They can then offer for fee services outside the system and collect fees as they desire to charge, if they are so motivated. This is most often taken up by specialists and surgeons. This also allows for those who desire to choose their own physicians outside of the basic providers to pay only the basic fee the government requires and then get all of their care privately. The four separate providers each are kept providing their services, including their additional service levels, at a reasonable rate as they are competing against one another. They also each provide separate additional plans leading to people choosing whichever of the four provide the services they are most likely to require. So diverse coverages, competition keeping fees low and physicians providing service to the general good before they can sell their services on the open market to earn additional fees. It provides the most for the least for the people and allows for physicians to make as much salary as they are able to command from an open market system as well. Everybody gets their advantages and all receive basic health coverage. Major Medical where hospitalization is covered for all is part of the system which appears to be much of what the United States is aiming to cover. There is one problem with the Israeli system, it is Israeli and that appears to disqualify it for some idiotic reason.

 

Beyond the Cusp

 

September 15, 2017

How to Kill Two with One Stone

 

If your aim is to cripple the United States and destroy its healthcare system with one idea, the left-wing of the Democrat Party is your place to be. If a Single-Payer Government Healthcare System is your desire, then the government will become almost exclusively a health care organization and abrogate all its other responsibilities. We are going to hear one lie repeated over and over during this debate quite often with a different nation place at the closure of the statement. Backers of the plan will claim, “Government run healthcare is used in every major Western nations and it works so well; just look at how well it works in (place your European nation of choice here). The problem is it has not worked in any nation without consequences, and the world cannot afford for the United States to fall for this trap and become just another collapsing European country. Inspecting each nation which has adopted Government Healthcare and some specifics become apparent to those wishing to see the truth.

 

The first and probably most important item of note is none of these nations has a decent military which could respond to any external threat. This has worked for Europe simply because they have NATO and NATO means the United States. Should the United States become just like Europe, then the entirety of the Western World becomes defenseless. That would leave Europe completely open to invasion by any of a number of enemies who do not care about their citizens but do care about their military forces. This brings to mind Russia, China and Iran right off the top of our heads. And as Iran has stated their desire to bring Europe to its knees bowing before Shia Islam, why not just invite them in and start the mass conversions and beheadings now. Why wait for the inevitable should there be no United States Army, Air Force, Navy and Marines? Allow the United States to fall for the Succubus of National Healthcare and she will become as weak as (place your European nation of choice here).

 

The main reason within the United States is the amount that taxes will need to be raised in order to have what will amount to Medicare for all. The first hurdle will be to get all the individual hospitals, physicians, clinics, HMO’s, PPO’s, EPO’s, POS’s and other various health plans to take Medicare style lowest cost for procedure payments. There will need at some point to pass a law which will make providing, receiving or paying for any form of healthcare outside the system to be heavily taxed. This will prevent the Middle Class from opting out of making the necessary payment into Medicare to belong and in its stead buying private healthcare at a private, government independent health providing system. This will never be made completely illegal, as the wealthiest five percent will still require their own competent best possible healthcare without traveling to Israel, India, Brazil or Mexico to receive their healthcare.

 

Meanwhile, the fee for receiving Medicare will start creeping upward leaving many elderly it was supposed to care for out in the cold without even basic care outside of Emergency Rooms. Taxes will also increase lowering the standard of living with every increase. The final stages will require the government to cut other programs in order to pay for healthcare costs which will continue to rise. The first cuts will endanger the military of the United States until the Navy becomes a shore patrol venture, the Air Force will fly only coverage of the United States skies, the Army and Marines an internal security force, the National Guard and Coast Guard will be absorbed into the Marines and Navy respectively and the Border Patrol absorbed into the Army. With time, even these will be drawn down to the point that the United States will barely be capable of guarding her borders.

 

 

After eviscerating the military and public Federal Protective Services, the government will begin to look elsewhere for funds. The Park Service, other social programs, anywhere and everywhere will become vulnerable and all the while, the quality of healthcare will fall. The physician pay will slowly be eaten away until nobody desires to become a physician, especially a surgeon or other specialist while nursing schools will become empty of students and healthcare will bleed and the number of places providing care will be eroded. Hospitals will be the first to close their emergency services and then their doors entirely. That will be the slow death of even the lowest denominator of decent care and the price will continue to skyrocket. Eventually the government will be forced to restrict service allowing only the most life threatening surgeries and other special services. Diagnostics will revert to the least expensive procedures and many actual diseases such as cancers will go undetected until far too late. Mortality figures will steadily climb and life expectancy steadily decline.

 

All of this will come at an ever-increasing cost with rising deductibles used as a way to discourage the use of the services which remain. When something is presumably provided for free, then it will be used to the point of abuse and beyond. This has been proven beyond debate using many government programs as the proof. Once the Federal Government ruled that all hospitals that receive government funds, that included Medicare and Medicaid and Veterans programs, were required to provide health services, particularly emergency room services, regardless of ability to pay for services, emergency rooms were swamped and hospitals who provided clinical services to the public found these clinics were used to replace normal physician visits costing hospitals from tens of thousands to tens of millions annually. Much of these care billings were passed by the Federal Government to the individual states who often were well behind or simply defaulted. What became basically free health care is what drove the hospital crisis threatening many hospital closings. This is one example of government health care and the inability to cover such costs. Another pair of prime examples are Veterans Hospitals and health care as well as Native American health care systems. Does anybody honestly believe that within a decade the same problems will not permeate any single payer government health care system?

 

Senators Bernie Sanders and Elizabeth Warren

Senators Bernie Sanders and Elizabeth Warren

 

Former Senate Finance Committee Chairman Max Baucus (Democrat from Montana) told NBC News “I just think the time has come. Back in ’09, we were not ready to address it. It would never have passed. Here we are nine years later; I think it’s time to hopefully have a very serious good faith look at it.” He subsequently added, “I started out by saying everything is on the table. But I did make an exception and that was single-payer. I said, nope, we’re not going to put single-payer on the table. Why? In my judgement, America was just not there … It’s branded as socialistic by too many people.” Baucus was the main centrist Democrat around which the Democrat opposition to Single Payer Government Health Care had been anchored. With his new position, these few remaining centrist Democrats no longer have anyone to take their position and hold the line. This would likely mean that the entirety of the Democrats in both houses of Congress will support the plan which Senators Bernie Sanders and Elizabeth Warren plan on submitting in the Senate this fall as the way of saving the nation from Obamacare. This is just one more prime example of the Congress creating a problem just to take more power and completely ruin what they first damaged beyond repair. How turning all of health care over to the same people who destroyed the best system for coming up with new drugs, treatments and cures the world has known for the past two centuries will improve it rather than bring its destruction is beyond us. The Democrats by voting as if they were a single block represented by their most-extreme leadership probably in history will only need approximately twenty-five Republicans in the House of Representatives and three in the Senate. With John McCain and his cohorts of “Never Trump” Senators consisting of about a half dozen, the Senate passing such a measure is assured, the House might be a little closer but as it appears that Speaker of the House Paul Ryan seeming to be colluding with the Democrats, the House would also likely pass such and that is the story if the people of America do not wake up fast and scream until the mountains crash. Without a popular uprising, single payer government health care, just like in Europe, will destroy the United States and leave the Western World all but defenseless.

 

Beyond the Cusp

 

November 22, 2013

Obamacare Working Just as Actually Intended

Everywhere you turn on the media, be it news coverage, late night entertainment, Comedy Channel faux news or virtually any talk show, you are hearing all about the failures of the Obamacare rollout and how literally thousands, hundreds of thousands and soon rumored to become millions losing their health insurance coverage largely because their current policy does not meet the stringent government mandated standards. Virtually everybody is treating all of the litany of disasters which is becoming the standard for all phases and measures of Obamacare as if they are either unintended consequences, results from measures which were mainly caused by miscalculations, overzealous application resulting from no clearly defined standards, or simply put none of the problems were intended, planned, foreseen or desired. Well, perhaps the media has gotten this as wrong as they have virtually everything else about President Obama and his entire agenda from their initial praise and infatuation with “Hope and Change” without even bothering to question Hope for what and Change what and how. Perhaps all of the problems with Obamacare including the disastrous computer site “healthcare.gov” with its cycle of having far more down time than operating normally, if anything with that site can be referred to as normal, has all been part of a delicately balanced, fully flushed out, intentionally plotted and insidiously nefarious plot and plan to destroy the entire private healthcare and health insurance industries in order to get to a completely different kind of healthcare imposed on the American people.

 

Believe it or not, but the entire Obamacare system with its thousands upon thousands of regulations, many of which are unfathomable to any sane person, is designed to ruin the health insurance industry initially and then, as a result of possibly the majority of Americans being forced from their present insurance coverage into the government provided insurance through the exchanges, placing a plurality if not majority of Americans on government provided health insurance and thus place their healthcare decisions under the thumb of government bureaucrats.  The initial proof comes when one considers the required coverage that must be included in from even the most basic plan all the way to the most expensive so-called Cadillac plans. Why must every insurance plan cover birth control pills, breast exams, prostate exams, prenatal care, and a complete list of either gender related items or age specific items with no exceptions even for single individuals whose gender makes such coverage ridiculous, not simply superfluous. There is but one logical reason to have a long list of gender, age and other very specific coverage to be required in every insurance package for it to be acceptable in the President’s plan. The Gender specific requirements would never be necessary for either one gender or the other yet they are still demanded to be in even plans for single adults. Age specific requirements are placed as requirements for insurance plans for all ages. Even items that have such a low instance of occurrence in certain age groups or either gender as to make it required makes no sense and which would seldom if ever be covered in any regularly issued health insurance plan has been included in Obamacare to make sure that the vast majority of health insurance policies in some way do not meet the specific and stringent required coverage demanded by the Patient Protection and Affordable Healthcare Act thus making them unqualified and thus their holders become uninsured fulfilling  the plan is to force all, or at least the vast majority, of these victimized people onto the government exchange insurance rolls.

 

What comes after such a large number of Americans are forced onto the exchanges and government regulated and run health insurance? Well, these plans are still backed by the health insurance companies but not all of those who were eligible to participate actually chose to pick up such coverage. The insurance companies who will underwrite the exchanges will likely find that payments will be delayed, contested, and eventually regulated so that the payments are made more affordable for the government when reimbursing the payment for care given. These companies can expect bureaucratic snags and the government contesting prices and other monetary remunerations and these insurance companies will soon find that their repayments have fallen so far in arrears that their very ability to make a profit will be in peril. Eventually the government will push many of these insurance companies into bankruptcy. Once this situation has made it so that the health insurance companies have refused to remain in the government system then the government will take over the responsibility for payment for all healthcare for those people still on the exchanges. With the government not being the most efficient system known to mankind, eventually there will be sufficient backup in making payments that hospitals and physicians will either end up financially destroyed or leaving the system and practicing on a cash only system. The government will make that illegal as soon as there are sufficient physicians and hospitals working independently from the now government healthcare payments and coverage that putting these renegade healthcare providers completely out of the system and business or begging to be reincluded under the government plans. This will cause sufficient boondoggle that the repayment of fees for coverage that the entire system will collapse under the weight and tangled inefficiencies and healthcare will be in complete disarray.

 

When this situation becomes dire enough and unworkable through planned obstructions to remuneration and payments the people will demand that the government do something as the healthcare system will truly be broken. That is when the salvation that will be offered will actually be the formalization of the very system that caused the problem, a single payer healthcare system under the auspices and whims of a fickle Federal Government. Once there healthcare will never return to anything even remotely close to the quality and quantity of healthcare which has been the benchmark of the American healthcare industry. Americans can forget any research producing new drugs, pioneering surgeries and treatments being formulated and perfected in the United States, efficiency which is among the best in the world or new innovated diagnoses. What can be expected is long wait times to see a physician, even worse wait times to see a specialist, delays in receiving surgery, managed care, refusal of care if deemed too expensive or risky by government agency which has no physicians or other healthcare workers on the committee, general delays in all forms of treatment eventually reaching the point that if one has the flu they will receive care within two or three weeks, eventually months, after they have completely recovered. If all of the Patient Protection and Affordable Care Act or Obamacare, pick whichever name you prefer, has not been discarded into the waste-can of lost causes totally repealing every aspect, every regulation and any other vestiges of this approaching intentionally designed and engineered disaster then we will be telling our children and grandchildren about the time in the seemingly distant past, though it will be only a very few years, when sick children were taken to see a doctor and be treated within hours or maybe a whole day and receive possibly lifesaving treatments and be healthy and outside playing even before we get to see a doctor these days. I hope no parent or grandparent ever needs to tell their sick child such sad and unnecessary stories, especially as an explanation of why they are still suffering from some formerly easily treated illness. The entire disaster in the making that is the plan behind Obamacare must not be allowed to claim future lives, especially of innocent children. This is an emergency intentionally being perpetrated on the American people who do not deserve such a threat to their healthcare and personal health.

 

Beyond the Cusp

 

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