Tuesday, October 23, 2012

10-21-12-This Election Matters - GET INVOLVED TODAY!

10-21-12 - Liability and Health Reform Update

Editor, Donna Baver Rovito

This periodic compilation of news and information about health care reform relies on numerous sources for he stories health care professionals and concerned citizens need to be well informed.

Periodic opinions or political comments are the editor's and the editor's alone and appear in blue italics. This eNewsletter is not affiliated with or financially supported by any advocacy organization or political candidate or group.

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To all,

Before you continue reading, this is a purely political issue of Liability and Health Reform Update. And this is just a gentle reminder that this newsletter is completely independent and an entirely volunteer effort on my part.

 In the past, there have been periodic misunderstandings about whether or not it's appropriate for me to "use Liability Update for political purposes." The simple answer is....well, sure it is, since it's basically my personal platform and mission to keep doctors and other health care professionals and interested people updated and informed about liability and health care reform issues....

 Please know that if you don’t want to receive emails from me about health care policy in the future due to political differences, that’s perfectly OK, and all you have to do is hit “Reply” and put “UNSUB” in the subject line, and I’ll remove your address from my list immediately.

 For those still reading…..It's important to note that elections have POLICY ramifications, which is why, from time to time, I have to "get political." It's a shame if that offends anyone, but I strongly believe that what will happen in the next several weeks, and what will happen as a result of what happens on November 6th, is far too important to NOT get political.

 Health care professionals seem to be particularly aware of that THIS election, and that's good, because they NEED to be. FAR too few people who actually take care of patients were involved in the creation of the health care law that MANY doctors, nurses, and other health care professionals are now fighting to REPEAL.

 Following are two links to get you involved with this year's election if you're a health care professional of ANY kind. The first is the Romney campaign's official national coalition for health care professionals, at which you can sign up to receive important campaign information or to volunteer. If you'd like to get involved, please do so.

 The second is a link to an "unofficial" Facebook Page – Health Care Professionals for Romney/Ryan 2012. (“Unofficial” means that the Romney campaign neither runs it nor pays for any costs associated with it.) I'm the administrator for the page, along with a few physicians and other health care providers. Please "like" the page to get news, information, and post your thoughts about the election and the new health care law. We'll also be posting information about specific action items health care professionals can DO to impact this election.

 Finally, there are several pieces following the first two links which have been created BY health care professionals for other health care professionals to use to reach out to friends, family, colleagues, and patients to impact the election.

 Some have been created by advocacy groups (D4PC and AAPS), while others have been crafted by individual doctors or other health care professionals who have simply reached out to their colleagues to support a mailer or a newspaper ad or letter to the editor, or a piece that doctors, dentists, veterinarians, podiatrists, optometrists, physician therapists and other health care providers can pass out to their patients, or in their waiting rooms, or put in staff lounges, etc.

 Please feel free to adapt any of these pieces, or the ideas behind them, for yourself and your own colleagues. Because patients are voters, and they CARE what YOU think. And the “power of the waiting room” is one of the vast, untapped resources available to health care providers to help you educate your patients about policies that ultimately benefit THEM!

 And here’s the bottom line: there is probably no time in recent history when it was more important for doctors to WORK TOGETHER to protect their profession and their patients as it is right now.

 Let me say that again:

 There is probably no time in recent history when it was more important for doctors to WORK TOGETHER to protect their profession and their patients as it is right now.

 The key here is the WORKING TOGETHER point.

 If you have questions, or would like to learn about additional ways to get involved, please contact me!

 Donna Baver Rovito
 Editor, Liability and Health Reform Update
 PA Coordinator, Health Professionals for Romney/Ryan 2012

 Healthcare Professionals For Romney – National Coalition Page:

 NEW Facebook Page:
 Health Care Professionals for Romney/Ryan 2012




 There will be Romney campaign materials available for doctors to pick up to distribute in offices, etc., at a location yet to be determined, this coming weekend at the PAMED House of Delegates meeting in Hershey, PA. Several PA physicians are coordinating this effort. Information will be available later as to where in the Hershey Lodge complex that interested physicians can obtain materials.


 Romney For President Announces Healthcare Professionals For Romney
 Mitt Romney Press | 9 October, 2012 - 13:00
 Boston, MA United States

 Romney for President today announced its Healthcare Professionals for Romney coalition.

 “I am pleased to announce the formation of Healthcare Professionals for Romney,” said Mitt Romney. “So much is at stake in this election, including the future of American medical care. Barack Obama put in place a massive governmental takeover of this vital sector of our economy. I am committed to repealing Obamacare and replacing this costly bureaucratic misadventure with a sensible reform that returns decision-making to states and localities, and patients and doctors. I am proud that so many distinguished physicians and members of the healthcare community, including my son Ben, have joined with me in a common cause for a better

 “I am so proud to join Healthcare Professionals for Romney,” said Ben Romney. “I know that my dad has the know how and the experience to turn around our economy. And as a doctor, I am as excited about his ability to turn around the healthcare industry. Healthcare costs have been on the rise for a very long time, and no big government program is going to stop it. We need real reform that focuses on doctors and their patients and that opens up more competition and more freedom in the healthcare market. It will take leadership to bring about that change, and I know there’s no one better for the job than my dad, Mitt Romney.”

 Honorary National Co-Chairs

 Sen. John Barrasso (WY)
 Sen. Tom Coburn (OK)
 Sen. Rand Paul (KY)
 Rep. David “Phil” Roe (TN)
 Rep. Nan Hayworth (NY)
 Rep. Andy Harris (MD)
 Rep. Phil Gingrey (GA)
 Rep. John Fleming (LA)
 Rep. Joe Heck (NV)
 Rep. Tom Price (GA)
 Rep. Rob Wittman (VA)
 Rep. Renee Ellmers (NC)
 Rep. Diane Black (TN)
 Rep. Anne Marie Buerkle (NY)
 Rep. Larry Buschon (IN)
 Rep. Bill Cassidy (LA)
 Rep. Michael Burgess (TX)
 Rep. Paul Broun (GA)
 Rep. Charles Boustany (LA)

 National Advisory Board

 Admiral Joxel Garcia M.D., USPHS (Ret.), Former Assistant Secretary for Health
 Josefina Carbonell, Former Assistant Secretary for Aging, U.S. Department of HHS.
 Rear Admiral (Ret.) Arthur J. Lawrence, Former U.S. Assistant Surgeon General
 Rear Admiral (Ret.) Ben F. Gaumer, Former Navy Assistant Deputy Surgeon General
 Dr. Stephanie Haridopolos (FL)
 Lt. Gov. Jane Norton (CO)
 Jeffrey Dorsey, CEO of Health One (CO)
 Dr. Nick Pandelidis (PA)
 Dr. Siobhan Dunnavant (VA)
 Dr. Miguel Machado (FL)
 Dr. Greg Henderson (FL)
 Dr. James Davies (CA)
 Dr. Greggory DeVore (CA)
 Dr. Daniel Durrie (KS)
 Please watch and share this 30 second commercial:

 Nothing's Free
 President Obama's healthcare law has come at a high cost. Whether it is taxing wheelchairs and pacemakers or cutting Medicare, free healthcare has come at a very high price.

 NEW Facebook Page:
 Health Care Professionals for Romney/Ryan 2012

 Support Romney/Ryan 2012 to REPEAL ObamaCare and replace it with free market measures that will actually work.

 Please "Like" our Facebook page to get regular news and information about the race, ObamaCare, and what health care professionals can do to make a difference!


 And while you're on our page, please post why YOU support the candidates who will repeal ObamaCare and why. Please include your name, specialty, and where you practice.



 ((A Pennsylvania orthopedic surgeon, Dr. Nick Pandelidis from Lancaster, spearheaded this Undecided Voter postcard, which due to his efforts and those of a few others will be sent to 21,000 undecided voters in PA, funded entirely by the 42 PA physicians whose names follow the text. Astoundingly, there were others who wanted to participate, but missed the deadline. Plus, a group of doctors in
Ohio have gotten together to fund sending out the same piece to 29,000 undecided voters in their state!

 The text of the piece follows – please feel free to use it to distribute to patients in your office, colleagues, as a letter to the editor, etc., adding your own name and location.))

 Dear Voter,

 We are a group of unaffiliated
physicians who felt compelled to send you this health care warning. Most of us have avoided expressing political views to our patients in the past, but now feel we have no other option. Unfortunately, politicians have inserted themselves into our exam rooms, threatening your health and our ability to care for you.

 While our country unquestionably requires health care financing reform, the President’s health care law will hurt patients rather than help them. It is a bureaucratic nightmare that infringes on medical decision making and violates the patient-physician relationship:

 • President Obama’s law slashes $716 billion from Medicare, which will decrease seniors’ access to physicians and health care services.
 • Nearly 20 million new patients will be dumped into substandard Medicaid programs which are already bankrupting states while federal mandates will increase the cost of everyone's health insurance.
 • Obamacare's Independent Payment Advisory Board (IPAB), a new unaccountable, unelected board of 15 federal bureaucrats, will impose centralized Medicare budgeting restrictions that will result in de facto age-related rationing of services.
 • 30 million Americans will STILL be uninsured by 2019, and much more.

 So we are asking you to please vote for Mitt Romney for President and Tom Smith for U.S. Senate. They are committed to repealing Obamacare and replacing it with patient-centered (not bureaucrat-centered) reforms that will lower costs, improve access, and preserve the sanctity of the patient-physician relationship.

 Your family's health depends on your vote.

 Thank you!

 Concerned Physicians for Pennsylvania's Health

 Domingo Alvear, M.D., Pediatric Surgery, Harrisburg
 Dan Bledsoe, M.D., Emergency Medicine, York
 Richard Boal, M.D., Orthopaedics, Camp Hill
 Marsha Bornt, M.D., Gynecology, York
 Tim Campbell, M.D., Internal Medicine, Pittsburgh
 Arvind Cavale, M.D., Endocrinology, Feasterville
 George Chovanes, M.D., Neurosurgery, Paoli
 Bhaskar Deb, M.D., Anesthesiology, Reading
 Luciano DiMarco DO., General Surgery, Harrisburg
 Cheryl Doland, M.D., Anesthesiology, York
 Jonathan Dranov, M.D., Internal Medicine, State College
 Elena Farrell, D.O., Ophthalmology, Harrisburg
 Raymond A. Fritz, Jr., D.P.M., Podiatry, Allentown
 Cora Gemil, M.D., Gynecology, West Chester
 Ann Greiner, M.D., Anesthesiology, Camp Hill
 Lynn Jensen, M.D., Emergency Medicine, York
 Peter Kummant, M.D., General Surgery, Pittsburgh
 George Lapes, M.D., Psychiatry, York
 Jenny Lee, M.D., Family Practice, Palmyra
 Cliff Lynd, M.D., Vascular Surgery, York
 Evan Madianos, M.D., Radiology, Philadelphia
 James McManaway, M.D., Ophthalmology, Hershey
 Brian Michael, M.D., Endocrinology, Gettysburg
 Michael Moritz, M.D., Orthopaedic Surgery, York
 Julie Nickles, D.O., Family Practice, York
 D. Scott Nord, M.D., Orthopaedic Surgery, Wyomissing
 Nick Pandelidis, M.D., Orthopaedic Surgery, York
 Steve Pandelidis, M.D., General Surgery, York
 Phyllis Parcella, M.D., Anesthesiology, Reading
 William Parrish, M.D., Orthopedic Surgery, Lancaster
 Danae Powers, M.D., Anesthesia, State College
 Sam Rashid, M.D., Family Practice, Palmyra
 Peter Rovito, M.D., General Surgery, Allentown
 John Salus, D.O., Anesthesiology, Camp Hill
 Benjamin Schlechter, M.D., Plastic Surgery, Wyomissing
 Alan Schorr, D.O., Endocrinology, Langhorne
 Mike Sicuranza, M.D., Orthopaedic Surgery, York
 Jim Srour, M.D., Gastroenterology, York
 Christine Stanko, M.D., Dermatology, Bryn Mawr
 Elena Volfson, M.D., Psychiatry, Haverford
 Steve Wolf, M.D., Orthopaedic Surgery, Harrisburg
 Wayne Wrigley, M.D., Radiology, Chester County  


 ((From our creative friends at Docs 4 Patient Care – these are available online to download and print off to hand out in your waiting rooms, at meetings, etc. There is no charge to download these materials. Or take to your favorite printer. There’s a post card which can be a handout OR a mailer, posters, and a detailed tri-fold brochure. OR, you can go online and order the materials already printed. Many thanks to Dr. Hal Sherz and the leadership and staff at D4PC for designing and making these outstanding resources available.))





 11x17 -

 Template - 24" x 36"


 Template - Outside


 Template - Inside







((From our good friends at the Association of American Physicians and Surgeons (AAPS) – print these letters off on your letterhead, sign your name, and pass them out in your waiting room – they’re free and available for your use. Kudos to Dr. Jane Orient, Dr. Alieta Eck and the hardworking and noisy docs at AAPS for anticipating the need and meeting it!))

 This Election Is Critical:
 Educate Your Patients and Employees

 Dear AAPS Members & Friends:

 I was stunned to learn, from a casual conversation with an acquaintance, that he really thinks this election is about Big Bird--or in his case, subsidies for the symphony!

 Your patients respect your opinion. Here is a short version and a long version of a letter you could place in your reception room. Please borrow and use as you like!


 Jane M. Orient, M.D.
 AAPS Executive Director



 My Valued Employees and Patients:

 I hope that when the New Year comes, I will still be here to sign your paycheck or to serve you when you are ill.

 But a lot depends on the outcome of the election.

 While I cannot tell you how to vote, I strongly urge you to consider all the issues carefully and to exercise your right to vote. And be sure that you, your family, friends, fellow parishioners, and other like-minded people are registered to vote and do so.

 As I see it, the one over-riding issue is the need to repeal ObamaCare. There are a couple of pages, constantly talked about, that many people like. And more than 900 pages that they wouldn’t like, if they knew about them. Most of these won’t be in effect until 2014—too late to influence the election.

 Obama has repeatedly promised that if you like your insurance plan or your doctor, you can keep them. But only, of course, if they are still there. ObamaCare is driving up insurance premiums and even outlawing the most economical policies. ObamaCare is forcing independent doctors out of practice altogether, or into employment by big organizations, to whom you are a cost, a liability, even an annoyance.

 The other thing that might not be there is your job. ObamaCare costs are causing many employers to cut the number of workers and avoid hiring new ones.

 Find out how your candidate would vote on repealing ObamaCare. And remember: if he or she is a Democrat running for Senate it might not matter. The Senate is under one-party, virtually one-man rule. If Harry Reid won’t bring an issue to a vote, your Senator can’t vote on it.

 The House of Representatives has voted some 30 times to repeal ObamaCare. This will not even come to a vote in the Senate and will surely be vetoed by the President if there is not a change in the majority party in the Senate or the occupant of the White House. That’s why party affiliation is of unprecedented importance this year.

 If you have questions, ask me. I would be delighted to discuss the issues with you, and provide more information.


 Your Doctor



 My Valued Employees and Patients:

 I am very worried about the future of our country. We are facing a “fiscal cliff” in January, in which things in our already stressed economy could rapidly get much worse. Much depends on the outcome of the election. While I cannot tell you how to vote, I strongly urge you to consider all the issues carefully and to exercise your right to vote.

 I would like to present some facts that you may want to take into consideration. We are all in this together, although the current administration and the press have created an environment that pits employers against employees, doctors against patients, the “rich 1%” against everyone else—as the government “spreads the wealth around.”

 A huge part of the problem concerns the one-seventh to one-sixth of the economy called “healthcare.” People are very worried about the future of their medical care.

 ObamaCare promises to solve the problems in our medical system. It promises to lower costs, to cover everyone or nearly everyone, to improve quality, and to allow you to keep your insurance plan or your doctor if you like them. You have probably heard about pre-existings and 26-year-old children many times. Those two popular pages come with nearly 1,000 other pages that people dislike when they learn about them.

 The Congressional Budget Office’s estimated cost has already more than doubled. The “savings” from taking money out of Medicare payments are now $716 billion.
 The costs of insurance premiums have gone up about $3,000, and many employers may drop their workers’ insurance plans. The premiums may be much greater than penalties for dropping coverage. One way to decrease penalties is to lay off workers. Many workers will wind up on Medicaid.

 Many believe that physicians are among “the 1%.” Some even say that American medicine is more expensive than European medicine because doctors make too much money. I won’t ask you to feel sorry for physicians, but you might like to know that the costs of running a practice siphon off 60% or even more of all revenue. With ObamaCare, bureaucratic compliance costs will go up, and revenue will go down.

 Many physicians love their practices and their patients so much that they have been subsidizing their payroll and office expenses from their savings, but this cannot continue indefinitely. Physicians are selling their practices to hospitals or other large entities or even retiring altogether. What this means to you as a patient is that you may not be able to keep your doctor because he simply won’t be there.

 Alternately, your doctor might be there but he might not be working for you. He will rather be dependent on a payout from an accountable care organization, which is focused on decreasing total expenditures and eliminating “disparities.” That means redistributing care from the patients who need it most to those who best serve to meet the plan’s “quality” and cost objectives.

 It is believed by the Administration that at least a third of the care that is rendered to Medicare patients is unnecessary. This may mean that your hip replacement, your cataract surgery, or treatment of your heart disease or pneumonia is among the unnecessary costs—or perhaps “futile” costs because you are after all frail and elderly and have many chronic conditions and cannot be restored to a robust state of health.

 The House of Representatives has voted some 30 times to repeal ObamaCare. This will not even come to a vote in the Senate and will surely be vetoed by the President if there is not a change in the majority party in the Senate or the occupant of the White House.

 You may recall from reading George Orwell’s classic book Animal Farm that as problems on the farm grew more and more severe, the good old workhorse named Boxer decided that he would just work a little bit harder. Ultimately, however, he could no longer carry the load and was sent to the glue factory.

 Our country is in dire financial straits. “Asking the rich to pay a little more” is not going to solve the problem. We must unleash the forces of free enterprise in the economy so that the economy can grow, generating wealth and productive enterprise.

 I think the choices in this election are pretty stark: Between those who plan to increase the load on the productive area of the economy and extract more and more to be redistributed to less productive sectors or individuals—or those who believe that we need to unleash the forces of freedom. We need to have all of our nation’s talented and productive people working as hard as they can and investing their capital, rather than deciding to quit while they are still a little bit ahead.

 ObamaCare is an experiment—of a type that has always failed—and we are the guinea pigs. But once the current system is destroyed, there is no going back.

 Will your candidate vote to repeal ObamaCare? Or does he want to redistribute your wealth and your care? Please think about these issues. Talk to your friends, family, and associates. Do not be distracted by talking points or by promised benefits that politicians simply cannot deliver when we’re already $16 trillion in debt. The future of our country, including the lives of your children and grandchildren, depend on you.

 I hope that when the New Year comes, I will still be here to sign your paycheck or to serve you when you are ill.

 If you have questions, ask me. I would be delighted to discuss the issues with you.


 Your Doctor


 Ohio Doctor Spearheads Physicians’ ObamaCare Ad Campaign

 ((This articulate Ohio
physician has given doctors throughout the nation blanket permission to use his piece and add their own names to his in their own communities. Doctors, most of the work is already done - all YOU have to do is raise the money and buy the ads. Or, if you live in an area with a small weekly paper, you might be able to persuade them to run it as an op-ed. Smaller papers are always looking for content. Most larger papers won’t even consider a piece this long, which is why Dr. Naffah and his colleagues BOUGHT ADS. That way, editors couldn’t limit what they said.))

 Dr. Farid Naffah wrote and paid to have the below letter printed in Ohio newspapers:

 The Risks and Perils of Obamacare
 Oct 19, 2012

 Many of those who cheered in March 2010, when the Affordable Care Act was signed into law, continue to be bamboozled by its promise. As details of the plan have emerged, however, a large number of people have changed their minds, realizing that what was pledged is an administrative and fiscal disaster, bringing higher health care costs, a severe physician shortage, and the rationing of medical services. In brief, a recipe for mediocrity.

 If all you know about Obamacare is that it will provide insurance to 32 million Americans who don’t have it; that patients with pre-existing conditions may not be excluded from coverage; that certain screening procedures are offered without co-payments, and that children may remain on their parents’ plan until the age of twenty-six, you would have no reason to fear or oppose it. Sadly, that is exactly where the Obama White House wants you to be: in sheer ignorance of the innumerable provisions that make up the 2,700 pages of the law. A law that directs you to providers you may not choose or even like, that forces you to pay more for the services you receive and that decides what level of care is suitable for you. Most disturbingly, it is a law that subjugates your doctors’ judgment-and their livelihood-to bureaucratic authority. Those whom you have come to regard as the guardians of your health will have other motives than to preserve or improve it.

 If the Affordable Care Act is not socialized medicine it will of necessity lead to it, by the exercise of regulatory mechanisms and fiscal pressure. Medicine will no longer be a liberal profession, but a government job, where your physician’s desire to excel in the delivery of care will cede its place to the fulfillment of government imposed requirements, the adherence to imperious rules and the fear of retribution.

 In a first phase, Obamacare eliminates private physicians and consolidates the practice of medicine around hospital institutions. President Obama once promised “If you like your doctor, you can keep him.” What he omitted to mention is that, sooner or later, your doctor will go out of business.

 The Affordable Care Act prohibits physicians from owning hospitals and implements measures to cripple and bankrupt their practices. Drastic cuts in reimbursement and a slew of new regulations have already led to the closing of many free-standing facilities or their acquisition by neighboring hospitals. Regulations have escalated to the point that full compliance has become virtually impossible. Physicians’ offices are raided on a massive scale and systematically audited to recover monies allegedly paid in wrongful billing. Impropriety is quickly adjudicated and called fraud to justify the huge fines which are then imposed. The intimidation and the resulting financial strain often lead physicians to close their practices. Auditors entreated with that task are compensated with a generous portion of the fines they collect, leaving little doubt as to their incentives. This is absurd in any free society but many physicians capitulate, in fear of retaliation. Those who contest the ruling do so at their own expense and, when victorious, can only hope to recover the fines they paid.

 That state of affairs, buttressed by media sensationalism and its unrelenting attack on the medical profession, unfortunately lends credence to the notion that physicians are somehow responsible for Medicare’s fiscal insolvency, a ridiculous notion, but one that furthers the Obama administration’s agenda to strip them of practice ownership and make them employees. Many have already resigned themselves to the new fiscal reality and hasten to avert the inevitable collapse. As they quietly surrender their practices for a hospital job, often in bitterness and depression, they put a pragmatic face on their decision. They soon find themselves trapped into roles they never wanted or felt prepared to assume. They become demoralized, sometimes rancorous, as they enter a world ruled by bureaucrats who, generally, don’t have a fraction of their education, their training or their experience. Yet, a hospital CEO typically earns north of a million dollars, sometimes several million. Other administrators are also generously remunerated but an internist can only hope for a $150,000 annual salary.

 Medical education and training is an arduous and lengthy process, requiring anywhere between seven and thirteen years after college, and its cost is exorbitant. Few students faced with the prospect of a career under Obamacare will sacrifice their youth to study medicine, while incurring a greater than $200,000 debt. First year earnings are often higher for MBA and law school graduates than for primary care physicians, with four or five fewer years committed to the study of their discipline, and their quality of life is certainly more appealing. They don’t work evenings, weekends or holidays, and rarely, if ever, do they have to face a lawsuit.

 It should therefore come as no surprise that, according to a recent survey, nine out of ten physicians currently dissuade their children from pursuing a career in medicine. The desirability of a medical career is nowhere better reflected than in the plummeting number of applications to medical school during the last generation. The quality of medical education will undoubtedly decline and the AAMC (Association of American Medical Colleges) predicts that by the year 2025, there will be a physician shortage of 160,000. What that means is that nearly one of five people will have insurance coverage but no access to health care. The reality is probably even bleaker, as disillusioned physicians, by then all employees, will have cut their hours, become less efficient and less productive, lost their desire for excellence and taken early retirement.

 When health care is not accessible, many will have to go without it, suffer or die. When physicians cannot be found in their offices and a growing population who demands care cannot be served, emergency rooms will be flooded, crowding out the critically ill, and lines will form at their doors. Those who were around in the late 1970s will remember with bitter nostalgia the long lines that formed at gas stations during the Carter years.

 What happens when a physician’s practice is acquired by a hospital is that the cost of health care soars. So much so that you will quickly long for the days when a mammogram and a screening colonoscopy entailed a small co-payment. Hospitals are compensated by Medicare and private insurers at rates far higher then the modest payments made to private physicians. For example, a routine visit which runs seventy dollars at your private doctor’s office will cost over $120.00 when that office becomes part of the hospital outpatient department. An echocardiogram, which costs $373.00 in a cardiologist’s office may bring in $1,600.00 when that office enjoys the hospital outpatient designation. A colonoscopy, reimbursed at a flat facility fee of $350 in an ambulatory center, easily reaches three times that amount when charges are itemized under the hospital label.

 In today’s economic reality, most patients with private insurance have large deductibles, ranging from $2,000 to $5,000 dollars. The increased cost burden incurred by hospital billing becomes the patient’s responsibility until the deductible is met and, even after that, co- payments remain considerably higher. Insurance premiums will therefore continue to rise, to accommodate the higher charges, and will set the stage for rationing. There just isn’t enough money to go around.

 Yet even so, Obamacare will continue forcing physicians out of their practices, by pressuring them to join accountable care organizations (ACO), and that will effectively dismantle the patient-physician relationship. The ACO is a new government-imposed structure, a group of physicians, in charge of delivering care to a certain population of patients. Its stated goal is to improve quality, by the fulfillment of preset criteria, and cut cost, by coordinating care amongst physicians and eliminating waste. ACO’s indeed have a financial incentive in cutting cost as they retain a portion of the savings they realize. Accordingly, physicians will find themselves in the uncomfortable position of denying care in the name of fiscal responsibility. Their obligation to their patients may be compromised by their loyalty to the group and the pressure to save may overtake the commitment to heal. Inferior care will rear its ugly head and frown upon unwilling partners in this new pact of negotiable morality.

 We will thus have established a new standard, one that the government will hail as thoughtful and well proportioned, that hospital administrators will label as coordinated and aptly delivered, and that regulators and accreditation agencies will honor as compliant. Regardless, the rest of us will recognize the new standard for what it really is: medical mediocrity.

 Contrary to what its name suggests, the Patient Protection and Affordable HealthCare Act neither protects patients nor is affordable. It only protects a new mammoth bureaucracy created to enforce the law by pilfering precious healthcare dollars. Innumerable agencies and boards will rise to administer those changes, i.e. provide insurance coverage to residents of each state, including illegal immigrants, and no fewer than  16,500 new IRS agents will be hired to monitor abidance by the law. Hundreds of billions of taxpayer dollars will be seized from the Medicare fund and squandered to support the new bureaucracy, seriously imperiling the treatment of seniors. And if that were not enough, the law imposes scores of new taxes and tariffs on individuals and businesses, most of which will hit the middle class.

 Furthermore, patients are far from protected. In fact, their rights are trampled upon as new paradigms are applied to the management of their health and they are forced to pay for services they find morally reprehensible.

 Supporters of the bill, including our congressional representatives, were dangerously misinformed about its contents and its devastating effects. The president and his allies preached that universal coverage was a moral issue but were careful to avoid discussion regarding the methods they would use to achieve it and the bleak future those methods portend on the quality of care, not to mention the economy. They wanted you to believe that just because the idea was good, the bill was sound.

 We would like to remind those fervent believers that support of the Arab Spring also seemed honorable and lofty but its execution proved foolish and calamitous. Those naive enough to trust the unfailing wisdom of government surely remember that sub-prime lending allowed many to achieve the American dream but led to the largest financial crisis in recent history. Misplaced generosity ushered the way to collective insolvency. Not only did the beneficiaries pay dearly but society went down with them. The plan was ill-conceived, its prosecution bungled. Similarly, not only will the health care law fail to bring good medicine to the newly insured, it will deprive everyone else of the quality care they have so far enjoyed.

 “If what Romney and Ryan say about Medicare is true, how come our plan is endorsed by the AMA (American Medical Association), the ‘national’ American Hospital Association and, most importantly, the AARP (Association of American Retired Persons)”, challenged Vice- President Biden in a recent campaign speech in Fort Myers, to an innocent and cheering group of supporters. Were they to infer that those organizations, perhaps by virtue of their names, are somehow the defenders of our rights, the guarantors of our morality? AARP is in the business of selling insurance and expects large profits from Obamacare’s onslaught on Medicare Advantage plans. Hospitals, the big winners in the Health Care Act, will see their coffers swell as doctors become their employees and patients pay more for services. Even catholic hospitals have embraced the law, while the Catholic Church is suing the federal government over it. As to the American Medical Association, far from representing physicians, with fewer than 17% holding membership, it survives on government funds. Mr. Vice-President, we are not stupid.

 In her address at the Democratic National Convention, Health and Human Services Secretary Sibelius declared that, for Democrats, Obamacare was a “badge of honor”. But if it is so wonderful, why have so many companies and organizations been exempted from it? Secretory Sibelius’ words betray her true sentiments, for the passage of the Affordable Care Act was purely a political victory, achieved solely by one party, without a single vote on the other side of the aisle. Such a political victory was hardly a way to bring the country together. It is fiscally catastrophic, the ruin of Medicare as we know it and, what is worse, the harbinger of the most dreaded consequence in a country where health care has been the envy of the world: medical mediocrity.

 Last year, Ohioans voted by a two-third majority to opt out of Obamacare. Today, that majority would be even greater. By 2015, when the law is fully implemented, ACOs have burgeoned around the country, to which patients are assigned without their knowledge, the IPAB (Independent Payment Advisory Board) is rendering decisions on the care to which you are entitled, and doctors are totally demoralized, few if any, will want the law upheld. The law must be repealed. Unfortunately, that will be impossible if President Obama is elected to a second term.


 Paid for by the above named doctors, written by Dr. Farid Naffah, Warren, Ohio 44484


 From the New York Post:

 ((This piece is by a fairly famous doctor who did NOT give us permission to borrow his words, but we can certainly pass them along with his name and a link to the original source, just to keep things legal.))

 Why doctors hate ObamaCare
 Last Updated: 12:38 AM, October 16, 2012

 I hope one of my colleagues is in the audience at tonight’s debate to ask a question about how ObamaCare is taking medicine in the wrong direction.

 You see, there comes a point where we doctors can no longer afford to stay in practice. We rely on an unfettered environment to provide creative health-care solutions. This is why survey after survey (most recently one by The Physician’s Foundation) show that ObamaCare is highly unpopular among physicians.

 Under ObamaCare, we’re being asked to provide the same high-tech service with more restrictions and regulations to more patients and to be paid less for doing so.

 Do you honestly think that a cardiologist who is being paid $280 by Medicare for performing and interpreting the same echocardiogram he was paid $560 for two years ago is happy?

 How do you think he will feel if the test he trained for many years to learn is suddenly ruled excessive by ObamaCare’s new Medicare Independent Payment Advisory Board?

 ObamaCare probably means fewer doctors, too. In the Physicians Foundation Survey of 13,000-plus physicians, more than half plan on cutting back on patients, switching to cash only or quitting over the next three years — thanks largely to the president’s “reform.” Indeed, 60 percent say they’ll retire if they can.

 Doctors don’t see their opposition to ObamaCare as political, but rather a justified response to being manipulated without our permission. We may be a special interest group, but many doctors don’t feel that the American Medical Association, which supported ObamaCare, truly represents our interests. That’s why only 15 percent of practicing physicians are AMA members.

 It is hardly surprising that a new Jackson Healthcare survey of over 3,000 doctors shows that 55 percent of doctors surveyed plan to vote for Mitt Romney, and only 36 percent support President Obama.

 Mind you, while 35 percent of the physicians surveyed identified themselves as Republicans, 24 percent were Democrats and 26 percent were independent, thus it’s significant that a majority are voting for Romney.

 The reason for the change is the Affordable Care Act. A full 55 percent of doctors surveyed said they’d repeal and replace it, as Romney says he would, compared to only 40 percent who said they’d implement and improve it.

 Doctors have every reason to vote against the mastermind behind a law that makes it harder for us to practice medicine. Our concerns should not be taken lightly.

 We may be a relatively small special interest group, but we happen to be attached to one of the largest groups: our patients.

 Dr. Marc K. Siegel is a professor of medicine and medical director of Doctor Radio at
NYU Langone Medical Center, and a Fox News medical correspondent.



 From the Official Campaign Website:
 ((In case someone asks you what Gov. Romney would replace ObamaCare WITH:))

 The Health Care Page under Issues:

 Health care is more than just one-sixth of the American economy. It is an essential source of well-being for individuals and families.

 Our health care system is blessed with many extraordinary strengths. It produces and attracts the best and the brightest across all fields of medicine, and provides unparalleled innovation, choice, and quality of care. But it also faces significant challenges: high cost, inefficiency, inconsistency, and tens of millions of Americans lacking insurance coverage. We can fix these problems.

 Obama's Failure

 Unfortunately, the transformation in American health care set in motion by Obamacare will take us in precisely the wrong direction. The bill, itself more than 2,400 pages long, relies on a dense web of regulations, fees, subsidies, excise taxes, exchanges, and rule-setting boards to give the federal government extraordinary control over every corner of the health care system. The costs are commensurate: Obamacare added a trillion dollars in new health care spending. To pay for it, the law raised taxes by $500 billion on everyone from middle-class families to innovative medical device makers, and then slashed $500 billion from Medicare.

 Obamacare was unpopular when passed, and remains unpopular today, because the American people recognize that a government takeover is the wrong approach. While Obamacare may create a new health insurance entitlement, it will only worsen the system’s existing problems. When was the last time a massive government program lowered cost, improved efficiency, or raised the consistency of service? Obamacare will violate that crucial first principle of medicine: “do no harm.” It will make
America a less attractive place to practice medicine, discourage innovators from investing in life-saving technology, and restrict consumer choice.

 In short, President Obama’s trillion dollar federal takeover of the
health care system is a disaster for the federal budget, a disaster for the constitutional principles of federalism, and a disaster for the American people.

 Mitt's Plan

 On his first day in office, Mitt Romney will issue an executive order that paves the way for the federal government to issue Obamacare waivers to all fifty states. He will then work with Congress to repeal the full legislation as quickly as possible.

 In place of Obamacare, Mitt will pursue policies that give each state the power to craft a health care reform plan that is best for its own citizens. The federal government’s role will be to help markets work by creating a level playing field for competition.

Restore State
Leadership and Flexibility

 Mitt will begin by returning states to their proper place in charge of regulating local insurance markets and caring for the poor, uninsured, and chronically ill. States will have both the incentive and the flexibility to experiment, learn from one another, and craft the approaches best suited to their own citizens.

 * Block grant Medicaid and other payments to states
 * Limit federal standards and requirements on both private insurance and Medicaid coverage
 * Ensure flexibility to help the uninsured, including public-private partnerships, exchanges, and subsidies
 * Ensure flexibility to help the chronically ill, including high-risk pools, reinsurance, and risk adjustment
 * Offer innovation grants to explore non-litigation alternatives to dispute resolution

 Promote Free Markets and Fair Competition

 Competition drives improvements in efficiency and effectiveness, offering consumers higher quality goods and services at lower cost. It can have the same effect in the health care system, if given the chance to work.

 * Cap non-economic damages in medical malpractice lawsuits
 * Empower individuals and small businesses to form purchasing pools
 * Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage
 * Facilitate IT interoperability

 Empower Consumer Choice

 For markets to work, consumers must have the information and the power to make decisions about their own care. Placing the patient at the center of the process will drive quality up and cost down while ensuring that services are designed to provide what Americans actually want.

 * End tax discrimination against the individual purchase of insurance
 * Allow consumers to purchase insurance across state lines
 * Unshackle HSAs by allowing funds to be used for insurance premiums
 * Promote "co-insurance" products
 * Promote alternatives to "fee for service"
 * Encourage "Consumer Reports"-type ratings of alternative insurance plans


 From National Review
 What Romney Needs to Say About Romneycare

 By Mona Charen
 ((This is the best response to accusations that ObamaCare is based on Gov. Romney's plan in Massachusetts.))
 Romney aide Eric Fehrnstrom's blunder -- telling an interviewer that Romney believes the individual mandate is not a tax -- was politically dumb, if revealing. It suggests that the Romney camp continues to struggle with the ghost of Romneycare. Romney's subsequent attempt at clarification, saying that it's a tax because the Supreme Court said it is, though, "I agreed with the dissent," succeeded only in further confusing matters.

 The campaign desperately needs clarity on this issue. It needs also to shake that worrying tentativeness on Romneycare -- a timidity that suggests to voters that Romney has something to hide.

 The answer to the question: "Wasn't Romneycare exactly the same thing as Obamacare?" is, to quote Nancy Pelosi, "Are you serious?" The
law contained an individual mandate, which states -- unlike the federal government -- are allowed to impose. But it did not consist of 2,700 pages of new regulations; 159 new boards and commissions; and more than $500 billion in new taxes (and counting); the Independent Payment Advisory Board, a rationing board whose decisions are unreviewable by the courts and practically untouchable by Congress itself; restrictions on religious liberty; Medicare cuts; affirmative action mandates for medical and dental schools; huge new authority over one-seventh of the U.S. economy for the Secretary of Health and Human Services; and open-ended regulations of the way doctors and others perform their jobs.

 Beyond that, a glance at the history of Romneycare in
shows that Romney's instincts and initiatives were for free-market reforms. An 85 percent Democratic legislature thwarted his best efforts, and a Democratic successor as governor twisted the law's trajectory dramatically.

 Before Romney's time,
had enacted a number of laws that made its health care system needlessly expensive. All policies offered in the state were required to cover expensive treatments such as substance abuse counseling and infertility. In 1996, the state passed a law requiring "guaranteed issue" and "community rating" -- meaning people could wait until they got sick to purchase health insurance. Naturally, rates skyrocketed. In addition, a 1986 federal law required hospital emergency rooms to treat all patients, regardless of ability to pay.

 Romney's idea was to permit
insurers to sell catastrophic plans. As Avik Roy explained in Forbes, "Shorn of the costly mandates and restrictions originating in earlier state laws, these plans, called 'Commonwealth Care Basic,' could cost much less. Romney also proposed merging the non-group and small-group markets, so as to give individuals access to the more cost-effective plans available to small businesses." Romney's plan would also have involved a degree of cost sharing so that those receiving subsidies would have an incentive to minimize their consumption.

 Romney agreed to the mandate, believing that
citizens would get the opportunity to purchase inexpensive, catastrophic plans. But the legislature, together with Romney's successor as governor, Deval Patrick, changed the law to require insurers to offer three tiers of coverage -- all of them far beyond catastrophic care. Perhaps Romney ought to have foreseen what future legislatures and governors would do -- but that's a far cry from the accusation that Romneycare was indistinguishable from Obamacare.

 Romney's proposed reforms included fraud prevention measures for Medicaid, requiring the income of both parents to be considered in children's Medicaid eligibility, medical malpractice tort reform, and giving individuals the same treatment as small businesses in the purchase of health plans. He envisioned a system of increased competition and choice.

 The bill that passed the legislature contained a number of features Romney couldn't countenance. He opposed the mandate, preferring to permit individuals to post a $10,000 bond in lieu of insurance. The legislature overrode him. He vetoed the employer mandate, coverage for illegal aliens, the creation of a new bureaucracy to be called The Public Health Council, a provision limiting improvements to Medicaid, and one expanding Medicaid coverage to include dental care. His vetoes were overridden.

 The health reform law Romney introduced -- as opposed to the one that was implemented by his successor -- stressed competition, reduced regulation and expanded choice for the consumer.

 It was a mistake for Romney to sign the bill. As Avik Roy put it, "The individual mandate was a loaded gun that Romney handed to his opponents, who used it to force individuals to buy comprehensive insurance they didn't need." But Romney's bona fides as a free-market advocate and critic of Obamacare are not undermined by Romneycare. He can rightly claim that he foresaw, and attempted to prevent, the consequences of heavy-handed government control of the health care market.


 The Determinators Movie
 ObamaCare Exposed
The Determinators movie (see link below) is based on the book The Battle for America's Soul, by CL Gray, MD and features leading experts in the field of healthcare who have studied the new law.

 The Determinators is a chilling, but true, documentary that explains and sheds light on the dark underside of the massive healthcare reform bill that, once fully implemented, will significantly threaten the way Americans live...and die. You need to know how this affects your personal life.

 Here is the link where you can watch this film:

 The movie is 58 minutes. If your time is short, at least watch the beginning; it is critical to your personal medical care that you understand what is presented here. We know this is long, but it explains the ramifications of the new law and massive new government bureaucracy of 169 new agencies that will affect your own access to medical care.

 Under the auspices of the new healthcare law, the expanded Independent Payment Advisory Board (IPAB) is authorized to use “healthcare” as a rationale to attempt to control and regulate every aspect of your life – what you eat, what car you drive, what guns you are allowed – to name a few. Congressman Paul Broun compares it to the way the Fed controls every aspect of monetary policy. This important film pulls quotes from the law along with expert testimony to expose these hidden dangers in ObamaCare.

 Please share this with as many friends, family, and undecided voters as possible. Ask each of them to do the same. We are at the fork in the road: one road can reclaim individual control over medical care. The other road puts all healthcare decisions in the hands of the Federal government and the Secretary of Health and Human Services. You decide on November 6 which you prefer.

 Patient Power America and AAPS stand for healthcare reform, based in the private sector, with a focus on individual life and the individual patient-physician relationship without government intrusion and limits on what medical services are approved.

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