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Patients: For Protection and Affordable Care, Opt Out!

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new-logo25Richard Amerling, M.D.

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I remember the days of black-and-white television.  When color television sets became available, they were expensive and few could afford them.  And few networks broadcast in color, since the audience was limited.  At a certain point of supply and demand, sets became less expensive, and networks went all-in for color.  The same phenomena occurred more recently with the move to high ObamacareHurtdefinition TV.  And so it will go with private, high quality medical care.

Years ago I penned the Physicians’ Declaration of Independence, urging physicians laboring under increasingly abusive third party contracts to opt out, to allow them to return to the unfettered practice of medicine.   Increasing numbers of physicians are opting out of Medicare, and few participate in Medicaid (full disclosure: as a nephrologist taking care of dialysis patients, I have not opted out of Medicare).  Declining reimbursements and ever-greater paperwork and reporting requirements are driving this trend.   To a certain extent, this is also happening in the private insurance sphere, and for the same reasons.  But what really limits physician opt out is the relatively small numbers of patients who are “self-pay.”   With the implementation of Obamacare, these numbers are set to explode. More

The Emperor Has No Clue

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new-logo25By Marilyn M. Singleton, M.D., J.D.,

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When President Obama hawks the wonders of the misnamed  Patient Protection and Affordable Care Act, I’m reminded of those “As Seen on  TV” products.

True believers ridiculed critics of the Independent  Payment Advisory Board and its unchecked power to ration health care. They were  impressed by the $575 billion cut to Medicare, although lower payments lead  physicians to accept fewer Medicare patients. They cheered because 11 million  Americans will be added to the Medicaid rolls over the next ten years. While  Medicaid looks like is a good deal with its low co-pays, provider payments are  so low that only one-third of physicians accept new Medicaid  patients.

True believers scoffed at claims of loss of privacy.  After the NSA snooping revelations, a Pew survey revealed that 70 percent of  Americans believe the government is using data for purposes other than fighting  terrorism. Not only could unethical employees misuse health and financial  information, the health “Data Hub” can be shared among seven federal agencies  for ill-defined “routine uses.” According to a former HHS general counsel, the  federal government’s computer program for insurance exchanges lacks privacy  safeguards and could expose applicants to identity theft.

President Obama has repeatedly promised that “if you  like your health care plan, you can keep it.” Even his Praetorian Guard has now  defected. The National Treasury Employees Union—which represents the IRS folks  who are ultimately in charge of ObamaCare—does not want its members to be  “pushed out” of the Federal Employees Health Benefits Program and into the  insurance exchanges. More

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