There are so many things wrong with Pres. Obama's massive Healthcare Initiative.

The medical profession has been my passion for decades and I feel strongly about what has been happening with medical care legislation.  I wanted to share a few observations.

There are so many things wrong with Pres. Obama's massive Healthcare Initiative, but I will start on just a few.

1.  It is a massive intrusion into the doctor-patient relationship. Instead of your doctor deciding if you neet a CT scan to rule out appendicitis, or a mammogram to look for breast cancer, an ultrasound of the leg to rule out a blood clot, or a chest X-ray, a bone density test, a pap or a PSA to look for prostate cancer....you will get government bureaucrats deciding what can be done...micromanaging your medical care.  This always leads to 'one-size-fits-all' regulations that waste money, decrease quality of care, entail long waits and frustration.

2.  In addition to being a massive government power grab, Obamacare has HUGE tax increases coming....conveniently put off until after the election.  January 1, 2013, 18 new taxes and tax increases kick in.  Medicare taxes go up, all the tax brackets increase (for example the 35 % bracket goes to almost 40 %).   There are huge increases on dividend income and capitol gains, medical devices, even a 10 % tax on tanning services....a NATIONAL sales tax.

3. It tramples on religious belief and freedom.

Healthcare spending explodes.  (We already spend way more than other countries with dubious results).  Cuts in care and tests and procedures and services will be made.  Obamacare sets up 159 panels of government bureaucrats to make and enforce the rules which Congress can only overturn by 2/3 vote in the Senate and House during a short period of time, then they are permanent.

These bureaucrats will decide what care you MIGHT get. NOT your doctor. NOT you.

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Diogenes October 10, 2012 at 01:05 AM
More bombastic rhetoric intended to frighten... A program that issues guidelines regarding what care will be reimbursed!? How horrible! Oops that is actually what happens with Medicare currently. Obamacare actually allows physicians to be reimbursed for preventive services provided to Medicare patients to keep them healthy. There are certainly problems with Obamacare, but not all healthcare providers feel as threatened as Robin A. The biggest problem with Obamacare ios that it falls short. Our society as a whole would have been better off if it had created a Medicare for All type of system. As far as "trampling on religious freedom," goes... what a red herring. The government is not making anyone use birth control nor is it making any church distribute it. To be clear, healthcare is already rationed. It is rationed by ability to pay. If you have the money, you can get any health service you desire. This will NOT change under Obamacare. Anyone that truly believes that, in lieu of Obamacare, there is nothing that interfere's with "the doctor-patient relationship" is naive. Any physican that wants to propagate that false belief must have a lot to lose.......
Ken October 10, 2012 at 03:04 AM
Electronic medical records (cost the physician $ 35,000-$ 50,000 each). I am assuming you already checked the CMS website for the EMR Incentive Program guidelines? I believe there are some sort of multi year incentive payments from the government for Medicare and Medicaid eligible providers. This means almost all physicians could qualify for this incentive since every medical practice typically has some % of patients covered by Medicare or Medicaid.
Ken October 10, 2012 at 03:23 AM
I did not mean to imply that a physician should spend their own time checking into the incentive program. That is a waste of a physicians time which needs to be spent with patients. The Practice Manager or someone they designate who is more involved with the financial end of the practice should be the one responsible for researching the EMR incentive program.
Dr. Robin Appleby October 10, 2012 at 10:35 AM
"healthcare is already rationed. It is rationed by ability to pay. If you have the money, you can get any health service you desire." I assume that you are saying that since "healthcare is rationed by ability to pay", that if you dont have the money, you dont get the healthcare services (please correct me if you didn't mean that). Let's examine that in a real world situation. I have delivered the babies of about 300 illegal immigrants. They received the same excellent and compassionate care as American citizens who were paying for their deliveries. Yet the illegal immigrants did not pay for the hospital, the nurses, the doctors, etc. Since you believe that healthcare is rationed by ability to pay, and they paid nothing, perhaps you could clear up this conumdrum ?
Dr. Robin Appleby October 10, 2012 at 11:06 AM
"Use of these tests to screen out or confirm a diagnosis will not change under the affordable care act." When Obamacare (PPACA) was passed in 2010 (not a single Republican voted for this bill) the guideline for mammograms to look for breast cancer was to start the first mammogram at age 50, then EVERY OTHER YEAR until age 74, then you didn't get anymore.....irregardless that a woman's risk of getting breast cancer rises every year of her life. To the government bureaucrats....the "value" of the woman's remaining life wasn't justified by the cost of the mammogram. ( I will get into this in the next blog). However, the American Cancer Society recommends screening mammograms start at age 40, and be done every other year. At age 50, the woman gets a mammogram EVERY YEAR as long as she is in good health.
Brookfield Resident October 10, 2012 at 12:26 PM
The massive coming tax burden is a radically under-reported impact of Obamacare. This article was pretty shocking to me: http://www.atr.org/five-worst-obamacare-taxes-coming-a7217
Dr. Robin Appleby October 10, 2012 at 01:13 PM
January 1, 2013 is Taxmageddon for America On January 1 st, 2013 there is an explosion of new taxes and tax increases coming. Personal income tax rates will rise. the 10 % bracket rises to a new and expanded 15 % 25 % to 28 % 28 % to 31 % 33 % to 36 % 35 % to 39.6 % Higher taxes on marriage and family Child tax credit cut in half from $ 1000 to $ 500 per child Middle class death tax returns Higher tax rates on savers and investors..Cap gains tax rises from 15 % to 23.8 % Top dividends tax rises from 15 % to 43.4 (tax hike plus Obamacare surtax) Some of the 20 new or higher taxes in Obamacare: the 10 % tax on tanning services, the medical cabinet tax, the HSA withdrawal tax, Medical device tax, Medicare Payroll Tax Hikes...2.9 % to 3.8 % for some), Special Needs Kids Tax (imposes a cap on FSAs of $ 2500 (unlimited now)), Also, the Obamacare 'Haircut' for Medical Itemized Deductions (10 % goes to 7.5 %).
Dr. Robin Appleby October 10, 2012 at 01:24 PM
Taxmageddon January 1 st , 2013 (continued) The Alternative Minimun Tax (AMT) will ensnare 31 million families at higher rates, instead of the 4 million now. Full business expensing will disappear. At present businesses can expense half their purchases of equipment....in 2013, they will have to be slowly depreciated over many years. Scores of taxes raised on all types of businesses, esp. "research and experimentation tax credit". Tax benefits for Education and Teaching reduces. Coverdell Educations Savings accounts cut. Employer provided education assistance curtailed. Student loan interest deductions disallowed for hundreds of families, teachers not able to deduct classroom expenses, etc. etc. Charitable contributions from IRAs no longer allowed. Add in Gov. Malloy's 50 tax increases costing CT. taxpayers over $ 1 Billion dollars. Add in Brookfield's ever rising spending and tax increases on homes and cars and personal property. Then add in hefty increases in food, gas, heating oil, insurance, college tuition, medical and dental care, etc. etc. that families are struggling with daily. Going to get exciting
Mary Davis October 10, 2012 at 11:21 PM
I will vote for the candidate that will repeal this bad legislation. Chris Murphy as a congressman voted for it without even knowing what he was voting for. He needs to go not get promoted.
Steven DeVaux October 11, 2012 at 12:15 AM
Welcome to the Democratic law of unintended consequences on a national scale. Get ready for the impact to make itself felt.
Diogenes October 11, 2012 at 01:26 AM
Robin - Let's examine youre statement: "I have delivered the babies of about 300 illegal immigrants. They received the same excellent and compassionate care as American citizens who were paying for their deliveries." What you provided was a service. It was a service that is required by law - EMTALA. In order to maintain priviledges at a hospital, you were required to provide this service. Opting out otproviding this service would have meant the loss of the setting in which you provided care to your paying patients and make money. Providing this service was simply a cost of doing business. Calling these new mothers "illegal immigrants" belies your claim that you provided care and makes it laughable that you would confuse your service with "compassionate care." If these same women attempted to schedule an exam in your private office for pelvic pain, they would have been sent away. Eventually, they may have gotten a work-up in the emergency room, again requried by EMTALA, but the work-up would neither be efficient, nor as comprehensive as what would be received by an insured patient in a private office. Ensuing treatment would be even more disparate. THAT is what I mean by care being rationed by ability to pay. I think you have missed the true "conundrum."
Diogenes October 11, 2012 at 01:26 AM
I would expect that these uninsured mothers received a service that was competent even if I can't believe that it was "excellent and compassionate care." If you can actually convince yourself that this was "excellent and compassionate care," it is good that you are now a real estate developer.
Mary Davis October 11, 2012 at 01:45 AM
Locoguy: I don't know Dr Appleby personally but I can tell from your statements that neither do you. How dare you presume to know anything at all about his care or compassion as a Doctor. Its quite insulting to me to read your illogical and ignorant rant. You should be ashamed of yourself and publicly apologize to Dr. Appleby... and to all doctors for that matter. I don't know you personally but I can tell the type of character you are. What you wrote is completely disrespectful, completely inappropriate, completely ignorant, and what a complete imbecile would write. It seems that you will argue anything as long as its contrary. I'm really saddened and shocked. Dr Appleby... don't let these idiots get you down... keep up the good work!!!
Linda Taylor October 11, 2012 at 01:51 AM
To Locoguy, Please rest assured that ANYONE who was treated by Dr. Appleby received excellent and compassionate care. I don't need him to convince me of it because I WITNESSED it! Many times he would tell a patient to 'bring him a plate of brownies" for payment. No-one was EVER turned away because of their inability to pay. The medical community lost one of it's most caring and compassionate members when Dr. Appleby was forced to retire due to cancer. I still care for the same patients and not a day goes by that I don't hear what a kind, wonderful human being he was (and is). We never, EVER turned a patient away based on their ability to pay. The next time you set out to disparage another human being perhaps you want to check with some people who were receivers of his excellent care. I can provide you with many examples if need be. AND by the way..read some of the 2700 pages of laws and mandates that make up PPACA. Some are INDEED scary.!
Brookfield Resident October 11, 2012 at 02:11 AM
My being able to live in a 20K sq ft mansion is rationed by my ability to pay - so surely we should pass a law to make the builders work for free to build it for me. My being able to eat out Five Guys whenever I want is rationed by my ability to pay - so everyone in the supply chain and the burger flippers should work for free. Many things I want, and even some things I need, are rationed by my ability to pay. So either we enslave those who can provide those things, or we make everyone pay for my mansion and burger. Absurd you say? So is thinking that "free medical care" (in which either the provider, or society is enslaved to pay for it) is not going to result in significantly reduced care and significantly greater costs for all of us.
sock puppet October 11, 2012 at 07:33 AM
I agree with Mary. Don't judge him as the bully he is until you get to know him better.
sock puppet October 11, 2012 at 07:34 AM
Socialized, government-funded medicine would have been a far better solution (as the rest of the developed world knows) but GOP and insurance companies would never have allowed it (by bringing up jingoistic fears)
Steven DeVaux October 11, 2012 at 09:43 AM
All people are entitled to a free and appropriate education so teachers and administrators should work for free.
Dr. Robin Appleby October 11, 2012 at 10:01 AM
Democrats-liberals-socialists ..Obamacare is YOUR baby. Democrat special interests wrote it in secret.....You wouldn't let us read it ahead of time....ONLY Democrats voted for it.....you told us how great it was and all the wonderful things it would do...and how much money it would save families..... This is your chance.....stop all the personal attacks for a few minutes....and TELL us why Obamacare is a such good thing.
Diogenes October 11, 2012 at 10:33 AM
Few would argue that the law is perfect. Indeed, many of us, healthcare providers included, would favor repeal and replacement with a single payor system. The status quo, however, is more difficult to defend. Far from extreme, it is modeled after "Mitt the Moderate's" plan in Mass. It was actually an attempt at compromise and it represents many of the same reforms proposed by the "Socialist" verson of the GOP that existed when Hillary Clinton was trying to tackle this challenge. Only Democrats and Independents voted for it, because the GOP/Tea Party, has been bent on road-blocking any advance under the current administration. In terms of improvements to the status quo, afforded by the law, here are a few: - Removing incentives for hospitals to under-treat or poorly treat, only to readmit a week later and get paid again. - Placing a premium on care coordination, via ACO's, to improve patient outcomes in the most efficient manner possible. - Allowing Medicare to pay for preventive care. - Eliminating life-time caps on insurance policies. - Moving government mandated care out of the emergency room, where it is the least efficient and most costly. - Incentivizing a national movement toward an electronic health care record which will improve patient savety. Again, it is clearly not perfect, but it is better than sitting on our hands and saying how "our system is the greatest system in the world," despite outcomes data that proves otherwise. OOOO! It IS Scary.
Diogenes October 11, 2012 at 10:36 AM
The only truly intellectually honest argument against the law would be that Healthcare is a comodity and the government has no business being involved in it... Everything else is fear mongering.
Dr. Robin Appleby October 11, 2012 at 10:51 AM
Good morning Dr. Matt.....I was about to give up on ever having an intelligent, adult conversation with a liberal-Democrat...on any subject. You and Locoguy/Andrew....dont need to do all the personal attacks Stand and make your case...that was very good Did someone say "our system is the greatest system in the world"?? I agree...the present system is terrible...let's REASON together and see if we can come up with a better system that serves the people better.
Dr. Robin Appleby October 11, 2012 at 11:34 AM
Sockpuppet/Andrew.....make your case without all the personal attacks....you are smart and have a lot to offer the conversation.
Brian October 11, 2012 at 07:58 PM
You make the mistake of tying the potential tax increases to the Patient Protection and Affordable Care Act. Every year now we are going thru this issue with what changes may or may not happen with our tax laws. This is not directly tied to anything within the PPACA nor is it definite that we will see these taxes increases actually occur. If you want to debate the PPACA, stay on point and don't confuse the issues.
Brian October 11, 2012 at 08:12 PM
Religous Beliefs and Freedom - Ah yes birth control. the PPACA has no mandates on what we as individual citizen chose to do about brith control or abortions. What is does have is some requirements for larger business to provide healthcare (including preventative healthcare) to their employees. Since the Cathloic Church has some organizations like hospitals this have a large employee base, they need to comply with providing healthcare plans to their employees. There is nothing in there about forcing anyone to chose something that is against their religous beliefs. Nor should one group's religous beliefs take precident over anyone elses. I know the Catholic groups tried to claim taxes would no be used to pay for abortions...but that simply is not the case. It was about Healthcare plans providing preventative services which includes birth control....but no tax money was being spent to pay for someone's birth control.
Brian October 11, 2012 at 08:16 PM
Pannels and Review boards...here I would agree that there are way to many and infact the PPACA does not go far enough to really address most of the pressing issues and where the most costs are that drive up the overall cost of healthcare in the US. But the PPACA was really a compormise about what could be passed and does do a lot to help people who would otherwise not be able to afford healthcare. Less pannels and more to getting heathcare out of the ERs and into the DR office and small local health clinics would be money better spent.....But don't turn this into the pannels are "death boards" which define what care each individual patient gets...that's no where near the truth.
Brookfield Resident October 11, 2012 at 08:19 PM
Brian, so is Obamacare unconstitutional if there aren't taxes in it? Seems to me the supreme court ruled it constitutional on the basis that it was a "tax". The bill has many changes that affect taxes. Don't know how you separate it.
Brookfield Resident October 11, 2012 at 08:32 PM
Locoguy, I think you nailed it with the intellectually argument. Now I suspect you will take that down the education / post office / medicare rabbit-hole, but just because those exist with heavy government interaction doesn't mean the government should be further inserting itself somewhere it has no right to be. I am not in the medical profession at all, but seems to me the biggest problem with healthcare now, and under Obamacare, is simple - we pay with other people's money. And I say this as a well-insured person, who's young family has gotten more economically from insurance than I have to-date paid in. When I buy a car, I ask what it costs, what the options cost, shop around, and negotiate the best deal. Why? It's my money. Do I shop hospitals? No, I go to the closest one. Do I ask what it will cost for each procedure and test? No, and even when I do, its very difficult to get a straight answer. Is it the super-high sticker price you want, or the negotiated insurance amount, or let's make it super easy on you sir - your out of pocket for this $3K list price procedure will cost you $150 out of pocket - do you want it? Sure, why not. It only costs me $150. I know I am over-simplifying to the extreme, but the healthcare system needs to be more competition and consumer driven for costs to ever really come down. Obamacare is a step in the opposite direction.
Brian October 11, 2012 at 08:57 PM
Again we try to muddy the waters....But it is pretty easy to separate the wild claims about taxes that have nothing to do with the PPACA.There is absoultely nothing within the PPACA which calls for "all the tax brackets increase (for example the 35 % bracket goes to almost 40 %). There are huge increases on dividend income and capitol gains" which is in the origianl post by Dr Appleby. The part you bring up is the fee/tax imposed is someone does not purchase a healthcare plan. This was the piece that was ruled as consitituational by the US Supreme Court. While many were hoping to use it as the lynchpin to declairing the whole PPACA unconsitutional, at least the US Supreme Court didn't buy into that.
Ryen February 01, 2013 at 06:57 PM
Thanks for the article and the added information. Also: Think about this wild, yet grave, hypocrisy: Obama wants all people who are citizens to prove that they have health care, yet Obama (figurehead for liberals and progressives) does NOT want all persons here in his country to need to prove that they are citizens!!!!! The absolute HEIGHT of HYPOCRISY! Think about the state of our great country when that is a position of our leader??? No matter what the cost, a CITIZEN living here must PROVE that they are making a choice to purchase health care--a private decision and personal and financial decision--yet, any old PERSON living here does not have to PROVE that they are a CITIZEN!!!!! An odd result: legal citizens and businesses will be punished and/or restricted and or charged for something that can BENEFIT persons who need not even prove LEGAL citizenship!!! THAT is socialism approaching FASCISM and LUDICROUS.


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