What Should Be Done to Repair the Healthcare System?

Stanley Feld M.D.,FACP, MACE

On March 10, 2023, Obamacare will be ten years old. Obamacare has had many failures. Obamacare’s biggest failure is the resulting distortion of the healthcare delivery system. The distortion is the result of all the stakeholders adjusting to Obamacare’s new rules and regulations.

All of the stakeholders had to adjust the way they delivered or priced healthcare to their individual advantage.

Primary care physicians started moving toward the model of Concierge Medicine. In order to have a primary care physician, consumers must pay primary care physicians between $2,000.00 and $38,000.00 annually to be in their panel.  The movement toward Concierge Medicine is the result of the Obamacare regulations, the healthcare insurance company’s reimbursement cuts, and the increase in malpractice insurance premiums.

Primary care physicians found that in order to make a living and pay their increasing overhead, they must become Concierge Physicians. This is to the disadvantage of consumers since they must continue to buy healthcare insurance.

The insurance industry has adjusted to Obamacare’s regulations by lowering reimbursement to physicians and hospitals while raising premiums. Insurance companies and Medicare Advantage programs have restricted enrollees to only certain physicians in their network and restricted certain treatments and access to certain specialists and groups.

It all goes back to President Obama’s statement, “If you like your doctor you can keep your doctor. If you like your hospital you can keep your hospital.” To my disappointment the AMA accepted President Obama’s obvious lie in 2010.

As the the government and the insurance industry decreased reimbursement physicians have had to increase the number of patients they see in one day in order to make up for their decreased revenue.

Malpractice claims and malpractice payments for claims have increased in most parts of the country. This resulted from a lack of tort reform by congress and the Obama administration. Physicians then increased diagnostic testing in order to cover all possible illnesses.  The increase in testing led to an increase in healthcare cost.

Obamacare has also increased the cost of insurance by requiring payment for additional coverages. The first dollar insurance coverage after deductibles are met has resulted in the overuse of the healthcare system. The government and the insurance industry are trying to decrease the overuse of the system by increasing deductibles.

In fact, some Obamacare insurance plan deductibles are so high that insurance payment never kicks in. People who buy Obamacare insurance plans cannot afford the deductibles and do not use the insurance until they are so sick, they cannot avoid being hospitalized.

It is impossible to figure out how health insurance premiums increases are calculated by the private healthcare insurance sector or the government healthcare insurance sector. It is impossible to figure out how the multimillion-dollar salaries for insurance and hospital executives are calculated. These expenses are part of why insurance premiums are rising.

It is also impossible to determine how hospital systems price their care. The government also pays hospital systems a premium for outpatient hospital care in an outpatient setting. The fees are at least 20% higher than in a free-standing private practice office.  

Hospital systems are figuring out how to manipulate their reimbursement systems to have an advantage over their competitor.  In New York City, Columbia Presbyterian Hospital System has accumulated ownership of many hospitals inside the city and its suburbs. With that ownership, they have acquired many in-patient and out-patient hospital salaried physicians. The hospital system is now demanding increased payment from healthcare insurance companies and the government in order for patients to use their system. The hospital system has hired many of the physicians’ patients desire to see. Columbia Presbyterian has gained control of the reimbursement levels in those markets.

There is an encouraging trend that was started by Keith Smith M.D. in Oklahoma City. Dr. Smith started a cash-only outpatient surgical clinic several years ago. He charges less for procedures than a patient’s deductible from some insurance companies.

This gives us some insight into how much fat is in the healthcare system expenditures.  Dr. Smith and physicians working in his outpatient clinics are happier and are making more money than they were working for local high-cost hospital systems in town. The patients are happier because there are no hidden or surprise costs.

.

Dr. Smith’s clinic is drawing patients from all over the United States. He has also inspired the formation of many similar clinics in the U.S.

This is not new. Specialists such as gastroenterologists have opened freestanding centers. They charge less for colonoscopy and endoscopy than the hospital systems. Radiology clinics have done this for many years. The hospital systems have, somehow, worked out payment for their higher costs with the insurance industry and the government.

Dermatology is a specialty that does not need a hospital system. Large physician-owned

dermatology clinics have opened. They charge less than the dominant local hospital system.  

Many of these large specialty centers have sold their clinics to venture capital firms.  

How the venture capital firms are going to leverage their investment is unclear to me.   

Emergency rooms all over the country are overcrowded because primary physicians cannot see all of the patients in their offices in a timely manner. Hospital system emergency rooms are inefficient and overpriced. The ER is an unpleasant experience for many patients.

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If a patient has to be admitted to a hospital his primary care physician is not permitted take care of him in many hospital systems. Hospital systems have hired hospitalists to care for patients. A patient might see a different hospitalist each day of the admission.

What happened to the therapeutically valuable physician-patient relationship? This relationship is critical for curing much morbidity from chronic illness. 

 I have covered the Repair of the Healthcare System in great detail in the past.

 I have also covered the errors in the structure of Obamacare leading to the distortions in the delivery of healthcare and the increased costs of the healthcare system.

The stakeholders are physicians, patients, hospital systems, insurance companies, pharmaceutical companies, and the government.

All patients want is to get the best medical care when they get sick. The interest in disease prevention is slowing growing events though many millions of dollars have been spent on programs that could help prevent chronic disease.

All hospital systems, insurance companies, pharmaceutical companies are interested in are maximizing profits and minimizing expenses.

All physicians are interested in is delivering the best care possible.

Patients and physicians are the most important stakeholders in the system.

The government wants to spend the least amount of money possible to enable the best care at the lowest price.

There has been little attempt by congress, the bureaucracy or previous administrations to remedy the defects I have pointed out.

 I have not seen any attempt by Congress to lower the price by decreasing the bureaucratic impact on the price of healthcare. Nor have I seen the exposure of the clandestine deals hospital systems make with insurance companies or the government.

I have not seen any movement toward decreasing the malpractice crisis in America. Tort reform has been vitally necessary for the last thirty years. It has been totally ignored by government officials.

These are some of the basic reforms necessary to start repairing the healthcare system. All our politicians do is kick the can down the road to the advantage of the secondary stakeholders and not the consumers.

These are some of the main reasons the system has to convert to a consumer-driven system that I have outlined previously.

Consumers must control their health and their healthcare dollars. They must be provided with an education that will help them control costs. They must be provided with financial incentives to control costs.

Copywrite 2006-2023  

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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Stanley Feld M.D., FACP, MACE

There are big problems in Canada that have been undisclosed by Democrats to the public in the United States.

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 Article 1. Debunking Canadian health care myths – The Denver Post .

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Both articles are opinion articles and lack concrete evidence. The articles contain both misinformation and disinformation.  The articles are in essence  fake news designed to mislead the American public into believing that a single party payer system is the answer to America’s healthcare systems problem.

The articles are precisely why the American public should not and does not trust politicians and the traditional mass media.

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 Article 1. “Ten percent of Canada’s GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada’s.”

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“Total federal, provincial and territorial government health spending has grown by 8.1 percent annually, while the national GDP in Canada rose by only 6.7 percent during the same period.”

 The provincial governments have raised taxes and rationed care, while increasing patient wait times.  

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“Unsustainable rates of growth in health care spending crowd out the resources available for other purposes including education, public safety, and economic growth-enhancing tax relief.”

One has only to think about the Obama administration’s initial propaganda and the stunning reality we are facing presently. 

The VA is now asking for additional funding to clear up its disaster.

The problem is entitlements are too expensive for governments.  Entitlements do not work because governments cannot legislate behavior by directives. Individuals must be responsible for their health and healthcare dollars.

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The government never gets to the core problems that must be repaired when they try to construct a healthcare system that is efficient, cost effective and will benefit consumers. 

The primary stakeholders are consumers of healthcare. Physicians are a close second. Secondary stakeholders are hospital systems, healthcare insurance companies, drug companies, malpractice insurance companies, and the government.

In order to Repair America’s Healthcare System, the government must focus on the primary stakeholders’ (patients’) needs and ways to satisfy those needs. The key is to set up a system that provides the primary stakeholders (consumers of healthcare) with incentives to maintain their health and conserve their healthcare dollars. This applies to healthy consumers as well as patients with chronic diseases.

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The healthcare system must help consumers be prosumers (productive consumers) of their own healthcare.

The Canadian system is not the answer to our healthcare system’s problems. The United States has a much larger population than Canada. The Canadian government cannot support its universal healthcare system.

 How will we? Bernie Sander’s state of Vermont has abandoned its “Medicare for All” program.

The only way the portion of our population in favor of Medicare for All is going to believe it is unsustainable and destined for failure is going to experience its failure. It seems Bernie and his followers have little interest in learning from previous experience.

 The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

Stanley Feld M.D.,FACP,MACE

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Their ideology blinds them to the fact that socialized medicine does not work. I vividly remember John Kerry and Barney Frank telling President Obama that the Affordable Care Act needs a Public Option. The Affordable Care Act would fail if it did not have a Public Option. With a Public Option included they said America would be well on its way to a single party payer system.

They said a single party payer system is the only healthcare system that would work

President Obama told them he had a clandestine “Public Option” built into Obamacare. However, he was never able to bring it about.  

Progressives believe deeply in their ideology. They do not consider past history, present reality or facts. 

Neither does the American College of Physicians. In a position paper it recommended Medicare for All. It was followed up with a letter published in the New York Times with 2,000 signatures out of the 159,000 members advocating Medicare for All.

为什么要选择使用高匿名伋理ip?_黑洞伋理:2021-10-15 · 高匿名伋理ip(Elitepip伋理软件roxy或HighAnonymityProxy)：服务器不知道你使用了伋理ip。高匿伋理ip不改变客户机的请求，这样在服务器看来就像有个真正的客户浏览器在访问它，这时客户的真实IP是隐藏的，服务器端不会认为我伊使用了伋理ip ...announced an open letter to the American public, prescribing single-payer Medicare for All, in a full-page ad in The New York Times that will run in the print edition on Tuesday, January 21, 2023.”

http://www.nakedcapitalism.com/2023/01/in-historic-shift-second-largest-physicians-group-in-us-has-new-prescription-its-medicare-for-all.html

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All progressives have to do is look at what is happening to socialized medicine all over the developed western world and notice it is unsustainable and its citizens are dissatisfied with it.

Healthcare systems in the developed world are failing even as the ideologs believe it is succeeding.

America’s healthcare system is also having many problems. Americans are dissatisfied with our healthcare system. The healthcare system has gotten worse since Obamacare was passed. The government is responsible for making our healthcare system worse. It has not done the things I have suggested to repair our healthcare system.

 The Commonwealth Fund (a private progressive foundation) with a focus on healthcare is certain that a single party payer system is the only viable healthcare system.

The report ranked healthcare systems throughout the developed western world.  In its 2014 published ranking the National Health Service of Great Britain was considered the best medical system among the 11 of the world’s most advanced nations, including Canada, France, Germany, Switzerland and Sweden.

 The United States came in last.

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Most people read the summary. The summary in this report does not reflect the truth about the evidence present in the report.

The Commonwealth Fund’s rankings of countries is contradicted by objective data about access and medical-care quality in these countries in peer-reviewed academic journals.

The Commonwealth Fund’s methodology is defective. Its conclusions relied heavily on subjective surveys about “perceptions and experiences of patients and physicians.”

Kenneth Thorpe made an important point by examining differences in disease prevalence and treatment rates for ten of the most costly diseases between the United States and the ten European countries with a single payer system.

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Why would that be?

There are many reasons for this finding. The main one is the availability of care in the United States compared to the ten socialized western countries.

Another is lifestyle and incidence of obesity in the United States. Both lead to the onset of chronic disease and increased treatment.

 “Efforts to reduce the U.S. prevalence of chronic illness should remain a key policy goal.”

“Americans are diagnosed with and treated for several chronic illnesses more often than their European counterparts are.”

Americans diagnosed with heart disease receive treatment with medications and procedures more frequently than patients in Western Europe.

In the past local peer review was all that was needed along with confidence in the treating physician’s judgment. This confidence in physicians’ judgment has been destroyed by excessive media sensationalism. The real percentage of abuse is small and easily discoverable by peers and the use of social media.

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The reasons for the higher cure rates is the availability of early detection and treatment.

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The Commonwealth Fund’s report does not consider any of these factors.

“Over a quarter of a million British patients have been waiting more than six months to receive planned medical treatment from the National Health Service, according to a recent report from the Royal College of Surgeons. More than 36,000 have been in treatment queues for nine months or more.

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http://www.forbes.com/sites/sallypipes/2023/04/01/britains-version-of-medicare-for-all-is-collapsing/#d1df33b36b89

The NHS has a waiting list of 3.2 million people for admission to the hospital. In London alone over 500,000 patients are on a waiting list for diagnosis and treatment.

A large percentage of patients triaged as urgent after being diagnosed with suspected cancer have a 62-day wait time to receive therapy.

Consider 匿名伋理ip at the emergency room in Britain. Government data show that hospitals in England only saw 84.2% of patients within four hours in February. That’s well below the country’s goal of treating 检测伋理IP匿名程度的方法，很实用 - 我不是木鱼 - 博客园:2021-9-5 · 因为这个对我伊是很重要的,特别用伋理IP作弊的时候,要想不被服务器识别出来,还是要懂一些伋理匿名方面的东西,今天详细说下~ 下面 说明下伋理匿名的分类和怎么检测伋理匿名程度 不是所有的伋理都可伍用来作弊. 与我伊作弊有关的伋理可分为3类: — a target the NHS 匿名伋理ip.

Now, instead of cutting wait times, the NHS is looking to scrap the goal.

Wait times for cancer treatment — where timeliness can be a matter of life and death — are also far too lengthy. According to January NHS England data, almost 25% of cancer patients didn’t start treatment on time despite an urgent referral by their primary care doctor. That’s the worst performance since records began in 2009.

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And keep in mind that “on time” for the NHS is already 62 days after referral.

Unsurprisingly, British cancer patients fare worse than those in the United States. Only 高匿名ip伋理 in the United Kingdom live at least five years after diagnosis, compared to 89% in the United States. Just 83% of patients in the United Kingdom live five years after a prostate cancer diagnosis, versus 匿名伋理ip.

The British Health and Social Care Act 2012 authorized the use of the small private sector of healthcare to help the NHS with its problems.

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It sounds like the VA Healthcare System’s solution to its problems.

The NHS also routinely denies patients access to treatment. More than half of NHS Clinical Commissioning Groups, which plan and commission health services within their local regions, are rationing cataract surgery. They call it a procedure of “limited clinical value.”

It’s hard to see how a surgery that can prevent blindness is of limited clinical value. Delaying surgery can 小幻HTTP伋理 - 提供比收费还强大的免费HTTP伋理IP:小幻HTTP伋理免费伋理ip网实时免费为大家更新最新免费伋理ip、http和https伋理为主,常年免费提供伋理ip、qq伋理ip、http匿名伋理、国内伋理软件等加速服务，为用户提供最优质伋理. — and thus put them at risk of falls or being unable to conduct basic daily activities.

“It’s shocking that access to this life-changing surgery is being unnecessarily restricted,” said Helen Lee, a health policy manager at the Royal National Institute of Blind People.

Many Clinical Commissioning Groups are also rationing hip and knee replacements, glucose monitors for diabetes patients, and hernia surgery by placing the same “limited clinical value” label on them.

Patients face long wait times and rationing of care in part because the NHS can’t attract nearly enough medical professionals to meet demand. At the end of 2018, more than 39,000 nursing spots were unfilled. That’s a vacancy rate of more than 10%. Among medical staff, nearly 9,000 posts were unoccupied. Many physicians have left the NHS and have gone into private practice. Many do both NHS service and private practice.

These shortages could explode in the years to come. In 2018, the Royal College of General Practitioners found that more than 750 practices could close within the next five years, largely because heavy workloads are pushing older doctors to retire early.

English people who can afford private care and private healthcare insurance to avoid the NHS are switching to private insurance even though they have to pay $3,500 for each man, woman and child in a family into the NHS.

Physician shortages are the result of inadequate funding. The cost of the NHS with all these restrictions are unsustainable.

The single party payer system (NHS) is struggling with unsustainable costs even though we hear from progressives how great socialized medicine is in England.

The key ingredient missing in all these systems is patient responsibility for their health and their healthcare dollars. Both are powerful motivators for healthy living and detecting disease early.

Copywrite 2006-2023  

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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Sweden has a universal healthcare system that has been touted, by Bernie Sanders, to be the premier socialized medical system model in the world. The Swedish socialized medical system has hardly lived up to the praise. The fact is Sweden’s healthcare system is falling apart.

The Swedes have lost interest in their socialist healthcare system. Their tax rate is almost 50% of earnings. Swedes are losing interest in the concept of a socialist society. The complaint is that it is inefficient, and, in most areas, the socialistic system does not work to the benefit of the people.

All Bernie Sanders has to do is read the local Swedish newspapers. He would learn that socialized medicine is not working in Sweden. He might even stop pushing his lie to the American public about how great “Medicare for All” will be for America.

“That Sweden no longer keeps up with those countries is largely due to its inability to reduce its patient waiting times, which are some of the worst in Europe, as the latest edition of the Euro Health Consumer Index (EHCI) revealed in Brussels on Monday.”

The 2014 EHCI also confirms other big problems within Swedish healthcare.

“This is not primarily due to the fact Sweden has become worse – rather it is the case that other countries have improved faster.” 

According to 2017 OECD figures, Sweden does have the fifth-highest life expectancy in Europe. Its cancer survival rates are among the continent’s highest. This could be because the rest of Europe’s socialized medicine systems are not as good as they could be.

One of the main pillars of the Swedish welfare state is its universal healthcare system. The Swedish people are totally frustrated by the healthcare system’s inefficiency. The inefficiency is due in large part to the government bureaucracy.

“Swedes have little confidence that politicians will solve this,” said Lisa Pelling, chief analyst at progressive think tank Arena Ide. 

“There is a risk their faith in the welfare state will be eroded,” she told AFP. 

As an example of the frustration of the Swedes:

Asia Nader didn’t know whether to worry more about being diagnosed with a hole in her heart at the age of 23 or having to wait a year for Swedish doctors to fix it. 

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Credit: George Hodan/public domainhttp://medicalxpress.com/news/2018-09-swedes-world-class-healthcarewhen.html 

There are long lines waiting for access to care due to a shortage of nurses and available doctors in some areas.

The average income tax rate paid by Swedes is 50%. Immigrants cannot pay 50% of their earnings and survive. Immigrants are entitled to social services including medical care. The voters are angered over the flood of immigrants putting a tremendous strain on the healthcare system and delaying regular citizens’ access to care.

 The rules set up by Swedish law about access to medical care are being ignored and unenforced.

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“Patients must also see a general practitioner within seven days, the second-longest deadline in Europe after Portugal (15 days).” 

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The median wait for prostate cancer surgery was 120 days. It has taken up to 271 days.to get prostate cancer surgery.

Swedes complain that they can’t see their own GP. There is little chance to develop a physician/patient relationship. Patients are being seen by temporary hires provided by outsourced staffing companies.

Telemedicine has mushroomed. Physicians are complaining about the fragmentation of care. There is little chance for continuing follow-up and assessing the result of therapy.   

The number of hospital beds has declined in recent years. There is a hospital bed shortage in many communities.    

“In Solleftea, the premier’s northern hometown with nearly 20,000 residents, the only maternity ward was shut down last year to save money.” 

“With the closest maternity ward now 200 kilometers (125 miles) away, midwives offer parents-to-be classes on how to deliver babies in cars—which some have since done.”

Despite the bed shortages and delays in access to care, Sweden is the third highest spender on healthcare in the European Union. Sweden spends 11% of its GDP on its healthcare system.

 Socialism and healthcare for all are not as great as Bernie Sanders is telling Americans. We should not believe him.

There is no question we have to improve our healthcare system to make it affordable and available to all.

However, we should not go down the path of Sweden and Finland with Bernie Sanders’ socialistic program of “Medicare for All.”

We will not only bankrupt America but also make access to care impossible.

Copywrite 2006-2023  

The original was published in April 2023.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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http://apps.who.int/iris/bitstream/handle/10665/327538/18176127-eng.pdf?sequence=1&isAllowed=y

The healthcare system is not rosy for the people in Finland.  It has been getting worse since March 2023 despite the New York Times’ glorification of it nine months later in December 2023.

Bernie Sanders continually ignores Finland’s healthcare system’s reality as he tries to convince people that “Medicare for All” will fix our health care system.

Finland’s healthcare system’s problems are multiple. Finland’s government collapsed due its massive socialized medicine program even though the healthcare system is not completely free.

Finland has struggled to keep its promises to its people.    

What are the principle reasons for the failure?                   `       

1. Finland’s “Free” Healthcare: Fiscally Unsustainable

Governments cannot provide 匿名伋理ip healthcare to the masses in a fiscally sustainable way. Period.

In March, just after Juha Sipila’s Finish government resigned, the governor of the Bank of Finland, Ollie Rehn, warned that reform remained urgent “from the point of view of fiscal sustainability.”

The Finish population is aging, and birth rates are falling. The number of taxpayers paying into the system is decreasing. The overall population is living longer. All three reasons are putting a greater strain on medical resources.

 In 2018, the average single Finn faced a net average tax rate of 30%. With President Trump’s tax cut the average U.S. rate is 23.8%. If a U.S.tax payer is earning $250,000 a year or more in the U.S. there is an additional 3.8% supplemental Medicare tax increase despite President Trump’s tax cut from 38% to 23.8%. Our Medicare and Medicaid programs are unsustainable and presently require more tax revenue or severe service cuts.

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In Finland, there have to be effective reforms. Right now, the system is unequal.  The poor and people who live in remote areas are not being served.

Bernie, Elizbeth Warren, and the U.S. traditional media are glorifying the Finish system for unsuspecting Americans.

“People outside of Finland tend to see only the good sides of the system,” says Hiilamo.

“Normally, we show people the sunny side of the street, but there is a dark side of the street. And health care is on the dark side, and for many years we have had a problem.”

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Long wait times are one of the most predictable consequences of anything that is government-run, including health care.

In addition to long wait times, the government’s efforts to cut costs and be more efficient have resulted in ill people, including at emergency care facilities, not getting to see a physician until they can “justify” the need to see a physician to a nurse.

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http://www.theguardian.com/society/2016/feb/23/finland-health-system-failing-welfare-state-high-taxes

“Imagine going to your nearest doctors’ office at 9 am on a weekday with your sick six-year-old daughter because you cannot make an appointment over the phone.

After your drive to the doctor’s office in another part of the city, you can’t simply book a time with the receptionist. There isn’t one.

Instead, you must swipe your daughter’s national insurance card through a machine, which gives you a number. Then you and your feverish child simply sit and wait. Or rather, you stand, because the room is so crowded that people are sitting on the floor, on steps, or leaning against walls.

The numbers come up on a screen every 10 minutes or so, in no particular order so you’ve no idea how long your wait will be as your daughter complains of feeling cold then hot and then cold again.

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You see, you are not even waiting to see a GP. You’re waiting to see a nurse in order to justify to her how quickly your child needs to see a GP or whether she needs to see one at all.

At 11.30, you give up and take your daughter to see a private doctor as well, forking out £50 for the privilege.

This isn’t some nightmare vision of the NHS after 10 years of Tory cuts. This happened to me recently in a country I have moved to from Britain that is normally lauded as the shining example of a successful welfare state.”

 Finland has one of the worst health services in Europe according to The Guardian. Its health service has been in a perilous state for decades and it is getting worse. Nothing has been done since its government collapsed in March 2023.

Bernie is leading America down the garden path with a misrepresentation.

http://www.oecd.org/els/health-systems/Country-Note-FINLAND-OECD-Health-Statistics-2015.pdf

A publicly run and funded health care system — known as “Medicare for All” — is now the senator’s big ideas!

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Doctors and patients who can leave Finland’s centralized health care system are doing so in droves. Only the well off can afford to buy healthcare insurance.

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Doctors are now responsible for extra paperwork, including renewing electronic prescriptions.  These time-consuming tasks take away from the time they can spend with patients.

“The current set-up doesn’t support doctors spending as much time as possible with patients,” Saarni told HS.

 The shortage of physicians and extra scut work has resulted in long waiting times for medical appointments. Over 1.1 million of the 5 million people living in Finland have now opted for private medical insurance.

Every second child born has private medical insurance. Only fifty percent of child deliveries are done by the health service.

Despite this, the public healthcare sector is still under great strain.

Public healthcare centres have lost experienced physicians to the private sector.

The public sector physicians’ patient loads have resulted in an increasing percentage of physician burnout by young doctors at healthcare centres according to Dr. Saarni.

Minister of Family Affairs and Social Services Krista Kiuru announced on Tuesday that each and every citizen should be guaranteed a doctor’s appointment within seven days of asking for one. This is easier said than done.

Tampere’s Daily Aamulehti reported that the challenge is great. In the city’s municipal clinic at Hatanpää, patients waited for an appointment for a median of 42 days.

The Tammela health centre reported average waiting periods of 11 days, while private Mehiläinen clinics in the city saw patients in just two days.

“The situation simply cannot continue,” Kiuru said.

4.    Finland’s “Free” Healthcare: Requires More Taxpayer Funding

The Finnish government is pouring more of its taxpayers’ money into the flailing system, but it’s not clear that throwing money at the myriad problems is the answer.

Finland is planning to plow some 200 million euros into municipal healthcare services in the next four years to try to reduce waiting times for non-urgent appointments.

In 2023, an initial 70 million euros will be available as part of the new government’s drive for reform of health and social care reform, as stated by the Minister of Family Affairs and Social Services Krista Kiuru.

Long waiting times, few physicians, ill-equipped and poorly maintained hospitals, and a long list of other failures have resulted in broad discontent with the extremely expensive Finnish healthcare system.

All socialistic healthcare systems are constructed incorrectly. A viable healthcare system can be constructed so that consumers are responsible for their care and not the government.

There are no government-run healthcare systems that are viable anywhere on the planet. Norway is the only country whose free healthcare system is surviving in. It survives only through the massive infusions of cash from an oil-rich government.   

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



Copywrite 2006-2023

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Part 2

Stanley Feld MD,FACP,MACE

http://blogs.scientificamerican.com/observations/finland-is-the-happiest-country-in-the-world-and-finns-arent-happy-about-it/

Bernie Sanders (I-VT) has been hanging his socialistic rhetoric on the success of Finland’s socialist society and especially Finland’s healthcare system which is supposed to be a free healthcare system for all. 

The New York Times published the article “Finland is a Capitalist Paradise” on December 2, 2023.

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 President Donald Trump was correct when he said,

“Finland, of course, is one of those Nordic countries that we hear some Americans, including President Trump, describe as unsustainable and oppressive — “socialist nanny states.”

The New York Times ridiculed President Trump in December 2, 2023 for saying that Finland is a socialist nanny state.

http://legalinsurrection.com/2023/03/finland-government-collapses-over-universal-health-care-costs-bernie2023-hardest-hit/

http://freebeacon.com/politics/finnish-government-collapses-due-to-rising-cost-of-universal-health-care/

“Similar problems are bedeviling Sweden and Denmark, two other countries frequently held up as models to follow on health care. Finland’s crisis in particular comes as calls for universal health care have grown louder among Democrats in the United States.”

Americans have heard from few in the mainstream media about the collapse of Finland’s government or the reasons for that collapse.

Norway is excused from this discussion because Norway has become a very rich country from its North Sea oil income and its restrictive immigration policies. It is the citizen’s sugar daddy along with a 50% tax rate. 

The Kaiser Family Foundation found that 58 percent of Americans oppose “Medicare for all” if told it would eliminate private health insurance plans, and 60 percent oppose it if it requires higher taxes.

Reuters reported that soaring treatment costs and longer life spans have particularly affected the Nordic countries financial problems.

“Nordic countries, where comprehensive welfare is the cornerstone of the social model, have been among the most affected,” according to Reuters. “But reform has been controversial and, in Finland, plans to cut costs and boost efficiency have stalled for years.”

Just a few days before Finland’s government collapsed over its inability to foot the bill for its expansive socialist experiment, Sanders took to Twitter in an attempt to shame America.

Bernie Sanders‏Verified account @BernieSanders

FollowFollow @BernieSanders

More

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Bernie Sanders is not being honest with the American people.

“With the collapse of Finland’s government over its inability to financially support its massive socialist agenda, Bernie will undoubtedly do the same thing he always does when socialism (or communism) fails: ignore, obfuscate, and deflect.”

 We only have to remember Vermont’s “Medicare for All” failure. 

Bernie Sanders and AOC should read Finland and Sweden’s newspapers to understand that the people are unhappy with free but unavailable medical care. The unhappiness of the citizens historically happens in every socialist state run healthcare system..

If Democrats are successful in getting “Medicare for All” into law, America will face the same dilemma in the future

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“My conclusion was that my government had to hand in our note of resignation,” he added. “I take my responsibility.”

http://www.politico.eu/article/finlands-government-collapses-over-failed-health-care-reform/

Finland has a decentralized system of health and social welfare programs, where much of the administration is left to local municipalities. This arrangement has led to widespread geographic variation when it comes to quality and access to health care services.

The reform was meant to address these inequalities and reduce the growing cost of the country’s health care system, which has come under increasing stress from an ageing population. It included centralization of the administration at a regional level.”

Finland has been held up as a model welfare state. The distribution of the resulting high taxes is spent on the social issues the politicians think are most important and not what the citizens think are most important.

The government should not be telling the people what they need if a healthcare system is to succeed. The people should decide on what they need and be responsible for their own care. The government should protect the people from both government and corporate abuse in a free enterprise system.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



Copywrite 2006-2023

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Stanley Feld M.D.,FACP ,MACE

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The media is the message. The article will resonate with many young couples trying to live a happy life in New York City.

The article also resonates with Bernie Sanders’ primary message.

Bernie: “Take a look at what Finland, the happiest country in the world, is doing. If Finland can provide everyone with health care, send everyone to college for free and provide affordable childcare, why can’t the US?”

The problem is the message is false.  

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 We’d just had a baby. She was our first, and much wanted. We were United States citizens and our future as a family should have seemed bright. But we felt deeply insecure and anxious.”

There is no dispute with that statement. The college debt burden could be added to that feeling of insecurity.

“Our income was trickling in unreliably from temporary gigs as independent contractors. Our access to health insurance was a constant source of anxiety, as we scrambled year after year among private employer plans, exorbitant plans for freelancers, and complicated and expensive Obamacare plans.

Obamacare was supposed to solve the healthcare insurance problem for this young couple. Obamacare hasn’t solved the problem because of its faulty construction, its top-heavy government bureaucracy and its inefficient administration.

 “With a child, we’d soon face overwhelming day-care costs. Never mind the bankruptcy-sized bills for education ahead, whether for housing in a good public-school district or for private-school tuition. And then there’d be college. In other words, we suffered from the same stressors that are swamping more and more of Americans, even the relatively privileged.

“As we contemplated all this, one of us, Anu, was offered a job back in her hometown: Helsinki, Finland.”

As usual, the New York Times could not help taking a shot at President Trump’s philosophy when they said,

“Finland, of course, is one of those Nordic countries that we hear some Americans, including President Trump, describe as unsustainable and oppressive — “socialist nanny states.”

It turns out President Trump is right.

The couple moved to Finland from Brooklyn. The evidence they used to make their decision was all hearsay from friends and family living in the United States.

Their impression, after living in Helsinki for over a year, sounds like Utopia.

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“What we’ve experienced is an increase in personal freedom. Our lives are just much more manageable. To be sure, our days are still full of challenges — raising a child, helping elderly parents, juggling the demands of daily logistics and work.”

The authors do not describe the meaning of personal freedom.

“But in Finland, we are automatically covered, no matter what, by taxpayer-funded universal health care that equals the United States’ in quality (despite the misleading claims you hear to the contrary), all without piles of confusing paperwork or haggling over huge bills.

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http://legalinsurrection.com/2023/11/finlands-healthcare-system-still-flounders-bernie-and-warren-hardest-hit/

Is this true? What is really happening in Finland?

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Why the New York Times, along with Bernie Sanders and Elizabeth Warren, does not tell us the truth about Finland is obvious. The truth does not fit their agenda.

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Seventeen percent (17%) of Finnish doctors work solely in the private sector. Most of these physicians are general practitioners. This is twice the percentage of physicians that were in the private sector twenty years ago.

An additional twenty percent of physicians work in both the private sector as well as the public sector. 

The bizarre thing is most employers in Finland pay for their workers to have private primary healthcare. Employers do not pay for their employees’ families. The families remain in the public sector.

The public sector is far from free. A visit to a family practitioner cost 16.10 euros. However, patients only pay for the first three visits and then it is free.

According to a Dr. Saarinen of Ula “the more experienced and “better” doctors end up in the private sector, leaving the “inexperienced” and “inefficient” doctors running the health centers.”

 Private practitioners are better paid and work under less pressure than public practitioners.

“A hospital consultation in the public sector costs patients about €38, and you pay for each night that you spend in hospital, up to a maximum of €679.”

伋理IP的高匿、匿名、透明是什么意思 - 简书:伋理IP的高匿、匿名、透明是什么意思 写过WEB后端伋码的同学都比较清楚，为了获取远程访问用户的IP地址， 我伊一般会取请求头里的REMOTE_ADDR、HTTP_VIA 、HTTP_X_FORWARDED_FOR 三个 … Municipalities pay for the free service. The result is service in poorer areas of the country tend to have bad health service and limited access to medical care.

Private GPs usually set up practices in more affluent areas where they are more likely to get paid.

It looks like a grim socialized medical system. No wonder Finns deny the finding they are the happiest people in the world.

“In Helsinki there are reports of huge queues at health centres (GP surgeries), waits for appointments of many weeks, and greater and greater demands with less and less funding. In south-eastern Finland it takes about a month to see a GP. Back in December 2013, it was reported that Finns were increasingly using private doctors in neighbouring Estonia to save time and money.”

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Finland’s healthcare system has been a mess for at least two decades.

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“Our child attends a fabulous, highly professional and ethnically diverse public day-care center that amazes us with its enrichment activities and professionalism. The price? About $300 a month — the maximum for public daycare, because in Finland day-care fees are subsidized for all families. 

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Nothing is free!

The New York Times reported on a UN study proving Finland is the happiest country in the world. The problem is the Finns do not think the study is accurate. The Finns claim that the study was poorly designed and inaccurate.

http://blogs.scientificamerican.com/observations/finland-is-the-happiest-country-in-the-world-and-finns-arent-happy-about-it/

The New York Times has once again printed fake news story to influence readers to believe in the wisdom of “Medicare for All.”

Bernie Sanders, has long been touting Finland, Sweden, Denmark and Norway as the shining examples of socialism and socialized medicine.

Bernie says:

“Take a look at what Finland, the happiest country in the world, is doing. If Finland can provide everyone with health care, send everyone to college for free and provide affordable child care, why can’t the US?”

Carl Sandberg said, in “The Prairie Years”, “If you tell a lie enough times it becomes the truth.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



Copywrite 2006-2023

匿名伋理ip

Healthcare Policy in The Post Truth Era

Stanley Feld M.D.,FACP, MACE

 The government has been deficient in trying to do anything to Repair the Healthcare System.

Unfortunately, John McCain’s vote blocked the repeal of Obamacare which froze any progress.  His reason was feeble and politically naïve.

John McCain wanted congress to work together and have bipartisan agreement on healthcare reform. The entire majority of the present House of Representatives has no desire to be bipartisan or help President Trump create or pass any bipartisan legislation.

Democrats in the house only want to impeach the president. They have no time for positive legislation to repair the healthcare system.

I believe the Trump administration has the right idea. 

President Trump and his administration have decided to make structural changes to the healthcare system by executive order until it can make big legislative changes. Their hope is they win a more cooperative Congress in 2023.

We are living in a Post-Truth era.

“Post-truthpolitics(also called post-factual politics^[1]and post-reality politics)^[2]is a political culturein which debate is framed largely by appeals to emotion 高匿 IP 伋理仍会有办法查出源 IP 吗 - V2EX:2021-7-18 · 伋理的本质只是用来改善路由实现加速或绕过防火墙实现突破。想要实现匿名的话需要额外增加好几个其他的措施。不过考虑到这里基本不存在真正需要匿名的人，就不说关于匿名的问题了。policy, and by the repeated assertion of talking points伋理IP的高匿名、匿名和透明的区别-动态ip:2021-2-17 · 伋理IP的高匿名、匿名和透明的区别 如果从隐藏使用伋理用户的级别上划分，伋理可伍分为三种，即高度匿名伋理、普通匿名伋理和透明伋理。(1)高度匿名伋理不改变客户机的请求，这样在服务器看 …

Post-truthdiffers from traditional contesting and 匿名伋理ipof facts by relegating facts and expert opinions to be of secondary importance relative to appeal to emotion. While this has been described as a contemporary problem, some observers have described it as a long-standing part of political life that was less notable before the advent of the Internetand related social changes.”

 The media is the message. Donald Trump threatens the Democratic Party, the bureaucracy and the traditional mainstream media.  He also threatens some of the Republicans.

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President Trump is working hard to streamline and increase the efficiency of the ever-expanding bureaucracy. He is a direct threat to their well-being. This is their justification for hating him.

The traditional mainstream media has promoted the Democrats’ agenda. They have helped obstruct President Trump’s agenda. The media has ignored or criticized the continual successes of President Trump.

It has either published disinformation or misinformation, ignored critical thinking on issues, or simply published non-truths.

President Trump has had no choice. Obamacare remained the law. It has been expensive and unsuccessful. It is impossible to know its yearly cost to the federal government. It is self-imploding and will disappear shortly.

Obamacare has just completed its open enrollment period for 2023. The enrollment period is supposed to end on December 15^th. The Obama administration extended it to March 31 during some enrollment years. The Trump administration has extended the 2023 open enrollment period until December 31, 2023 this year.

85% of people who enrolled in Obamacare have a preexisting illness. The Obama administration has subsidized most of the premiums. It did not subsidize the deductibles. Obamacare participants still could not afford to pay the deductible. In essence, participants have no healthcare insurance because they could not afford to use it.

Open enrollment as of December 7, 2023, was awful.

There are only 6,134,477 who have enrolled in 2023 compared to 16.1 million enrollees in 2014. Medicaid was expanded by 9.3 million in 2014. With the Medicaid expansion, a total of 25 million people received insurance in 2014. 

Medicaid is a single party payor. It is inefficient. It has a problem getting physicians to participate because reimbursement does not cover most physician’s overhead.

President Obama decided to have the federal government pay over 90% of the state-run Medicaid programs for a few years.  The states, which signed up for the Medicaid expansion, did not have an increase in costs.

When states have to start paying more for the Medicaid expansion, they will have to raise taxes because by law they cannot have a budget deficit. At the moment most of those states have unauthorized budget deficits. Those deficits will become worse when they have to fund expanded Medicaid.

The mainstream media and Democratic congress continually publish the figure that Obamacare has decreased the uninsured by 20 million. However, eleven million were that result of the expanded Medicaid program.

2014

The numbers do not match. The government graphs are complex and confusing. However, they are very informative. The graphs tend to confuse us with estimates and actual enrollees.

 In 2016 the numbers decreased to 9.3 million with open enrollment extended to February 1, 2016

 2016

 Medicaid enrollment increased in 2016 to 15.3 million.  The Medicaid increase is included in the total number of previously uninsured, Obamacare provided healthcare insurance. Obamacare’s increase in previously uninsured is, in fact, an expansion of Medicaid.  The mainstream media use the number 20 million newly insured patients which is a misleading justification for fixing Obamacare. Some of Medicaid’s increase enrollment could represent the illegal immigrants who are now entitled to healthcare coverage.

The net Medicaid increase since March 2010 in 2016 was 16.3 million. It looks like Obamacare’s goal was to increase Medicaid. The next step is to have “Medicaid/Medicare for All.”

2018 remained the same as in 2016, with many more dropouts because people realized Obamacare’s unaffordability. Since it was unaffordable, they realized they could not afford care event thought they paid their premium. Therefore, they dropped out and stopped paying their premiums.

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Everyone is dissatisfied.

Only 6.1 million consumers have enrolled in Obamacare for 2023.

President Trump is hoping that after the 2023 election, he will have a friendlier Congress. Obamacare will be repealed. Congress will want to do something to help him repair the healthcare system. Meanwhile, he can only do some structural changes to lead us on the path toward an affordable healthcare system.

I predicted Obamacare would eventually fail when it was passed in 2010. Obamacare did not align stakeholders’ incentives!

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Bernie Sanders’ and Elizabeth Warren’s “Medicare for All” will suffer the same fate as Obamacare.

Most of all the taxpayers in the nation will suffer the most.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



Copywrite 2006-2023

Please have a friend subscribe

Stanley Feld M.D.,FACP, MACE

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President Trump has kept his steps toward healthcare reform under the radar. It is all published and there for everyone to see.   

President Trump is hoping that after the 2023 election he will have a friendlier congress. A congress that wants to do something to help him help American consumers of healthcare obtain affordable healthcare.

Consumers need relief from the Obamacare disaster. Obamacare has caused increased dysfunction on top of an already dysfunctional healthcare system.

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I hate to say it. I predicted Obamacare would fail in 2010. Basically Obamacare did not align stakeholders’ incentives.

I explained why Obamacare was failing in each subsequent year of its passage.

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President Trump has taken important steps to repair the healthcare system. He has brought back the power of “Associations.”  Associations now have the ability to negotiate with healthcare insurance companies and sell healthcare insurance to its members.

In addition, Associations now have the ability to offer its members healthcare insurance at pre-tax dollars. This is a very big deal. Previously individuals seeking individual insurance had to pay for that healthcare insurance with post-tax dollars.

Instantly, healthcare premiums are effectively reduced to consumers by 20-40% using pre-tax dollars. This make present premiums more affordable.

Associations are growing very rapidly as final rules are being created to make their healthcare insurance available. The significance of Associations has been largely ignored by the mainstream media. 

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The traditional mainstream media has been busy publicizing the socialist concept of “Medicare for All.”

I have pointed out that “Medicare for All” doesn’t work. It has never worked in a financially sustainable way for many countries. In countries that have socialized medicine consumers are dissatisfied because there are long waiting times and a shortage of the access to medical and surgical care.

Our leftist politicians say socialist medicine has worked beautifully in countries like Sweden, Denmark, Canada, and England to name a few.

I have published the difficulties consumers have had in these socialized medicine countries.

Unfortunately, our leftist politicians are either ignoring the truth or do not know what they are talking about. The traditional mainstream media are simply acting as puppets for our leftist Democratic politicians who want to control the healthcare system.

Everyone knows the larger the bureaucracy the more inefficient the system. The VA healthcare system is a perfect example of this statement.     

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“It will level the playing field to enable individuals in both groups to negotiate healthcare insurance premium prices through their associations with the same purchasing power that large corporations have.”

It could also work for consumers working for large corporations. Those employees who are displeased with their corporate provided healthcare insurance coverage can change to association provided insurance.

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These new regulation has had little coverage in the New York Times, network television or any other mainstream media.

The traditional main stream media have been pushing the Democratic Socialists’ idea of “Medicare for All.”  “Medicare for All” cannot work.

“On Thursday June 20^th 2023, the Department of Health and Human Services announced a final regulation that allows businesses to fund employees who buy health insurance on the individual market–something that until now has been illegal.”

 “The U.S. Departments of Health and Human Services, Labor, and the Treasury issued a new policy that will provide hundreds of thousands of employers, including small businesses, a better way to provide health insurance coverage, and millions of American workers more options for health insurance coverage匿名伋理ip

Since this new policy is a President Trump initiative, the elites in the media must have concluded that is a silly policy and it cannot work.

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A close study of Health Reimbursement Arrangements (Associations) will make it clear that these numbers are correct. In fact, these estimates might be a gross underestimation of increased number of consumers with healthcare coverage.“Under the rule, starting in January 2023, employers will be able to use what are referred to as individual coverage HRAs to provide their workers with tax-preferred funds to pay for the cost of health insurance coverage that workers purchase in the individual market, subject to certain conditions. … Individual coverage HRAs are designed to give working Americans and their families greater control over their healthcare by providing an additional way for employers to finance health insurance.”

Associations allow everyone to be participants in the large corporation negotiating healthcare market. It allows consumers to avoid the trap of large, bureaucratic and by definition inefficient government control healthcare.

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 The new policy empowers individual consumers to shop the market and select the healthcare coverage that best meets the needs of their family.

The insurance industry will not have to comply with the burdens of Obamacare’s regulations for healthcare coverage. They can create new products including medical savings accounts without restriction.

This will create an extremely competitive healthcare insurance environment.

“This is a good example of how the Trump administration is moving forward in practical ways on important issues, empowering consumers and freeing up markets. The Democrats don’t like it, of course. But the new HRA system will be popular with millions of Americans whose ability to access the individual market and exercise consumer choice will be enhanced.”

The only big barrier is that it will make consumers become responsible for choosing their healthcare coverage and be responsible for their healthcare dollars.

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