Allow The Physicians To Speak...

Learn what physicians think about the real issues. On Sermo, physicians collaborate on everything from patient care and medical ethics to healthcare reform and practice management. We’ve highlighted some of their most vibrant discussions on the Sermo Blog.

From the Founder: A Squandered Opportunity

Like so many physicians and citizens, I find myself frustrated, saddened, and more than anything scared by what is playing out in the healthcare reform effort. While I believe people understand the concept that the ends justifies the means, one cannot help but wonder what the ends are at this point.

The subversion of our democratic system violates every lesson we learn as school children about separation of powers in the government. If this bill is so good for the public, then why do opinion polls overwhelmingly say that the public is not in favor of this and why are some legislators doing things that can only be described as extraordinary?

The worst thing? I hope this bill passes.

It is our last best hope at ANYTHING meaningful occurring. That being said, I think the damage is done. This is no longer about the goal, it is about the process. The proponents HAVE to pass the bill. It has become a self fulfilling prophesy. Rationality and what is "best" for our country have long since left the conversation. Unfortunately, true healthcare reform will be just the first casualty here. The healthcare system, the broader economy, and ultimately our nation will pay the price. We have squandered the opportunity of a lifetime for the benefit of a tiny number of special interests. On this point, I truly hope that I am wrong.

Almost two years ago, the Sermo community called for healthcare reform with over 12,000 physicians signing the open letter. This community went on to predict that the AMA would fail physicians in their moment of need, pointing out that the AMA's business model made them beholden to the government and insurance companies, not physicians. Finally, this community consistently pointed to the key elements needed in meaningful healthcare reform (not one of which is in the bill). Lately, this community has been making perhaps the most alarming prediction of all:

• Physicians are opting out of medicine in alarming numbers.
• We are opting out of Medicare/Medicaid in even larger numbers.

Ultimately, it will be our patients that pay the price. As our nation holds its collective breath on the eve of this historic vote, we all should all remember that.

Daniel Palestrant, MD

Founder & CEO

Sermo, Inc.

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America Hanging by A Thread - Rush

America Hangs by a Thread Rush Limbaugh

RUSH: Today, as we start the radio program, America is hanging by a thread. So we have to see what we can do with a thread. At the end of the day, our freedom has been assaulted. This is the kind of change that people did not think they were going to get when they voted for Barack Obama. Freedom must win the day. Great to have you here. We'll be talking to you about all of this, 800-282-2882 is the number. The e-mail address: ElRushbo@eibnet.com. You have to deal with reality here, and that means focusing on the future. Now, there are some people who want to look back at the past and say, "How did we get here?" and that's all fine and dandy, but we know how we got here. Barack Obama was elected president. If you want to go back any further than that, we can, but we are here because Barack Obama was elected president. We are here because the Democrat Party has a majority in the Senate and the House of Representatives. There's a lot of anger at Bart Stupak today. Bart Stupak was always going to vote for this. The thing that Bart Stupak needs to be hounded out of office for is for misleading an entire nation and giving an entire nation a big, fake feint job that he and his cohorts were somehow going to do something to stop this on the basis of a false premise, anyway. I want you to hear a piece of audio from Stupak. This is October 24th in Cheboygan, Michigan. He held a town hall meeting. This is Internet quality, here. He held a town hall meeting, and he told a questioner, one of his voters, that if he liked everything but the abortion funding he would vote for it. He said this last October. STUPAK: If everything I want [is] in the final bill, I like everything in the bill except you have public funding for abortion -- and we had a chance to run our amendment and we lost. Okay, I voted my conscience, stayed true to my principles, stayed true to the beliefs of this district. Could I vote for health care? Yes, I still could. RUSH: And he did. He was always going to, as were the moderate Democrats. There were some of them that were given a chance to vote "no" because they had enough of a majority last night. But up until four o'clock yesterday afternoon, theoretically, Pelosi did not have the votes. I'm asking myself what kind of country are we today. We're not a representative republic. The will of the people was spat upon yesterday. The will of the people is of no concern to the people who now have power and authority from the White House all the way down to Capitol Hill. The will of the people is something to be crushed. So we're not a representative republic. You can't even say, loosely defined, we are much of a democracy. We have to restore these things. We have to do this by getting rid of these people at the ballot box. We must get them out of office. That's the only thing here. I hear people talking about repeal, and that's great, but there's something that has to happen before we can do that. We can't repeal this thing as we sit here today. We don't have the votes. We didn't have the votes to stop it; we're not going to have the votes to repeal it. We have to start winning elections. But I'm going to tell everybody in the Republican Party that's running around talking about repeal: It had better be more than a campaign slogan. You better mean it. Don't declare something as principle and then play it like a $5 poker chip like Bart Stupak did. Stupak has humiliated and disgraced himself. He lied because he held out the hope to millions of Americans that this travesty would not happen. Bart Stupak has not only humiliated and disgraced himself; he has as big a role in destroying this country as it was founded as Barack Obama does. Last night, Bart Stupak damaged the already crippled Democrat Party more than he knows, more than they know. That executive order? Totally laughable. Stupak just wanted his "Notice me!" moment. Stupak is no different than Neville Chamberlain, who came back with that little letter from Hitler, "Oh, yeah, Hitler says no war between his country and ours." Churchill said, "Well, you're a fool."

Well, Stupak got his executive order which is worthless and can be rescinded, but it does not have the ability to counter statute. So whatever's in the Senate bill -- and there is federal funding for abortion in the bill; and folks, make no question: The lies that we have been told about what's in this bill, what's not in this bill, it is an utter disaster. If you want we can spend some time today going through some of these individual items, which we've been doing for a year-and-a-half. The point is, the American people have awakened and they finally have seen what statists look like and what they do and how they act. Even McCain, who as recently as a year ago wanted to "walk across the aisle" and work with these people, said today he's upset just looking at how happy they are at what they've done. Of course, it need not have happened had we... Well, I don't even want to go there. Focusing on the past is only relevant in terms of how we learn from it and not make the same mistakes in the future. So yep, we repeal -- fine and dandy -- and we take these lawsuits. These lawsuits are an uphill climb. We can't rely on lawsuits to win the day. I mean, they need to be filed and they need to be argued, and we need to push back in every direction, but the focus has to be on defeating Democrats in November in these midterm elections. We have the people. We have the intellectual arguments. We have the commonsense arguments. We have history. But they won yesterday. They won because they held Congress and the presidency, and therein lies the lesson: We need to defeat these bastards. We need to wipe them out. We need to chase them out of town. But we need to do more than that. We need to elect conservatives. If there are Republican primaries, elect conservatives and then defeat the Democrats -- every last one of them -- and then we start the repeal process. And by "repeal," I mean use every single legislative and bureaucratic tactic we can muster to obstruct, derail, and defeat them. Just saying "repeal" does not make it happen. We're going to have to turn out en masse in November and stop these people. As you have seen, the law will not stop them, the Constitution will not stop them, hoping that they will do the right thing will not stop them because their definition of "the right thing" has nothing in common with ours. They must, my friends, be hounded out of office. Every single Democrat who voted for this needs to know, safe district or not, that they are going to be exposed and hassled and chased from office. We now have leftist radicals in charge of your health care decisions rather than doctors. I got up today and I said, "We're hanging by a thread," and there's a difficult balancing act on this program today: Dealing with the reality of what has happened, which can't be candy coated, with the need to fight on. The need to fight on and the urging to fight on must have some substance to it and not just be rhetoric and language and lingo. It has to have some substance behind it, because we really are facing the prospect that our country will never be the same after yesterday, if this stands. It will never be the same, and a majority of the American people understood it. A majority of the American people understand it and know it and are outraged by this. Americans are now eagerly awaiting their insurance premiums to be reduced by $2,500 a year. Obama has been promising this since his presidential campaign of 2008. Americans are now eagerly awaiting for all of the uninsured to magically have health insurance. The American people are now waiting for their premiums to magically go down and for their access to go up. I was listening to some of the Democrats in the media last night. Juan Williams on Fox was just excited. "Oh, my God, this is so wonderful! It's so wonderful! No more preexisting conditions! No more preexisting conditions! Everybody gets insurance," and I'm saying, "Does anybody not understand economics here?" We're not even talking about an insurance business anymore. What's happened here is not insurance. Insurance is you insure yourself against a catastrophe, something that might happen to wipe you out. This is not insurance. This is simply the insurance companies being captivated or taken over by the government and having their behavior mandated for the express purpose of putting them out of business. Under this bill, as I told you last week, you don't have to buy insurance. You can wait until the accident or the illness happens and then buy it that day, and they have to sell it to you. No matter what. If you get terminal cancer and the doctor gives you three months, they have to sell you your coverage. Except you're not going to have to buy it. If you can't afford it, we -- all your neighbors -- will. No insurance company can stay in business doing this. It's the same thing with preexisting conditions. No preexisting conditions? The liberals keep talking about automobile insurance companies. What happens to you if you have an automobile policy, you're driving around, and you have an accident and you do a lot of damage? Hey, guess what? You are a higher risk. Your auto insurance premium goes up, right? Why shouldn't that happen with health care? Why shouldn't it? (whining) "It's not fair? No, it's not fair!" Well, it won't now. It won't now. So, yeah, preexisting conditions are going to be covered, but who's going to pay for this? Insurance premiums are going to skyrocket in the next couple of years until they are out of business and the government steps in to take over with the...public option. Which is just waiting a couple of months, couple of days, couple years down the tracks. It's just waiting to happen, because this bill mandates the destruction of the private health insurance business.

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Senate Health Care Bill Raises Health Care Costs, Kills Jobs, and Weakens the Economy

from the Heritage Foundation

On the eve of the House of Representatives push to jam through the misguided and highly unpopular Senate health care bill, , the President continues to try and convince the American people that the health care bill would reduce cost while showing his commitment to creating jobs and improving the economy. The raw facts make it clear that he cannot keep either of these promises. For example:

• The President claims the health care proposals would reduce health care spending. The reality is health care spending would increase. According to the latest Congressional Budget Office report of the Senate bill, health care spending under the Senate bill would increase by $210 billion over the next 10 years. This is similar to the results found by the President’s Chief Actuary which estimated an increase of $222 billion. While CBO predicts spending would decrease in the second decade, history shows spending rarely, if ever, goes down on government health programs. Medicare is hurtling toward a financial crisis, and Medicaid is breaking state budgets.
• The President claims the health care proposals would reduce premiums. The reality is premiums will go up for many under the Senate bill. The Congressional Budget Office and the Joint Committee on Taxation have estimated premiums in the non-group market would be 10 to 13 percent higher in 2016 than they would be with no bill and cost would likely fall higher on young and healthy families. In addition, this is before the government specifies and locks into place new federal benefit mandates that will no doubt further increase premiums for all Americans. There is little or no experience of government officials reversing these trends.
• The President claims the health care proposals would cost under a trillion. But, that figure excludes major health care provisions – like filling the Medicare “donut hole”, fixing Medicare reimbursement to physicians, and creating a new long-term entitlement program – pushing the price tag to over $2 trillion. Only in Washington does spending more money equal saving money.
• The President claims the health care proposals would reduce the deficit. Unlike CBO’s restricted scope of analysis, the independent analysis by the Lewin Group estimates that when taken in its entirety, which means accounting for the expected $200 billion plus boost in Medicare reimbursement for physicians, the proposal would actually add to the deficit, not reduce it.
• The President claims he is committed to improving jobs and the economy. Based on his own policies, the opposite is true. The Senate bill would result in 620,000 fewer job opportunities and would increase the national debt by $755 billion through its lethal combination of mandates, taxes, and government spending. As Heritage analysts have pointed out, “Because investment is what drives productivity and economic growth, less investment–even if only slightly less–leads to lower productivity, slower economic growth, weaker wages and salaries, and lower household wealth.” Even worse, his own proposal to “fix” the bill adds a new tax on investment income that would result in 115,000 lost job opportunities and disposable income is estimated to be $17.3 billion less per year than it otherwise would be.
• The President claims he will “fix” the bill. Although he promised to ensure no federal funding would be used for abortions and eliminate the repugnant special deals, House passage of the Senate bill would lock these into place, and they could only be undone through a highly uncertain reconciliation process to “fix” the bill in the Senate. Not only is taxpayer funding of abortion not fixed, it is expanded under the Senate bill. Moreover, the ugly special state deals at the expense of the taxpayers still remain.

Author: Nina Owcharenko

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Fox News' Bret Baier Chats with Barry

Hat tip to Investor's Business Daily

Leadership: After his interview with Fox News, it's obvious why President Obama hasn't held a real press conference in eight months: He has no intention of explaining the legislative lunacy he has loosed on America.

Some may call Bret Baier impolite, or "disrespectful of the office," as some put it, for the way the Fox anchor kept interrupting Obama during the interview Wednesday evening. But we'd call him thoroughly professional.

For the first time we can recall, someone actually tried to get some straight answers from the man who is trying to ram through a radical "reform" of a medical system that nearly nine of 10 Americans think is fine the way it is.

Too bad Baier didn't have more time, because the few minutes he got elicited little more than talking points from a politician so slippery he makes another Democrat known for his slickness sound inarticulate by comparison.

As it was, Baier had to butt in repeatedly in a futile effort to get simple answers to basic questions that centered mostly on the fairness of the process being used by Congress to take over a sixth of the economy without so much as a direct vote.

Why all the trickery to pass a bill that's so good? Baier asked in behalf of what he said were the 14,000 viewers who sent him questions. "I don't spend a lot of time worrying about what the procedural rules are in the House or Senate," the president sniffed.

Then there was the president's brush-off when Baier asked about the contents of the bill that only Thursday saw the light of day. Are all the special deals still in there — the Cornhusker Kickbacks, the Louisiana Purchases, etc?

"By the time the vote has taken place, not only I will know what's in it, you'll know what's in it, ... " the president assured — sort of. But for the record, he said he's all for giving Louisiana millions of dollars because the state had gone through a "national emergency" — just like Hawaii when an earthquake hit.

We're still checking on that Hawaii reference. But even if there's been no such quake, we doubt the media would make much of the gaffe. This isn't George W. Bush, after all.

Which brings us back to the main point here: The media performance so far in the Obama presidency, and especially in covering health care, has been shameful.

Here we are on the verge of passing the most important piece of domestic legislation of our time and no one seems to know what's in it, how much it'll cost and what it'll really do. Seems to us that the man who's pushing it hardest would be a good one to ask.

But as Bret Baier found, good luck with that.

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I Remember Mad Magazine as a Kid!

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Hooray for Hoosier Healthcare

Indiana's Republican Governor Mitch Daniels explains the brilliance of Hoosier Healthcare. It works! And, one has to wonder, is anyone in Washington listening?

excerpt - In Indiana's HSA, the state deposits $2,750 per year into an account controlled by the employee, out of which he pays all his health bills. Indiana covers the premium for the plan. The intent is that participants will become more cost-conscious and careful about overpayment or overutilization.

It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: "Is there a generic version of that drug?" "Didn't I take that same test just recently?" "Where can I get the colonoscopy at the best price?"

The Indiana experience confirms what common sense already tells us: A system built on "cost-plus" reimbursement (i.e., the more a physician does, the more he or she gets paid) coupled with "free" to the purchaser consumption, is a machine perfectly designed to over-consume and overspend. It will never be controlled by top-down balloon-squeezing by insurance companies or the government. There will be no meaningful cost control until we are all cost controllers in our own right.


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Reagan Weighed In On Socialized Healthcare

Emotions are flying hot and heavy on this subject. Ronald Reagan explains the relationship between freedom and government control of healthcare...50 years ago! And his input is more valid today than ever!

"From here, it's a short step to all the rest of socialism," Reagan said.

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Bipartisan Baloney

The IBD skewers any notion that the Baucus Grand Government Healthcare Takeover proposal is somehow bipartisan.

Bipartisan Baloney

Health Reform: As predicted, the Democrats are using the vote of one very liberal Republican as proof their health care takeover is "bipartisan." It's nothing of the sort. But then, we're getting used to such exaggerations.

To ensure passage even in a Congress where they have an overwhelming, veto-proof majority, the Democrats have used deceit and outright lies to make their case. Calling the Baucus health overhaul "bipartisan" simply because Republican-in-name-only Sen. Olympia Snowe of Maine opted to vote for the bill is just one example.

Snowe in fact is more liberal than most of Blue Dog Democrats, some of whom have shown the wisdom to object to the nationalization of 17% of the U.S. economy.

Before Baucus, she voted for the bogus $787 billion "stimulus" package that's done nothing for our economy but promise to send our children into perpetual debtor status. So in one year, she voted to expand our deficit by a minimum $1.5 trillion in the next decade.

Bipartisan? Democrat Joseph Lieberman of Connecticut says he won't vote for the bill's passage, as it stands now. Nor will Democratic Sen. Jay Rockefeller. He objects to taxes on high-income health care recipients — who happen to include, believe it or not, many coal miners in his home state of West Virginia.

Doesn't that show opposition to the bill is more bipartisan?

And what about the 158 House Democrats who, like Rockefeller, won't vote for the Senate bill if it includes the 40% tax on so-called "Cadillac" health care plans — supposedly a tax on "the rich," but in reality one that will hammer the job-creating entrepreneurs in many Democratic districts.

As for Snowe and her fellow Maine Republican, Susan Collins, their possible embrace of the Baucus bill doesn't make it bipartisan either. Heck, they aren't even "moderate," as the media have described them. They're liberal. And that's not merely an opinion.

The American Conservative Union scores legislators on a number of key votes to gauge how conservative or liberal they are. Here's what the ACU had to say about its 2008 tally: "For the first time, two Republicans scored as absolutely liberal in voting."

The two? Snowe, with a score of 20%, and Collins, at 12% — more liberal even than then-Sen. Barack Obama, who scored 17%. Not surprisingly, Collins says she may also back the Baucus bill.

No, none of this is "bipartisan" in the least. But that's par for the course in this debate, where so many outright falsities masquerade as truths.

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Open letter to the White House

Dearest Linda Douglass,

This is laughable. At http://www.whitehouse.gov/blog/Facts-Are-Stubborn-Things/ you directly request the public to respond:

If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.

OK. Since a representative like John Conyers publicly admits he hasn't even read the bill, and would require the assistance of a couple of lawyers to interpret the bill either way, how would I know what sounds fishy? If he's ignorant of what's in it, why should I rely on my government to adequately inform me? Hmmm? Our own majority members of congress are not intimately familiar with this massive boondoggle and therefore they are unworthy of our inquiry. That irresponsible representation alone directs me to seek alternative sources for information.

Now, you sit here and lie to me regarding your own plan to eliminate the private individual medical insurance market with government run health care and insist that false rumors abound? You're truly out of touch. And, you must be very naive and simple. Via your plan, the only folks who will NOT lose their private insurance coverage are members of Congress!

1,000 plus pages of government run trash. Dump it! You can keep your attempt at communism. There's not even a lick of tort reform in this hastily compiled garbage!

I will continue to seek out alternative views on this disastrous attempt at legislation for no other reason than that I cannot trust you or your president to be truthful. I'd be delusional to think otherwise.

Jeff Wahlen - Orlando


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I'm stickin' with the IBD...

The Investor's Business Daily gallantly continues the fight against the BarryCare government run elimination of the private medical insurance market despite all of the White House denials. I'm stickin' with the IBD for my truth, not Captain Barry!

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