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home : opinion : opinion May 26, 2016


2/12/2013 6:00:00 AM
Column: Obamacare: Unexpected stings
Elizabeth Vliet
Tucson Physician

Many promises were made to different groups to sell the new health care law to a skeptical public. Having watched the medical insurance games - government and private - for my whole career, I thought these promises were too good to be true.

What is coming to light now is like "The Big Con" that Robert Redford's character skillfully pulled off in the classic movie The Sting. Only the Pelosi-Reid-Obama trio forced through an even bigger "Sting" on the entire country, especially the very constituencies they promised their health care law would help.

One by one, the political promises fall like dominoes. The very groups that strongly supported government control of health care are now some of the ones getting stung badly. The effects are like a swarm of killer bees suddenly descending on the unsuspecting, stinging everyone in sight.

Our personal New Year's sting was a 22.5 percent jump in my husband's Medicare supplemental premium for the 2013 renewal. Reason: Obamacare regulations and mandates.

Then I received the notices for our employees' health insurance premiums: more premium increases - even though we have a high deductible, catastrophic illness-type plan to help keep costs affordable.

Next, the IRS projected premiums of $20,000 per year for a family of four. Affordable? For whom? This sting is a $3,000 to $5,000 increase instead of the promised $2,500 savings per year - a miscalculation of $5,500 to $7,500 for a family of four.

Large national restaurant chains are cutting employees' hours because they cannot afford to pay the high health insurance premiums for "full-time" employees. How can the middle class make ends meet on part-time work?

Liberal groups that overwhelmingly supported Obamacare are also getting stung. Of course, these announcements came after the election, in which these constituent groups supported Obama in droves:

College students: Before Obamacare, young healthy college students paid average health insurance premiums that only cost $100-600 per year. Obamacare mandates mean that premiums are rising to $1,700 to $2,000 per year. In New Jersey, where health insurance is mandatory for college students, this is indeed a huge sting!

College faculty: At many universities, faculty hours are being cut back to less than 29 hours a week to avoid the costly Obamacare premiums.

Union members: the sting of Obamacare has come in many forms, so Big Labor is now seeking waivers for union members.

Smokers: Many who fell for Obama's promise of "free" or lower cost medical care are learning that their premiums will be 50 percent higher than nonsmokers - up to $4,250 dollars per year in excess costs for smokers age 55 and older.

Employers: Paying for all the Obamacare mandates in employer-provided health insurance adds $1.79 to the hourly rate to hire an employee. That's why many are not hiring.

Seniors: After the election, seniors are learning that all the promises of "no cutbacks" in their medical care were false.

The Senior Sting is especially ugly. One 80-year-old patient told me his heart medicine was no longer covered, "because I am too old now." Preventive services and cancer screenings for the older patients, such as prostate and breast cancer checks, are being cut to pay for "free" birth control pills. As of 2012, hospitals are paid more to provide fewer surgeries. Popular and lower cost Medicare Advantage plans are being cut back or eliminated.

Then there is the Medicaid sting: States that are expanding Medicaid plan to cut payments to doctors and hospitals to about 56 percent of what private insurance companies pay. This means more patients lined up for fewer doctors and hospitals.

And let's not forget the privacy sting. Your electronic health record will be used to decide what treatments you will be allowed. The IRS will be collecting expanded personal information about your income, habits and family to decide what to sting you on penalties.

In short - old or young, black or white, liberal or conservative - once Obamacare was forced on patients across the country (except Congress and the President) - everyone has gotten The Sting - in the Biggest Con of all.



Elizabeth Lee Vliet, M.D., is a preventive and climacteric medicine specialist with medical practices in Tucson and Dallas. Visit http://www.aapsonline.org/ for more information.


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Reader Comments

Posted: Wednesday, February 20, 2013
Article comment by: origional Kingman Resident

@ Anson

From your first reply to my comment:

“The republicans actually wanted to improve the health care system by passing tort reform and allowing interstate competition for health insurers.

Actually they did not, more on that coming.



From your second reply to my second comment:

“Actually the Republicans did put forward tort reform and interstate insurance competition as 2 solutions to the health care problems.

I never said they did not, "


You need to re-read your comments to keep your story straight.





Posted: Tuesday, February 19, 2013
Article comment by: Anson's Nephew

“Oh, but Rasmussen is one those right wing idiot fringe websites that aren't acceptable in your world huh?”

Actually you are correct. Rasmussen is a well-known Right Wing site that is wrong so often it makes one wonder why anyone would use them. I stand by my figures – check Galup, Quinnapac (sp), Wall Street-Journal, etc.


Posted: Tuesday, February 19, 2013
Article comment by: Jonathan Walker

AN wrote, "As I pointed out over 70% of the people in this nation are liking what has taken place with the ACA and look forward to other parts of it being implemented next year."

Incorrect, as of late January, 45% had a somewhat favorable opinion of Obamacare while 51% had an unfavorable view. Oh, but Rasmussen is one those right wing idiot fringe websites that aren't acceptable in your world huh?

http://www.rasmussenreports.com/public_content/archive/health_care_update_archive/february_2013/54_expect_costs_to_rise_under_health_care_law


Posted: Monday, February 18, 2013
Article comment by: Anson's Nephew

“Actually the Republicans did put forward tort reform and interstate insurance competition as 2 solutions to the health care problems.”

I never said they did not, what I did was poit that both of those items are scams that will benefit only the insurance industry and will not be any kind of a panacea for health care in this country.

“The majority of the Americans do not want the government mandating and controlling the health care system.”

As I pointed out over 70% of the people in this nation are liking what has taken place with the ACA and look forward to other parts of it being implemented next year.

“Already, Americans are realizing that they will be paying much more for medical care and their access to care is decreasing.”

Not true. My costs have gone down for both insurance and medications and my access to more preventative care options has drastically increased.

“Single payor systems have not been a success in the other countries where they have been implemented.”

Also incorrect. In a visit to Canada I found the people very happy with their health care. So much so in fact that when they selected the Canadian that had done the most for their nation they overwhelmingly voted for Tommy Douglas the father of the Canadian Health Care system.

“People wait for exceedingly long times for treatments and the availability of treatments are curtailed.”

Both incorrect.

“The US was held up as the leader in health care”

The US is number 37 in the world for access to health care.

You kept posting that I need to do my research when it is obvious that you have done none.

w/c282


Posted: Monday, February 18, 2013
Article comment by: V Stokes

@AN...
I apparently posted earlier before completing my statement.

Why in the world would a business pay $12+ an hour for unskilled labor? Even $9 is a bit ridiculous. I started work at a national home improvement chain in 2005 at $10/hr PT. When I went FT it moved to over $11. When I went in to a specialty it jumped again and a few years later I finished at $14.50/hr after annual raises. About 10% per year on average. I also had skills and knowledge that the avg 19 y/o couldn't hope to have. Before taxes that's about $30K a year just in wages. If I was 20-25 yrs old with just basic skills, that would seem to me to be a pretty good deal. Keep your toy purchases down, don't overspend, and you could live pretty well on that. At the age I was, with a home and vehicles to pay for...no, that was not my only source of income.

Should every 16 y/o start making almost $13K a year working PT at McD's??


Posted: Monday, February 18, 2013
Article comment by: Origional Kingman Resident

@Anson

Actually the Republicans did put forward tort reform and interstate insurance competition as 2 solutions to the health care problems. You need to do some research and educate yourself on the issue. The Republicans were also very explicitly told that their input was both not wanted nor necessary on numerous occasions.

The majority of the Americans do not want the government mandating and controlling the health care system. Another area in which you need to educate yourself.

Already, Americans are realizing that they will be paying much more for medical care and their access to care is decreasing. This before the provisions are fully implemented. The government has had to scrap 2 of its programs under Obama Care due to the expense. One was the long term care program for elderly people. The other was a program to offer care to uninsurable patients temporarily until the mandate for insurance companies to do so takes effect in 2014. The costs of treatments was much higher than anticipated and the fund ran out. What do they think this will do to the insurance companies in 2014?

Single payor systems have not been a success in the other countries where they have been implemented. People wait for exceedingly long times for treatments and the availability of treatments are curtailed. The US was held up as the leader in health care due to the fact that it was privatized. It allowed for greater innovation for drugs and treatments, and more efficiency in treating patients.


Posted: Monday, February 18, 2013
Article comment by: Frank Lee Speaking

@ansons nephew

"the minimum wage needs to be rasied to $12.40 cents!"

Gee AN, why not make it 50 bucks an hour, or 100 bucks an hour. Then every underachieving minimum wager would have the living wage you leftists demand..........At least until the business folds. Do you think business can pay $12.40 per hour and NOT have to pass the cost of that on to the consumer?

@V Stokes

"Unless we want to pay $6 for a 1/4 pounder."

Not a problem. Once leftists finally get the single payer healthcare system they crave, 1/4 pounders and all burgers other than veggie burgers will be banned. They contribute to the high cost of healthcare for the collective.

Now report to the nearest govt re-education camp immediatly so we can get your mind right, comrade.


Posted: Sunday, February 17, 2013
Article comment by: Anson's Nephew

“The republicans actually wanted to improve the health care system by passing tort reform and allowing interstate competition for health insurers.”

Actually they did not, more on that coming. As to tort reform that is a gambit put forth by the insurance industry to prevent payouts to damaged individuals – simple as that. Selling insurance across state lines is another scam that would allow insurance companies to sell from states that have the most lax laws and would take away a States right to regulate an industry that has shown throughout history they must be regulated to protect the people.

As to the single payer system. This is the concept put forth by Presidents dating back to FDR that would provide a Medicare type system available to every citizen of the U.S. Single payer works very well and is in place in virtually every other industrialized nation on Earth. However, the Republicans wanted the individual mandate, a concept put forth by the Heritage Foundation (a Right Wing Loon lobbying group) in 1989 and advocated and pushed by virtually Republican in Congress throughout the 1990s and early 2000s (and put in effect in MA by the darling of the Republicans, Willard the Money Hider. Whatever happened to that guy?) and President Obama capitulated and accepted the individual mandate – which the Republicans now decry as something terrible.

“The American people, … overwhelmingly did not want Obama Care.”

Incorrect and as the ACA has been brought on-line over 70% of the people in this nation like the program and look forward to further implementation of the ACA next year.

w/c266


Posted: Saturday, February 16, 2013
Article comment by: Origional Kingman Resident

@Anson

We all know that you support Obama care no matter what the facts are.

Since you have claimed to have read the entire bill, it's funny that you are unaware of the board of 15 appointed people who will decide what treatments and drugs will be alotted to people in various age groups. (The death panel). And the authorization for the IRS to hire thousands of new employees to deal accounting for with the new "tax" for people who don't buy coverage.

As far as the single payor system. The republicans actually wanted to improve the health care system by passing tort reform and allowing interstate competition for health insurers. Unfortunately, Obama and the Dem controlled house and senate blocked the Republicans out. Much of the bill was discussed behind locked doors. McCain was told by the president at a round table"discussion" that the campaign was over and Obama won. So much for bipartisan input.
The American people, who all of the politicians work for, overwhelmingly did not want Obama Care.


Posted: Friday, February 15, 2013
Article comment by: V Stokes

"So Obama is wrong...."

What? What? Not possible! He's a Democrat and they are never wrong!

Just jerkin yer chain a bit....lol.

That said...I agree with what you said...but it will never happen. Unless we want to pay $6 for a 1/4 pounder.


Posted: Friday, February 15, 2013
Article comment by: Anson's Nephew

“ He's upping minimum wage from $7.25 an hour to $9.00 an hour.”

No he’s not and he does not have the power to do so. What he did was suggest that the minimum wage should be $9 an hour.

A totally clueless Republican (is there any other kind) bragged during an interview about how minimum wage at her first job in the early 1970s was just fine and she lived well on it. However, if we factor for inflation (which we must) the minimum wage she received in the early 70s would equate to $12.40 today. So Obama is wrong – the minimum wage needs to be rasied to $12.40 cents!


Posted: Thursday, February 14, 2013
Article comment by: Anson's Nephew

“Again you are quite mistaken AN. It IS a mandate under Obamacare. Just as the 16,500 new IRS agents, the Death panels, and much, much more!”

Again you are incorrect and I will now ask that you provide each section of the ACA that deals with the items you presented. This has been asked dozens of times and to date no one has produced the sections, but please, go for it.

”Why don't you be honest enough to say you support a 'Single Payer system', i.e. the Federal Government ‘owning’ and nationalizing all health care, like Canada and England.”

I have long advocated – right here – that we should have a single-payer system which is what the president wanted and then he foolishly capitulated to the Republicans who demanded the individual mandate and then raised $%#@ when it was passed.


Posted: Thursday, February 14, 2013
Article comment by: Joe Schmo

@ Samuel Adams:

"Why don't you be honest enough to say you support a 'Single Payer system', i.e. the Federal Government "owning" and nationalizing all health care, like Canada and England."

There is a big difference between single payer health insurance and a government-run health care system. Canada has its own version of Medicare which is like ours except that it is not limited to just those over 65, but is for everyone. It is a single payer system, but doctors, hospitals, clinics are not run by the government. They are private just like in the US.

The UK's National Health Service is indeed government-run as well as single payer, just like the VA health care system in the U.S.

So we already have both versions of these health care systems in the US. They just don't cover everyone like they do in other countries.



Posted: Wednesday, February 13, 2013
Article comment by: Samuel Adams

Again you are quite mistaken AN. It IS a mandate under Obamacare. Just as the 16,500 new IRS agents, the Death panels, and much, much more!

Why don't you be honest enough to say you support a 'Single Payer system', i.e. the Federal Government "owning" and nationalizing all health care, like Canada and England.


Posted: Wednesday, February 13, 2013
Article comment by: Anson's Nephew

“Humana raised the rates from 2012 to 2013 for my mother, 21%.”

Sounds like time to dump Humana. I’m with United Health Care and saw an increase of $6 (or .03%).

“Humana STOPPED paying for her heart medication. That was part of the so-called ‘Affordable Care Act’”

Another reason to dump Humana and actually that had nothing to do with the ACA, that was an independent decision by Humana. However, your mother can still obtain the medication by simply paying for it or having her doctor prescribe a generic.


Posted: Wednesday, February 13, 2013
Article comment by: Todumtu Care

Indeed the Libotards refuse to see the proof put before them as they dig deeper to support their Mesiah.
Me own Medicare Supplemental Health Plan cost increased by 31% in Janurary. No doubt this increase is somehow headed for the government coffers in the end. Speaking of which we're all gonna be takin it in the end.


Posted: Wednesday, February 13, 2013
Article comment by: Doctor Up Story

@ She Speaks The Truth - Your response has more credibility because you speak from your own experience. My experience thus far, found that AHC coverage is better, the co-pay is lower than that of my old private insurance, the deductible is a little less, and, although not cheap, the premium is a whole lot better than under COBRA. It stands to reason that the premiums under AHC will go down as more people enroll. Yes, the doctors will have to adjust and learn to live on less at first, just like the rest of us are doing and find innovative ways of doing more with less, so they actually see an improvement overall. But they, as a group, along with us as patients, are not alone in being affected by the remodel of our healthcare system. The hospitals, their suppliers, and the insurance industry itself, all are having to make drastic changes to shake off the 'charge 'em to the moon' mentality and their inefficient, redundant practices they've maintained for years. I've been reading about some changes made by our own KRMC already. I think, however uncomfortable they are now, these changes are a good thing for us, once the dust clears. You say your mother is 93. God Bless her! I'm not a doctor, but I would guess that most illnesses that could be detected by a pap smear, colonoscopy, or mammogram would not likely 'come to a head' until pretty near the end of her life expectancy (which she may be past now), AND the treatment for any such illness would likely be as risky to her life as the illness could be, due to her age. I would not like to be faced with that dilemna if it were me or my mother, but as much as we want to defy death, it is inevitable at some point.

Posted: Wednesday, February 13, 2013
Article comment by: anonymous anonymous

The new health care law is a transitiion to whats coming, which will be universal government health care much like the VA system, cannot say if any co-pays will exist in this eventual system but its inevitable and the insurance companies, doctors, nurses those with a dog in the fight will resist, whine, cry till the end, but their monoply will one day end, and if they are unhappy change careers, immigrate to a country where they allow leeches to suck the life blood out of the sick and ill!

Posted: Tuesday, February 12, 2013
Article comment by: Linda Athens

And more unexpected stings. We had yet another State of the Union address tonight by The Amateur, a man who never worked a job nor created and ran a business.

He has no clue! He's upping minimum wage from $7.25 an hour to $9.00 an hour. That translates to more layoffs.

Every single thing he brought up had GOVERNMENT as the answer. BIG government is all this man knows. I would like to see him even run a lemonade stand and make a success of it.

He took credit for more drilling. Left out was the fact the drilling is all being done on private land - no new drilling on government land thanks to him and his EPA cronies.

Gas was $1.80 a gallon when he took office. It is now $4.00 a gallon.

Today I read of a company (name forgotten, will have to re-look it up) that is having to shut down. They would have provided thousands of jobs but new EPA regs are instead, causing them to completely shut down. This isn't unusual, this is the norm under The Amateur.

The saddest of all, he spoke of guns and the violence caused by them. NOT ONE WORD ON HIS FAST AND FURIOUS THOUSANDS OF GUNS THAT HAVE KILLED HUNDREDS OF INNOCENT MEXICANS BECAUSE HE AND HIS DOJ HEAD'S PROGRAM GAVE THEM TO THE MEXICAN CARTELS.

Wake up liberals. Or are you just too ashamed to admit what a piece of #^@#%^%@ this POTUS really is.


Posted: Tuesday, February 12, 2013
Article comment by: Steven Robinson

@Anson's Nephew:

Humana raised the rates from 2012 to 2013 for my mother, 21%. Second, immediately after the liars on your side of the aisle screwed the process and sleazily pushed through Obamacare, Humana STOPPED paying for her heart medication. That was part of the so-called "Affordable Care Act".


Posted: Tuesday, February 12, 2013
Article comment by: Delmar Billy

Yeah, that's a convenient response from the libs: "Give me proof". Look how easily a liberal will dismiss the claims of a doctor that is board certified in Texas and Arizona...that's willing to put their name out there in an attempt to bring some facts to the public. Just like thousands of other doctors are doing every day now as the grim realities of Obamacare are coming forth.

Yeah, you could tell a liberal that the Sun is hot and they'd demand "proof". I'll tell you one thing we don't need ANY more proof of, is that liberalism is a mental disorder. Nor do we need any more "proof" of what some babbling liberal claims they are currently paying for health insurance.

Some of you people take the term "useful idiots" to a new level. You are in such freaking denial. You can't believe that you were fooled so badly by that guy in the White House. But that's how fools are, they don't believe they're being fooled BECAUSE they're fools. It's interesting when you observe that some of the smarter fools have a slight inkling they've been fooled but they just get angry about it and want to lash out at those who have exposed them for being fools.
Watch, you'll see.


Posted: Tuesday, February 12, 2013
Article comment by: Jimi Lightfoot

“Obamacare busted 2 doctors in Scottsdale and one in Parker for charging Medicare for melanoma treatments of several patients.” “billions of dollars have been recovered”

Billions recovered? No way when property seized averages 4 to 7 cents on a dollar, then subtract agency and agent costs, then contractor fees for auctions and administration fees.

Maybe one cent on a dollar recovered.

But rarely these doctors have ever had assets worth over a million.

The doctors that defraud Medicare aren’t the billionaire TV villains.

They are people with severe debt, drug and gambling problems.

Recovering anything of value is like going through the pockets of a crack head.

The sting, nationwide, used over 500 federal agents. Resulted in the arrest of 91 individuals, coast to coast, including home health workers all the way up to doctors, charged with fraud in the TOTAL of $429.2 million.

An average first year federal agent makes 61,000.00 a year. The sting was 5 years long.

Base pay for agent salaries in the sting was over 150 million. Not to include per diem, lodging, paid informants, gas, vehicles, etc.

The sting started in 2007 under Bush, with Holder now taking credit.

Add the 30 million per year minimum in operating cost. That’s an average of 150 million minimum spent in salaries for 429.2 million in fraud.

Now try to recover and seize then auction those assets. That 429.2 million is GONE!

There is no net profit or substantial recovery of this money through seized assets.

Obama said he’d pay for healthcare from the arrest and seizure of assets. Medicare fraud was prosecuted and assets were seized before we’d even heard of Obama.

And you thought it was Obama that made Medicare fraud illegal.


Posted: Tuesday, February 12, 2013
Article comment by: biker randy

Why would this Dr. make these claims if they were untrue? We're all stuck with whatever happens next and the complete medical changes by Obamacare have yet to happen.

Obama is the most dis-honest president I have ever had to live by in 69 years. Clinton was bad, but Obama makes him look like a wannabe now.


Posted: Tuesday, February 12, 2013
Article comment by: She Speaks The Truth

@ Doctor Up Story, what she says is true. I work for a physician and Medicare reimbursement was cut by 25%, however it won't go into affect until 2014. It will also be reflected in payments for AHCCCS patients. Also, my Mother is 93, she has an HMO and they will no longer do PAP tests, colonoscopies or mammograms due to her age. Thank goodness she is in perfect health. A physician that used to be in town would not do preventative testing on anyone over 80. As an upcoming Senior....I am concerned.

@Ansons Nephew...seriously just pay for it? Have you seen the cost of some of these medications? There is a new cleansing prescription you can obtain that is easier for the patient to take and easier on their bodies prior to a colonoscopy, the cost....$500.00. It is new and does not have a generic.

@What a load...Busted for a couple of cases of melanoma...seriously..yikes that's about 20 to 30 bucks each. Let's stop the hospitals from overcharging patients first, over testing, retesting, etc and then we can go after the physicians.


Posted: Tuesday, February 12, 2013
Article comment by: Joe Schmo

Let’s be clear about a few things. First, Obamacare is based on the Republican alternative to moving toward single-payer health insurance aka Medicare for all. The premise was to try to expand health insurance coverage for more Americans while maintaining our for-profit health insurance system. Republicans were for the idea before they were against it. Second, the individual mandate was created to insure that we don’t have free riders that everyone pays for in the form of higher insurance premiums. Third, costs in health care have been rising for decades. This is precisely because we still have a for-profit health system rather than an efficient non-profit health delivery system that is patient-focused with an emphasis on preventative care.

If the goal is not just expansion of coverage but cost control then we need to move toward single-payer health insurance. When the health care debate was happening there was an attempt to create a public option. This would have bridged the gap between those who make too much to qualify for Medicaid, but still cannot afford their own health care plan. Unfortunately too many of our politicians are bought and paid for by the health insurance industry. They did not want the competition that an efficient, less costly, non-profit Medicare-type program would provide. So the idea died.

I see Obamacare as flawed. But it is, nonetheless, a first step toward a single-payer health insurance system like every other advanced country in the world has already figured out. Eventually the public option is going to come back in some form as both a cost containment measure and a means to insure that everyone can get health care coverage. That will eventually lead to an expansion of Medicare for everyone while for-profit health insurance will move toward voluntary catastrophic and supplemental plans.

w/c 299



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