Obamacare haters are patient lovers

When I speak out against Obamacare, I am often called a hater-at best. The very people I fight for, attack me. Ironically, it is the grueling rite of passage from little girl to physician that has equipped me to take the heat and stay the course in the fight for the patient-doctor relationship and against the government’s effort to supplant it. I learned how to “wear my big-girl pants” and “cowgirl up”. Here is what the American patient must know from the trenches.

Most physicians believe in universal healthcare and providing a safety net to achieve this, as do I. By universal healthcare, I mean providing care to each and every precious human in need. By safety net, I mean a mechanism to care for those precious individuals who cannot afford the care they desperately need. This does not mean I believe in socialized medicine; I do not.

A few years ago, I was getting ready to go to a long-anticipated Saturday family function with my four daughters when my phone rang-it was the ER. A mom had brought in her little boy, injured, and they needed help. I broke the news to my girls that I couldn’t go with them and raced to the ER. Little five year old Luke (fake name, so I won’t be fined for a HIPAA violation) sat quietly in his young mom’s lap. She was weeping. Luke’s older brother had thrown a broken beer bottle at him the night before. Luke had cried himself uncontrollably to sleep. Mom, single, working, and going to school to become an LVN, while caring for four small children, had not noticed the severity of Luke’s beer bottle encounter until the following day when he would not open his eyes. Beautiful little Luke was at one of those crossroads where your life changes in a blink. The broken glass had cut his eye wide open. His cornea was lacerated with his iris prolapsing out into the outside world blocking total collapse of the globe. He could see only light. The contents of his eye had been exposed to all the germs of the world for hours. The injury was disfiguring and potentially blinding-life-changing. Luke’s mom stated they had no insurance. I contemplated transferring him to the county hospital, but he and I had bonded; he was brave and trusting. I knew operating on him opened me up to potential lawsuit if he had a bad outcome-even if the injury was horrific initially and even if I had done my best. Again, I contemplated transferring him, but he and I had bonded; I was brave and trusting. My girls were disappointed, patiently waiting for me. This would be a long, intricate operation. Once again, I contemplated transferring him, but the girls were patient and brave and trusted me. My girls trust me to do the right thing in life, even if it is the hard, risky thing; that is our bond.

Luke’s mom passed him from her arms to mine. Our eyes locked, tears welling in all four, as I carried Luke to the OR. Such profoundly humbling moments I cannot put into words, and only through my faith and experience do I muster the courage to do such things. By the grace of God, Luke’s surgery went flawlessly. Today, he sees 20/20, and his eye looks absolutely perfect. I see a bright future for this brave, trusting child. I never received a penny. In fact, I incurred great expense and great risk to care for Luke over the next several months. My reward is not monetary. My reward- again, no words…

I am privileged and humbled by cases such as Luke’s. This is why I fight. My colleagues and I know better than government how to do what we, America’s physicians, do. My physicians and surgeons and I know better than government how to treat me and my cancer; yes, doctors are patients too.

In reality, Luke could have been on a form of Medicaid, but his mom, had not signed him up. Our current safety net for the poor is Medicaid. It does not work well. The United States spends exorbitant amounts of money on it and achieves outcomes worse than those of patients who have no insurance. The status quo is Medicaid, a government safety net for the poor, costing us trillions in unfunded liability for poor access to suboptimal care with a big price tag all tied up with strings of waste, inefficiency, and bureaucracy. This status quo, Medicaid, is what needs healthcare reform. What does Obamacare do? It expands Medicaid instead of fixing it. Instead of fixing Medicaid, Obamacare expands the definition of poverty to put more people on Medicaid. Instead of getting people out of poverty, Obamacare expands the definition of poverty to get more Americans in it, so they can get on Medicaid (the part of Obamacare that really needs reform). This insanity is so frustrating. When the Obamacare supporters call me “hater” and say I am cruel for “not wanting 40 million to have health insurance”, I literally chuckle in disbelief. They are the actual haters, befuddled in their mob-mentality-induced blindness, for not wanting all 314 million Americans to have actual medical care. Health insurance does not translate into actual medical care under Obamacare. We can and must do better. The irony of Luke’s case is that had he actually had Medicaid, he wouldn’t have had me. I don’t accept Medicaid, and government would not have let me see him. I prefer to provide my services for free, or even at a loss, than participate in Medicaid, a failed system that is red-lining our economy and flat-lining our people.

Finally, when the Obamacare lovers say “there are no alternatives” and that Obamacare opponents just want to return to the status quo, stop and call out the irrationality. The status quo is Medicaid. Medicaid is the very problem that needs to be fixed. Their fix is to double-down on Medicaid, expanding it and the definition of poverty, so everyone can be on it. Returning to the status quo is returning to dysfunctional Medicaid, which they are expanding. There is no logic or reason here. There is no faith or trust. There is no truth.

Truth is, excellent plans for true patient-centered, physician-guided, market-driven healthcare reform do exist. See examples of such plans at www.AmericanDoctors4truth.org and www.Docs4PatientCare.org among others. The same people that want to expand Medicaid do not want you to know about REAL REFORM, because once the public learns about available alternatives to Obamacare, the fewer people will want it. Insanity Reigns. We must dethrone it, because in truth we Doctors are lovers, not haters, with minds ruled by reason not politics. We must stay the course, brave, undeterred, and patient-for the patients.

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Trust me, I’m a doctor and a patient, and I’m not for sale-even though Obamacare says I am!

The patient–physician relationship is based on complete, unadulterated trust and faith. When I plunge a scalpel into the only eye of my patient to remove a cataract and place a new lens and when my surgeon plunges a scalpel into my chest to remove my cancer and reconstruct me, we-the patient and doctor-have an intimate, unspoken bond like no other. We start with morality, virtue, intelligence, wisdom, skill, experience, compassion, and common sense and end with honesty, transparency, and informed consent, all of which are foreign to big government. Enter Obamacare-the biggest fraud ever perpetrated on a free people in the history of the world.

Obamacare empowers a few political elites, their operatives, and cronies to do whatever they want to the American people on the false promise of access to “free”, “quality” “medical care”, AKA tyranny-through-medicine. They write and rewrite the deceitfully-passed law for political expediency, power, and money; patients are an afterthought, an annoying impediment to their ultimate goal- socialized medicine, the keystone in the arch of Socialism. These Alinsky-inspired, Cloward-Piven trained, Marxist-admiring operatives will do anything to undermine the US Constitution and fundamentally transform the United States of America. These crooks will do anything to achieve their ends. They will lie, cheat, and steal. We cannot trust them. They think we are the problem and that there are too many of us.

We, the patients and doctors, are being scammed, used. I trusted my government until 2009; I was naïve. I do not trust my government now. Our current Federal government is the antithesis of all that composes American medicine and the sacred patient-doctor relationship.

Accordingly, I have fought Obamacare and will not comply with parts of it that I regard as unethical, unconstitutional, illegal, and ungodly. January 1, 2014, Obamacare plans will begin. I will not participate- on principle. I will care for my patients directly, free of government constraints, in accordance with the patient-doctor relationship and the Hippocratic Oath.

Currently, I am contracted with all the major insurance companies, accepting countless, but not all, versions of their various plans. After intensive application process, I was accepted, and I signed contracts with these companies to provide care for “their” patients. I can terminate the contracts with written notification, usually requiring 3 month notice. Most plans are self-renewing; I am sent updated fee schedules for my services, and if I am not willing to accept what they offer, I must give written notice to terminate the agreement. I decided, when or if the Obamacare plans came across my desk, I would decline them. They never came.

Then, recalling that I cannot trust these people, I decided to verify that I am not somehow on the Obamacare exchange plans. I wondered who would be. Not my billing company, not my colleagues, not my patients, not the insurance representatives- really no one, knows what is going on. How can we? The law changes as we go, over 20 times thus far that we know of, by fiat or blog, in Friday news dumps and obscure regulations, at the whim of one man and one women, Obama and Sebilius- who I do not trust.

My office manager, a former insurance specialist, logged on to HHS.gov to see what’s being advertised. Lo and behold, a few plans I’m on were listed, as was I, as a “provider”. How did this happen? We presume, the plans I am contracted to are offered to the exchange by the insurance companies; they never asked me- a physician whose services they are selling.

I’m not an attorney, but can a company legally sell my services without my consent? I fathom, they will claim the terms of the contract haven’t changed-that they are just selling the plan to more patients, on a new individual market. Herein lies the problem, while the insurance company may claim the terms of the contract have not changed, the terms of the contract have most certainly changed once it is offered under the Obamacare umbrella.

The Obamacare umbrella is one I refuse to get under. The Obamacare umbrella is oppressive; government holds it over patients and physicians, and we must move under its tiny moving cover or face punishment ranging from loss of revenue, loss of license, audit, and even imprisonment for doctors to loss of doctors, hospitals, drugs, and treatment options for patients. If I do not comply with ICD-10 by October 1, 2014, I cannot even file a claim with CMS. I am not going to comply with ICD-10 (along with many other aspect of Obamacare), so logically, in 10 months I will not be able to comply under the Obamacare umbrella. I will be shoved out. Patients will have signed onto these plans having seen a provider list which has been falsely represented to them. This is false advertising, continued deception and political gamesmanship, by big government and big insurance at the expense of the little people, the American patient and doctor.

I have not seen a new pay schedule for me from the insurance company that now advertises my services for sale under Obamacare. What will they pay me? Will it go up for a little while to play the political game? I can hear it on MSNBC now, “Obamacare exchange plans pay doctors more!”. Then, once the propaganda/news-cycle has run its course, they will slash what they pay us and pocket the cash.

As it is, apparently, I must now give the insurance company 3 months written notice and terminate my contract. First of all, will I have to accept Obamacare patients for the next 3 months of the termination notice period, during which, starting 01/1/2014, I am on the hook for patients who thought they were signed up through the dysfunctional, insecure HHS website but really weren’t? There is a 3 month grace period for patients, but not for doctors. I will have worked, incurred tremendous overhead, lost opportunity cost, and medico legal risk, and I will not get paid. Not surprisingly, government will bail out and subsidize the insurance companies for their losses during this period, based on the “honor system” much less.

Secondly, when I submit my 3 month notice of termination relating to Obamacare exchange patients, will the insurance company then say, “Well, then that means you are terminating that contract for All patients-even your existing ones.” Is this extortion?

Again, I’m no attorney, insurance magnate, or elite politician, but as an American patient and physician, I call these crooks out. Stop playing the American people for fools. We’re not playing any more. Game over. We chose the trust and faith in the sacred patient-doctor relationship over the deceit and doubt in the government-patient relationship.

Dear Patients, rest assured. There are excellent plans out there from real doctors for true patient-centered reform that provides actual access to actually affordable, actual quality, actual medical care from actual doctors without the political games, false promises, waste, and theft of Obamacare. Guess what, when they say these don’t exist, they’re lying. Trust me, I’m a doctor and a patient, and I’m not for sale.