Obamacare-Colluders Anonymous: Stop the cycle of addiction to the lifeblood of the American patient

Americans must understand that our federal government has chosen to collude with insurance companies, hospitals and drug companies to take total control of our healthcare system and one sixth of the US economy rather than collaborate with patients and physicians to achieve good healthcare reform that benefits each individual patient. This unholy alliance is facilitated by lobbyists bearing gifts of money and power. Individual patients and physicians are by comparison penniless and powerless. We are nothing more than pawns in a game which we can play no more. This is the ultimate game of life, and the only way not to lose is not to play.

A very bad national healthcare law has now been spun and woven within and throughout a very bad national tax policy, strangulating and choking the life out of the American patient and American medicine. Patients and doctors must stand and say “No more!” First, we must understand the disease, so we can fight it.

There are two components to a medical bill. One component is the bill for the hospital or outpatient facility services/supplies; let’s call this the hospital bill. The second component is the bill for the physicians’/surgeons’ services; let’s call this the doctor’s bill. We must make a very clear distinction between the “Bill” and what is actually paid and by whom. When Americans talk about our staggering medical bills, we are predominantly referring to the hospital bill, which is nothing more than a usurious, manipulative tool.

The hospital bill is staggering. It is enormously, artificially, and intentionally inflated to produce phantom losses resulting in tax-exemption for the hospitals and scaring patients to death, into believing they cannot survive without expensive, comprehensive health insurance. Dr. Keith Smith of The Surgery Center of Oklahoma gives a good explanation of how this is achieved and contrasts his model for excellent care at a fraction of the cost http://t.co/cWwfA9y0fo .

Here is my real life example: the hospital “bills” $12,000.00 for a minor procedure on a woman with a gynecologic condition. The woman gasps at the bill when she open the envelope, and then concludes “Thank goodness I have health insurance; everyone needs health insurance.” In reality, the intentionally hard-to-decipher bill cloaks the billing game/tax scam. While the hospital shows the patient the $12,000.00 bill, the hospital has actually agreed to accept far less from the insurance company; this is called an allowable, which in this case was $5000.00. By billing $12K but accepting $5K from the insurance company, the hospital recognizes a $7K phantom loss, which it reports on its tax return, thus maintaining a “non-profit”, tax-exempt status. The individual patient, now with a huge $5000.00 deductible because of Obamacare, must write a check to the hospital for the entire $5000.00, on top of her monthly $250.00 premiums ($3000.00 annually). The patient has come out of pocket $8000.00 with Obamacare style insurance. In stark contrast, if the patient was uninsured, she could have negotiated a direct fee with the hospital for $1200.00.

So, follow the money. The hospital got $5000.00 from the patient plus a $7000.00 tax write-off in return for less than $1200.00 of services/supplies. The insurance company got $3000.00 in premiums from the patient and paid $0 to the hospital, while the patient paid all of the $5000.00 allowable because of the high Obamacare-induced deductible. The patient ended up paying $8000.00 ($5000.00 deductible plus $3000.00 in premiums) for the privilege of paying more than if she had no insurance (the $5000.00 insured negotiated allowable v. the $1200.00 uninsured cash price) and gets no tax benefit for her health care expenses. Understand this: the individual spent $8000.00 with no tax break because she was mandated to buy Obamacare, and she would only have had to spend $1200.00 if she was uninsured. If business gets a tax break, most certainly should the individual as well, but with Obamacare the individual patient is in essence penalized. $6800 of this woman’s livelihood was essentially laundered to sustain a Government-Lobbyist-Insurance Company-Hospital-Drug Company Collusion Scam. The government, insurance company and hospital profit and get tax breaks- from our health, our bodies, and our lives- by manipulating us and scaring us. This is just wrong.

Now, what about the doctor’s bill? The surgeon’s insurance company allowable was $600.00. For a relative pittance, the doctor assumes all the risk and must practice under oppressive, punitive, coercive, innovation-stifling, mind-numbing, ever-changing-at-the-whim-of-a-politician government control. This $600.00 must then be spent toward overhead (taxes, employees, rent, supplies, malpractice, continuing education, computers…) into which it doesn’t make a dent. Doctors don’t get tax breaks either. Doctors love their patients. We are all patients. Americans are generous, compassionate, and self-sacrificing. Physicians and surgeons are willing to accept ridiculous agreements to retain our patients, who in reality have now been bought by government from insurance companies in collusion with hospitals. Hospitals, insurance companies, and government now own the doctors too. Doctors and patients must refuse to play this deadly game anymore. Stop and look at who actually paid what to whom, not just what the hospital “bills”. Expose the truth.

Americans are smart. When everyone understands what is going on, we can call out these gamers, get rid of their fixed game, and implement true patient-centered healthcare reform at dramatically lower cost with increased choice and access to good doctors and state-of the-art care for all. In the meantime, we are complicit enablers. They cannot do this without us. You can’t get your appendix out or broken hip fixed without a surgeon. Doctors and patients, together we must acknowledge the problem and stop enabling. Only tough-love can stop this cycle of addiction of the colluders to the power and money sucked from the lifeblood of the generous, compassionate, self-sacrificing, scammed, and scared-but very smart- American patient. We need our own version of AA and a twelve step plan for the recovery of American medicine.

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11 thoughts on “Obamacare-Colluders Anonymous: Stop the cycle of addiction to the lifeblood of the American patient

  1. I don’t believe you are correct with your math regarding an uninsured person. I speak from experience. When my son was hospitalized with pneumonia some years ago, we did not have insurance. The hospital not only refused to negotiate with me, they demanded payment up front for a bill that was over $10,000. They sold it to a collection agency for an unknown sum, but surely more than what it cost them to care for my son. They have no reason to negotiate a better price if the patient is uninsured; they can sell it to a collection agency for a better deal.

    I do agree that Obamacare is a crappy deal all the way around. It merely speeds the way to a two-tier health care system: one in which most of the population will be in (Obamacare) and one in which those with power and influence (not to mention money) will get good quality care.

    What I see happening already is that staffing is becoming more and more sparse and the workload on nurses and aides is becoming more and more unbearable – and undo-able – while the profits stay with administrators in the form of salaries, bonuses, and conferences/retreats. A year down the road it’s going to be much, much worse.

    • In the current environment, some hospitals are very willing to negotiate. My surgery center allows me to charge my uncovered patients 1/10th of the Chargemaster fee. The doctor has to go in and cut the deal. With transparency across the board, we could easily find hospitals that would routinely give a fair deal,largely because they wouldn’t have to play the tax game of creating phantom losses to stay profitable. Watch the link I posted to the Surgery Center of Oklahoma. The uninsured get hurt the most. In a good system, even the poorest and sickest (the ones who are actually sick and actually need care) could have access to the good plans. We have a template for reform on http://www.americandoctors4truth.org. In addition to what happened to you and your son from the hospital standpoint, uninsured face usurious costs of drugs. Look up and understand what The Chargemaster is. Always find a hospital that will work with you. Thank you for your comments and I hope your son is doing well!

      • Slightly different experience. I visited my dermatologist (of 16 years) and discovered she was no longer on my new plan. She gave me a rate of 50% of her normal rate. I then filed the cost with my insurance company and they paid me 100%. So in the end the doctor got more than she would have gotten under Medicare and my visit cost me nothing. We are both happy.

      • Hi Jake, You are right. It is much better to go direct between the doctor and patient. Costs will plummet when we get the middlemen out of it! I am moving this direction.

  2. Thanks for another wonderful article. The place else
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  3. This is wrong on so many levels. First of all, you imply patients should go without insurance and negotiate directly with the hospital and doctor. That’s fine for simple elective procedures but what about the young man with a life threatening head injury or the middle aged guy with a massive heart attack? Suggesting they go without coverage and just negotiate a price when they need care is irresponsible.

    Secondly, to say that the ACA brought about $5000 deductibles and $250 premiums is dishonest. Insurance companies have collected like premiums and deductibles long before the ACA. Insurers decide what to charge. The ACA is not perfect but no change would have passed this congress unless it perpetuated our market based system.

    • Hi Lisa, everything I have to say is right on every level. I do not imply people should go without insurance-I believe everyone should have a major medical plan for such instances as you describe. Such plans don’t exist in Obamacare. The ACA absolutely created the huge deductibles and higher premiums. I have proof of it. Just go to the Obamacare exchange and compare Obamacare plans to plans from the very same insurance companies for customers who get the very same plan employer based instead of on the exchange. I didn’t make these #’s up. This is the cold hard truth.You are being dishonest when you tell me I am dishonest for giving absolute 100% proven fact! Where do you get your false info. I am a cancer patient and a doctor. I know all this for a fact. You need to evaluate who you trust. There are liars out there, but I’m not one of them. Does “If you like your health plan, you can keep your health plan…” ring a bell? Go to AmericanDoctors4Truth.org to see a template for patient-centered healthcare reform.

    • Government has been working with insurance companies long before the PPACA came about. Please refer to the HMO Act (1973.) Insurers decide what to charge with the blessing of the government. The government is, in no way, saving us from insurance companies. The government funds insurance companies. The general public has been completely unaware of just how involved government is with health care. That involvement has steadily increased over the last 40 years, most noticeably in the last 20.

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