How to Protect Yourself From Obamacare

[Conan71]

Be better than the "Etch-A-Sketch" alternative.

I'll take flexibility over proven failure any day.

[Hoss]

I'll take flexibility over proven failure any day.

If you call 'flexibility' changing one's opinion on something (like say, healthcare, abortion, gun control..you name it) to placate one's party, then yeah, he's also a failure.  I can't believe you would justify that as 'flexibility'.  I know you're not that dense.

When the President claimed 'flexibility' on gay marriage, Repubs were up in arms.  When their guy does it?  It's 'revisiting'.

[Conan71]

When the President claimed 'flexibility' on gay marriage, Repubs were up in arms.  When their guy does it?  It's 'revisiting'.

There's no difference and I won't engage in a game of semantics.  Let's face it, you have two politically expedient people running for office.  Obama was actually on record at some point in his past saying he had no problem with gay marriage.  He's also "evolved" on many other issues as well.

How much better off are we than we were four years ago?  Who shows a far better grasp on business and how jobs are created?  I'll take the guy with private sector experience who has also had to lead a very left-leaning state as a Republican.

Personally I think Romney is a solid moderate.  Sure, he's going to spout the party line on social issues, but let's face it, gay marriage, decriminalizing pot, and abortion are either states issues or simply are not going to be affected by the POTUS.  Roe V. Wade has stood for almost 40 years.  It's not going anywhere.  I wish he'd simply say: "Stuff it" on social issues.  He really doesn't need those to rally the troops on ousting Obama.

The Obama camp will say and do anything to keep the focus off Obama's poor job performance, including going so far as muddling the reality of Romney's record on social and business issues, or an outright whisper campaign on Mormonism to frighten the likes of the TTC's out there.

[Townsend]

I wish he'd simply say: "Stuff it" on social issues.  

Oh man, how much better would all this be if that was the general consensus among all candidates in every race?

[Teatownclown]

In a few minutes the final debate to repeal 'Obamacare' is about to begin. The Republicans will make speeches about why it's a bad thing to help Americans stay alive.

After this debate, the Republicans will then hold speeches as to how to create jobs for America and then they will debate the best way to win a Presidential Election without trying to cheat. 

[TulsaRufnex]

I'll take flexibility over proven failure any day.

Bin Laden is dead, GM is alive, my pre-existing condition (one yr from cancer-free) cannot be used against me in the coming decades, low interest student loans are available that cut out the middle-man (banks), kids in college now FAR MORE LIKELY to have health insurance because they're covered under their parents until age 26, a dow jones that is close to DOUBLE what it was on 3/9/2009 (6,547), the government took action to stabilize the housing market http://www.nytimes.com/2012/05/10/business/fannie-mae-profit-signals-a-stabilizing-housing-market.html, a new Fiat-Chrysler stock offering in 2013, FEMA is arguably a much more competent organization under Obama than Dubya, ended the war in Iraq, ended the use of waterboarding (torture), expanded loans for small business, closed the Medicare prescription drug "donut hole," adopted the economic substance doctrine as federal law (a policy that states that tax changes must have significant economic justification), establish a credit card "bill of rights," etc, etc, etc....

Proven failure?  Hell no.
Partisan hackery?  Yes.  The type of hackery I've come to expect from someone who has characterized Obama as an "empty suit" from Day One.

[Conan71]

Bin Laden is dead, (Let's see which president would not have given orders to go through with this mission? I'm pretty certain others would not have taken so much personal credit for other's work and sacrifice) GM is alive, (you realize Bush approved the bail out in the first place, right?) my pre-existing condition (one yr from cancer-free) cannot be used against me in the coming decades, (I agree that is a good thing but it wasn't necessary to overhaul an entire system where healthcare and insurance already works quite well for many of us) low interest student loans are available that cut out the middle-man (banks)(Kudos, that was a brilliant move which was long overdue.  I believe we need more grants than loans though, there is no better investment than higher ed at keeping the US competitive globally.  Also consider U/E rates for college grads is lower), kids in college now FAR MORE LIKELY to have health insurance because they're covered under their parents until age 26,(there were plenty of other ways for them to obtain insurance with similar premium costs which parents could pay for) a dow jones that is close to DOUBLE what it was on 3/9/2009 (6,547), (Great for investors and the 1%'ers.  Completely meaningless to someone who has been unemployed or under-employed for 3 to 4 years.)the government took action to stabilize the housing market http://www.nytimes.com/2012/05/10/business/fannie-mae-profit-signals-a-stabilizing-housing-market.html, (Of course they did, that was the only logical thing to do after a major cataclysm)a new Fiat-Chrysler stock offering in 2013 (How is that an Obama success?), FEMA is arguably a much more competent organization under Obama than Dubya (How many major tests has it been put through in 3.5 years?  Ever stop to consider the magnitude and frequency of disasters FEMA was put through in a very short amount of time?  Bush took criticism of FEMA seriously and made changes where necessary, starting at the top), ended the war in Iraq (on the original Bush timeline), ended the use of waterboarding (torture)(Comfort and aid to sworn enemies of the U.S. has never been high on my list.  You really believe rendition has ended? How's that closing Gitmo promise coming?), expanded loans for small business(Funny small business owners are still complaining they can't get loans), closed the Medicare prescription drug "donut hole," adopt the economic substance doctrine as federal law (a policy that states that tax changes must have significant economic justification), establish a credit card "bill of rights," etc, etc, etc....

Proven failure?  Hell no.
Partisan hackery?  Yes.  The type of hackery I've come to expect from someone who has characterized Obama as an "empty suit" from Day One.

WASHINGTON — The emergency bailout of General Motors and Chrysler announced by President Bush on Friday gives the companies a few months to get their businesses in order, but hands off to President-elect Barack Obama the difficult political task of ruling on their future.

The plan pumps $13.4 billion by mid-January into the companies from the fund that Congress authorized to rescue the financial industry. But the two companies have until March 31 to produce a plan for long-term profitability, including concessions from unions, creditors, suppliers and dealers.

In February, another $4 billion will be available for G.M. if the rest of the $700 billion bailout package has been released.

Even before the March 31 deadline, it might fall to the Obama administration to persuade Congress to release the second $350 billion of the Treasury Department's huge financial system stabilization program — a request that the Bush administration is reluctant to make.

http://www.nytimes.com/2008/12/20/business/20auto.html?pagewanted=all

General Motors Chairman Daniel Akerson tells Newsmax that both President Obama and former President George W. Bush should share credit for the successful bailout of the auto industry.

Akerson also flatly denies allegations that the federal government — which still owns nearly 30 percent of General Motors stock — has been involved in the day-to-day running of the company.

And he warns that while he sees a positive outlook for GM over the next several years, he believes the economy has not fully recovered due to a weak housing market which he predicts won't bottom out for another "couple of years."

http://www.newsmax.com/Newsfront/akerson-bailout-general-motors/2012/05/01/id/437704

[Teatownclown]

And this is the crux of the issue....capitalist doctors. They've lost their way except when it comes to needing more stuff....and vacation homes...and Mercedes...and on and on. I fault the Big Pharma Doctor Insurer triangulation. But the same people want to scapegoat  our President.

Insurers Pay Big Markups as Doctors Dispense Drugs
http://www.nytimes.com/2012/07/12/business/some-physicians-making-millions-selling-drugs.html?nl=todaysheadlines&emc=edit_th_20120712

When a pharmacy sells the heartburn drug Zantac, each pill costs about 35 cents. But doctors dispensing it to patients in their offices have charged nearly 10 times that price, or $3.25 a pill.

The same goes for a popular muscle relaxant known as Soma, insurers say. From a pharmacy, the per-pill price is 60 cents. Sold by a doctor, it can cost more than five times that, or $3.33.

At a time of soaring health care bills, experts say that doctors, middlemen and drug distributors are adding hundreds of millions of dollars annually to the costs borne by taxpayers, insurance companies and employers through the practice of physician dispensing.

Most common among physicians who treat injured workers, it is a twist on a typical doctor's visit. Instead of sending patients to drugstores to get prescriptions filled, doctors dispense the drugs in their offices to patients, with the bills going to insurers. Doctors can make tens of thousands of dollars a year operating their own in-office pharmacies. The practice has become so profitable that private equity firms are buying stakes in the businesses, and political lobbying over the issue is fierce.

Doctor dispensing can be convenient for patients. But rules in many states governing workers' compensation insurance contain loopholes that allow doctors to sell the drugs at huge markups. Profits from the sales are shared by doctors, middlemen who help physicians start in-office pharmacies and drug distributors who repackage medications for office sale.

Alarmed by the costs, some states, including California and Oklahoma, have clamped down on the practice. But legislative and regulatory battles over it are playing out in other states like Florida, Hawaii and Maryland.

In Florida, a company called Automated HealthCare Solutions, a leader in physician dispensing, has defeated repeated efforts to change what doctors can charge. The company, which is partly owned by Abry Partners, a private equity firm, has given more than $3.3 million in political contributions either directly or through entities its principals control, public records show.

Insurers and business groups said they were amazed by the little-known company's spending spree. To plead its case to Florida lawmakers, Automated HealthCare hired one of the state's top lobbyists, Brian Ballard, who is also a major national fund-raiser for the Mitt Romney campaign.

"I consider the fees that these people are charging to be immoral," said Alan Hays, a Republican state senator in Florida who introduced a bill to bar physicians from dispensing pills that was defeated. "They're legal under the current law, but they're immoral."

Physician prescribing works like this: Middlemen like Automated HealthCare help doctors set up office pharmacies by providing them with billing software and connecting them with suppliers who repackage medications for office sale. Doctors sell the drugs but they do not collect payments from insurers. In the case of Automated HealthCare, the company pays the doctor 70 percent of what the doctor charges, then seeks to collect the full amount from insurers.

The number of doctors nationwide who dispense drugs in their office is not known and the practice is prevalent only in states where workers' compensation rules allow for large markups.

Dr. Paul Zimmerman, a founder of Automated HealthCare, said that insurers and other opponents of doctor dispensing were distorting its costs by emphasizing the prices of a few drugs, rather than the typical price spread between physician- and pharmacy-dispensed drugs.

Both Dr. Zimmerman and physicians who sell drugs also said the workers' compensation system was so bureaucratic and complex that an injured employee could wait days before getting a needed medication through a pharmacy.

"We did not institute this because of the money," Dr. Marc Loev, a managing partner of the Spine Center, a chain of clinics in Maryland, testified last year at a public hearing in Baltimore. "We instituted it because we were having significant difficulty providing the care for workers' compensation patients."

The loophole that raises the price of physician-dispensed drugs often involves a benchmark called "average wholesale price." The cost of a medication dispensed through a workers' compensation plan is pegged in some states to that benchmark, which is supposed to represent a drug's typical wholesale cost.

But doctor-dispensed drugs can undergo an "average wholesale price" makeover. It happens when firms that supply doctors with medications buy them in bulk from wholesalers and repackage them for office sale. These "repackagers" can set a new "average wholesale price," one that is often many times higher than the original.

For example, in 2010, a physician associated with the Spine Center, Dr. Loev's practice in Maryland, gave a patient a prescription for 360 patches containing a pain-numbing drug, lidocaine. The worker's insurer was charged $7,304, according to a copy of that bill provided to The New York Times by a lawyer, Michael S. Levin, who represents insurance companies.

A similar number of patches dispensed by a doctor in California, which changed its regulations in 2007, is about $4,068, according to the California Workers' Compensation Institute, a research group.

Warren G. Moseley, the president of a company in Tulsa, Okla., Physicians Total Care, that repackages drugs for office sale by doctors, said it charged physicians $2,863 for 360 patches.

Dr. Loev, who uses Automated HealthCare's services, declined to be interviewed and did not respond to specific written questions from The Times.

Dr. Charles Thorne, a principal at Multi-Specialty HealthCare, another Maryland-based chain of clinics that dispenses drugs, also declined to be interviewed.

Dr. Zimmerman, the co-founder of Automated HealthCare, said that drug prices are set by companies that repackage medications for office sales.

He added that Automated HealthCare referred doctors to about a dozen repackagers. But the company has a relationship with one repackaging company called Quality Care Products, based in the Midwest. The two firms have exhibited their services together and jointly sponsor a charity golf tournament.

The president of Quality Care, Gene Gunderson, declined to be interviewed and the company did not respond to written questions.

Data collected by Florida insurers who handle workers' compensation claims shows that Quality Care supplies about 40 percent of the drugs sold by doctors in the state, a market share three times as high as that of its closest competitor.

Robert M. Mernick, the president of Bryant Ranch Prepack, a company in North Hollywood, Calif., that repackages medications for office sale, said he found it extraordinary that lawmakers in other states like Florida and Maryland were allowing such drug markups to continue.

"I see it as corruption," he said. "I think it is horrible."

In 2010, Abry Partners, a private equity firm in Boston, bought a stake in Automated HealthCare for $85 million. Officials of Abry also declined to be interviewed for this article.

That same year, Florida lawmakers tried to clamp down on how much doctors could charge for drugs. Automated HealthCare responded with a major lobbying and spending campaign, focusing its efforts on state leaders like the president of the Florida senate, Mike Haridopolos.

When the bill was reintroduced this year, Mr. Haridopolos declined to allow a vote. The state's insurance commissioner had backed the move, saying it would annually save firms and taxpayers $62 million, a figure disputed by Automated HealthCare.

Mr. Haridopolos said he didn't believe the bill had a chance of winning. "It seemed like a big political food fight," he said.

Mr. Hays, the legislator who introduced the measure, said he found that hard to believe. "The strategy of the people that were opposed to this bill was to put the right amount of dollars in the right hands and get the bill blocked," he said. "And they were successful in doing that."

Not only has this Medical Industrial Complex turned the USA into a bunch of drug addicts, they've refused to move forward with new science favoring instead to protect their self interests. Conflicts of interest abound.

This industry needs to be single payer...and it needs price controls.

[nathanm]

I would just be happy if we could convince Congress to ignore the AMA and open up more residency slots. There's clearly a shortage of doctors. Can't have that, though. It might make existing doctors have to lower their rates. Competition, it's a grumble.

[Conan71]

I would just be happy if we could convince Congress to ignore the AMA and open up more residency slots. There's clearly a shortage of doctors. Can't have that, though. It might make existing doctors have to lower their rates. Competition, it's a grumble.

There again, though are there enough competent applicants to fill additional slots?

Considering how foobared up and corrupt the FDA is, do we really think Congress is any better a manipulator of AMA policy?

[nathanm]

There again, though are there enough competent applicants to fill additional slots?

Considering how foobared up and corrupt the FDA is, do we really think Congress is any better a manipulator of AMA policy?

Yes, there are people who could fill the extra space, and the FDA has nothing to do with funding for residency slots. Even if there aren't at the moment, wouldn't it be good to have as many spaces available as there are qualified applicants?

[Conan71]

Yes, there are people who could fill the extra space, and the FDA has nothing to do with funding for residency slots. Even if there aren't at the moment, wouldn't it be good to have as many spaces available as there are qualified applicants?

I brought FDA into the discussion as a perfect example of an agency who claims to have the best interest of the consumer in mind, yet constantly does the bidding of the drug companies.

Trusting 535 mostly corrupt legislators, most of whom have legal backgrounds- not medical, to pretend to know what is best for medicine?

Understand where I'm coming from yet?

[Teatownclown]

I brought FDA into the discussion as a perfect example of an agency who claims to have the best interest of the consumer in mind, yet constantly does the bidding of the drug companies.

Trusting 535 mostly corrupt legislators, most of whom have legal backgrounds- not medical, to pretend to know what is best for medicine?

Understand where I'm coming from yet?

Do tell the solution?
Common ground...good day.

[nathanm]

Trusting 535 mostly corrupt legislators, most of whom have legal backgrounds- not medical, to pretend to know what is best for medicine?

You seem to think this isn't already what's going on. I thought you were a free market kind of guy. Seems to me that artificially restricting the supply of doctors is the opposite of what we need.

[guido911]

A concerned citizen doing his part to provide quality health care, and for free...