Dr. Russ Fasolino: Fixing Obamacare

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In regards to Rep. Scott Tipton’s commentary about Obamacare, I appreciate his concern with the huge difference in policy price between rural vs. urban Colorado residents and his attempts to offer an alternative (H.R. 2300). The cheapest policy for my wife and myself is rising from less than $500 per month to just less than $1,100 per month with a higher deductible, which is unaffordable to us. So Tipton is right that Obamacare is turning out to be “a mess.”

What I don’t appreciate is how he took six opportunities to slander President Barack Obama and Democrats in general and left any alternative solutions for later in his article. I am a swing voter because I will vote for the candidate with the policies that make the most sense for solving current problems. In that regard, I think we all are swing voters. I voted for Obama twice because at least the guy was trying to fix a health care crisis in America. Republicans, you were not.

Here are my suggestions for fixing the mess. First, cut the for-profit middlemen (insurance corporations) out of the deal. This means either requiring health care insurance companies to be non-profit or to quit creating unfounded fears about socialism and have the government take over health care reimbursement.

Look, America already has many social systems that work fine. Roads, schools, airports, libraries, the justice system, even medicine, though it’s reserved for our elderly. Why can’t we trust our government to expand it to include the rest of us?

Second, control the tort system. A limit on malpractice claims would financially harm the very occasional person while benefiting the vast majority of patients with lower medical costs. Physicians would stop feeling the need to legally “cover their butts” by ordering multiple expensive tests. By lowering malpractice policy rates for these physicians, the cost can be passed on to the American public as opposed to lining the pockets of the insurance corporations.

Third, get rid of deductibles and cover preventive screenings (mammograms, colonoscopies, etc.) and “alternative therapies” such as chiropractic, acupuncture, massage, etc., all of which have been proven to encourage health and lower medical costs. Fewer and fewer Americans are using these services because insurance premiums and deductibles are so high that we can’t afford any additional out-of pocket expenses.

So politicians, please stop the rhetoric and do your jobs, which is to create meaningful legislation to ensure all Americans get decent health care at reasonable costs. America is rated dead last out of all western industrial countries, not because we lack in quality medicine, but because it is increasingly only available to the rich. This is not ethical. Do your job to get our votes.

Sincerely,

Dr. Russ Fasolino

East-West Natural Health Clinic

Steamboat Springs

Comments

Dan Kuechenmeister 5 months ago

Dr. Fasolino, Thank you for having the courage to state that "Obamacare is turning out to be a mess". My concern with your letter is you state that Rep. Tipton "took six opportunities to slander President Barack Obama and the Democrats in general". Honestly, I have re-read Rep. Tipton's piece several times and have yet to find one example of slander on Rep. Tipton's part. He certainly has called out the president and the Democrats for the issues the Affordable Health Care Act, AKA Obamacare, is experiencing and you actually seem to agree in general that it is a mess. It would be helpful next time if you are going to accuse some one of slander you use an example. In my opinion, one of the problems in the USA is the amount of hyperbole and misinformation that is produced both on the left and the right. As an example, Rep. Tipton's piece may not be read by those who disagree with him. They will read your piece as it appears to disagree with at least a portion of Rep. Tipton's article. They will see you state that he took an opportunity to "slander" Obama and the Dems. Then they go out in the public forum and repeat the "fact" that Rep. Tipton is slandering the president and the Democrats. Similar to you, I am a voter who decides to vote based on the candidate and not the party affiliation. I appreciate your being willing to share your thoughts in this forum and hope you will re-think your use of the term slander.

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Michael Bird 5 months ago

If we remove insurance companies, employees who will run the government program will be federal employees who will receive a defined pension plan, more paid holidays than private insurance companies provide, much high annual salaries, and an an almost impossibility of getting fired for shoddy work - all of which would greatly increase the costs of running a government plan.

Lets look at insurance company profits, which unlike the medical field, are highly regulated as all rates (premiums) are now regulated by each State. Is it highly profitable ? Let us check. Again unlike Dr. Fasolino area, insurance companies' profits are regulated. So do State Farm, Allstate, Travelers, GEICO Prudential, MetLife, Progressive, Hartford, Nationwide, and the list goes on and on - sell health insurance ? No is the resounding answer. Wait a minute - if health insurance is so profitable and insurance companies are in the business of making a profit, why aren't almost all insurance companies selling it ? Guess it must be a lack of return on income or equity unlike the medical field. Isn't it interesting that Dr. Fasolino did not mention that the most expensive part of the equation should not be greatly reduced - medical providers' expenses.

Insurance companies provide transparent competition - online insurance prices are readily available. Where are the posted fees for the medical field ? Why don't medical Doctors eliminate the "white line" and report instead of protect bad Doctors ? - thus greatly reducing legal awards from Doctors who never should now have a license. Why isn't there a national license for Doctors so that when one loses it in one State he or she cannot simply go to another State and quickly be licensed ?. There is so much that needs to be done now (defined as within 12 months) to improve our system. Our medical personnel and facilities must have adequate net incomes. Needed changes need to be led by them and this must include significant cost reductions.

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mark hartless 5 months ago

"... at least the guy was trying to fix..." That is a matter of opinion. Another explination is that he was simply "not letting a good crisis go to waste" (the words of his then chief of staff).

Roads are underfunded. Schools are funded more than ever before and better than most of the world but continue to turn out rubbish. Yet they have the audacity to continue to claim to be underfunded. Your tax dollars in Routt county are subsidizing the airport and they are, by most americans testimony, a place of utter frustration.

The justice system??? You are kidding, right??? You are seriously saying our current justice system is an example of something being done so well by government that we want to put the managers of IT in charge of our kidney transplants??? Get real.

"Why can't we trust our government..."? Dude, are you high?? The NSA is reading your e-mail, recording your phone calls. There are drones flying over your house... It was government that told you your premiums and deductibles wer egoing to go down, but by your own admission they are going UP... all courtesy of the government which you want to EXPAND???

Getting rid of deductibles is the exact wrong approach, as it is the patients disconnectedness from their medical bills which has caused much of the skyrocketing costs of healthcare.

The only part of this "perscription" with which I can agree is that tort reform is desperately needed. And that seems contrary to the writers assertion that government is doing a good job with the justice system.

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mark hartless 5 months ago

Back in the Soviet Union the Bakeries were "non-profit".

The sign on the shelf at the grocery store read: "Bread 10 cents." That was the "law of the land" !! But there was not one loaf of bread on that shelf. Why? Because Borris and Ivan were not stupid enough to work for little or no wages when they could sell the bread out behind the grocery store to starving Russians for $20/ loaf.

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mark hartless 5 months ago

You folks desperately need a history lesson BEFORE you find yourselves living one.

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John Fielding 5 months ago

I sure don't like the idea of the government running health care, but what the private sector is doing is (or should be) criminal. I was injured on the job, an unusual spinal injury that does not manifest for at least 24 hours, at which time the nerve damage is noticed in the loss of feeling and control. The experts say this is the invariable pattern for this type of injury.

But the comp carrier (Travelers) said "you can't prove this happened at work", and denied the claim. I nearly lost my house, got far less treatment than I should have received, and finally after 18 months had to give a lawyer 20% of the settlement. All the care providers generously reduced their fees so I was left with something, otherwise I could not have resumed treatments after the award.

Dr. F is right that the profit motive is inappropriate in health insurance. Making money is accomplished by denying patients and doctors their due. Doctors working for these companies are awarded bonuses for finding reasons to deny care. That is not just unethical, it is evil, as plain as can be.

Thank you Russ for going out on a limb and continuing to treat me when it looked like I would lose everything.

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mark hartless 5 months ago

John,

Situations like yours are admitedly common and need to be prevented. And they could be resolved with simple changes to small aspects of the system; mainly on the legal side.

I fail to see how taking profit out of something and then adding that much cost OR MORE in government red tape and bureaucracy will make anything different; except government will be in the position your insurance company was. How exactly is that an improvement??

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Robert Huron 5 months ago

Mark John's situation is not the exception it is the norm. Insurance Companies have a 30% administrative cost as compared to Medicare which has a 2 % cost. They have to pay executive salaries in the millions plus bonuses to their employees that find ways to deny claims. Please explain to us why the US is the only country in the western world that your healthcare is dependent on your employment. Why should employers have the cost of supplying health care in the first place? How many small businesses can afford $10,000 to $20,000 a year per employee to supply healthcare? Yes the big corporations can, like Wall St. giant Goldman Sachs. They supply at a cost of $20,000 a year Texas Sen. Rafael "Ted" Cruz his healthcare which is why he opted out of the Congressional System. .As taxpayers we are already paying a price for healthcare for public employees like Teachers, Police, Fire, VA, Military etc. Plus we also pay for the uninsured when they use the ER at an extremely high cost. One day at the ER at YVMC will run $10,000 and you and I pick up the tab. The US needs to change the way we provide healthcare for all our citizens. We have the highest cost system in the world with poorest results. If Obamacare is not the answer then what is the alternative? Right now the state with the lowest amount of uninsured(less than 4%) is Mass. which has Romneycare and the highest is Texas(30%) which has Cruzcare which is use the ER. The US can do better but it can only be accomplished if all of Congress works together to find solutions and stops all the BS.

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John Fielding 5 months ago

My suggestion is that if a claim is made it must be paid, then it is up to the insurance company to prove fraud (to a criminal standard) and recover the overpayment or see the perpetrator incarcerated. The insurance companies can control over prescribing of drugs and procedures by selecting which providers they accept in their networks. They can also set limits of coverage for certain procedures. All these conditions can be part of the consumers decision of which policy to buy.

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mark hartless 5 months ago

"Please explain to us why the US is the only country in the western world that your healthcare is dependent on your employment." I'm not employed and I have healthcare insurance. But totally agree. I don't think employers should be responsible for healthcare insurance. They shouldn't have to do withholding taxes, social security and all that mess either. The induvidual shoud deal with all that crap on his/her own.

We might have the most expensive healthcare, but it is FAR from the poorest. People come from all over the world to acces our "terrible" system.

So, if it can "only beaccomplished if all of congress works together..." then you agree with me that we're screwed?.

Like many problems there is no one simple answer but here are a few things we could do short of giving the imperial federal gubbamint control of our kidney transplants:

1. allow insurance companies to do business across state lines.

2. Go to a "loser pays" legal system like most of the rest of the world so as to cut out the frivilous lawsuits.

3. Make individuals responsible for their own healthcare and make them pay some percentage of EVERY DOLLAR, from the first dollar the the million'th (is that a word?). maybe 20% of the first $5,000 then 10 % of the next $50,000 then 1% of the next $80,000 and so on. But NEVER EVER have a system where a person getting a product doesn,t give a tinkers dam what that product costs.

Going to a gubbamint system won't help anything if we don't figure this simple principle of economics out. Making people pay a percentage would get them shopping around for the best price and rates would drop. Lasik eye surgery is not insurable and rates for it have dropped every year for decades. That's because people pay attention when they are spendinbg THEIR money.

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Kevin Nerney 4 months, 4 weeks ago

Throughout this entire Obamacare mess not once have I heard about doctors taking a pay cut. Same goes for the pharmacy companies. I sure the local pharmacist has had his or her salary lowered or their hours cut, but the profit margin for corporate has surely risen. Plumbers, carpenters, city workers of all kinds are making less but hospital rates continue to rise, and doctors and dentists still charge an arm and a leg. We've all seen the commercials where you can give a third world vaccination for just pennies, and i just got a letter in the mail saying I could give a Thanksgiving dinner to needy folks for just a $1.92. My question is why can't I get vaccinated and eat for less then 2 bucks? Where does the AMA stand on Obamacare? They have been awfully quiet, because they're laughing all the way to the bank.

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Tim Keenan 4 months, 4 weeks ago

Medicare actually has very low administrative costs, and those who are on it, like me, are for the most part quite satisfied. I'm sure there'd be some growing pains if we expanded it to cover everyone, but I'm equally sure it'd be better than the mess we have now. Getting rid of the middle man, (Signa, Humana, Wellpoint -- you gotta love those names) should be the first step. I don't know about you, but I'd rather my intermediary be sworn to serve me as "the people" than their company's bottom line. Vermont has blazed the trail with single payer. Let's see how they do.

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Fred Duckels 4 months, 3 weeks ago

Much talk about the government as being the answer. This is much like having one party rule or a dictatorship, How much good do you think is going to come of this arrangement long term?

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Dan Kuechenmeister 4 months, 3 weeks ago

200 year old filibuster rule tossed out on a simple 50 + 1 majority vote. 55 Democratic senators, 45 Republican senators. I guess we are going to find out the answer to Fred's question. "And so, my fellow Americans: ask not what your country can do for you - ask what you can do for your country." That quote rings pretty hollow these days.

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Fred Duckels 4 months, 3 weeks ago

In this case we have those who would give the government the reins of healthcare system that is loaded with resources all developed from the private sector. Government left to it's means would have produced a Yugo look alike. Given time, minus private sector magic, we will have the poor healthcare that the naysaying socialists say we now have.

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