Health care reform starts and ends in the exam room.

For most of my 27 years as an internist, I have structured my medical practice to align the financial incentives (for both patient and doctor) with patient wellness and lower costs. When we lower health care costs, all our health care woes — the [...]]]> DR. CHARLES WILLEY

Health care reform starts and ends in the exam room.

For most of my 27 years as an internist, I have structured my medical practice to align the financial incentives (for both patient and doctor) with patient wellness and lower costs. When we lower health care costs, all our health care woes — the uninsured, the skyrocketing premiums, Medicare insolvency — disappear.

But more importantly, we can offer high-quality health care to all Americans.

We can begin to instill this novel thinking with a simple accounting change in regular Medicare by allowing individuals to keep the Medicare Part B Tax in their own Health Savings Account (HSA). This simple change will spill over to transform all of American health care.

The government deducts on average $98 a month from seniors’ Social Security checks to pay into the insurance pool for Part B (doctors’ office services). This is cash out-of-pocket for seniors. If we instead structure the $98 as an HSA, unspent dollars would roll over year to year.

I know from experience that, overnight, Medicare beneficiaries would become eager partners with me to improve their own health and make judicious health decisions. Ask any doctor how patients change behavior when their own money is at risk.

The relationship between quality of patient care and health care spending is part financial and part psychological.

Fischer and Wennberg at Dartmouth famously demonstrated that in Medicare, increasing spending on care is inversely proportional to quality of care. Another of their uncomfortable findings: Half of our health costs result from unhealthy behavior.

I experienced this trend in my practice. We designed our own Medicare Advantage plan so that our patients can afford the care necessary for long-term health with zero premium and affordable but meaningful co-payments. It even pays for their membership to fitness centers. My patients save money by becoming healthy and avoid waste by spending their own money wisely.

Patients who act instead as customers (as Medicare beneficiaries would, with their new Part B HSAs) are more cautious, less wasteful and more collaborative about health decisions.

In health care, the price elasticity of demand curve is very steep. Patients with low personal costs, and anxiety fueled by incomplete Internet information, are more likely to demand MRIs for a tension headache or a CT scan for three weeks of coughing.

Attention to spending, even in a Medicare Part B HSA, incentivizes patients to keep their costs low by improving their health, which improves their quality of care. This will spill over to Part A (hospital and other expensive services) affecting all costs in Medicare.

As the Medicare patient’s daughter observes the efficacy of careful health care shopping for mom, she’ll use those acquired skills for her own family’s health. This simple change in the Medicare Part B tax would ripple through the entire culture of American health care. Health would improve, costs would go down and nothing is “cut.”

My current plan also rewards doctors for keeping their membership happy and healthy. We preside over fewer chronic disease complications and hospitalizations. Healthier patients save money. My total cost of care is half of the area average.

In addition to clinical responsibility, our physicians take the health insurance risk which, combined with a 10- to 15-year relationship with our patients, motivates us to invest in our Medicare patients’ long-term health. We are well-paid for early intervention and spending time to encourage patient participation in better “cost of care” decisions.

Preserving the “donut hole,” for example, motivates the patient to choose Pravastatin 40mg at $40/year instead of equally effective Lipitor 10mg at $1,240/year. With a 20% co-payment and my coaching, patients with wet macular degeneration ask retinologists for Avastin at $40/injection instead of Lucentis at $2,000/injection.

With money saved, the patient can now afford other essential expensive medications, such as insulin. We take the time, for example, to diagnose toothache that’s really impending heart attack.

We celebrate $30,000 for bypass surgery that saves our patient’s life, a far better outcome than resuscitation and spending six miserable weeks in ICU at approximately $300,000.

The woefully underpaid fee-for-service doctor simply cannot afford time for in depth diagnostic history-taking, teaching, and motivating and following up.

With substantial savings in the program, doctors instead are paid for value (including responsibility for their insurance risk), provide the richest health benefit for seniors in our market and invest heavily in information technology at lower cost, which also improves outcome. Medicare Part B as HSA will drive change in the culture of our health care delivery system to provide value instead of fee-for-service transactions.

Structurally, the short-term decrement in the general Medicare Part B fund created by the HSA will recover through substantial savings in Part B and Part A in the short term. Accumulated HSA funds will be restricted for Medicare-covered services, and passed on to the beneficiaries’ heirs. Medicare should simply return accountability for cost and care to the doctor and patient by aligning each party’s incentives.

Aligned incentives are working for us for 20 years running, and it can work for everyone. A survey of my patients shows they love the idea. Changing the culture of health care starting with this simple Medicare Part B modification enables the doctor and patient to jump-start the most useful and locally effective market-based health care reform.

Willey, founder of a physician-owned Medicare Advantage plan, practices with three advanced nurse practitioners as Innovare Health Advocates in St. Louis.

The Senate is still dominated by leadership and members like Harry Reid and Claire McCaskill who are dedicated to keeping President Obama’s “signature” legislation alive, so there is little hope that a bill will reach the President’s desk.

Even if it did, the President has shown [...]]]> January 12th, the House has scheduled a vote to repeal Obamacare.

The Senate is still dominated by leadership and members like Harry Reid and Claire McCaskill who are dedicated to keeping President Obama’s “signature” legislation alive, so there is little hope that a bill will reach the President’s desk.

Even if it did, the President has shown no remorse at conspiring with Nancy Pelosi and Harry Reid and the rest of his party to ram this legislation down our throats.  President Obama will not sign a repeal, nor are there enough conservatives in Congress to override the president’s veto.

So why bother? Because the people need to be made well aware of who is or is not in favor of reforming health care in a way that does not wreck our health delivery system.  Although at this point the bill is a symbolic shot across the bow of Obamacare, the symbolism is important as we hold those legislators accountable for passing and standing pat on this terrible law.

First, a confession: I have never found New Year’s Eve and New Year’s Day to be particularly satisfying holidays.  Perhaps this is because I find Christmas and the celebration of the birthday of Jesus so personally meaningful.

And, then there is always a kind [...]]]>

Endings and Beginnings

First, a confession: I have never found New Year’s Eve and New Year’s Day to be particularly satisfying holidays.  Perhaps this is because I find Christmas and the celebration of the birthday of Jesus so personally meaningful.

And, then there is always a kind of “pressure” to really celebrate New Year’s and make it soooo memorable.  This rarely worked for me – as evidenced in my current failure to really recall any of the New Year’s celebrations.  Even the college football bowl tradition seems so watered down (and the national championship game is just about played in February!).

I heard a local radio talk show say “And, like most dads in America who said this at one time or another: ‘New Year’s is amateur night! ‘”  This seemed very true to me too.

Finally, I never really found the end of the year, this big turning over of the calendar, to be the best time to take stock of the past year or to come up with new resolutions.  Somehow, the school year seemed better for these.  For these reasons, I never made a big deal about the New Year.

However, this year end seems different to me.  It really IS a kind of end for me and for our campaign for Congress.  After nearly 18 months of working together, we begin transitioning (this is code for “ending”) our campaign.  I cannot thank each of you and especially our legion of volunteers and the citizens of Missouri’s Third enough.  What a great experience and what success we had!  May we continue to build on it in 2011 and 2012.

I hope to see each of you at our Open House on Jan 2nd at Two Hearts Banquet Center from 3-6pm.

As to our campaign, we still have a few loose ends to tie up but we will be shutting most of our campaign operations down.  Our website will remain up but will go static.  Our Twitter and Facebook efforts will go quiet – at least as to the campaign.

For me, I will be back to work building my business (law) and fighting for conservative principles. I will be back at the helm of the Conservative Heartland Leadership Conference (we seek to educate about conservative principles in action).  In the new year, I will be speaking out on Obamacare and the truth of it as well as speaking out on Voter Fraud and the future of elections.

You can expect to hear from me every now and again from this email address.  However, I will be setting up shop in some new places on the Internet.  Please look for these over the next few weeks.

ObamaCare and “Death Panels”

You may recall that the original Obamacare bill included provisions that would allow for “end-of-life” counseling.  These provisions were cut from the bill after opponents expressed concern – correctly in my opinion – that this counseling was intended to prepare patients for inevitable rationing based on bureaucrats in Washington DC.

Medical professionals should be free to talk with patients about such matters, but the discussion is initiated by the patient and done within a climate where the patient can be confident that their physician has the patient’s best interests in mind.  That there would be an officially sanctioned, government funded end of life discussion is recognized by most people as ethically suspect, which is why many members of congress cautioned each other to downplay these provisions. Ultimately this subterfuge was found out and these parts of the legislation were struck.

What the left could not achieve by legislation, they are going to get by regulation.  The medical regulation bureaucracy in Washington DC is gearing up to do the very thing that the people’s representatives refused to allow by dint of law.  Consider this from the Wall Street Journal:

ObamaCare proponents derided fears of “death panels” as a product of tea partiers’ fevered imagination, and they lamented when Congress removed the provision that would have provided for end-of-life counseling that might coax the elderly away from life-sustaining but expensive treatments. Not to fear: The administration has resurrected that provision through regulations, and Medicare will now pay for such counseling as part of elderly “wellness assessments.” Yes, the “death panels” charge is somewhat crude, but combine cost-based rationing with end-of-life counseling and, well, here we are.

As the Food and Drug Administration conspires with the Centers for Medicaid and Medicare Services to reduce the availability of medicines and provide bureaucratic pressure on physicians who accept Medicare and Medicaid patients to change the medical culture, we see a sterling example of big government in action.

The bottom line is that Federal bureaucrats are effectively thrusting upon the American people regulations too repellant to be accepted even by a congress utterly contemptuous of the will of the American people.

Right of center politicians are often hounded by their left-wing opponents for preferring private sector solutions over big government solutions.  They fail to understand the difference between “expensive” due to market forces and “unavailable” due to government fiat.

Open House January 2nd

We would love for you to join us on Sunday, January 2nd, from 3- 6pm at Two Hearts Banquet Center 4532 Lindbergh Blvd. (Lindbergh and Gravois) in South County for an afternoon that will fondly recall the fun and fellowship of this past year as well as provide a chance to look forward and discuss all the  opportunities that lay ahead.

Thanks for reading.  We will see you Sunday!
Ed

YOU CAN HELP: Between now and the primary in Missouri on August [...]]]>

August 3rd is your chance to let congress know how you feel and protect Missourians from the worst provisions of Big Government Health Care. We cannot take the vote for granted. The Missouri Hospital Association is spending $200,000 to defeat the measure.

YOU CAN HELP: Between now and the primary in Missouri on August 3rd volunteers are needed to help with phone banking for passage of Prop C. Even if you only have a couple of hours to spare your help would be greatly appreciated. Hours are very flexible. For more information contact Bev at 314-608-0168.

LOCATION:
Pillar in the Valley
229 Chesterfield Business Parkway
Chesterfield, MO 63005 – Map

Prop C Phone Bank Schedule – Call Bev 314-608-0168

Invites Carnahan, Local Officials to Pledge Support for HCFA

(ST. LOUIS, MO.) July 15, 2010 – Ed Martin visited with hundreds of seniors this week talking to them about Missouri’s Health Care Freedom Act, or Proposition “C” at several assisted and independent living senior centers in Missouri’s [...]]]> IMMEDIATE RELEASE
Press Contact: Theresa Petry, (314) 807-7077

Invites Carnahan, Local Officials to Pledge Support for HCFA

(ST. LOUIS, MO.) July 15, 2010 – Ed Martin visited with hundreds of seniors this week talking to them about Missouri’s Health Care Freedom Act, or Proposition “C” at several assisted and independent living senior centers in Missouri’s 3rd district. Pelosi and Congressman Carnahan’s “pass the health care bill –then find out what it entails” attitude has left seniors, the largest group of health care users, in the dark regarding their future care. It has been months since the government takeover of health care and seniors are still at a loss for how it impacts them. What seniors do know and what they’ve expressed to Ed is; they want their voices heard and they want the right to choose. They do not want the government to come between them and their doctors – possibly risking their health care.

A similar message echoed throughout a health care forum titled “Obamacare’s Impact on Seniors…And Where We Go From Here.” Tuesday some 460 seniors attended the forum in St. Louis where Ed Martin was asked to speak. He spoke as not only a congressional candidate but also as a bioethicist and an attorney whose law focus was health care ethics.

Ed Martin told the crowd of seniors that one common sense approach to health care is to vote “Yes” on Proposition C, Missouri’s Health Care Freedom Act, August 3rd. Missouri is the first state to stand up and allow voters to speak out on the national debate of Obamacare. Ed Martin sent a letter to elected officials in the area asking them to pledge their support, as he has, to vote “Yes” on Prop C and return the right of health care back to the people of Missouri.

“I support a common-sense health care fix that cuts costs, does not cut care and provides more choices for every American. Health care costs are simply too high and the current system needs to work better. However, the Pelosi/Reid/Carnahan government takeover of health care is not the answer to our health care needs. Congressman Carnahan’s vote for the government takeover of health care raises taxes on every American, rations health care and cuts Medicare for our seniors. We need to start over and pass a new plan that will actually cut costs without cutting care, increase competition among providers and insurance companies, provide more choices for Americans and mandates coverage for pre-existing conditions,” said Ed Martin.

For more information about Martin’s background and the campaign, visit EdMartinforCongress.com, or follow him on Facebook and Twitter @ed4congress.

Theresa Petry
Press Secretary
“Ed Martin for Congress”
(314) 807-7077 (cell)

theresa.petry@edmartinforcongress.com
www.edmartinforcongress.com

Cuts in Medicare, starting today, reduce funding and will cut care

(ST. LOUIS, MO.) April 1, 2010 –The concern regarding Medicare cuts becomes a reality for seniors today. The healthcare “reform” that Pelosi and Rubberstamp Russ Carnahan voted for boils down to a 21.3% cut in Medicare reimbursements. Unlike much [...]]]> IMMEDIATE RELEASE
Press Contact: Theresa Petry, (314) 807-7077

Cuts in Medicare, starting today, reduce funding and will cut care

(ST. LOUIS, MO.) April 1, 2010 –The concern regarding Medicare cuts becomes a reality for seniors today. The healthcare “reform” that Pelosi and Rubberstamp Russ Carnahan voted for boils down to a 21.3% cut in Medicare reimbursements. Unlike much of their reform plan this cut to seniors’ care takes effect today.

Even one of Rep. Carnahan’s Democratic colleagues recognized the underlying harm this bill would inflict on our seniors. Rick Boucher (D-VA) stated, “My concern largely centers on the dramatic reductions in Medicare funding required by the legislation. Over the next 10 years, the bill requires that Medicare funding be reduced by $450 billion. In fact, in April of this year, doctors in our region and across the nation will have their Medicare payments reduced by 21 percent. Over the next several years, additional reductions in payments to doctors will occur. Because of these reductions, many doctors may decide to stop treating Medicare patients.” (Boucher webpage, March 21, 2010)

The Philadelphia Inquirer released an article yesterday regarding the healthcare reform. It called the cuts to Medicare as “good, bad, and potentially ugly.” “Some physicians already see a need to limit their reliance on Medicare. Now, with reform expected to cover another 32 million Americans, physicians can more easily focus on non-Medicare patients, making it difficult for older adults to find qualified primary-care physicians.” (Philadelphia Inquirer, March 31, 2010)

Despite the blows it will undoubtedly strike on our seniors Rep. Carnahan continues his sales pitch of Pelosi’s reform. Seniors in the third Congressional district are scared and we’re learning they are rightfully so.

“I have had a number of seniors call my campaign office in a panic over this reform. Most of them are on fixed incomes and fear they may not be able to even find the care they need. These are our seniors! We made a deal with them, they paid in all those years, and Medicareis broke. Instead of mending that promise Rep. Carnahan voted to add insult to injury. Sure Medicare adjustments were needed but cutting reimbursements and jeopardizing care isn’t what they bargained for and it’s simply not fair to seniors. We need to honor our deal. We can and must do better,” said 3rd district Congressional candidate, Ed Martin.

The federal entitlement programs that were already in place were unsustainable yet Obamacare was added. You can expect cuts, tax increases and more under Pelosi and Carnahan’s reform – and not just for our seniors. Even Boucher understands and acknowledges that. After carefully reviewing Pelosi’s plan he concluded that,” these dramatic Medicare cuts would both decrease the quality of health care that is delivered to our region’s senior citizens and result in increases in health insurance premiums for the currently insured,” said Boucher. (Boucher webpage, March 21, 2010)

For more information about Martin’s background and the campaign, visit EdMartinforCongress.com, or follow him on Facebook and Twitter @ed4congress.

Theresa Petry
Press Secretary
“Ed Martin for Congress”
(314) 807-7077 (cell)

theresa.petry@edmartinforcongress.com
www.edmartinforcongress.com

As more kickbacks are uncovered the call to repeal Carnahan rings loudly

(ST. LOUIS, MO.) March 22, 2010 –The news becomes more disturbing as we learn just how low the President and Pelosi stooped to get their health care bill passed. From the start the people voiced their opposition [...]]]> IMMEDIATE RELEASE
Press Contact: Theresa Petry, (314) 807-7077

As more kickbacks are uncovered the call to repeal Carnahan rings loudly

(ST. LOUIS, MO.) March 22, 2010 –The news becomes more disturbing as we learn just how low the President and Pelosi stooped to get their health care bill passed. From the start the people voiced their opposition to the massive overhaul of the health care reform bill. Even pollsters to the past two Democratic presidents understood this. Patrick H. Caddell and Douglas E. Schoen made the following statement in the Washington Post, “Nothing has been more disconcerting than to watch Democratic politicians and their media supporters deceive themselves into believing that the public favors the Democrats’ current health-care plan…However, a solid majority of Americans opposes the massive health-reform plan.” (Washington Post, March 12, 2010)

Poll after poll showed the vast majority of Americans did not want this health care bill. And amid the thundering sound of gasps and disgust Rep. Carnahan continued to try and sell his vote to his constituents saying, “Today, hope and change have triumphed over fear and obstruction.”

“No matter how Russ Carnahan tries to spin it, this is still a trillion dollar government takeover of healthcare. With its Medicare cuts, tax hikes and shady backroom deals, it’s no wonder Missouri families overwhelmingly oppose this massive bill. Having put the interests of President Obama and House Speaker Nancy Pelosi before the needs of Missouri families, Carnahan can expect that the upcoming campaign will be the fight of his life.” – Tom Erickson, National Republican Congressional Committee spokesman.

When news of kickbacks in return for votes unraveled, opposition grew even stronger and now more backroom deals are coming to light. Rep. Russ Carnahan, acting as Pelosi’s puppet, did nothing but his usual rubber stamp of the bill, never once did he voice concern over the corrupt deals being brokered.

The Senate is supposed to “fix” the bill and remove the special deals but it was the Senate that approved them in the first place. “House Democratic Leaders have promised their Members that a ‘fix’ bill will modify the Senate’s health care bill once the House has passed it.  If such a bill cannot be considered by the Senate – as Senate Democratic Leaders seem to fear – then the Senate-passed bill will stand as the law of the land, including the ‘Cornhusker Kickback,’ the ‘Louisiana Purchase,’ the ‘Gator-Aid’ deal for Florida, and every other payoff, kickback, and sweetheart deal,” says Rep. John Boehner (R-Ohio.)

And now there is speculation that Stupak’s game changing vote was bought as well. In what is a curious coincidence Rep. Stupak’s district in Michigan was given almost ¾ of a million dollars in grant money just two days ago. “U.S. Congressman Bart Stupak (D-Menominee) announced three airports in northern Michigan have received grants totaling $726,409 for airport maintenance and improvements,” reads a press release dated 3-19-10 on Rep. Stupak’s website.

“It’s another example of Obamacare at any cost and the cost is staggering - not just monetarily. People are upset this bill passed but I’m hearing they’re even more upset over how it was passed. This is America this isn’t a place where bribes and force reign supreme. It’s the land of the free, not government control. It’s the land of ‘We the people,’ where our voices are heard by the people who represent us. Since Rep. Carnahan refuses to represent the people of the 3^rd district they are standing up with me and asking for a repeal of Carnahan,” said Congressional candidate Ed Martin.

Since being created late Sunday night the website www.repealrusscarnahan.com has received countless hits with voters pledging to repeal Congressman Carnahan.

For more information about Martin’s background and the campaign, visit EdMartinforCongress.com, or follow him on Facebook and Twitter @ed4congress.

Theresa Petry
Press Secretary
“Ed Martin for Congress”
(314) 807-7077 (cell)

theresa.petry@edmartinforcongress.com
www.edmartinforcongress.com