Lessons from Ryan Care: We Need Reform, Not Relabeling

By: Elizabeth Lee Vliet, M.D.

“Drain The Swamp” was President Andrew Jackson’s rallying cry to rid Washington of cronyism and corruption in 1828. This call has new meaning in 2017, intensified by the saga of House Speaker Paul Ryan’s failed American Health Care Act (AHCA).

ObamaCare, ironically called Patient Protection and Affordable Care Act (ACA), has created a swamp of metaphorical alligators devouring patients, physicians, and the economy. A partial list includes:

  • rising out of pocket costs
  • higher deductibles before “coverage” (if allowed at all) kicks in
  • restricted networks of doctors and hospitals
  • reduced availability of medications
  • reduced availability of home health services and medical devices
  • greater difficulty getting surgical approvals
  • reduced access to specialists and longer wait times
  • overcrowded emergency rooms
  • devastating regulatory burdens on physicians and hospitals, forcing many to close their doors
  • stunning job-killing effects of the employer mandate
  • rising taxes, and more due to go into effect in 2017.

Despite fervent Republican promises to “repeal” ObamaCare, Ryan’s AHCA has retained most of its problems. Ryan’s Plan did not ðrain the swamp. It maintained the swamp of cronyism, rewards for special interests, artificial controls on free market options, and the features that guarantee more of the unaffordable costs that drive younger, healthier, low risk patients out of the market. Continue reading

ObamaCare Repeal vs. Reality

By: Jane M. Orient, M.D.

The attempt by House Speaker Paul Ryan and other powerful Republicans to “repeal and replace” the Affordable Care Act (ACA or “ObamaCare”) has run into a buzz saw of opposition from both sides. Most proponents of the American Health Care Act (AHCA) concede that the Act is “not perfect.” But there is “political reality” to consider—what can make it through the congressional sausage-making machine? Already Congress is telling us the most important consideration for them: staying in power. The 2018 election will be a “bloodbath” for Republicans if AHCA is not passed—or else if it is passed.

The outcome of the midterms supposedly depends on how unhappy the American people are. But the political reality is that the happiness of the donor class is far more important. Most of the donor class resides in the Swamp. Perhaps the best thing to say about AHCA is that it has the right enemies: the AMA, big hospitals, and some big insurers (who all favor ACA). Continue reading

20 ideas to crush Obamacare and cure America’s health care crisis

Sen. Bernie Sanders, I-Vt. (F, 16%) is famous for declaring health care a right. He is actually correct if we were to tweak his statement to read, “free market health care is a natural right.” Yes, we the people have a right to finally create a free market health care system that will do to the medical field what Uber, Apple, Amazon, Netflix, Walmart, FedEx, and UPS have all done to their respective industries.

In so many ways, health care and health insurance – and no, the two are not the same – have missed the great technological revolution. The reason? Big, bad government.

It’s time to bust apart the regulatory state that enriches the big government-big business cartel. And we can start with these 20 ideas on a state and federal level that kick government to the curb and return the power to consumers, entrepreneurs, and health care providers:

Health care reforms

  1. End the medical malpractice boondoggle
  2. Allow hospitals to turn away non-urgent illegal aliens
  3. Offer a tax deduction for those providing health care to indigents
  4. Reform FDA approval process … big time
  5. Make more drugs available over the counter
  6. Stop boxing out specialty hospitals with burdensome certifications
  7. Expand who can deliver care so health providers have to compete for the customer
  8. Promote telemedicine and other modern delivery systems
  9. Break the AMA monopoly on medicine and prevention of for-profit healthcare
  10. Repeal the HIPAA regulatory leviathan
  11. Encourage health care providers to post prices online

Health insurance reforms

  1. Tear down regulations
  2. Promote health status insurance to deal with pre-existing conditions
  3. Stop socially engineering employer-based insurance through the tax code and treat it the same as individual plans
  4. Allow unlimited Health Savings Account spending
  5. Let consumers and employers purchase health insurance plans across state lines
  6. Permit individuals to pool together for group insurance
  7. Change antitrust laws so Big Pharma’s stranglehold on competition is destroyed
  8. Make Medicaid work with the market, not destroy it
  9. Allow affluent seniors to opt out of Medicare

– See more at: https://www.conservativereview.com/commentary/2017/03/20-ideas-to-crush-obamacare-and-cure-americas-health-care-crisis#sthash.t7bVggtI.dpuf

Health Care Related Excerpts from HRCs Paid Speeches

As Reported by WikiLeaks: https://wikileaks.org/podesta-emails/emailid/927

Affordable Care Act

Hillary Clinton Said She Wants Us To Have A Debate Where Our Differences Are Fully Aired On Healthcare Reform Since There Are Different Approaches. “Now, what does that have to do with health care reform?  Well, I want to see us have a debate where our differences are fully aired because, clearly, there are different approaches about what we think can work.  We don’t have one size fit all.  Our country is quite diverse.  What works in New York City is not necessarily going to work in Harrison, Arkansas or Albuquerque, so we do need to have people who are looking for common ways of approaching problems using evidence but leaving their blaming, their gaming, their shaming, point scoring at the door.  Because when we think about it, our country is such a remarkable accomplishment.  Think about how diverse we are.  We’ve had lots of disagreements.  We even had a civil war for heaven sakes, so it’s not like we just — you know, like in those drug commercials where we just hold hands and dance through the meadows while somebody is telling you everything that can go wrong like your ear’s falling off if you take the drug they’re advertising.” [02262014 HWA Remarks at HIMMS [Orlando].DOC, p. 10] Continue reading

The Maze Of Medical Pricing – How Much Does It Cost and What Are We Paying For?

By Gerard Gianoli, M.D.http://earandbalance.net

In a previous editorial, I commended candidate Trump’s proposal of price transparency for hospitals and doctors. It is astounding that this has not been an element of the GOP formula for healthcare reform until now and that an outsider had to bring it up. It is so obviously part of a free market that only in an overly regulated healthcare market could it be overlooked. However, there is another element of price transparency that the Trump campaign (along with the rest of the GOP hopefuls) missed. What about insurance industry price transparency?

Insurance premiums and deductibles are advertised by the insurance industry, but patients do not know what they are really getting for their money. Patients have no idea how much the insurance company will pay the hospital or the doctor for any of the services rendered. And most doctors and hospitals don’t know how much they will be paid by the insurance companies either. Continue reading

A Physician Comments on Donald Trump’s Health-care Plan

By Elizabeth Lee Vliet, MD – http://herplace.com

Republican presidential candidate Donald Trump recently released his health-care reform plan by summarizing the problems of Obamacare that the Association of American Physicians and Surgeons (AAPS) has been warning of since 2009:

“Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan president in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next president and a Republican Congress lead the effort to bring much-needed free market reforms to the health-care industry. But none of these positive reforms can be accomplished without Obamacare repeal.”

Clearly Donald Trump understands the job-killing effects of Obamacare and its unsustainable costs. Thus, Step One is full repeal of Obamacare. Trump then lists several key reforms that free market proponents such as AAPS have been advocating for many years: Continue reading

Trump Is Right On Illegal Immigration: Your Medical Care Is At Risk

By Elizabeth Lee Vliet, M.D.http://herplace.com

Donald Trump, the leading Republican Presidential candidate, appeared on Saturday Night Live recently in a comedy sketch including a focus on the problem of illegal immigration. Trump’s stand on illegal immigration has been criticized by both Democrats and Republicans. But the problem of illegal border crossers is no joking matter.

Donald Trump is right about this: illegal immigration is one of the most serious threats to national security, American sovereignty, and economic stability.

Even Trump, however, has not yet addressed the even more serious medical dangers of illegal immigration for Americans.

  • The invisible travelers coming across the border with the people: bacteria like tuberculosis (TB), viruses such as EVD-68 that killed so many US children in 2014, Ebola, West Nile, dengue fever, parasites, and fungal illnesses.
  • Delays in access to medical services for Americans with longer waits to see doctors, especially for Medicaid patients.
  • Long waits in Emergency Rooms jammed with illegals waiting for care at US taxpayer expense.
  • The vastly higher costs for states to cover Medicaid services designed to provide medical care for low-income American citizens, but now expanded to serve those here illegally as well.

Continue reading

Sex, Gender, and Politics: Restore Common Sense and Public Safety

By Elizabeth Lee Vliet, MD – http://herplace.com

Some claim that sexual orientation is a preference, not genetic, and therefore can be changed. However, nothing is more clearly genetic than our biological sex. It is determined by our two “sex” chromosomes, one from each parent. Two X chromosomes determine a biological female, while one X and one Y chromosome determine a biological male. The Y chromosome can only come from the child’s father.

But in the 21st century, “gender” has moved beyond biology, morphing into a new construct that is part socio-cultural, part ideological, and part political: that gender is based on one’s self-perception of being male or female, and is changeable.

Hence we have controversial legislation allowing self-selection of public bathrooms by transgender individuals—or anyone who claims to be transgender.

“Social equality” activists believe that one’s feeling of gender cannot be questioned by the rest of society, and policies should be made according to the individual’s assumption of gender rather than biological sex. Such self-perceptions are rarely considered the criteria used for decision-making in other areas of medicine, psychiatry, or social policy. To do so across the board would result in chaos. Continue reading

Is Donald Trump Right About Single Payer?

By Elizabeth Lee Vliet, MD – http://herplace.com

As an independent physician advocate for patients against restrictions of “establishment medicine,” I greatly admire that both Senator Cruz and Donald Trump have been unafraid to speak the truth about critical issues that affect the very survival of our country.

I applaud Trump and Cruz for boldly stating the obvious: the flood of illegals into America is costing us dearly in lives and social costs. They are right: it must be stopped, and soon.

Trump has also been masterfully successful in business. He understands that the key with countries like Mexico, China, Russia, Iran, and others is negotiation from a position of strength, not concession.

But these two men are at opposite ends of the spectrum on healthcare:

  • Trump admires the “single-payer” system of Canada and Scotland/UK.
  • Cruz is for immediate and total repeal of Obamacare.

“Single payer” is healthcare policy jargon. Most people don’t know what it really means: government control of every aspect of medical care delivery, how many doctors, in what specialties, what treatments are allowed and for whom, and price controls that drive hospitals, doctors, home health agencies, hospices, medical device makers, and pharmaceutical companies out of business. All of the controls implicit in “single-payer” healthcare mean patients lose access to medical care.

Cruz supports a return to the free market, giving patients more control, and portability, more choices of what insurance to buy and what treatments to use. It is freedom that has allowed the innovation making American medicine the best in the world, with the best survival times for critical illnesses.

I have personally experienced being a patient for major medical emergencies and surgeries in two free-market systems (U.S. and Santiago, Chile) plus 3 single-payer systems (UK, Argentina, and Canada). I will tell you unequivocally that for top quality, best outcomes, and survival, the U.S. and Chile lead the world.

“Single-payer” government-run systems everywhere, as I experienced as a patient, have three consistent, systemic, and immutable flaws:

  • Long waits for access to primary medical care, even longer for specialists;
  • Reduced options for state-of-the-art treatment and choice of specialists;
  • Reduced quality of care. Simply look at the VA here in the U.S. to see how the single payer treats our veterans.

To take an approach from business, at which Trump clearly excels: check the bottom line. In every example of single-payer systems, the bottom line is the same: Patients lose.

Some patients lose their lives waiting for care. Some lose critical function unable to get timely treatment. Most lose quality of life.

I doubt that Trump would accept such poor quality outcomes for his business enterprises. Why should we accept these poor results for medical care that affects patients’ lives?

Since Trump’s business success has come from free market opportunities that would have been denied him in a “single payer” buyer’s monopoly (or monopsony), I respectfully recommend that he re-evaluate his position on whether single payer “works well” for patients with serious medical problems.

On the issue of freedom, and thus excellence in medicine, Senator Cruz and Dr. Ben Carson are exactly right: Obamacare must be repealed in its monstrous entirety. The GOP members of Congress, and other Presidential candidates, have been talking about “tweaking” or “fixing” Obamacare rather than repealing it.

Think about it. You would not want to “tweak” or “fix” a bomb under your house! You’d want it dismantled and removed. Obamacare is a bomb already exploding healthcare costs, closing hospitals and doctors’ offices, and reducing patients’ choices of physicians and hospitals.

Mr. Trump’s “single-payer” model of government micro-management, restricted options, and price controls do not work any better in medicine than in business.

The first GOP debate certainly created a firestorm on many issues. I work in Arizona and Texas, so I know the border issues in depth, particularly as they place heavy burdens on the medical system and taxpayers. Cruz and Trump are both right on immigration.

On medicine, Cruz and Carson see the most clearly. Free markets are crucial for business—including the business of medical care.

Medicine, however, is more than a business: it is patients’ lives at stake.

Decisions in medicine belong in the hands of patients and the doctors they choose: not in the hands of third parties, such as insurers under Obamacare dictates, or government as “single-payer.” Cruz and Carson support return to patient-centered medicine. I approve this message.

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For further substantiation, see Forbes link here:  No, Donald Trump, Single-Payer Health Care Doesn’t ‘Work Incredibly Well’ In Canada & Scotland


Elizabeth Lee Vliet, M.D., is Chief Medical Officer of Med Expert Chile, SpA, an international medical consulting company based in Santiago, Chile whose mission is high quality, lower cost medical care focused on preserving medical freedom, privacy, and the Oath of Hippocrates commitment to individual patients. Dr. Vliet is a past Director of the Association of American Physicians and Surgeons (AAPS). Dr. Vliet also has an active US medical practice in Tucson AZ and Dallas TX specializing in preventive and climacteric medicine with an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems. Dr. Vliet received a NECO 2014 Ellis Island Medal of Honor and the Arizona Foundation for Women 2007 Voice of Women award for her pioneering medical and educational advocacy for overlooked hormone connections in women’s health. She received her M.D. degree and internship in Internal Medicine at Eastern Virginia Medical School, and completed specialty training at Johns Hopkins Hospital. She earned her B.S. and Master’s degrees from the College of William and Mary in Virginia. Dr. Vliet has appeared on FOX NEWS, Cavuto, Stuart Varney Show, Fox and Friends, Sean Hannity and many nationally syndicated radio shows across the country as well as numerous Healthcare Town Halls addressing the economic and medical impact of the 2010 healthcare law. Dr. Vliet is a past co-host of America’s Fabric radio show. Dr. Vliet’s health books include: It’s My Ovaries, Stupid; Screaming To Be Heard: Hormonal Connections Women Suspect– And Doctors STILL Ignore; Women, Weight and Hormones; The Savvy Woman’s Guide to Great Sex, Strength, and Stamina, and The Savvy Woman’s Guide to PCOS. Dr. Vliet’s websites are http://www.HerPlace.com, and http://www.MedExpertChile.com.