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I’m Busted

Posted Apr 02 2013 1:39pm

 Stanley Feld M.D., FACP, MACE.





As we get closer to 2014 and the scheduled full implementation of Obamacare conditions in the practice of medicine are getting worse.

I have described how most of the major programs initiated by Obamacare,

(such as the Accountable Care Organizations , the Electronic Health Record initiative s and the Health Insurance Exchanges development ), are failing or off to a slow start.

 A detailed critique of the Obama administrations’ Obamacare can be found using the search engine in my blog.

If you receive my blog by email (RSS) double click on the blog title or go to the web site http//

Search for the topic in the search engine in the top right corner of the blog post.

The shortcomings of Obamacare are becoming obvious to many citizens. Most physicians and hospital systems are finding Obamacare’s new programs difficult to execute.

A reader wrote

"Dear Dr. Feld,

Once it becomes so painful for the average voter, Obama will simply say, “a single payer system is the only way to fix this insurance company mess.”  He’s doing exactly what he planned to do, he’s just not telling the truth about it.


It is becoming more apparent that President Obama’s goal has been to destroy the public and private sector healthcare systems. In reality the money in both the public and private healthcare system has been controlled by the healthcare insurance industry and not by the government.

The Obama administration is building the infrastructure to easily convert the healthcare system to a single party payer system. The majority of Americans are opposed to a single party payer system. It eliminates choice.

The expense of Obamacare has been and will be enormous to all stakeholders with 300 new agencies and 20,000 new regulations.

The new healthcare taxes are scheduled to take effect almost monthly.

At present at least 40% of the healthcare system is a single party payer system when considering the government healthcare plans in place.

The Obama administration will have two major problems converting America totally to a single party payer.

The public will be outraged when it becomes aware of that the direct costs to them, the lack of availability of medical care and restriction to access to care caused by Obamacare.

There are two possible solutions. Either repeal Obamacare and start from square one or let the government control the entire system.  

The government will not be able to afford a single party payer system. It will have no choice but to increase taxes further to support the healthcare system.

The other major problem Obamacare will have with a universal single party payer system is the healthcare insurance industry will continue to control the money in the system.

The government does not have the infrastructure to provide the administrative services and to adjudication claims. There are many hidden cost in the movement of money that most are unaware of.


The entire situation reminds me of Ray Charles’ song “I’m busted.”



In 2008, after President Obama was elected I wrote him six letters explaining how he could reduce the costs of medical care in America by introducing cost savings initiatives.

Dear President Obama Part 1

Dear President Obama Part 2

Dear President Obama Part 3

Dear President Obama Part 4

Dear President Obama Part 5

Dear President Obama Part 6

I took a Willie Sutton approach. “ Go where the money is.” 

If the government provided incentives to decrease wasteful spending, the healthcare system would self correct without the myriad rules and regulations    that will not work and cannot be enforce.

Simple things such as:

  1. Incentivize individual responsibility with Medical Savings Accounts,
  2. Encourage the use of a Universal Electron Health Record with a fully functional EHR in the cloud. Physicians and hospitals would pay for its use inexpensively by the click. It would be sort of like a toll way fee without capital expense. The EHR could be upgraded and serviced at no expense.
  3. Create a healthcare system that is consumer driven with consumer owning their healthcare dollars and being responsible for their healthcare choices.
  4. A Tort Reform System that eliminates the need for defensive medicine that over tests patients to avoid law suits.
  5. Chronic Disease Management Systems to teach patients to be the professor of their disease in order to avoid costly complications of their disease.
  6. Develop patient educational systems available on the Internet 24/7 as an extension of their physicians’ care.
  7. Help develop disease specific Social Networks. The development of a disease specific community can serve to solve some problems patients have.
  8. Eliminate secondary stakeholder waste, fraud and abuse.
  9. Eliminate the purchase of first dollar healthcare coverage from the healthcare insurance industry  

I believe if all of the above was done correctly it would save $750 billion to $1 trillion dollars a year for the healthcare system.

President Obama has ignored every point I have tried to make. Obamacare has not included any of the real cost drivers in a non-punitive way.

He has simply added a huge bureaucracy with rules and regulations that are expensive, difficult to execute and more difficult to enforce.

If my recommendations were initiated and executed properly America would have a sustainable healthcare system.

 The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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