Obamacare…the dark side

I have written several posts on the provisions of the Affordable Health Choices Act being pushed by Sen. Dodd (D. Ct.), some informative, some laughable, but, this concept is deadly.  It is referred to as the “medical home model”, and, although only mentioned twice in the act (section 2707, and section 212), we can be assured that it is the lynch pin of Obamacare.

Section 2707 provides that:

…an insurer shall develop a reimbursement structure…that provides incentives for implementation of care that includes the use of the medical home model…(emphasis supplied)

Looks both friendly and innocent, but guess again.

Obamacare is today’s version of insurance plans developed in the late 1980’s, and, this method of “treatment” was probably one of the main reasons that Hillarycare crashed and burned before it ever got off the ground.  So, rather than repeat that debacle, this plan hides it in the hopes you won’t recognize the stealth.

Then, it was referred to as the “Gatekeeper”, and here is how it worked.  You picked, or were assigned to, a primary care physician, and, that primary care physician had a group of “specialists” surrounding him or her.  If you needed a specialist, you were required to go to one in the group, no matter how incompetent that doctor might be.  But, it got worse.

The insurance company withheld a portion of your primary care doctor’s payment (typically 10%) for each patient seen.  Then, at the end of the year the insurance company reviewed you doctor’s “track record”.  If he or she referred too many patients to specialists, or ordered too many tests for patients, your doctor would receive only some (or none) of the withheld payments.  These plans created an obvious conflict of interest between you and your doctor.  Referring you to a specialist, or ordering a test (whether necessary or not) could put less money in your doctor’s pocket.  All you could do was hope that your doctor cared more about your health than his or her wallet.  These programs were so reviled by the public that many states passed laws curbing the abuses.

So, the next time you hear the President say, as he did in his Saturday, June 13 radio address:

if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs (emphasis supplied)

understand what he means.  You doctor will be monetarily rewarded (Obama calls this an “incentive”) to not send you to a specialist or to not order a test.  This will not be the “best care”, as our President proclaims, it will be the worst care.

The specialist not seen, or the test not ordered could very well have been what would have saved your life.

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The Sound Off Sister was an Assistant United States Attorney for the Southern District of Florida, and special trial attorney for the Department of Justice, Criminal Division; a partner in the Florida law firm of Shutts & Bowen, and an adjunct professor at the University of Miami, School of Law. The Sound Off Sister offers frequent commentary concerning legislation making its way through Congress, including the health reform legislation passed in early 2010.


  1. Dimsdale on July 7, 2009 at 4:22 pm

    I think the concept of the PCMH (patient centered medical home) is devolving into a GCMH (government centered medical home).

    I wonder if the Connecticut DMV will do triage?

  2. donh on July 7, 2009 at 5:53 pm

    We saw what is to come under Obamacare during Obama's infomercial answer to the caretaker of an 105 year old woman "End-of-life care will be one of the most difficult sets of decisions we’re going to have to make" Translation…. Decisions will be made that have the effect of ending life. The cold inhumane cruelty needed to make uncomfotable decisions that violate people's moral sensibilities will be called "courage" . Welcome to the world of neo fascism. It is worth reviewing the old debates between Malthus and Marx. Malthus declares the reality of massive population growth will make socialist utopia impossible. Rather than deal with the arguements directly, Karl Marx personally attacks Malthus in his footnotes… .http://www.cooper.edu/humanities/core/hss3/k_marx2.html

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