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Introduction
Real Health Insurance, Not Prepaid Plans
Tax Reform
Insurance Portability
Health Savings Accounts
Medicare Modernization
Eliminate Destructive Government Monopolies
Eliminate Frivolous Lawsuits
Help the Needy
Conclusion
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Primum non nocere
“First, do no harm”

Once the envy of the world, America’s healthcare system arose as a manifestation, perhaps even the prime exemplar, of American Exceptionalism itself. Free from government overseers, it was the patients themselves – not politicians – who were at the center of this healthcare universe, free to choose which doctors and which
private companies could provide the skill, compassion, innovation and, most importantly, results.

And it worked.

President Obama’s healthcare overhaul, The Patient Protection and Affordable Care Act, is the most dishonestly named law in American history. ObamaCare does not protect patients, it is not affordable and, in reality, President Obama does not care. The ObamaCare false promises are already causing millions of Americans to suffer.

T&F

The most consequential and disastrous law of our lifetimes was promulgated upon weary Americans in the most dishonest of ways. The results are already devastating and getting worse. Millions have already lost their insurance and tens of millions more soon will. Perverse incentives have destroyed the 40-hour work week transforming America into a part-time nation. Meanwhile, the looming doctor shortage is worsening.

As destructive as ObamaCare is, it is critical to understand that the decline of America’s healthcare system began decades earlier and it was a series of self-inflicted wounds from a government that sought control over you and your doctor. As I explained in my book in 2011, First, Do No Harm: The President’s Cousin Explains Why His Hippocratic Oath Requires Him to Oppose ObamaCare, the decline of our healthcare system began early in the last century.

Tragically, ObamaCare is a doubling down of the heavy-handed failures of our past that created our healthcare problems to begin with: central planners, artificial price controls, endless regulations, and healthcare rationing. The fatal conceit of ObamaCare is the absurd notion that the government can spend your money more wisely than you can and that bureaucrats are capable of making your most intimate, personal decisions for you.

I oppose ObamaCare, not simply because it is too expensive, but because it is immoral. I oppose government-run healthcare not only because it wastes too many dollars – it does – but because it wastes too many lives and it causes too much suffering and heartache.

We must replace our current government-centered healthcare system with a patient-centered system.

Reagan

Nearly two decades ago, I took the oath to serve my patients – to first, do no harm – and I bear the scars to prove it. In medical school I quickly learned that regardless of what the politicians do or the administrators or bureaucrats or anyone else says, all that ultimately matters is the care I provide to my patients. Everything else is secondary.

So at every level of constructing an innovative, 21-century healthcare system worthy of America, a simple question should be asked: What is best for patients? Not what is best for government or lawyers or even doctors, but what is best for patients.

The cornerstones of a patient-centered system are compassion and efficiency. Compassion is achieved when doctors and patients are empowered to choose what treatments are best, and efficiency is achieved with the powerful engine of market-based competition. This patient-centered, market-driven healthcare system worthy of a 21st-century America, I call simply: PatientCare.

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Milton R. Wolf, M.D.

Introduction

About Dr. Wolf
a Doctor, not a politician”

Milton Wolf is a doctor, not a politician. He received his Bachelors in Human Biology in 1995 from the University of Kansas and his Medical Doctorate in 1999 from the University of Kansas School of Medicine. While only a third-year medical student, Milton joined a select group of peers nationwide to be inducted into the Alpha Omega Alpha Honor Medical Society.

Dr. Wolf completed his internship in 2001 at Baptist Medical Center in Kansas City and completed his diagnostic radiology residency at the University of Missouri Kansas City which included training at Saint Luke’s Hospital, Truman Medical Center and Children’s Mercy.

During residency, Dr. Wolf received training at the Walter Reed Army Medical Center Armed Forces Institute of Pathology.

While still a resident, Dr. Wolf authored a computer program called The Wolf Files: An Interactive Radiology Atlas of Fundamental Cases which quickly became a favorite among medical students and doctors around the country and even among military doctors serving overseas.

In 2011, Dr. Wolf wrote First, Do No Harm: The President’s Cousin Explains Why His Hippocratic Oath Requires Him to Oppose ObamaCare which exposed the horrors of the president’s new law and also prescribed alternative solutions that put patients first.

Over his nearly two decades of serving patients, Dr. Wolf has delivered babies into this world and comforted families during loved ones’ final days. He has served tens of thousands of patients all across Kansas, in rural underserved areas and in a metropolitan city. He has educated medical students and doctors across the country and around the world.

Called the “Arch Nemesis of ObamaCare,” Dr. Wolf has fought tirelessly to inform Americans about ObamaCare and to propose patient-centered solutions.

Dr. Wolf is a board certified diagnostic radiologist, a member of the American College of Radiology, and served as a Medical Director in his practice.

Real Health Insurance, Not Prepaid Plans

Building an innovative, 21st-century healthcare system worthy of free Americans starts with a fundamental understanding of what exactly health insurance is and what it is not.

Perhaps the greatest irony of the entire national healthcare debate is that our government has so thoroughly undermined the health insurance system that it is hardly recognizable as insurance at all. Health insurance is meant to provide you with the means to obtain the care you need and to protect you financially in the event of unexpected illness or injury. Instead, our system today has devolved largely into expensive prepaid health plans that price families out of access to their doctors.

Politicians may promise free well-child checkups, mammograms or birth control but, of course, nothing is free.

And these politicians who claim that you will pay nothing out of pocket are the same ones who are driving up your premiums and raiding your paychecks to make up the difference and to collect nice, tidy sums for their connected crony friends.

Imagine if the government imposed their same harmful rules upon your car insurance that they have forced upon your health insurance. Your monthly rates would skyrocket as Barack Obama and Kathleen Sebelius would try to buy votes with false promises of free windshield wiper replacements and oil changes . Meanwhile, providers of the services would flee the industry leaving you with less options and long lines.

And since your car insurance would be connected to your employment, your boss would get to choose what car you can drive. But worst of all, if you get into a fender bender, you would be stuck in your current job for life because you could no longer qualify for new insurance coverage elsewhere. This is a system that enriches politicians and their connected cronies at the expense of Americans.

Your health insurance should be personal. It should be portable. And it should be permanent.

Tax Reform

A 21st-century healthcare system should empower Americans, unfettered from government overseers, to choose whatever health insurance is best for them. The first step is to eliminate the current perverse manipulation of the tax code that coerces Americans to purchase employer-based insurance instead of personal, individual policies.

As unbelievable as this may sound, our tax code actually punishes citizens who act responsibly and wish to purchase their own individual health insurance policies. If you purchase your own policy, you must use post-tax dollars whereas employer-based policies can be purchased with pre-tax dollars. This is a tax on being responsible.

This tax discrepancy also undermines a central tenet of our democracy, that all Americans should play by the same set of rules. The current system coerces Americans to purchase employer-based policies by penalizing those who choose to purchase individual policies, typically the self-employed. We must eliminate these perverse, ill-conceived taxes.

The current employer-based insurance model has unintentionally and yet unmistakably created the unacceptable situation where employers intrude upon their employees’ privacy.

Employees have learned the hard way that if your boss pays for your insurance – with money he would have otherwise paid directly to you – then understandably he believes he should have a say about your medical treatment, your private behavior and, in some companies, even your weight. This system undermines the doctor-patient relationship and sacrifices your privacy. The government does not belong in your private examination room and neither does your boss. 

Tax neutrality between employer-based versus individual insurance would empower you to choose for yourself what policy is right for you and your family. And since no two families are the same, your family should not be forced to accept the government’s or even your own employer’s one-size-fits-all plans.

If you choose to purchase your own personal policy, you will soon realize the benefit of having an insurance company that is answerable directly to you rather than to your boss. There are other benefits as well, namely portability.

Insurance Portability

A 21st-century healthcare system should empower patients to control their own personal and portable health insurance policies.

When health insurance is decoupled from employment – as is auto insurance – you no longer risk being stuck in a job you hate for medical reasons. This is one of the great travesties of our time and our federal government is directly responsible for it. We all know of someone who has suffered as a result, and not just their career but their quality of life.

The story is all too common: A person who works hard, pays their taxes and plays by the rules is unfortunately stricken with an illness. While we can’t always prevent the illness, of course, we can prevent the abuse she suffers at the hands of our government. Because her insurance is inseparable from her employment and because her new diagnosis makes it prohibitively expensive to purchase a new policy elsewhere, she becomes stuck in her current job for the rest of her career.

The economic impact on the nation caused by the millions of Americans stuck in jobs that don’t fulfill their potential is incalculable but staggering. Yet it’s not the waste of dollars alone that offends; it’s the waste of lives. The human cost of trapping poor souls in jobs they don’t love is unthinkable, unbearable and immoral.

On the other hand, insurance that is personal is also portable. You take it with you from one job to the next, just as you do your auto insurance. And so long as you continue to pay your premiums, health insurance companies cannot drop your coverage, even if you are unfortunately stricken with illness.

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Health Savings Accounts

A 21st-century healthcare system should empower patients to control costs and decide for themselves what treatments are preferred with the confidence of knowing that resources are available when they’re needed.

The Health Savings Account, or HSA, puts patients first. The concept is simple: patients set aside their own healthcare funds into a tax-free savings account that they continue to own and control so that the funds can be used as they see fit. As the HSA grows, patients can benefit from lower priced major medical insurance.

If, for example, a patient has saved $5,000 into her HSA, she would likely purchase more affordable insurance with a higher, say $5,000, deductible but still be assured her money is available in the event of an illness or accident.

Health savings accounts save patients money.

Why wouldn’t they? Patients have an incentive to avoid unnecessary treatments and tests. Whatever money the patient saves, she keeps for herself. The key is that the patient herself calls the shots rather than submitting each claim that ultimately is determined by a government rationing panel.

Instead of allowing unnamed bureaucrats to find savings by means of rationing, the HSA unleashes 300 million Americans to become the watchdogs of our healthcare system.

Under the watchful eyes of Americans who control their own HSAs, hospitals and healthcare providers would be rewarded for adopting transparent pricing structures. The marketplace would demand that providers compete not just on the basis of quality but also on the basis of price.

Health savings accounts save lives.

Critics falsely claim that patients will deny themselves necessary treatments in order to pocket the savings. Empirical evidence shows otherwise. Monetary savings are achieved with the HSA – and here’s the key – without compromising health outcomes. And, frankly, this dim view that critics hold of Americans that they will sacrifice their own health for a buck is not just wrong, it’s insulting.

Medicare Modernization

A 21st-century healthcare system should treat our senior citizens with dignity and respect and empower them to make their own healthcare decisions.

Politicians routinely peddle false hope but doctors and patients understand that nothing is more cruel than making promises that cannot be kept. Medicare is insolvent and cannot keep its promises. Its own trustees estimate that the program’s unfunded obligations have ballooned to nearly $43 trillion dollars which threatens the existence of the program itself.

To paraphrase economist Herbert Stein: Spending that cannot go on forever, won’t.

The government’s response to this self-inflicted crisis has been to ration care and to reduce reimbursement to healthcare providers. The obvious result has been less care and fewer doctors to provide it.

Even before ObamaCare, the United States government had already become the biggest denier of medical claims in America. Under ObamaCare, our senior citizens now must face the new Independent Payment Advisory Board (IPAB), the so-called death panel.

As reimbursement for treatments continues to be ratcheted down, physicians struggle to provide the services – sometimes at a loss – and are increasingly leaving government-run healthcare or even leaving the practice of medicine altogether. Medicare itself acknowledges that its ObamaCare reduction in reimbursements threatens to make as many as 40 percent of hospitals in America unprofitable. Seniors are being left without options.

Modernizing Medicare begins with giving patients options.

Allow seniors to choose which plans meet their unique needs. Seniors should be given the freedom to voluntarily enroll in programs outside of traditional Medicare such as Medicare Advantage if they choose.

Premium support for seniors would encourage competition in Medicare analogous to how the Health Savings Account encourages competition in the healthcare system at large. When seniors are entrusted to spend their healthcare dollars as they see fit, insurance companies and providers must compete on the basis of quality of service and affordability of care.

The results will be expanded options for the patients and savings for patients and taxpayers.

Eliminate Destructive Government Monopolies

A 21st-century healthcare system should eliminate harmful government mandates and meddling so that free Americans are empowered to choose which insurance policies and which doctors are right for their unique needs.

Government busybodies are convinced that they know what’s best for you. In healthcare, their stock-in-trade is the insurance mandate. By force of law, bureaucrats dictate what insurance options you must purchase and they don’t care if you don’t want them, don’t need them or can’t afford them.

It is now widely recognized that President Obama’s claim that “If you like your plan, youCertified can keep it,” was deeply dishonest. What he really meant was that if the president himself liked your plan, you could keep it.

Mandates expose the ruling class’s inherent distrust of the citizenry to govern their own lives. You cannot be trusted to choose your own insurance – their reasoning goes – and so the government that knows best will choose for you.

While medical services themselves may be desirable for some, the governing by- mandate approach forces patients to purchase services they don’t want or need. Obstetric care, for example, is wisely desired by many but mandating that single men or postmenopausal women purchase it, is foolish and wasteful.

Healthcare by mandate is anti-competitive to the core. It’s no surprise that as the government eliminates less expensive policies, prices climb. And as insurance companies leave the state or even leave the industry altogether, prices climb even higher. What’s left is a government monopoly, or at least cartel, of favored companies protected from competition.

The same holds true of medical licensing. Doctors and other healthcare providers are protected from competing with other doctors and professionals which ultimately drives prices upward.

The solution is straightforward: States should open their borders and allow reciprocity for physicians and insurance carriers that are licensed in other states to practice medicine and offer more insurance products to compete for your business.

 

Eliminate Frivolous Lawsuits

A 21st-century healthcare system should protect patients from harmful lawyers whose frivolous lawsuits drive up the costs of care for everyone.

Patients pay a hidden “lawsuit tax” embedded into every medical procedure, every pill and every product they need.

In a litigious society where lawyers file frivolous lawsuits for coffee that’s too hot, it’s not surprising that medical costs spiral out of control and patients are priced out of the hospital.

Take obstetricians, for example. In the last decade, OB/GYNs’ malpractice insurance has increased by 160 percent as a direct result of increasing lawsuits. The effect is obvious. If an obstetrician is charged $100,000 a year for insurance and delivers 100 babies in the year, that’s a $1,000 “lawsuit tax” on each baby that mom and dad must pay.

Healthcare costs are escalated further though the practice of “defensive medicine.” Medical students learn early in their careers that every white coat comes with a large bullseye on its back.

I learned this the hard way myself.

Early in my training, in my very first week of residency no less, I was tangentially involved in a case – which is to say, my name was on the chart – that ultimately caused me to be dragged into a lawsuit. I hadn’t even directly participated in the patient’s care.

In this case, my professor interpreted the patient’s chest x-ray – correctly and no one contended otherwise – and, as his resident, my name went on his report. I was later dropped from the lawsuit – as was my professor – for the obvious reason of being uninvolved, but not until substantial legal expenses had already incurred.

The damage in frivolous cases like these is very real and goes well beyond the legal defense costs themselves. Doctors quickly adopt defensive strategies to avoid being targeted. While it’s difficult to pinpoint which tests and which procedures are unnecessarily ordered, the undeniable cumulative effect is over-utilization. As a result, healthcare costs have spiraled upwards.

The solution is straightforward:

States should reform the medical liability laws to reduce or eliminate frivolous lawsuits. States that have adopted, for example, the common-sense reform of limiting non-monetary damages, have not only controlled costs but have seen
improved access to medical care, even in underserved and rural areas. It’s no surprise that more doctors are willing to practice in, and will even relocate to, areas with more sensible laws.

Patients should be protected, not only from harmful doctors, but also from harmful lawyers whose frivolous lawsuits drive up costs and therefore limit access to healthcare.

Help the Needy

 

 

 

 

 

 

 

 

A 21st-century healthcare system should provide care for the needy without treating patients as wards of the state and without driving up costs for everyone else.

ObamaCare unleashes the worst possible approach to those in need. First, government intrusion, by its very nature, artificially raises insurance costs beyond the means of millions of Americans. And second, taxpayer-funded subsidies, falsely promised to offset the higher costs, place an additional burden on everyone else.

This system is deeply flawed and unworkable.

Consider this: Families earning up to $94,000 a year are eligible for government handouts under ObamaCare. It is an astonishingly absurd notion to believe that a family in the top 25th percentile of income earners in the most prosperous nation in history should become a ward of the state in whole or in part.

This is a double disaster since Americans are not only forced to pay higher insurance premiums but they are also forced to pay higher taxes to cover the subsidy handouts that, in some cases, are directed to their affluent neighbors. This is a train with too many cabooses and not enough engines and sooner or later it will come crashing down the hill.

A civil society will always take care of those who truly cannot take care of themselves.

Medicaid has undeniably become a second-class system. It’s no surprise that health outcomes are worse among Medicaid patients than private-insurance patients. But Medicaid is far worse than that.

Medical outcomes are often no better and in some cases even worse among Medicaid patients than among uninsured patients.

Give that thought. Only the government could create a a health insurance program so bad that it delivers worse medical outcomes than having no insurance at all.

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We’ve put the federal government in charge of healthcare and there’s already a shortage of care.

But there is a better way.

Medicaid should be transformed from a second-class, government-run program into a premium-support plan that affords the needy the ability to purchase their own private insurance that they can choose for themselves. And once they’re back on their feet, their plan is portable and remains theirs to keep and control.

The first step is to unleash the “laboratories of democracy” by block granting the money directly to the states. This allows state officials who are closest to those in need to provide innovative solutions. The block-grant model has already shown remarkable success in the 1990s in the welfare-to-work reform.

As the Mercatus Center says, “Block granting Medicaid or other poverty-related programs to the states will not be a panacea, but should help create an institutional setting for the more efficient use of tax dollars.”

A 21st-century healthcare system worthy of America treats “the least of these” with
the dignity and respect that all patients deserve.

Conclusion

A 21st-century healthcare system must be compassionate and efficient, which is to say, it must be patient-centered and market-driven.

Milton Wolf and his wife Karrie in February 2013 just before she was discharged following a nearly fatal splenic artery aneurysm rupture.

Milton Wolf and his wife Karrie in February 2013 just before she was discharged following a nearly fatal splenic artery aneurysm rupture.

It has been many years since I first took the oath to my patients. I’ve stood with families in the best and worst moments of their lives.

I know the profound honor of delivering new souls into this world with my own hands, and I have been
humbled trying to stare down the unflinching face of death.

Every doctor’s worst nightmare is for their own loved ones to become their patients. I know this challenge all too well. Last year, while my wife Karrie was training for her first marathon, she suffered a splenic artery rupture, a rare event that’s usually fatal. She lost twice her blood volume as transfusions could not keep pace but she survived – and eight months later, she ran in that marathon! I’m reminded that every patient whose life I hold in my hands is not just a patient but is someone’s wife, someone’s mother, someone’s child.

And whether I serve one patient or all of America, I will not abandon that oath.

There’s a saying in medical school that “M.D.” stands, not for medical doctor, but for “make decisions.” That’s what we must do: make decisions. Every day in my medical practice, I am called upon to make decisions that make the difference between life and death. Sometimes these decisions are gut-wrenching and sometimes even soul-searching.

Ultimately, however, patients are best served when these decisions are made with the sharpened mind but guided by the humbled heart.

The reality is that a nation’s healthcare system can no sooner escape the laws of
economics than a stone can escape the laws of gravity. As Economics Professor Thomas Sowell explains, the allocation of scarce resources, whether done efficiently or inefficiently, is not some abstract economic theory but instead carries the consequences of life and death. Indeed.

The decisions we make about healthcare reflect our enduring struggle between liberty and tyranny that we Americans have always faced. We have to, as my medical school professors would say, make decisions. Will we embrace the mantle of freedom based on constitutionally limited government and individual liberty that our forefathers fought and died to deliver to us? Or will we abandon those principles now and accept a second-class fate as subjects of a European-style, social-welfare state?

I’m a doctor. I’m not a politician.

My patients are not Republicans or Democrats; they are people in need. They judge me, not by my intentions, but by my results, so I champion a healthcare system that, above all, works.

I realize that no earthly system will ever be perfect, but in the end, we face an elementary choice that will define our very essence as a nation: Will we trust our fellow Americans to freely live their lives or will we not? Will we embrace a system that empowers patients and unleashes the power of the free market or will we surrender ourselves to a government-run leviathan?

It’s time we put patients first.

America is indeed exceptional and deserves a 21st-century patient-centered, market-driven healthcare system that is worthy of our patients and worthy of our American heritage.

America deserves PatientCare.

Conclusion

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