STEVE PIECZENIK TALKS

Obamacare Starting to Fall Apart: More Medicaid Patients Use Emergency Rooms than Private Physicians! 

90% of Patients Are Sicker!
I have said very little concerning Obamacare. I knew that it would eventually implode on itself because it was based on extremely faulty premises. First, Medicaid patients could not and would not find physicians. Secondly, physicians would be reimbursed at a much lower rate than before. Thirdly, there were not enough physicians [especially American-trained ones] to take charge of all the patients who were supposed to receive the insurance. Finally, over 100 Million people have some type of insurance for mental health care yet there are not enough psychiatrists and mental health professionals to take care of a fraction of these people.

You get the idea.

Obamacare is going to fall apart from its own structural/ functional distortions which were based on faulty premises created by legislators who never had to worry about their own health care. From the very beginning of the Obamacare, I had a serious concerns about those who created this dysfunctional healthcare system. Most of the Senators and Congressmen who voted for the Nancy Pelosi ‘grab-bag’ –“lets find out what Obamacare really entails after we have passed the bill” were spoiled, entitled people who for the most part, should have visited pediatricians rather than internal medicine practitioners.

Pelosi was, as were her congressional henchmen, completely inept in their understanding or implementation of health program that had no correlation to what these legislatives centurions were accustomed to in terms of their own health care. All legislators have the Navy Bethesda Hospital as well as Walter Reed Army Hospital at their convenience for FREE! They are cradled in a special insurance plan that could take care of dystrophic alien with total body ailments [whatever that would be] ---again for FREE!

In reality we have the weakest, most effete element of our society designing a system to work for the rest of us. It doesn’t work to entrust those least able to provide for themselves in the open capitalist markets without constantly pandering for  special favors [which is what a politician is really about] in return for nothing.

The WSJ article on May/4/2015 discusses what I have known and suspected for decades since I first started practicing medicine in 1968—the Emergency Rooms of most hospitals has always acted as the primary care facility for most patients in the USA. We, doctors, have not been able to turn away any patient once they stepped into the Emergency Room. Never in my career as a Medical Doctor and Board-Certified Psychiatrist have I turned away anyone in need of physical or mental health care.

Now, these patients who come to the ER have been older and sicker as the population of the country has aged accordingly. Also, as fewer American citizens refuse to curb their voracious diet for sweets, fats and junk food, we, doctors, are seeing a preventable epidemic of diabetes, heart disease and other symptoms of a drastically bad diet and sedentary life.

The notion of preventive medicine has not and probably will not invade our pervasive mindset, fostered by the greedy Big Pharma, that all medicines, irrespective of how expensive they were, could rescue our bodies from the inevitable destruction of “well-being” sloth and ignorance. I know of several cases where men and women patients decided that it was easier to risk surgery for a stomach band [which is paid in full by the USG] than go on a reasonable diet or exert oneself for some type of moderate exercise.

Instead, we find the easy way out.

Yet it just does not work.

One example: overweigh patient undertook a stomach-band surgery in order to lose weight. This patient developed severe bronchial asthma as a result of the obesity. This patient then went on inhaler and nebulizers which created heart arrhythmia. This patient was admitted to the hospital several times to arrest the arrhythmia and ended up with an unsuccessful ablation of the AV node.

So the story goes on and on.

The administration was so concerned about making certain that everyone had health insurance that was affordable yet the actual cost of healthcare rose dramatically. New policies that reimbursed physicians at a much lower rate so physicians now refuse to see the patients and pass them on to the ER where they were charged a significantly large amount of money for a very simple procedure which could have been treated by a primary doctor –who no longer exists because it is impossible for him/her to make a decent living. Fewer doctors are left to treat patients.

I was recently offered a full time job as a psychiatrist for the state of Maryland at about 2/3 of the money that was offered to the actor, Matthew McConaughey, for speaking at the commencement ceremony of the University of Houston for just an hour ($155K).  Also, let us not forget that Rami Emmanuel, then Chief of Staff for the Obama White House, agreed to pay over $80B to the Pharmaceutical Industries to allow the passage of the Obamacare bill. Now, that is a pretty penny.

As a physician who has decided to leave my profession, I strongly suggest that if you have any type of mental ailment or dyspepsia, please call the aforementioned actor or an executive at Big Pharma that continues to insist that they can charge as much as they can and want, even for generic drugs. Ask the Big Pharma rep if she/he knows how to prevent or treat suicidal ideation with a modicum of success?
Better yet, please call up Dr James McDermott, Congressman from Washington State [paid by Boeing] and ask him why he does not identify himself as a Board Certified Child and Adult Psychiatrist rather than a Congressman? He worked for in the State Department as a Regional Medical Psychiatrist. Now, he hides behind the platitudes of palaver and process. That’s his choice!
Its time for Americans to vote in those representatives who can dismantle this absurd beached behemoth, entitled “Obamacare” ; after a costly segue of internet incompetency which marked the beginning passage of a piece of legislation which belongs to no citizens; other than those who have already been treated for free. We are not a healthy nation. We have no will power or discipline to enact anything other than indulging in immediate mental and culinary gratification. We Botox our faces. We drink beer as if it were water from a faucet. We eat as if there is no other meal will be served. We glorify our chefs as they become the new elite of our society; adoring their every word and motion in the kitchen as if culinary arts was the new religion de jour.

It is often said that an army walks in its stomach. But, I say that a nation that crawls on its stomach to the Emergency Room is destined to die a prolonged, ghastly death.

Unfortunately, there is no real recourse. Once in the ER; next in the OR; then in the mortuary.

In the words of the comedian, Woody Allen:

“I’m not afraid to die. I just don’t want to be there when it happens.”