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Medicaid expansion is a good thing. Ask Mitt Romney!

Medicaid expansion is a good thing. Ask Mitt Romney! 

I never thought I would see, in America, what I saw as I came out of the Harvard University campus onto one of the streets of Cambridge, Massachusetts a few months ago. There she was, sitting on the side of the road with a sign that said, “Cancer patient. Please help.” I was stunned. I went and talked to her.  She said she was 52 years old and diagnosed with bladder cancer that might have spread to her liver. She had no family or health insurance. Thanks to Medicare and Mass Health, the state run insurance, she was able to get some medical treatments, including chemotherapy. She was glad to be in Massachusetts because everybody in that state was mandated to have health insurance. According to her, unlike in many other states, if citizens of Massachusetts didn’t have enough money to buy private health insurance they would go to the state and apply for Mass Health and they would get it. She didn’t know the name of the governor that brought on such health coverage for the poor like her but sure was thankful to him.
That governor was Mitt Romney. 
Romneycare was, in principle, the first Medicaid expansion before Obamacare and it worked by providing medical coverage for the poor as well as improving their health. Massachusetts is the only state with health coverage for nearly 100% (99.8% to be exact) of children and 98% of adults. By the way, Romney, in spite of incessant Obamcare bashing and demonization of federal government as the Republican Presidential candidate, was only able to pull that off because of the federal dollars.
So, I am somewhat perplexed about the wisdom and rationale of many Republican and some Democratic governors, when I hear that they are hesitating to expand Medicaid, even after the federal government said it would assume complete financial responsibility for such expansion for the first three years and for 90% a few years after that.
Bobby Jindal, the governor of Louisiana and one of the five republican governors to refuse Medicaid expansion, said he would rather improve the economic condition of the residents of Louisiana, so that they can purchase private insurance, than expand Medicaid. With Republican majorities in the state senate and house, I am wondering who is stopping Mr. Jindal from doing that. By the way Louisiana takes more federal dollars than it contributes to the federal government. I know he admonished the Republican Party not to be a stupid party, after the recent shellocking in the elections, but am not sure of his wisdom regarding how he is going to suddenly turn the economy around and provide healthcare coverage to citizens of Louisiana without some federal help.
As far as Rick Perry, Governor of Texas, also one of the five, I am not sure if he even knows or understands about the three healthcare areas in Texas that are already receiving federal government money. After watching how he forgot the three federal departments that he would abolish, during the Republican presidential primaries, I won’t be surprised if he needs a refresher that Medicare, Medicaid and Veterans Affairs are the three areas Texas is already benefiting from federal dollars.
Recently, Rick Scott, governor of Florida, one of the most vocal opponents of Obamacare had a change of heart. He agreed to expand Medicaid. I don’t want to talk about the plans of Mr. Scott for Medicaid expansion in Florida, other than to warn Floridians to be careful about his alleged plans to privatize Medicaid. His history in healthcare industry, as a corporate hospital lawyer, should make every Floridian to be cautious. He was the CEO of Columbia-HCA, a private for profit hospital conglomerate company, when it was fined, the biggest ever amount in US history, for Medicare fraud; $1.7 Billion. Need I say more? Still, his desire to expand Medicaid is astonishing and a good thing for Florida.
A few months ago Rick Snyder, Republican governor of Michigan agreed to expand Medicaid in Michigan. As a practicing neurosurgeon in Flint, Michigan for 16 years, and having taken care of many patients with no insurance or inadequate insurance, I was glad and welcomed his decision. The expansion is expected to provide at least some health coverage to 470,000 Michiganders by 2021 and cut the uninsured of the state by half but the euphoria didn’t last long.
A few days ago the House health budget sub-committee in Republican controlled legislature of Michigan voted not to expand Medicaid. I don’t think those Republicans realize that the expansion is a good thing. They need to ask Romney. He knows it. He has been there and done it. He won’t admit that his signature legislation as the governor of Massachusetts, Romneycare, which is the father of Obamacare, has benefited many citizens of Commonwealth. But I have a feeling that deep in his heart he is proud of it.
Damn proud of it! 

Medicaid expansion is a good thing. Ask Mitt Romney!

Medicaid expansion is a good thing. Ask Mitt Romney! 

I never thought I would see, in America, what I saw as I came out of the Harvard University campus onto one of the streets of Cambridge, Massachusetts a few months ago. There she was, sitting on the side of the road with a sign that said, “Cancer patient. Please help.” I was stunned. I went and talked to her.  She said she was 52 years old and diagnosed with bladder cancer that might have spread to her liver. She had no family or health insurance. Thanks to Medicare and Mass Health, the state run insurance, she was able to get some medical treatments, including chemotherapy. She was glad to be in Massachusetts because everybody in that state was mandated to have health insurance. According to her, unlike in many other states, if citizens of Massachusetts didn’t have enough money to buy private health insurance they would go to the state and apply for Mass Health and they would get it. She didn’t know the name of the governor that brought on such health coverage for the poor like her but sure was thankful to him.
That governor was Mitt Romney. 
Romneycare was, in principle, the first Medicaid expansion before Obamacare and it worked by providing medical coverage for the poor as well as improving their health. Massachusetts is the only state with health coverage for nearly 100% (99.8% to be exact) of children and 98% of adults. By the way, Romney, in spite of incessant Obamcare bashing and demonization of federal government as the Republican Presidential candidate, was only able to pull that off because of the federal dollars.
So, I am somewhat perplexed about the wisdom and rationale of many Republican and some Democratic governors, when I hear that they are hesitating to expand Medicaid, even after the federal government said it would assume complete financial responsibility for such expansion for the first three years and for 90% a few years after that.
Bobby Jindal, the governor of Louisiana and one of the five republican governors to refuse Medicaid expansion, said he would rather improve the economic condition of the residents of Louisiana, so that they can purchase private insurance, than expand Medicaid. With Republican majorities in the state senate and house, I am wondering who is stopping Mr. Jindal from doing that. By the way Louisiana takes more federal dollars than it contributes to the federal government. I know he admonished the Republican Party not to be a stupid party, after the recent shellocking in the elections, but am not sure of his wisdom regarding how he is going to suddenly turn the economy around and provide healthcare coverage to citizens of Louisiana without some federal help.
As far as Rick Perry, Governor of Texas, also one of the five, I am not sure if he even knows or understands about the three healthcare areas in Texas that are already receiving federal government money. After watching how he forgot the three federal departments that he would abolish, during the Republican presidential primaries, I won’t be surprised if he needs a refresher that Medicare, Medicaid and Veterans Affairs are the three areas Texas is already benefiting from federal dollars.
Recently, Rick Scott, governor of Florida, one of the most vocal opponents of Obamacare had a change of heart. He agreed to expand Medicaid. I don’t want to talk about the plans of Mr. Scott for Medicaid expansion in Florida, other than to warn Floridians to be careful about his alleged plans to privatize Medicaid. His history in healthcare industry, as a corporate hospital lawyer, should make every Floridian to be cautious. He was the CEO of Columbia-HCA, a private for profit hospital conglomerate company, when it was fined, the biggest ever amount in US history, for Medicare fraud; $1.7 Billion. Need I say more? Still, his desire to expand Medicaid is astonishing and a good thing for Florida.
A few months ago Rick Snyder, Republican governor of Michigan agreed to expand Medicaid in Michigan. As a practicing neurosurgeon in Flint, Michigan for 16 years, and having taken care of many patients with no insurance or inadequate insurance, I was glad and welcomed his decision. The expansion is expected to provide at least some health coverage to 470,000 Michiganders by 2021 and cut the uninsured of the state by half but the euphoria didn’t last long.
A few days ago the House health budget sub-committee in Republican controlled legislature of Michigan voted not to expand Medicaid. I don’t think those Republicans realize that the expansion is a good thing. They need to ask Romney. He knows it. He has been there and done it. He won’t admit that his signature legislation as the governor of Massachusetts, Romneycare, which is the father of Obamacare, has benefited many citizens of Commonwealth. But I have a feeling that deep in his heart he is proud of it.
Damn proud of it! 

Bitter Pill Doc 2013-02-10 13:34:00

 Buddha, Papa John’s, Applebee’s and Obamacare.
“Anger, ignorance and greed are the three demons in a man’s life.” 
Buddha 
An artificial knee replacement surgery costs six to ten times less in India than a comparable quality
surgery in America and also includes two weeks of home physical therapy after surgery.
John Schnatter of Papa John’s Pizza and Zane Tankel, the owner of Applebee’s franchise, said that they would transition some of their fulltime employees to part time just because of Obamacare. There was a businessmen in Vegas that said he fired some of his employees for the same reason. Another Georgia businessman called C-SPAN and said that he made sure that a couple of workers that he fired, also because of Obamacare, were the ones that voted for Obama. These businessmen are angry with Obama for trying to provide access to affordable quality healthcare for every American. They are barking up the wrong tree. 

Many of these businessmen say they would like to provide healthcare to all their employees only if healthcare is less expensive. That’s the crux of the problem; escalating healthcare costs. I have been practicing neurosurgery in Flint, Michigan, for 16 years and I know how GM got bankrupted partly by the skyrocketing healthcare costs. Last year, my father underwent a knee replacement in India, operated by an Orthopedic surgeon trained in England, using an artificial joint prosthesis from an American medical device company, DePuy. The total cost of the surgery including four days of private room and two weeks of physical therapy cost me less than $8000. The same surgery cost on average of $160,000 in Texas, in 2009 and still costs $45,000 to $70,000 across the country. 

Most of the businessmen that are upset with the Affordable Care Act are unfortunately ignorant of the real, deep-rooted cause that is destroying healthcare in America. J. Patrick Rooney and Dan Perrin, architects of Health Savings Accounts during the George W. Bush era, wrote in their book, “America’s Health Care Crisis Solved” and I quote; 

The problem is greed. The ship has lost its moral rudder. It is awash in greed. We can’t expect the industry to fix itself. There’s just too much self-interest at stake. We can exhort our health care providers to charge less, but we doubt that will work. The money is too easy, and the greed too strong.” 

It is ironic that greed, the essence of unregulated capitalism that creates millionaires and billionaires, is also responsible for pushing the middle class into poverty and creating many of the poor in the current economy.
The healthcare industry has not been immune to that greed. Clearly, healing the sick in America has become a mega business, costing the nation $2.8 Trillion to be precise. I don’t find it surprising at all, for “America’s business is business.” Instead of being angry with Obamacare, the emphasis should be in bringing down the costs of the healthcare business which has created a “medical industrial complex” that is highly profit oriented, driven by greed and perpetuated by a corrupt political system and benefits mostly the special interests. I am not sure if the owners of Papa John’s or Applebee’s will be in favor of voluntary implementation of less greedy practices or mandatory laws to prevent such practices in the healthcare industry. That is against the core profit motive of business and will be like shooting one’s own greedy capitalist foot.
Papa John’s would rather pass on the 11 to 14 cent per pizza extra cost of providing healthcare to its employees onto the customers than accept a little less of the $100 million per year profit. I am sure he considers himself a compassionate man because he made some charitable donations but I am not sure if Buddha would have called it compassion, when such charity is the money made off of the sweat and tears of the hard working employees that were denied basic healthcare. On the other hand there are businessmen that say, even if one doesn’t provide healthcare to their employees out of compassion or kindness, it makes good business sense to do so, for healthy and happy employees are more productive for the bottom line.
Martin, a part owner of Ian’s Pizza, and owns a handful of pizzerias in Wisconsin, provided healthcare benefits to all his employees even before Obamacare mandated the employers to provide healthcare. He did it because he believed that was the right thing to do.
That, I am sure Buddha would have agreed, is a true compassionate businessman. 


Dr. Vivekanand Palavali has been practicing neurosurgery for the past 16 years in Flint, Michigan. He is also the producer/director of the healthcare documentary, “Bitter Pill: America and healthcare in America; A brain surgeon’s dissection and prescription.” as well as the author of a companion book. 
www.bitterpilldoc.com

Buddha, Papa John’s, Applebee’s and Obamacare

“Anger, ignorance and greed are the three demons in a man’s life.” 
Buddha 
An artificial knee replacement surgery costs six to ten times less in India than a comparable quality
surgery in America and also includes two weeks of home physical therapy after surgery.
John Schnatter of Papa John’s Pizza and Zane Tankel, the owner of Applebee’s franchise, said that they would transition some of their fulltime employees to part time just because of Obamacare. There was a businessmen in Vegas that said he fired some of his employees for the same reason. Another Georgia businessman called C-SPAN and said that he made sure that a couple of workers that he fired, also because of Obamacare, were the ones that voted for Obama. These businessmen are angry with Obama for trying to provide access to affordable quality healthcare for every American. They are barking up the wrong tree. 

Many of these businessmen say they would like to provide healthcare to all their employees only if healthcare is less expensive. That’s the crux of the problem; escalating healthcare costs. I have been practicing neurosurgery in Flint, Michigan, for 16 years and I know how GM got bankrupted partly by the skyrocketing healthcare costs. Last year, my father underwent a knee replacement in India, operated by an Orthopedic surgeon trained in England, using an artificial joint prosthesis from an American medical device company, DePuy. The total cost of the surgery including four days of private room and two weeks of physical therapy cost me less than $8000. The same surgery cost on average of $160,000 in Texas, in 2009 and still costs $45,000 to $70,000 across the country. 

Most of the businessmen that are upset with the Affordable Care Act are unfortunately ignorant of the real, deep-rooted cause that is destroying healthcare in America. J. Patrick Rooney and Dan Perrin, architects of Health Savings Accounts during the George W. Bush era, wrote in their book, “America’s Health Care Crisis Solved” and I quote; 

The problem is greed. The ship has lost its moral rudder. It is awash in greed. We can’t expect the industry to fix itself. There’s just too much self-interest at stake. We can exhort our health care providers to charge less, but we doubt that will work. The money is too easy, and the greed too strong.” 

It is ironic that greed, the essence of unregulated capitalism that creates millionaires and billionaires, is also responsible for pushing the middle class into poverty and creating many of the poor in the current economy.
The healthcare industry has not been immune to that greed. Clearly, healing the sick in America has become a mega business, costing the nation $2.8 Trillion to be precise. I don’t find it surprising at all, for “America’s business is business.” Instead of being angry with Obamacare, the emphasis should be in bringing down the costs of the healthcare business which has created a “medical industrial complex” that is highly profit oriented, driven by greed and perpetuated by a corrupt political system and benefits mostly the special interests. I am not sure if the owners of Papa John’s or Applebee’s will be in favor of voluntary implementation of less greedy practices or mandatory laws to prevent such practices in the healthcare industry. That is against the core profit motive of business and will be like shooting one’s own greedy capitalist foot.
Papa John’s would rather pass on the 11 to 14 cent per pizza extra cost of providing healthcare to its employees onto the customers than accept a little less of the $100 million per year profit. I am sure he considers himself a compassionate man because he made some charitable donations but I am not sure if Buddha would have called it compassion, when such charity is the money made off of the sweat and tears of the hard working employees that were denied basic healthcare. On the other hand there are businessmen that say, even if one doesn’t provide healthcare to their employees out of compassion or kindness, it makes good business sense to do so, for healthy and happy employees are more productive for the bottom line.
Martin, a part owner of Ian’s Pizza, and owns a handful of pizzerias in Wisconsin, provided healthcare benefits to all his employees even before Obamacare mandated the employers to provide healthcare. He did it because he believed that was the right thing to do.
That, I am sure Buddha would have agreed, is a true compassionate businessman. 


Dr. Vivekanand Palavali has been practicing neurosurgery for the past 16 years in Flint, Michigan. He is also the producer/director of the healthcare documentary, “Bitter Pill: America and healthcare in America; A brain surgeon’s dissection and prescription.” as well as the author of a companion book. 
www.bitterpilldoc.com