Tuesday, December 29, 2009

Obamacare and Bernie Madoff

December 29, 2009

Obamacare and Bernie Madoff

Sorry again about another healthcare reform related newsletter, but I get mildly agitated when people not in the healthcare field, especially politicians, try to tell me how to do my job.

We all have heard about Bernie Madoff, and his, how can I say it, not exactly stellar accounting. Bernie Madoff by way of his ponzi scheme, led what may soon be known as the second biggest swindle in the nation. The first will be either the Senates or House of Representatives healthcare reform bills, which if either of them becomes law, will forever be known as the ObaMadoff healthcare plan.

Understand that our politicians do not play by the same rules that ordinary citizens abide by. We put money in the bank, and can only withdrawal what we have. On the other hand, our politicians, both democrat and republican, spend our money, and more than we have.

Oh, but they can raise more money to pay for all their pet programs you say.

You are correct.

But the politicians do not earn money like we do. They raise money in a few ways.

1) They increase the taxes we have to pay.
2) They borrow money from other countries and ask we, the taxpayers to pay the interest.
3) They turn on the printing presses and print more money, diluting the worth of the dollar and making our money less valuable.

In other words, they spend our hard earned money like there is a never-ending supply!

So what does this have to do with healthcare?

I'll tell you.

Our country is deep in debt, due to all the money spent by our politicians over the past four decades. At last count, our country is over 12 trillion dollars in debt, not counting current and future entitlement obligations. So now, our politicians want us to go further in debt and add a new entitlement to reform the healthcare system, and they will raise the money to finance these reforms in the three ways mentioned above.

So how does this differ from what you and I do to access healthcare?

1) To pay for healthcare, we as individuals have to work and earn income. We can not collect tax money from others to pay for our care.
2) We can borrow money from banks and credit cards, but we are held individually responsible for our debt. Our politicians are not responsible for the debt they place our country in. We are, along with our children and grandchildren.
3) I think we would go to jail if we had a printing press printing money we did not earn. So why does our government get away with it?

This healthcare reform is not the change we believed we were getting during the 2008 presidential campaign. Let us take a look at the president's healthcare campaign promises and how they have changed by looking at the present healthcare bills, their costs and how they are paid for.

House Bill:

Who is covered?

It is estimated that about 94% of legal residents under the age of 65 will be covered. Presently about 83% are covered. There will still be about 24 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.

Cost: 871 Billion dollars over ten years. That is $871,000,000,000 dollars. That's alot of zeroes.

How It's Paid For:

Fees or taxes on the following: Insurance companies, pharmaceutical manufacturers, medical device manufacturers, medicare payroll tax increase on income over $200,000 for individuals, or $250,000 for couples, 10% sales tax on tanning salons, excise tax on high cost insurance plans, and fees for employers whose workers receive government subsidies. I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.

Cuts to Medicare and Medicaid

Fines on people who fail to purchase coverage.

Senate Bill:

Who is covered?

About 96% of legal residents under the age of 65, leaving an estimated 18 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.

Cost: 1.2 trillion dollars over 10 years. That is $1,200,000,000,000 dollars. That's even more zeroes.

How It's Paid For:

Taxes on the following: New income taxes on single people making more than $500,000/year and couples making more than $1 million dollars a year, an estimated $20 billion from new taxes on medical device makers, limiting contributions to flexible healthcare spending accounts. As with the House bill, I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.

Cuts of more than $400 Billion to Medicare and Medicaid.

Fines on individuals and employers who do not obtain health insurance coverage.


OK, so that is a synopsis, and definitely not the whole enchilada. But let me start breaking this down to what it means for you and how it differs from the 2008 promises made by the president during the 2008 presidential election campaign.

Promise #1 : No Individual Mandate

In both of the above bills, there is an individual mandate for insurance coverage or a fine is imposed. And as we still do not know the extent of government subsidies to help purchase insurance, it appears that many individuals will be coerced or forced by the government to purchase coverage that they may not want, or face the wrath of government fines. In essence, the government wants to pass a law forcing individuals to purchase something against their will.

Promise #2 : Complete Transparency

Need I actually go into this one?
Candidate Obama promised that health care deliberations with Congress and special interests would be transparent to the extreme. To quote candidate Obama: "That's what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are," Mr. Obama said during his Jan. 31, 2008 debate with Clinton. "Because part of what we have to do is enlist the American people in this process. And overcoming the special interests and the lobbyists who -- Senator Clinton is right. They will resist anything that we try to do."


I had my TIVO set up as a season pass to record all healthcare negotiations on C-SPAN. Funny thing. Nothing recorded. I called TIVO and asked what the problem was with their service. I found out it was not TIVO. There were not any negotiations broadcast on C-SPAN.

So what actually occured?

Politics as usual, but on steroids. Both bills have been written along party lines, with mucho mucho special interests involved. These special interests do not represent you. They represent their corporations and their businesses. Now in a free market capitalistic economy, that is fair game. But were'nt we promised transparency and an overcoming of the special interests???

Promise #3 : Lower Premiums by $2,500 for a Family of Four

For this one, I'll believe it when I see it. I am pretty good at math, but not an accountant or mathematician. But to add 20-30 million more people into health insurance, and at the same time lower the cost of insurance premiums, you need to be a magician, not a mathematician.

Now back to who is covered, the cost and how it is paid for.

If we go midway between both the House and Senate bills, we will still be left with about 14 million uninsured, at a cost of over a trillion dollars over ten years, paid for by cuts to Medicare and Medicaid and large taxes on many segments of the healthcare industry and individuals. The healthcare industry segments will end up passing along the increased taxes as higher costs to you. As employers and individuals, who, unlike the federal government can not print money, will pay higher taxes, and they will have less money in their budgets to expand their businesses and hire more workers. So the trickle down effect of higher taxes ends up costing everyone, not just those who pay the taxes, while still leaving about 20 million people uninsured.

Question 1: If you are unemployed, do you prefer being forced to purchase health insurance, or do you prefer to get help finding a job?

Question 2: With cuts to Medicare and Medicaid, and more people enrolled in these programs, how do we improve care for individuals with these two government plans?

Now, I will attempt to do some math.

Assuming midway between the House and Senate plan, we add 34 million people to the health insurance rolls. The taxes and fines start in year one, while the insurance coverage does not start until years 4 through 6. I will estimate 6 years of insurance coverage for 34 million people at a cost of 1 trillion dollars. That comes out to about $5,000 per year for insurance coverage for each individual, or just under $420 per month. The premiums I pay now are much less than that, and I am not mandated by any government to purchase it!

Question 3: Is the healthcare reform debate about doing what is right, or more about politics?

I'll let you answer that one.

Call your Senator and congressmen and tell them to put a halt to this healthcare reform debacle before it is too late. The legislation currently before Congress was crafted more out of political desperation and not the needs and desires of the large majority of the American people.

One thing I have learned from this debate is that elections do mean something and they do have consequences. Sometimes good, sometimes not.

My hope is that these reforms get stopped, and we reboot the debate and start over. First step, follow the president's campaign guidelines for reforming the healthcare system with true transparency, and a lack of special interests at the table. The table should consists of patient's and healthcare providers and the reforms should focus on individuals and not politics. We can then reform the system one step at a time and move in a direction that helps everyone without adding any costs to the system.

I also truly, truly hope this debate ends so I can spend more time on medically relevant newsletter topics instead of the machinations of our politicians in Washington, D.C.
I previously wrote about a big conflict of interest concerning the American Medical Association and the current healthcare reforms. A recent Chicago tribune column goes into further detail corroborating my views.
Our Healthy Weight program will be available starting January 4, 2010. Info on the program and pricing can be found here. Wellness Plan members get a steep discount on this program.

This program combines physician supervision, internet guidance and communication, with optimum nutrition to not only help you attain a healthier weight, but at the same time help to prevent or treat other diet related disorders including Diabetes, High Blood Pressure, High Cholesterol, Heart and Vascular Disease, among many others.

I am excited to help you get a jump start on a healthier you for 2010!!

To Good Health!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
Previous newsletters can be found at http://drhorvitz.blogspot.com/

Saturday, December 26, 2009

NJ Physicians views on healthcare

December 26, 2009

I hope everyone had an enjoyable holiday.

Today I would like once again to talk about healthcare reform and the disinformation about physicians views on this subject. The president and the congressional leaders like to say that the majority of physicians support healthcare reform. This is, unfortunately, very deceptive, if not an outright lie.

Please read below the Medical Society of New Jersey's letter on this subject from December 22. 2009.
Dear Colleagues:

The United States Senate has chosen to amass a “Health Care Bill” that, in our opinion, will quickly destroy the ability for physicians to continue the practice of medicine.

The Senate Majority Leader has locked in 60 votes to break a filibuster against the legislation. His reported tacit dealings with Louisiana, Vermont and Nebraska senators for votes are obviously “Washington politics business as usual”. This disrespect for the citizens of our country sickens the Medical Society of New Jersey.

• Lacks Any Tort Reform
• Doesn’t Permanently Fix the SGR Formula
• Will Break the Medicaid System in New Jersey (already the worst in the country)
• Lacks Transparency and Detail on the Effect on Physician Practices

The Medical Society of New Jersey is not supporting the American Medical Association’s position on this issue nor their ineffective approach to this major piece of legislation.
We personally want all physicians of New Jersey to know that the Medical Society of New Jersey is appalled at our representation by the AMA and are not supportive of their leadership.

Very truly yours,

Joseph H. Reichman, MD
To read more opinion from the MSNJ, please go here.

My opinion:

Point 1) National organizations have lost touch with their constituents.

American Medical Association is in favor of the present reform package, while the NJ state society is adamantly against.

Point 2) Our elected politicians have all elected to vote along party lines, instead of with their constituents. The latest Rasmussen Reports weekly tracking update shows that 41% of voters nationwide favor the bill and 55% are opposed. Yet the politicians still seem bent on voting for reform.

Point 3) Ethics - I know. It is strange to use ethics and politicians in the same sentence.

But I cannot even accept a pen from a drug rep, yet congress can bribe senators with hundreds of millions of sweetheart dollars to buy votes for a reform plan that will effectively decimate the future of american medicine in a very short time. And where does the congress get these hundreds of millions of dollars. I'll tell you where. From the taxes that we pay!

If we want the healthcare system reformed, it is time to ask individual physicians, not national organizations, hospital systems, Big Pharma, health insurers, medical suppliers, or even large physician groups. The larger the organization, the further away from individual thought we get. Large organizations tend to cater to themselves, instead of their customers, in this case, you, the patient. This is another of the reasons I founded The Institute For Medical Wellness, and have remained a solo family practice physician. In my practice, I only answer to you!

No politics.
No lies.
No deceptions.
High ethics.

I could go further, but I have said enough for now.

The Institute For Medical Wellness will continue to operate as it has since 2008. As we do not accept third party insurance, we are somewhat insulated from the Washington D.C. shenanigans. We do however still accept Traditional Medicare, as at present, the government bureaucrats stay out of patient care. But this reform bill may change that. Our participation with Medicare may end, leaving more Medicare patients less options for their care, unless they choose to join our Wellness plans or pay fully out-of-pocket. As many seniors are on fixed incomes, this could create an economic hardship. If that occurs, please feel free to thank Congress and the president for their meddling.


Enough about politics!

I am still a physician and providing healthcare is what I love to do.

So look soon for the rollout of our new wellness plans, along with our new Healthy Weight Program.

We also now have a list of the supplements we offer which can be found here.

To Good Health!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Friday, December 18, 2009

Take this healthcare plan or else !!

December 18, 2009

Caution: This newsletter may be a bit opinionated. But then again, people do pay me for my opinions, so here goes!!

Take this healthcare plan or else?

It seems that every day I watch the news, healthcare reform gets sicker and sicker. And now it appears that our elected officials think they know more about healthcare than doctors and patient's. The one thing our elected officials in both parties do know is how to spend money they do not have. And unfortunately, all this borrowed to be spent money will eventually be paid back on the backs of our children and grandchildren. This is just not right!!

Healthcare reform is supposed to bring down costs for everyone without raising taxes. The present Senate bill does not.

Healthcare reform is supposed to bring insurance to the majority of the 47 million temporarily uninsured. The present Senate bill does not.

Healthcare reform is supposed to bend the cost curve down. The present Senate bill does not. Especially when we get taxed for 2-3 years before any reforms start.

What does the Healthcare reform bill do?

It cuts Medicare. So for everyone on Medicare who has paid into the system for the past 20-40 years, tough luck!

It penalizes young healthy individuals who choose to take a risk and not purchase health insurance.

It will also raise the premiums on younger individuals to help subsidize others.

It creates multiple new bureaucracies that will put barriers between you and your doctor.

Now for the scariest part.

When the government puts their power and weight, otherwise known as coercion, into the healthcare system, they do so by telling doctors not only what to do, but what not to do. Health insurers try to do this, and they have partially succeeded. They coerce, also known as twist the arms of doctors to perform tests that may not be necessary, or use medications and treatments that may not work, usually on the basis of possible cost savings. Why would the insurers do this? That answer is simple and closes the loop on the problems with our helathcare system. Insurers are trying to stay in the good grace of Uncle Sam and the bureaucrats who think they know better. The only thing worse than a health insurer telling a doctor what to do, is a government bureacrat doing the same.

So who is left out and forgetten in this government-insurance dominated system?

I'll answer that. You, the patient are left out as you become a number, a statistic, a covered life!

I may be rambling a bit here, but I get very offended when anyone other than my patient tries to tell me how to do my job. When I founded The Institute For Medical Wellness, I went out on a limb professionally. It was my personal and professional risk and I chose to go full steam ahead with a health delivery concept that focuses on individuals, not insurances, and not government bureaucracies. When you are in my office, my attention is focused on you. So a healthcare bill that gives broad powers to the government to decide what care is and is not necessary is an extremely scary proposition. I fear that your care will suffer if you are forced into a government controlled system.

I do not expect everyone to feel the way I do. And I respect all points of view, especially those I do not agree with. I learn alot every day, from hearing how others view their health, what they are eating, how they are exercising, what works for their individual ailments and what does not. I have learned from my 15 years in practice that no two individuals are the same. So any healthcare plan that focuses on numbers and populations as opposed to individuals will never, ever have my support!

I want reform. But I want reform that gives patient's more choices in their healthcare, not less. I want reform that allows patient's and doctor's to decide what is needed for their care, without a 2000+ page federal healthcare bill getting in the way. I want a plan where everyone has access to healthcare not governed and controlled by Uncle Sam.

The Institute For Medical Wellness will thrive and expand regardless of healthcare reform because we focus our care on individuals and families, period. We have no ulterior motives, no insurance quotas in the back of our mind guiding our treatment. We will grow as more people are dissatisfied with the direction of government sponsored healthcare. But I would prefer that The Institute For Medical Wellness grows due to our outstanding care and committment to everyone who chooses us for their healthcare.

My promise to you. No matter what comes out of Washington, D.C., The Institute For Medical Wellness will continue to be where you can go for healthcare that is focused solely on you!

I will end with the mission statement that I wrote back in 2007, while putting the wheels in motion for the founding of The Institute For Medical Wellness. This mission statement describes how I want to be treated when I access medical care, and it is how I will always care for you!



To provide outstanding family medical care to our patients with a focus on comprehensive wellness and prevention.

To inform you of healthcare options that your health insurance carrier may not want you to obtain or know about.

To be an advocate for your medical care without regards to the health insurance bureaucracy.

Where patients go to be treated as a person and not as a commodity.

Where patients go to have a Physician who listens carefully and respects what the patient has to say and encourages the patient to say what is on their mind.

To give patients the ability to see their own Doctor and to make appointments without unreasonable waits.

To provide this care with an open mind, and to make your healthcare a team effort between Dr. Horvitz, his office staff, and you, the individual.


The Institute For Medical Wellness is now experimenting with Twitter.

If you "tweet" or follow others, you can find us at http://twitter.com/IMWHorvitz

Please email us at DrHorvitz@DrHorvitz.com to let us know what type of "tweets" you would find useful.

To Good Health!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Monday, December 07, 2009

Prelude to your New Years Resolutions !!

December 7, 2009

Institute For Medical Wellness prelude to your New Years Resolutions!

The new year is almost upon us and I hope everyone is thinking about their New Year's Resolutions. As many resolutions revolve around health, at The Institute For Medical Wellness, we are putting the finishing touches on helping you with a common resolution, with our soon to released healthy weight program.

One of the most common New Years Resolution is to achieve a healthier weight. So we are putting together a program that will help you achieve just that. Many weight loss programs work for a short while, only to become too difficult to continue. These difficulties can be in the program itself, an early plateau of weight loss, or the return of intense hunger and cravings that sabotage your ability to achieve your goal. Our goal is to help you defeat the cravings by giving your body the nourishment it needs. And our program will achieve this with sound nutritional advice and supplements, but without prescription medications.

Why I am so positive about this program?

About four months ago, I tested it out on myself. Now I rarely hear anyone tell me I need to lose weight. But, any weight I would gain would always go to my midsection, the worst area for good health. For this I thank my genetics. I will not get myself into trouble by naming the family members responsible. I know better than that! But central obesity or abdominal obesity is a high risk factor for Diabetes and High Blood Pressure, among other ilnesses. Please refer back to a previous newsletter on how central obesity leads to a deterioration in health.

But let me move on to results. After about 3 months my weight loss peaked at 15 pounds, 10% of my body weight, and is still there today. My waist size is down, and my clothes all fit well again. In my case, 95% of my weight loss occurred from my midsection. The other 5% somehow came from my fingers, so if anyone finds my college class ring in my office, please let me know! My energy level is definitely up. In fact I increased my exercise after I lost about 12 pounds, not before. Exercise is important for good health, but when it comes to weight loss, your diet is the most important factor.

Now, not everyone has the same genetics or metabolism. But most people make the same mistakes when it comes to eating. Most diets revolve around menu plans and portion control. It becomes a mental exercise to determine what you can put into your mouth. It should not be that way, and this is where our new program will help. Our program will revolve more around teaching you what you should not eat, than what you should. Portions should not be an issue, for if you eat the proper types of food, hunger cravings go away. If you choose to follow the media's diet headlines or Oprah's latest diet sensation, then I wish you luck, and I'll still be here to help you when it fails. But I hope that you will give us a chance instead, to help you not only lose the excess weight, but to achieve an overall healthier you!

So look to a future newsletter for the roll out of our new Healthy Weight Program. And start thinking about how The Institute For Medical Wellness can help you achieve your upcoming New Year's resolutions!


Do you still have money left in a medical or healthcare flexible spending account (FSA) for 2009?

Many of these accounts enable you to put aside money for healthcare for each calendar year. One drawback is that you lose the money if it is not used at the end of each calendar year. Our Wellness Plans put this money to excellent use. So if you have an unused balance for 2009, or looking to budget your account for 2010, check out our Wellness Plans. You can use your 2009 remaining balance to prepay for a 2010 Wellness Plan!

To Good Health!!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Please follow us on twitter at http://twitter.com/IMWHorvitz