Obamacare and You

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#0000BF" TEXT="#F7F7FF" bgproperties="fixed" background="044005a0exvipq.gif"> <div> <FONT SIZE="1" COLOR="#FFCC33" FACE="Copperplate Gothic Bold" ><A HREF="index.htm" TARGET="_top" TITLE="Eastside Republican Club"><U><B>Home</B></U></A><B>  </B><B> </B></FONT><B>  | </B><B> </B><B> </B><B>  </B><FONT SIZE="5" COLOR="#FFFFFF" FACE="Copperplate Gothic Bold" ><B>Eastside Republican Club</B></FONT></div> <bR> <div> <A HREF="erc_meeting_dates.htm" TARGET="_top" TITLE="Events"><U><B>Events</B></U></A><B>   |   </B><A HREF="eastside_republican_review_summary.htm" TARGET="_top" TITLE="ERC Review"><U><B>ERC Review</B></U></A><B>   |   </B><A HREF="michigan_s_13th_district.htm" TARGET="_top" TITLE="Congressional District News"><U><B>Congressional District News</B></U></A><B>   |   </B><A HREF="civic___governmental_links.htm" TARGET="_top" TITLE="Links"><U><B>Links</B></U></A><B>   |   </B><A HREF="erc_officers.htm" TARGET="_top" TITLE="About Us"><U><B>About Us</B></U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFFFFF" TEXT="#080000"> <bR> <bR> <div> <B>Obamacare and You</B></div> <div> <A HREF="link_to_michigan_gop.htm" TARGET="_top" TITLE="Michigan Republicans"><U><B><IMG SRC="05358580.gif" border=0 width="88" height="88" ALT="Michigan GOP" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <A HREF="michigan_s_13th_district.htm" TARGET="_top" TITLE="Congressional District News"><U><I><B>Congressional District News</B></I></U></A></div> <div> <A HREF="east_lansing.htm" TARGET="_top" TITLE="Michigan GOP Convention 2010"><U><I><B>2010 Republican Convention</B></I></U></A></div> <div> <A HREF="erc_testimonials.htm" TARGET="_top" TITLE="What Theyre Saying About Us"><U><I><B>Read what they've said about us</B></I></U></A></div> <div> <A HREF="erc_meeting_dates.htm" TARGET="_top" TITLE="Events"><U><B><IMG SRC="81b871f0.gif" border=0 width="135" height="31" ALT=">>Events" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000"> <div>  <A NAME="top_of_page"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><FONT SIZE="4" COLOR="#000000" FACE="Arial" ><IMG SRC="1b04fda30.jpg" border=0 width="253" height="419" ALT="Robert Steele, MD" ALIGN="RIGHT" HSPACE="8" VSPACE="6"></FONT></div> <div> <I><U>Dr. Robert Steele</U></I></div> <div> <B>What's Next for Fighting Ann Arbor Cardiologist</B></div> <div> <B>After Running an Energetic Congressional Race?</B></div> <div> Voting for Republican candidate Dr. Robert Steele of Ann Arbor was one choice Detroit eastsiders didn't have at the polls in November 2010. But what's next for the energetic campaigner?</div> <div> Speaking March 15, 2011, to the Eastside Republican Club Forum at the Grosse Pointe War Memorial, the upbeat Dr. Steele made one thing clear -- he has no plans for a rematch with Democrat John Dingell in Michigan's 15th congressional district that reaches from Dearborn to Monroe to Ann Arbor.</div> <div> Growth in the liberal precincts of Washtenaw County over the past decade have tilted it far from the common sense, lunch bucket district it was in 1955, when Mr. Dingell was first elected to Congress.</div> <div> Although Steele was the first Republican ever to carry Monroe County, local results in the gubernatorial race were an indication of the challenge even a victorious Republican gubernatorial candidate faces in winning at the polls in Ann Arbor.</div> <div> Steele noted, “While Snyder was the perfect candidate for Governor who was not a Democrat, even [Snyder] got beat in Ann Arbor two-to-one.”</div> <div> Nevertheless, the medical doctor still has lots to say about a common sense approach to health care, and without committing to any future candidacy was quick to tell his audience, “I have no plans to run for Congress again in that district.” </div> <div> Unanswered is the question of the Ann Arbor doctor's availability or viability as a future Republican candidate for some other office. Time will tell.</div> <div> <I><B>Health Care Challenges</B></I></div> <div> Steele was quick to acknowledge that Americans face a “real challenge” with health care.</div> <div> For example, he said there are people who comprise the “chronic uninsured.” Many, he said, are healthy young people who simply decline coverage.</div> <div> They make up part of the forty million people who lack coverage for more than a few weeks every year. But, coverage isn't everything.</div> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="1" WIDTH="305" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="LEFT" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 352 ><NOBR><div> <IMG SRC="1b062c5a0.jpg" border=0 width="300" height="346" ALT="Dr. Rob Steele with ERC chair Jenny Nolan, back, and Meghan and Luke Beaman" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 370 ><NOBR><div> <IMG SRC="1b082c6c0.jpg" border=0 width="300" height="364" ALT="Eastsider Mindy Naumann with speaker Rob Steele, MD, at March Forum" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 473 ><NOBR><div> <IMG SRC="1b0a2cd30.jpg" border=0 width="300" height="467" ALT="ERC members chat with Dr. Rob Steele at March 15 ERC Forum" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </NOBR></tD> </tR> </TABLE></div> <div> The doctor asked, “Even with all of the uninsured, is anyone denied care?” Steele noted that although care delivered in an emergency room is not ideal, urgent care and the ER are both available when you need it.</div> <div> Americans do complain. But he suggested we consider the facts: even the average U.S. resident who lives at or below the poverty level has more color televisions, air conditioners, cars, etc, than does the average person in western Europe.</div> <div> Steele pointed to the culprit behind skyrocketing costs.</div> <div> “The reason for exploding health costs is what's called `third party' payment.” That's payment to the provider by someone other than the patient -- even though the patient is best able to evaluate the quality of the service.</div> <div> This `disconnect' between the medical service and the cost and quality of providing that service drives up costs and compromises quality, he said.</div> <div> To quantify, he explained that in America, the average direct cost paid by the consumer for one dollar of health care received is just twelve cents. A third party, either an insurance company or government subsidy pays the balance.</div> <div> <I><B>The ObamaCare Factor</B></I></div> <div> Predicting further cost escalation, Steele said, “Under ObamaCare, the total cost of medical service delivery will escalate, because the consumer will experience a direct cost of only ten cents.”</div> <div> He noted that as the gap widens between the actual medical consumer and third party payment for the service, the incentive is nearly eliminated for the patient to make wise decisions based on value received.</div> <div> Instead, incentives and decision-making are handed over to a government panel, rule maker, or insurance company.</div> <div> Making matters worse, according to the Congressional Budget Office, the cost of ObamaCare implementation is estimated at $105 billion. Uncle Sam will collect taxes over the next 10 years to pay for just six years of care delivery.</div> <div> “People ask, `Can I keep my plan?' Absolutely not!” said Steele. One example, he said, will be elimination of popular Medicare Advantage plans.</div> <div> Further, he said, 34% of large employer plans would cease to be offered.</div> <div> Today, individual State insurance commissions prescribe mandated coverage for the plans offered in each state. Under ObamaCare, the Federal plan will prescribe incredible mandatory coverage! The patient and doctor will have even less control over what is needed.</div> <div> Steele observed that “one size doesn't fit all” as proved by the more than 1,000 employers -- with over three million workers -- already granted waivers from meeting the mandated coverage. They have been deemed ”exempt,” because the entity can't afford the mandated insurance and would otherwise go broke. Not surprisingly, many of these waivers are for unions and other favored groups.</div> <div> He noted that in an effort to introduce fairness, Michigan Congressman Mike Rogers has introduced a bill to allow both individuals and small business to apply for the waivers.</div> <div> <I><B>The Doctor Shortage</B></I></div> <div> Steele said, “A massive physician shortage exists today.”</div> <div> Added to that problem, access to care will decline. He said, “We can't expect ObamaCare to improve this.” Even if health care is 100% covered, there is still no guarantee a patient will have access to care.</div> <div> While demand for more health care will increase, the doctor shortage is expected to worsen as 40% of existing physicians have indicated plans to retire. Others are relocating their practices off shore.</div> <div> One reason for the increasing shortage is the government's misguided attempt to hold down costs by fixing certain medical fees, rather than spending the same money to provide patient reimbursement. A patient voucher would drive efficiency by restoring the doctor/patient relationship.</div> <div> <I><B>Halting the Cost Spiral</B></I></div> <div> So, what can be done? The doctor, who has business experience running his own medical office, offered several suggestions for corralling costs.</div> <div> Steele explained that a big reason why many have difficulty obtaining medical insurance at a reasonable cost today is that for 50 years coverage has been tied to employment.</div> <div> He said, “This is simply an artifact of the tax code that has made it advantageous to tie the tax benefit to the employer, rather than to the individual.”</div> <div> Steele suggested making the tax break the same for both the employee and the employer.</div> <div> Next, he suggested reform of malpractice rules. He said that while actual malpractice claims compared to all medical costs are small, they still drive up the cost of “defensive medicine.”</div> <div> Waste and fraud are another factor contributing about 6% to the cost of health care. The opportunities for fraud increase as third party payers play an increased role.</div> <div> Finally, he cited the need for transparency in pricing. Today, because the typical patient is responsible for only a few cents on the dollar, there is little motivation to restrain costs.</div> <div> Steele called for greater consumer involvement and common sense discussion between doctors, patients, and families.</div> <div> To allocate scarce medical care, instead of imposing arbitrary rationing, he suggested insurance plans with higher deductibles. He said that there is often a huge economic benefit.</div> <div> Citing an example from his own experience, Steele related that by simply raising the insurance deductible by $5,000 he saved $8,000 in premiums. He reminded, “That's what we do to keep costs in line for our homeowners and car insurance.”</div> <div> “The alternative,” he said, “will be that care will have to be rationed, as costs will be so much higher than they are now.”</div> <div> Because the federal government has gotten so involved in making health care decisions, and perhaps hinting at something on his own mind, he added, “We need a lot of new U.S. Senators in 2012.”</div> <div> <I><B>The Michigan Physician</B></I></div> <div> The medical doctor grew up in Greenville, Michigan. He was educated at the University of Michigan, graduating from the six-year integrated pre-med/medical program with his bachelor's degree in 1978, and medical degree in 1981. After an Internal Medicine residency at the University of Cincinnati, he went to Barnes Hospital and the Washington University School of Medicine in St. Louis, where he received fellowship training in cardiology and became a medical school faculty member.</div> <div> In 1987, Steele joined a medical school mentor in private practice at Ann Arbor's St. Joseph Mercy Hospital, while also serving on the clinical faculty at the University of Michigan medical school. A Fellow of the American College of Cardiology, he has received advanced certification in echocardiography and interventional cardiology, and has performed more than 15,000 cardiac catheterizations.</div> <div> Steele was a founding member of Michigan Heart PC, where he served on the board of directors. He also chaired the finance and benefits committees for the practice that grew to include 36 physicians and 300 employees at seven permanent and two satellite offices in five counties. The practice was recently sold to St. Joseph Mercy Hospital in Ann Arbor.</div> <div> He has previously served on the board of directors of a large nonprofit, managed care organization, and various medical staff, and physician organization committees.</div> <div> Steele has had an interest in American history and has been a member of the Heritage Foundation for more than 20 years, and was a founding member of the southeast Michigan committee for Heritage.</div> <div> A long-time auto enthusiast, Steele enjoys all things automotive, including autocross, racing, mechanical work, and restoration. He is a lifetime member of both the National Motorist Association and NRA, and current member of the Washtenaw Sportsman Club.</div> <div> Steele and his wife, Dr. Phyllis Boniface, a psychiatrist with a busy practice specializing in psychopharmacology, have four children.</div> <div> The Eastside Republican Club Forum is normally held on the third Tuesday of the month from September through June. Admission is free and the public is always welcome.</div> <DIV ALIGN="LEFT"></DIV> <div> <A HREF="#top_of_page" TITLE="Obamacare and You"><U>back to top</U></A></div> </td> </tr></table></body>