Obama Hides Trojan Horse Holding Recommendations Like Mammogram Ones, in Old Law/MedPAC Which Handles Medicare Funds

THE OBAMA PLAN IS THE GREEK PLAN OF HIDING AN ARMY OF RECOMMENDATIONS SIMILAR TO THE MAMMOGRAM RECOMMENDATIONS, WHICH CAUSED A FIRE STORM RECENTLY, INTO A TROJAN HORSE. THAT TROJAN HORSE WHICH IS AN OLD LAW, CALLED THE MEDPAC LAW WHICH OBAMA IS ATTEMPTING TO AMEND, HANDLES MEDICARE REIMBURSEMENTS. THIS IS THE LAW WHICH OBAMA AND HIS ACOLYTES ARE IN THE PROCESS OF AMENDING. AND THEIR SOLE PURPOSE IN PASSING IT IS TO SECRETLY INSERT OBAMA'S MEDICAL RECOMMENDATIONS WITHIN ITS BOWELS. OBAMA IS BUILDING THAT HORSE RIGHT NOW, TO SAFEGUARD THESE RECOMMENDATIONS WHICH ARE SIMILAR TO THE MAMMOGRAM ONES- FOR AMERICANS THERE IS NO TIME TO LOSE.

TO UNDERSTAND WHAT OBAMA IS ATTEMPTING TO DO IT IS IMPERATIVE TO UNDERSTAND THE LEGEND OF THE TROJAN HORSE ITSELF. THIS LEGEND, IS A METAPHOR FOR HOW OBAMA IS SERENDIPITOUSLY ALTERING OUR HEALTH CARE DELIVERY SYSTEM. AS THE STORY GOES, AFTER TEN LONG YEARS OF WARFARE BETWEEN THE GREEKS AND THE TROJANS,WHO WERE HIDING BEHIND THEIR 20 FOOT WALLS, THE GREEK GENERAL, ODYSSEUS, CAME UP WITH A PLAN TO DEFEAT HIS ENEMIES.

GENERAL ODYSSEUS PRETENDED THAT HE AND HIS ARMY WERE LEAVING TROY. IN A SCENARIO OF IMPLIED DEFEAT BY DEFAULT, WHILE THEY SIGNALED THEY WERE LEAVING, THE WILEY GREEKS STILL LEFT BEHIND A MASSIVE BUT BEAUTIFUL WOODEN HORSE AS A GIFT FOR THEIR GULLIBLE ENEMIES. BUT HIDDEN WITHIN THIS BEAUTIFUL HORSE WERE 30 ARMED GREEKS. THAT NIGHT, THE TROJANS, UNAWARE OF WHAT WAS WITHIN THE HORSE, BROUGHT THAT GIFT HORSE INTO THEIR CITY. THAT VERY NIGHT, THE HIDDEN GREEKS LEFT THE BOWELS OF THIS HORSE AND DESTROYED THEIR ENEMIES.

THERE IS A FAIL- SAFE MECHANISM SIMILAR TO THAT IN THE TROJAN HORSE, CREATED TO PROTECT THE HEALTH CARE BILL'S MAIN MANDATE OF HOLDING AND PROTECTING RECOMMENDATIONS WHICH WOULD CAUSE RATIONING, IF, AND WHEN, THIS BILL BECOMES LAW. TRAGICALLY, ONLY A HAND-FULL OF AVERAGE AMERICANS WILL BE AWARE OF THAT MANDATE.

THIS FAIL- SAFE MECHANISM WAS DESIGNED PURPOSEFULLY BY OBAMA AND HIS ADMINISTRATION TO PROTECT THE RECOMMENDATIONS. IT WAS ALSO SPECIFICALLY DEVELOPED, SO THAT NOW AND IN THE FUTURE- FOR EXAMPLE, IN 4 TO 8 YEARS OR MORE- IF AMERICANS WERE DISSATISFIED WITH THE NEW HEALTH CARE LAW'S MEDICAL RECOMMENDATIONS, AND A STRONG MAJORITY, EVEN AS HIGH AS 80% OF THOSE WHO WERE POLLED VOTED AGAINST THEM IN PUBLIC POLLS, THE MEDICAL RECOMMENDATIONS WOULD STILL REMAIN VIRTUALLY UNTOUCHABLE.

IN ADDITION, EVEN WITH ANOTHER PRESIDENT IN POWER, IT WOULD BE NEARLY IMPOSSIBLE TO AMEND OR CHANGE THE MOST ONEROUS SECTIONS OF THE NEW MEDIPAC BILL, OBAMA'S TROJAN HORSE, IF IT BECOMES LAW, BECAUSE IT CONTAINS THE PROVISION WHICH PROTECTS THE RECOMMENDATIONS. THIS STATEMENT IS TRUE, EVEN IF THERE WERE A REPUBLICAN PRESIDENT IN THE WHITE HOUSE, AND THE CONGRESS AND SENATE WERE SIMILARLY PACKED WITH THIS PRESIDENT'S OWN PARTY. EVEN GIVEN THIS SCENARIO, WE WOULD STILL BE STUCK WITH THIS ALBATROSS AROUND OUR NECK..

If you are curious about this fail-safe mechanism, a Healthcare Trojan Horse, that is specifically designed to protect the most onerous provisions of this Healthcare Bill, if it indeed does become law, you will find it imperative to answer these questions:

1--What is the fail-safe measure that protects Obama's Healthcare program ?

2--What particularly onerous sections of the Healthcare Bill does it protect ?

3--Why would anyone want to prevent the amending of a law, The MedPAC Law in the future ?

4--- How would you design a bill/law to make it literally impervious to any process where you could practically amend it ?

5---Why is a president who insists that he and his administration are the models of transparency, did not openly reveal that there are some disturbing sections of the Health care bill, disturbing to the public and many members of Congress ?

6---Why is there a fail-safe device, a Trojan Horse, that Obama believes is necessary to protect elements of this Healthcare Bill, both now and in the future, from the scrutiny and the outward removal of these troublesome sections from this bill ?

7---How will this Trojan Horse effect you, the Health Care consumer ?

The fail -safe measure was designed by Obama. It will protect some of the most controversial elements of the Healthcare Bill which may soon become law. The fail-safe mechanism will be hidden is in an old law, that controls the money that funds Medicare reimbursements to both hospitals and doctors, and is advised by an independent advisory board called MedPAC.

President Obama is attempting to re- design this old law and make it his Trojan Horse to carry hidden within its bowels, the power to make hidden recommendations the rule of law. One such example, was the recommendation that 40 to 49 year old women not be screened for mammograms. In addition, they have re-designed the old law MedPAC, to in effect, leave both American patients and Congressmen, without a plausible recourse to contest these recommendations and have them removed, even in the future when Obama is no longer president.

It is essential for Americans to fully understand that the old law concerning MedPAC, is still not changed or revised, and at present it is fair and impartial. But there are several bills in both in the House and the Senate to completely over-haul MedPAC and amend it and finally to make it impenetrable.

Today this independent advisory board is presently composed of respected health care experts, who are elected for 3 year terms to advise Congress on reimbursement rates, which Congress gives to those who provide services for Medicare patients. Congress presently has oversight over them, but- and it is a big " but, " their advice is currently not mandatory. In short, Congress can take their advise or leave it right now, but not in the future, once the bills sponsored by the Obama administration become law. Obama is attempting to make several changes to this law and to radically over haul his Healthcare Delivery System. Some, but not all of the basic changes are:

1--- It will carry the recommendations, such as the the mammogram one, that caused such a controversy.

2---It will move MedPAC to the executive branch, where it would be under executive branch control.

3--- MedPAC members would be appointed by the president himself.

4--- Because MedPAC would no longer advise Congress, this legislative branch would lose almost all control over MedPAC findings, directives,and recommendations.

5--- The term the members would serve will be changed from 3 years to 6 years, pushing its sphere of influence into the next president's venue whether Obama serves 4 or 8 years.

6---The number on the MedPAC board would be reduced to only 5 members, and the 3 members on the board presently, who currently are practicing doctors, would be eliminated- leaving none. This so upset The College of Surgeons that they wrote a letter of protest to Congress and the president to re-consider including this noxious provision.

7----All directives, whether financial or those dealing with Healthcare screenings, like the one on prostate cancer screenings, use of certain drugs, hospital admissions, rewards or punishments for physicians who do comply, and for those who do not comply with their directives, will be mandatory. * This list is a sampling of recommendations that will be included, but not an all inclusive one.

It is very important to also realize that MedPAC has enormous influence over the entire Medicare and Medicaid insurance structure, as well as, private insurance companies. This is because private insurance companies commonly use the MedPAC reimbursement level as their base, to determine their own rates, typically adding at least 20% or 30% or more to that baseline, in order to reimburse the medical providers of these private companies.

In short, either directly, or indirectly, as in the case of private insurance companies, MedPAC affects over 16% or roughly a little less than 1/6 of the United States' Gross National Product. In addition, once the mandates of the new MedPac Law go into effect, the federal government fully expects private insurance companies to follow in lock-step behind them. In fact they are counting on it. And they are right.

MedPAC - will be changed by the new law into The Medicare Payment Advisory Commission and will be comprised of Healthcare analysts pulled from universities and the Healthcare field. They would play a key role in achieving savings. As I have pointed out previously, although there are 3 practicing doctors on the present board - on the new one, there would be none and this would be done by design.

A-- This law would be empowered to enact a procedure where the MedPAC recommendations would go into effect, unless they were blocked by a joint resolution of Congress- which would mean a 2/3 vote in both the House of Representatives and the Senate; and in addition, require the approval of the president himself. This process of over-turning the recommendations is Draconian and would rarely if ever occur.

You may recall, for the Democrats to even discuss the Healthcare Bill on the floor, and to avoid cloture, they needed less votes, than are required to rescind a medical recommendation. At least 60 in the Senate were necessary, when they already had 60 votes for Democrats in the Senate, when you add in the vote of the Independent- Joe Lieberman. Even then, they barely were able to swing this deal for themselves. Imagine what it would take to get 67 votes in the Senate and to garner 66 2/3% of the votes in the House and get the president on-board also.

B--This new law and this new commission would in addition to setting Medicare reimbursement rates, [ show me the money] add an additional power to this commission, which is the broad control of medical practices, called " best practices. " These would range, from the bundling of fees, [ arranging to have doctors work as a team from the first appointment, through the surgery and the follow-up, and set a cost limit for everything- from the aspirin to a bandage at the beginning, to physical therapy at the end ] ; to what type of preventive screenings are effective, and whether you would be entitled to have them, and at what age; to what cardiac operations were deemed to have greater benefits to harms. Or perhaps you would be found at 66 to be too old for that hip replacement, and the recommendations would state that pain-killers might be a better option for you- after all it would cost the government less.

They would also decide if your doctor was admitting too many people to the hospital, including perhaps yourself. And they would determine whether to punish him by fining him; or making him ineligible to treat Medicare patients [ this would affect you too, since even if you desperately needed surgery- he would be watching his over-all number of admissions, and that number- instead of your condition, might in the end, influence his decision on your case.]

In the amended new law on MedPAC, where would the new recommendations come from, when this new MedPAC added on their new power, which is the broad control of medical practices, which they refer to as " best practices ? " Their Bible is The Darthmouth Atlas- many recommendations would filter from it to several agencies. Many would come from the National Institute of Health, and several would be created through Comparative Effectiveness Research. Most would come from the Department of Health and Human Services, specifically ( A.H.R.Q.) which isThe Agency on Health Research and Quality, and some from The Preventive Services Task Force which is within A.H.R.Q., and released the" no mammograms in your forties directive. "

For example, coming out of The Senate Finance Committee is S. 1110, The Medicare Payment Advisory Commission (MedPAC ) Reform Act of 2009 which is governed by these mandates :

1- Directs MedPAC to determine payment rates for items and services under Medicare.

2-Requires the Comptroller General to study and report annually to Congress on changes to payment policies under the Medicare Program.

3-Authorizes MedPAC to advise The Secretary of Health through ( A.H.R.Q.) and the Director of the National Institute of Health on priorities for health services research.

4-Directs MedPAC to develop a council of health and economic advisers to advise it on the development analyses and implementation of payment policies. * These are but a handful of these mandates.

In addition, there are other such bills to broaden the powers of MedPAC and all of them have a fail-safe property to destroy any attempts to stop or modify the Trojan Horse within, which is the ability to modify or eliminate recommendations on medical practice which citizens find odious. For example, there is the MedPAC Reform Act of 2009 ( S.1380) and the MedPAC Reform Act of 2009 (H.R.2718)

Still citizens will ask why ? Why change MedPAC to store within its bowels, the entire battery of recommendations which will determine how doctors will practice medicine on you, once Obama's Healthcare Bill becomes law? And why does the new MedPAC bills all have fail -safes like electrified fencing to prevent the worst medical recommendations from being discarded, once the old MedPAC Law is replaced by the new MedPAC Law ?

The answer is simple. This administration has determined that once the Healthcare bill becomes law, and once the system releases the recommendations as law, patients will rebel and call the recommendations rationing, and attempt to have them discarded or amended. And that would have been possible if the recommendations had been placed under the old MedPAC Law, which would have been under Congress, because voters can influence Congress by threatening to withhold their votes, but voters and Congress are powerless when MedPAC is under the executive branch, as it will be under the new MedPAC law.

Congress would have been pressured by irate constituents which would have threatened them with loss of votes and ultimately their seat in Congress, under the old law. Under the new law you will need a 2/3 vote in both the House and the Senate and approval of the president to eliminate the recommendations, and as was stated previously, the executive picks his own people for this council and they are appointed for 6 years. This means that even if Obama loses in 2012, his appointees will still live on in this council, as well as, his draconian regulations.

This plan to foil the rights of patients and Congress' control of an advisory and not a mandatory council under the previous MedPAC law, was an idea voiced by the brother of Obama's chief of staff. This brother is Ezekiel Emanuel the head of The National Institute of Health. He had previously made such controversial statements such as the following one which I will paraphrase as, " that those with dementia were not entitled to basic healthcare, " which appeared in a article in The Hasting Center in 1995, and he had also bitterly complained that he thought it was selfish for a doctor to put the needs of the patient first.

This doctor Emanuel in his statements and his writings, wanted an organization like the Fed to house the Recommendations of Comparative Effectiveness Research in an agency where they would have long term safety now, as well as, in the future from partisan influence. This doctor, when he said he wanted the medical recommendations to be free from partisan influence, meant that he wanted to create an agency where doctors, average Americans, and even Congress could not get rid of the medical recommendations, no matter how odious they were, or perceived to be. Dr. Emanuel and the Obama administration were looking for an agency model with the self autonomy and protection you would find in the " Fed. "

They have found their agency model, and it is (BRAC) Base Realignment and Base Closing. This is a commission which deals with the fallout from citizens and Congressmen in a district where a military base closes, and the impact that closing has on the economic status of that area. Such a base closing would result in prompting the Congressmen of that area to put enormous pressure on the military, to rescind the order to close that base. A procedure of the military under BRAC to both neutralize and eliminate that pressure, was the perfect plan for the Obama administration to pre-empt any effort to force the administration to rescind recommendations such as the mammogram recommendations to cancel screenings for 40 to 49 year old women.

Under BRAC, the Secretary of Defense makes recommendation to a commission nominated by the President and confirmed by the Senate. This administration of Obama noticed that when the Brac recommendations went into effect, they could only be changed by a joint resolution of Congress, because otherwise a Congressman who had a base in his district closed, would lobby for the base closing recommendation to be canceled . In addition, the whole list of all bases to be closed must be accepted as a whole or rejected as a whole, according to the BRAC rules.

Therefore, the Obama administration has adopted the joint resolution of Congress, the 2/3 majority in the House and in the Senate and the approval of the president, to side -step any action by Congress or the public to eliminate the medical recommendations.

We can only hope, that when a list of say of 25 recommendations are released simultaneously by The Agency on Research and Quality, housed in the Department of Health, which will turn over its report to MedPAC, that like the procedure in Brac where you cannot vote on a single base closing, but must accept them all or reject them all, we will not be forced to accept all of the medical recommendations or reject them all, because that makes it much more difficult to get that 2/3 vote in both houses of Congress.

In conclusion, the new MedPAC bill, if it becomes law, will have a Trojan Horse inside which will house medical recommendations that are mandatory, and that most Americans will interpret as rationing. This will be accomplished by including an extra power within MediPAC to house Medical Recommendations on devices like hip replacements, medical screening tests, several types of operations, the availability and use of expensive drugs for cancer, and even hospital admissions, to name a brief few.

In addition, that Trojan Horse will have a fail safe clause, if patients or even Congress wishes to nullify a medical recommendation. That process would require a 2/3 vote in both the House and in the Senate and the approval of the president- making it almost impossible to nullify a "best practices " recommendation.

To return to our original metaphor, the legend of " The Trojan Horse, " the story of giving a gift, somewhat like the gift of health care that president Obama is showering down on the heads of Americans, we health care consumers wait in anticipation that it will fill all our health care needs. However, in regard to this particular gift, Howard Dean recently said he was disappointed, that although consumers with pre- existing conditions could get insurance with the new Healthcare Bill, unfortunately they would have to pay triple the rate.

But the truth is that with the amending of the old MedPAC Bill, so that it can now administer medical recommendations, which are in effect rationing which is mandatory, plus the inclusion in this bill of a fail- safe provision which makes it virtually impossible to rescind the onerous medical recommendations, President Obama has given new meaning to the old saw "BEWARE OF GREEKS BEARING GIFTS." Americans had better add, " BEWARE OF PRESIDENTS BEARING HEALTHCARE GIFTS, TOO. " After all, you never know what is really inside a gift, until you open it, now do you ?