Raymond Kordonowy of Internal Medicine Of Southwest Florida
January 24th, 2014

This week we continue to read about how the health care act is not working as anticipated. President Obama and his administration appear proud that the plan has increased enrollment in Medicaid substantially. I feel compelled to reach out to everyone and ask that you arm yourself with information and facts.  The green highlighted text in this newsletter will link you to my prior blog postings.  Please give some of these a read. 
How Should The Health Care Market Work?

Doctors w computers Medicaid to this point has always been considered the safety net for the most unfortunate and poorest in this nation. It historically has not been a prideful thing to inform your friends and neighbors that you are a medicaid beneficiary. With Obamacare/ACA (formally PPACA), apparently our president is proud to claim he and the health care act have increased the number of folks in this program by potentially 9 million more.  

I don't know about you but I find it comical and very telling that the leader of this great nation is considering this a grand achievement. I consider this a massive disappointment. If Americans now gauge the country's progress on adding to the bottom 10-20% then we have a serious disconnect from our proud past.  

I wanted to remind my readers that I have penned prior articles regarding the atrocious errors in thinking that are occurring.When are we going to start speaking up for ourselves?  When are we going to look into ourselves instead of out to the federal government for the answers? 
As the President of the Independent Physicians Association of Lee County, I continue to plead to my fellow doctors to start declining all these government, centralist policies and start rethinking what our priorities are. Let's stop adjusting to more harmful policies and stand up for our patients and our profession. 

I and my group started making these first steps nearly a decade ago by first stopping signing insurance contracts. The reasoning for this is simple- these contracts don't result in patient savings and serve the insurance industry by validating their control of the system. Insurance companies do not deliver health care services- doctors and hospitals do. Thier contract should be between the patient and them, not us. In exchange for this decision we have elected to publicly post prices for our most common services.  This is how we doctors can begin to offer local market solutions to delivering health care. 

Proper economic thinking is how to best optimize the delivery of our services. This is where I am coming from when I critique the centralists trends. Criticism alone is meaningless. Solutions are obvious but it takes courage to make changes. 

So are we satisfied that we have increased the number of people in Medicaid?  Is pushing more people into the bottom 10-20% considered "mission accomplished"?  We have to end price-fixing as this is distorting the health care market both in the direction of underuse/access crisis as well as overuse/distorted supply.  It is ironic that the Federal government has made it explicitly illegal for doctors to discuss pricing yet this very agency openly fixes the price of my/our services.  Hypocrisy at its finest.  

Raymond Kordonowy MD
Internal Medicine Of Southwest Florida