Virginia is one of the few states in the nation that has taken the bold step to automatically enroll all Virginians covered by the traditional Medicare/Medicaid plan into a Humana-managed health care plan. By managing elderly care (read rationing), money will be saved by denying needed medical tests, surgery, care, and physical therapy to elderly Americans who have paid into Medicare/Medicaid for decades. How else will millions of illegal aliens recently granted amnesty by executive action receive free Obamacare?

There is an option to opt out of the Humana managed care in Virginia and return to the traditional Medicare/Medicaid plans but few patients understand the language in the letter or are able to read it for themselves. This is one of the veiled moves to strip Medicare of $719 billion dollars in order to help fund and support the (Un) Affordable Care Act.

If you like your rationing of care, you can keep your rationing of care. If you like the loss of your well-trained physician, you can keep your third world doctor who is yet to be licensed in this country.

If you enrolled in a plan that fit your budget and your medical needs last year, the Centers for Medicare and Medicaid Services (CMS) has proposed the rule to strip that option from your list of choices, they are going to enroll you this year by December 25 into a cheaper plan of their choice. Too bad you forgot to choose a plan annually. They will select what is best for you, without knowing your medical history, your financial situation, your current treatment under a specialist, and maybe take away access to your favorite doctor who did not play by the new government rules.

When the open enrollment ends, the government would have effectively stuck you with a plan you did not want. Rep. Mark Meadows from North Carolina wrote, "I sent a letter to CMS demanding they immediately strip this provision from the pending rule and abandon any future attempts to single-handedly choose Americans' healthcare plans." I am sure the bureaucrats will listen, just like they listened when a majority of Americans asked them to defund Obamacare.

Because there is a "war on doctors," as Dick Morris so aptly described it, we will eventually have a sort of CastroCare in this country that Americans are not prepared to deal with but will be forced to accept it.

The double reimbursement for procedures that doctors in a hospital setting receive when compared to doctors in private practice, will eventually regulate doctors into a 8-4 hospital employment which I witnessed recently when my mother was in a hospital for 8 days and I never saw the doctor visit her once, she was treated by a nurse practitioner the entire time. There was not much hands-on care, just robotic, computer-driven medical care delivered by inadequately trained people. They were more concerned about her falling out of bed and a lawsuit from a potential fall than anything else. She was discharged without a proper diagnosis.

The forced electronic medical records-keeping will make it more difficult and expensive for private practice physicians who would be forced to spend a large part of their day on record-keeping and data entry instead of treating the patient.

In addition to reducing doctors' income, physicians retiring early because they do not want to practice government-regulated medicine, Congress won't expand residency programs to train more doctors.

Residency programs are funded by Medicaid/Medicare which gives higher reimbursement rates to teaching hospitals. Since the government refuses to pay for more residency programs, Americans should prepare themselves for substandard care delivered by nurse practitioners, nurses' aides, and ER treatment replacing high quality medical care.

Hospitals are busy buying up private practices of retiring doctors in order to "capture their patients." Most physicians are busy forming Accountable Care Organizations (ACOs) which combine multiple care providers under a hospital umbrella which has better access to capital.

This will lead to a doctor passing the care of his/her patients after the end of the shift to someone less qualified whom the patient has never met.

I recall the EU-modeled socialized medical care in 2012 Romania where I saw no doctor or RN anywhere in the large hospital in which my uncle was a patient. His wife delivered all his care, meds, diabetic shots, bandage changes, bed linens, bathing, towels, food, and trash removal. She was the de facto medical person caring for her own husband who would otherwise die of medical neglect in one of the largest hospitals in the capital. Incidentally, the courtyard was littered with stray dogs and we had to pay 5 euros to the gate guard to gain access into the hospital with five dingy floors and no operational elevator.

Online magazine Digi24 reported on December 17, 2014 that patients' rights are often trampled on by medical personnel who refuse medical services unless the patients offer them personal benefits in the form of bribes. The accompanying photograph published by Digi24 is visual confirmation of the unsanitary conditions in some socialized medicine hospitals.

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Photo courtesy of Digi24

According to Zoel M. Zinberg, associate clinical professor of surgery at Mount Sinai Hospital in New York City, "The new breed of physician-employees will split their allegiances between their employers and their patients." The employer's goals of making money and saving a buck every which way and the patient's welfare will not coincide, and the physician will seldom be allowed to use his best judgment in treating a patient. He continued, "Salaried employees and independent professionals behave differently."

Dr. Zinberg cited a recent study in Health Affairs which found that …"practices owned by hospitals had 50 percent more preventable admissions than practices owned by physicians." He concluded that "The days of the family physician who made house calls are long gone. The doctors who would squeeze you in for a visit on short notice and take your calls after regular business hours are disappearing."

The less discussed issue of economic side effects of the Affordable Care Act should not be overlooked. Casey Mulligan, professor of Economics at the University of Chicago, in his speech delivered to Hillsdale College on October 24, 2014, explained the three taxes in ACA, two taxes on full-employment and one on income. All three combined have a net effect on employment (3 percent less) and on Gross Domestic Product (2 percent less). He concluded, "If you like your weak economy, you can keep your weak economy."

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