News / Brèves Obama Impeachment / Destitution d’Obama Back to previous selection / Retour à la sélection précédente Obamacare Genocide in Action: What is Already Underway 21 October 2013 (LPAC)—On June 24, 2009, Lyndon LaRouche’s Executive Intelligence Review submitted testimony to the House Ways and Means Committee of the U.S. Congress, which argued, in detail, that “ObamaCare is Genocide,” and presented an alternative of what must be done. In its upcoming issue, dated Oct. 25, 2013, EIR will present a Fact Sheet that will include its preliminary findings on how this genocide has been carried out over the three and a half years since the implementation of the Affordable Care Act (ACA) in the spring of 2010, and its further projections of how this fascist program is set to be implemented over the immediate future. We present part of these findings below: SHUT DOWN HOSPITALS The U.S. hospital-centered health care system, already contracting, is now under assault from multiple Obamacare measures. Overall, Obamacare specifies cuts of $716 billion through 2020 in Federal health care programs (Medicare, Medicaid and “new”), much of which are cuts to hospitals, directly and indirectly. * Penalize readmissions. Financial penalties against hospitals are in effect for their “too-frequent” re-admission of sick patients. Since October, 2012, hospital rates of re-admission are reported quarterly and evaluated. A rate considered too high results in docking Medicare payments to the hospital. The cut is up to 1 percent in FY 2013; up to 2% the next year; and 3% thereafter. As of early 2013, of the 3,282 hospitals in the HRRP (Hospital Readmissions Reduction Program), fully 66.7%, or 2,189 facilities suffered a cut in Medicare payments. Teaching hospitals, which tend to have complex cases of elderly patients, and safety-net hospitals serving the poor, predictably have the most need for re-admissions, and they are reeling from the cuts. HRRP will cut Medicare spending by $8.2 billion from 2013 to 2019, say Obamacare statisticians. * Cut charity care reimbursement. Obamacare specifies cuts in Federal aid to hospitals, which has defrayed costs of treating the uninsured. Starting in 2014, Obamacare will cut what is called DSP—Disproportionate Share Payments. The hospitals are to get $22 billion less over the current 10 year period, according to the American Association of Medical Colleges and the Commonwealth Fund. * Sequester cuts. Some $95 billion in other cuts in Medicare programs are underway, including the impact of the sequester, all of which are slamming hospitals, according to Caroline Steinberg, vice president for analysis at the American Hospital Association. In fact, a specific sequestration automatic cut has taken away $45 billion from hospitals—more than double what the Obamacare DSP charity cut was. * Mass threat to rural hospitals. In August, the Obama Administration proposed a rule change to what is called the Critical Access Hospital (CAH) program, which would shut down hospitals in rural areas en masse. There are currently 1,332 CAH hospitals nationwide, with potentially two-thirds in line for shut down. The CAH system was set up in 199x, to act to curb closures of rural hospitals. The way it has worked prior to the Obama proposed change, is that, under the CAH system, since 2006, state health officials designate which of their community hospitals—often in low population density areas—are critical to remain open and viable in their localities, in order to provide Medicare residents the physical means to receive care. The criteria include that the facility not have more than 25 beds, it be at least 35 miles distant from other hospitals, and other factors. These CAH facilities then get reimbursed by the Federal CMS (Center for Medicare and Medicaid Services) at 101 percent for their Medicare-related expenses, not at the usual lower Medicare reimbursement rates. But in August, Inspector General Daniel Levinson, for the Health and Human Services (DHS) Department, said that hundreds of these CAH hospitals no longer meet the criteria. So states should no longer have the right to designate CAH facilities; the HHS/CMS should do so, and they will disqualify many such hospitals from adequate reimbursement. This will financially ruin the hospitals. Particularly vulnerable are Iowa, with 82, and Kansas with 83, CAH hospitals. DRIVE OUT DOCTORS Under various Obamacare measures, physicians are under financial and subjective pressure to acquiesce to the intent of the ACA to cut care and lives. Already, two-thirds of the doctors in the United States no longer practice medicine independently, but they are now in the employ of other entities—groups and hospital systems, to the point where the American Medical Association, in November 2012, issued guidelines on how to cope with the “conflict of interest” involved—namely, where the physician wants to treat his patient according to the Hippocratic Oath, and the Obamacare system does not. Only 36% of all U.S. practicing physicians own their own practice (in whole or in part), which is way down from 57% in 2000; and way below 85% or higher in the 1960s. Rural areas are desperate for physicians, and the threat to shut down Critical Access Hospitals is a threat to cut off all advanced care in these localities, in particular in the farm states, where counties have a high percent of elderly. In addition, new “ratings” for physicians, upon which their pay will be evaluated, are being devised under the title of the “Physician Value-Based Modifier.” CUT DIAGNOSTICS Screenings for diseases and conditions, and the staff and facilities to conduct them, are being denied and reduced under Obamacare. One of the methods, is the issuance of guidelines to cut back on preventive screening, by the U.S. Preventive Services Task Force (USPSTF), a pre-existing agency in the Department of Health and Human Services. * Breast cancer. Within three months of the enactment of Obamacare, new guidelines were issued that women should get less frequent mammograms. This decree was made, despite the national concern for the fact that mammography use was declining in the 2000s, mammography facilities were decreasing, and doctors feared a rise of breast cancer mortality rates. As of 2009, 27% of U.S. counties had no mammography facilities at all, associated with poor and rural areas. In May 2010, the U.S. Preventive Services Task Force stated that screening mammography for women aged 50 to 74 should be every two years, not yearly; and for younger and older women, such screening should be less often, and decided on an “individual” basis. This went directly against the modern standard, recommended by cancer specialists, for women aged 50 and above to have annual screenings; and every two years for those 40 to 49. Since the USPSTF decree, preventive mammography rates in women in their 40s have dropped nearly 6 percent, as of 2012 (Mayo Clinic study). * Upper limits on screenings? The Task Force is considering an upper age limit for screening mammography. In The Netherlands, women over 75 are not prohibited from mammograms, but they are no longer reminded to do it, despite the fact that breast cancer for elderly women is still a clinical concern, and treatment can extend their lives. * Prostate cancer. In May 2012, the Task Force recommended against prostate-specific antigen (PSA)-based screening for prostate cancer.