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    Within the Clinton administration's 1997 balanced budget act lurks a small section that carries with it immense national impact on the healthcare of nearly every American citizen. Section 4507 of that document, entitled, "USE OF PRIVATE CONTRACTS BY MEDICARE BENEFICIARIES" contains language that is intended to impute heavy penalties to any physician or health practitioner treating elderly patients outside the government's Medicare system. If they presume to enter into what the act refers to as private contracts, they must file an affidavit with the government that essentially eradicates a major part, or possibly even all, of the practitioner's income.

    Subsection 3, paragraph B (ii) of that budget agreement states that:

"The affidavit provides that the physician or practitioner will not submit any claim under this title for any item or service provided to any Medicare beneficiary (and will not receive any reimbursement...for any such item or service) during the 2-year period beginning on the date the affidavit is signed."

    This means, simply stated, that a physician or health practitioner who treats ANY Medicare-eligible senior citizen on a private, independent basis, outside the Medicare system, cannot for two years submit any claims to Medicare for financial reimbursement. Those penalties, according to an article in the Wall Street Journal, August 22, 1997, entitled "Medicare Showstopper", would be sufficient to drive out of practice any but those doctors serving the wealthiest of communities whose patients can afford to pay their physician apart from any government assistance.

    Republicans who regularly lay claim to the title of guardians of conservative American freedoms are responsible for this extreme draconian clause in the budget act. Representative Bill Thomas, the GOP chair of the Ways and Means health subcommittee, takes credit for increasing the doctor's exclusion time from the Medicare program from one to two years, thereby, virtually ensuring the agency's control over all doctor/patient relations with senior citizens.

    A previous attempt to impose government controls over private physician/patient relationships was initiated by the Health Care Financing Administration (HCFA) in 1995 when they set about to compel doctors to abide by their regulations when treating any patient who is even eligible for Medicare--whether or not that patient is actually enrolled in the program.

    In an unprecedented invasion of physician/patient privilege and privacy, "Doctors are supposed to submit bills for all their elderly patients to Medicare once they care for a single Medicare patient," theWall Street Journal report added. This would be the equivalent of a person cashing a check at a grocery store and granting the store legal permission to examine all of that person's financial transactions and records. "One physician trapped in the Medicare web received a demand from HCFA to make refunds to patients who had willingly paid fees higher than allowed....The best guess is that doctors' practices with heavy Medicare loads spend over a quarter of the time on Medicare, bureaucratic socialism reigns supreme." (ibid.)

    "This isn't reform," says theDaily Oklahoman, August 30, 1997. "It's socialism....It's nationalizing healthcare bit by bit, and it happened with the full approval of many Republicans in Congress....'This assault on the doctor-patient relationship is deliberately designed to make private contracts with Medicare patients all but impossible' says Robert Moffit, a former deputy assistant secretary at the Department of Health and Human Services" (ibid.)

    In the U.S. government's goal of absolute control over its citizens or "subjects", ironfisted authority over the healthcare of Americans and their physicians is a major objective. When any nation can thoroughly socialize its medical community, enabling that government to provide or deny healthcare to whomever it chooses and for whatever reasons, it possesses a most powerful tool of subjugation over its population. In this case of startling over-regulation of a doctor's financial affairs between physician and patient, it is somewhat easier to accomplish than it might be in other instances. Most Americans believe that medical practitioners are paid too highly anyway, and seem to be willing to tolerate the government's intrusion into another area of what is essentially private enterprise. One can rightfully ask that since it does not in any manner address or effect a patient's medical welfare, how is this justified?

    In a previous WINDS article the intent of the United Nations and the U.S. Food and Drug Administration to impose food and food supplement controls on a worldwide scale under the auspices of the UN Codex Alimentarius Commission was discussed. Placing these two subjects under the same illumination appears to reveal a considerable body of hypocrisy within the government of our own nation--a hypocrisy with a purpose. On the one hand, this country preaches the gospel of freedom of body or "pro-choice" when a mother makes the decision to erase the life of her unborn child through abortion. On the other hand, the same nation, the same administration that sanctions the killing of millions of children, refuses physicians and patients the freedom to engage in private, independent treatment when the point in contention is nothing more than sums of money. The question here presents itself simply: what's wrong with this picture?


    January 1st of this year, the President signed into law an article of legislation known as the Kennedy/Kassebaum Bill after its sponsors Senators Edward Kennedy and Nancy Kassebaum. Legally titled the Health Insurance Portability and Accountability Act (HIPAA), the bill appears on the surface, as do most, to be common sense legislation. Not far beneath that surface, however, can be seen an unparalleled assault upon the healthcare freedoms of the American public.

    Title II of the act is innocuously labeled, "Preventing Healthcare Fraud and Abuse; Administrative Simplification". What thinking person, after all, would not be in favor of preventing fraud and abuse and would certainly applaud any act that would result in administrative simplification?

    In an article written for the Oklahoma Bar Journal, Robert G. McCampbell, a former Assistant U.S. Attorney implies that a significant avenue for potential governmental abuse of power has been created within section 201 of the document, entitled Fraud and Abuse Control Program. "Because fines, penalties, assessments, and forfeitures will go into the Account to fund further enforcement activity," McCampbell says, "the program has the potential of becoming a mammoth, self-funding enforcement bureaucracy directed solely toward healthcare providers. This will be very different from the traditional model," the author continues, "in which law enforcement resources are continually reallocated to the greatest need." This will potentially create a government organism that feeds on conflict of interest. The more money they can extract from "fraudulent" practitioners the more they have to prosecute further "violations" to extract even more money to prosecute even more "violations". The cycle could indeed become vicious and self-perpetuating--a metaphorical "flesh-eating bacteria" of government bureaucracy.

    The bar association article also indicates that the Medicare Integrity Program established by the act and administered by HCFA will "provide for a 'bounty' system, similar to that employed by the Internal Revenue Service, in which a person reporting fraud against Medicare can receive a portion of money collected by the government." This opens enormous potential for an unlimited number of people to indulge in unrestrained whistle-blowing with hopes of receiving monetary reward having invested nothing of their own save a telephone call.

    It might be noted here that one of the principle methods used by Hitler's Third Reich to fragment German society and, thereby, gain dictatorial control over it was to institute a system of informants within families, businesses and other organizations. It should also be observed that any society is in serious moral declension when monetary reward is the most effective means of arousing members of that society to do that which would be a matter of course to an honest, community-minded individual. In the absence of social and moral integrity, the government resorts to bribing its citizenry to do what they might be motivated to do by conscience--ultimately resulting in acts that would not be conscionable under any other circumstances.

    Subtitle C, section 221(a) of HIPAA provides for the establishment of a database to record any adverse actions against a physician or health practitioner. By this provision a private health maintenance organization (HMO) can register a complaint against a practitioner of alternative medicine for providing "suspected" non-approved treatment. Though there may be no illegal activities being performed by the accused practitioner, this information would still be logged into the database and that individual would logically be scrutinized in much the same way as one who is falsely reported to the IRS for financial "irregularities"--and, likewise, regularly audited for no other reason than someone reported them. Since practitioners of alternative medicine have historically been at odds with traditional medicine, this scenario does not seem at all unlikely.

    The most portentous result of this law can be envisioned from the contents of the aforementioned, "Fraud and Abuse Control Program". Within the auspices of this subdivision lies wording that federalizes nearly all "abuses" within the entire healthcare industry--even within those private organizations that do not cross state lines with their services and, therefore, do not normally fall within federal law enforcement jurisdiction.

    According to McCampbell, the act gives the government additional powers to enact and federalize several new crimes, more pervasive authority to exclude providers, and, most ominously, it empowers the federal government to extend its enforcement into states and "in some cases, all healthcare even if privately funded."

    Does the chimera of infinitely intertwining tentacles of a federal law enforcement bureaucracy present itself to the imagination? "Over the next several years, this...should be anticipated to impact every healthcare provider, supplier, and practitioner." (ibid.)

    Even more alarming content of the HIPAA bill is contained in a single sentence. It assess penalties for any practitioner who tenders a claim for "a pattern of medical or other items or services that a person knows or should know are not medically necessary". The term "medically necessary" is not defined in the document or any legal resource this reporter was able to access. This ultimate ambiguity of government legislation appears to open a door of creative definition through which Mir could fly without touching the edges. Any time the government wants to harass and even jail a practitioner of alternative medicine, all that is necessary is to allege that the practitioner's treatment is not "medically necessary"--and if the field of alternative medicine is scrutinized through the eyes of traditional medical practice, little or none of alternative medical therapies are deemed as necessary.

    Because the legislation allows state and federal cooperation during investigations of medicalcare fraud, the governmental agency possessing ultimate determination as to how any such investigation is conducted and prosecuted becomes, by historical precedent, federal. For a state to argue jurisdiction with federal authorities becomes an exercise in legal-academic futility. It is much akin to arguing evolution with God. Merely the fact that one is engaged in the debate automatically indicates they are wrong.

    In simple summary, this act becomes another nail--a very large nail--in the coffin of states' sovereignty and rights against the federal government and in the establishment of something the Founding Fathers dreaded--a national or federal police force imposing itself into every aspect of the citizen's life.

    The net this nation is weaving for its "inmates" is being called a protection, or a safeguard against evil and the loss of liberties. Even when it fully encompasses its prey, very few will observe what has happened. Most will still believe the net to be a barrier against harm from "out there" somewhere. "Why," some will ask, "does it not appear more obvious--this immense international conspiracy?" It is the nature of any snare to remain invisible until it is too late for its object to escape it. Those "birds" who have recognized the true nature of the deception have already fled to a safe refuge.

    Well did King Solomon express the words of Omniscience for this day:

"Wisdom...uttereth her voice in the streets: she crieth in the chief place of concourse, in the openings of the gates: in the city she uttereth her words, saying, How long, ye simple ones, will ye love simplicity? and the scorners [those who say, "What conspiracy?"] delight in their scorning, and fools hate knowledge? Turn you at my reproof: behold, I will pour out my spirit unto you, I will make known my words unto you.

"Because I have called, and ye refused; I have stretched out my hand, and no man regarded; but ye have set at nought all my counsel, and would none of my reproof: I also will laugh at your calamity; I will mock when your fear cometh; when your fear cometh as desolation, and your destruction cometh as a whirlwind; when distress and anguish cometh upon you.

"Then shall they call upon me, but I will not answer; they shall seek me early, but they shall not find me: for that they hated knowledge, and did not choose the fear of the LORD" Proverbs 1:20-29.

    Whether or not one chooses to heed the warnings, all have been warned.


Written 10/21/97


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