The Tax-Exempt California Medical Savings Account
Bureaucracy makes the terms profoundly confusing, complicated, corrupt and chaotic, for both doctor and patient
By Patrick Wagner, MD, October 27, 2024 9:09 am
One who is gracious to a poor man lends to the Lord, and He will repay him for his good deed. Proverbs 19:17
The siege of Governor Gavin Newsom and his prejudicial, patronizing “elite” Marxist regime, disguised as “Medi-Cal” (or “Newsomcare”, or “Obamacare”), is over! Now, we Californians, in partnership with our California physicians have a stellar opportunity and responsibility to provide for ourselves a more perfect medical and surgical payment system, because the one we have now is broken, dangerous, unaffordable, and has hit rock bottom. We need SOLUTIONS.
It is mandatory for us to establish a top-notch free enterprise operation with built-in protections to keep bigoted Marxist lunatics from ever having a shot at our sacred caring and healing industry again!
Health insurance is a scam. It’s a Ponzi scheme, designed to take our assets, our health, and our sovereignty completely away from us. Think of it as a high-risk zero-sum corrupt economic game, and we are losing. Every dollar stolen from you and me buys senseless power that is squandered by the government and its “corporate cronies” into extraordinary bank accounts, and thus is redistributed into an elite ruling class from a newly formed permanent underclass, namely you and me. Truly, we are the great class, the middle class, so we must now start acting like it. Your healthcare dollars are counterfeit and there is no guarantee of any worthwhile medical treatment now. It’s a hopeless pit.
No longer do California physicians, including ACADEMIC physicians, have to tolerate the oppressive forces of the evil Marxist “labor assignments” and regulations now imposed by Newsom and his hand-picked deep state. We’ve had enough! No more hopeless indentured servitude and fear for our doctors. It is time to liberate them and privilege them to work for us peacefully and gently. One does good work when he or she is at peace.
Let us teach our doctors how to run small businesses and thrive and compete, truly glad and fulfilled to be back in contract with and working for their prized partners, the patients! Let’s make it a requirement of the first-year medical school curriculum and be sure our future doctors are smart small business “mom and poppers”, attentive to their patients. And most importantly, tirelessly loving every minute of their jobs. The quality of all our lives will skyrocket because of it. Can you imagine healing becoming infectious? Think of all the new small businesses that will flourish and contribute to the overall economy of the golden state! Think of it as the Spirit of Economic Initiative. We need to kick start our California economy! It’s time for doctors to invest in patients and patients to invest in doctors, and it isn’t rocket science. We can leave that to Elon Musk now!
It boils down to …”Who is the doctor’s boss, bureaucracy or patients?”” The principle of my argument is to “delete the elite.” We don’t need them. Here is an axiom I came up with called the seven “P’s” of the physician:
“Proper physician payment prevents pernicious perverted performance”!
Doctors work their best, look their best, and are their best when they care about who they are working with.
Are you going to let the government and the “crony corporates” like health insurance companies and Pfizer pharmaceuticals continue to rule and kill our doctors, or are we going to invite them to work for us again?
Which brings us to the purpose of this paper – the establishment of the tax-exempt California medical savings account, or CMSA. Do we have legal standing? Ask a government lawyer or a bureaucrat, and the answer is no. For them, the system is just fine. That’s like asking the prison gang who took over the warden’s office to calmly step down and give him back his authority!
But what if we asked the opinion of an organization like the Howard Jarvis Taxpayers Association to help us craft a safe, affordable, fair, transparent medical payment system that we the participants (namely doctors and patients) have complete control over? We might get a very different and workable answer. They are the best when it comes to property taxes, maybe they can help us here as well. We will get this done, one way or another. We must. We are determined.
Health insurance has proven to be an extremely lousy way to pay for healthcare expenditures. When a bureaucrat is injected into the medical business agreement, with a systematic sole purpose of destroying the health and safety of patients and bankrupting them, and denying a reasonable income and ultimately the job called physician, things just don’t work out well, as you can see all around you now! For both doctor and patient, endlessly jumping through hoops takes the two farther and farther away from each other. It’s almost as if the process is by hateful design. For example, look at the new and very unsafe habit now developing called “telemedicine.” NO, medicine and diagnosis and treatment require one-on-one participation, in person. It is malpractice not to personally attend to a patient in a very private setting for a very serious reason. The doctor misses out on many physical hints, and the patient misses out on developing trust. So, denying the physical aspect of this very important meeting becomes unsafe and of no worth whatsoever. The meeting is unsatisfactory without hands on close attention to detail. How do you establish a diagnosis, an informed consent, a treatment plan and a procedure without trust and close examination of the facts? You don’t!
Furthermore, the economics of the doctor-patient meeting is profoundly clouded. For example, the patient doesn’t have a clue as to how much is being charged for the treatment but is told that the doctor is being kept in line by the ethical (thieving) bureaucrat, and the doctor is wondering whether he or she is going to get paid for the “encounter.” Doctors and patients alike are hoodwinked into believing that they are getting a good deal when truly they are not.
A doctor-patient relationship is a small business venture. You could also call it a “great” business venture if the process goes well, and it is completely because of the fellowship and intimacy of it all. We can make it better yet by both doctor and patient understanding the terms of the contract, which include the objective of the therapy, the timeframe for completion of the treatment, the quality of the treatment anticipated, the safety of the treatment, and the cost. A complete “menu” of the cost of services must be presented. For example, I as a surgeon will remove your gallbladder for $1500.00, including both pre and post operative treatment, both inpatient and outpatient care. It must be advertised for all patients to see.
Bureaucracy makes the terms profoundly confusing, complicated, corrupt and chaotic, for both doctor and patient. It separates the two prime ingredients of a good deal, the doctor and the patient, and rips both off. No critical thinking is allowed for either. Both are blind. The results are a financially broke patient who is still sick, and a hopeless doctor who is no longer a doctor but a sick heart-broken fool.
Greatness is simplicity. A tax-exempt California medical savings account would have the following characteristics:
- For the first time, an innovative California doctor-patient created form of payment for most medical costs will come on the stage. It is a savings account specifically for medical needs.
- This savings account is unique in that each family member can begin a personal account and watch it grow. Parents can start CMSA’s for their kids.
- The accounts compound in interest.
- One can pay as little or as much into the account as they like. However, it is imperative that one be careful and anticipate that when one gets sick or when it’s time to retire, it will be smart to have adequate funds to pay for regular cost procedures and therapies. It’s called Providential Living. It requires fiscal discipline. It works for your pets and the payment of your veterinarians, why not for you. “Self-pay for well-care”. It will keep your doctors attentive and caring.
- There’s always enough money in the account, and any doctor will be glad and accept cash for services rendered. It will be a universal process, making many, many competitive, board-certified physicians available to you.
- It will encourage every citizen in California to develop fiscal discipline and contribute to our freedom of economics, and warn anyone not contributing to society to get out of our state. They won’t even feel like hanging around. What a stimulus for everybody to develop a purpose, a gainful employment, and goodwill for his or her California countrymen, minus wokeness! That includes the important job of running a family, the most important job of all!
- The goodwill, friendship, care and concern of both the doctor and the patient will be palpable. Those doctors will compete and strive to keep their prices down and supply you with superb, gentle, painless as possible treatment. They will love their colleagues. And the patients will recommend those doctors to their friends and neighbors. It’s a goodwill system, based on reputation.
- With cash, the confusion, complications, corruption, and chaos of the worthless bureaucracy go away, and simplicity and peacefulness flourish.
- There will no longer be hospital bias, meaning that hospitals will no longer discriminate against patients because they don’t accept those healthcare insurances. This means that if you live in a region a long distance from your doctor and/or the hospital they have admitting privileges in, you can utilize the local hospital instead and get the same high-quality care via friendly and gentle board certified physicians. Remember, cash is king.
- First class catastrophic medical insurance will come on the market, with zero deductibles, nondiscrimination policies, great claims payouts, highly affordable and competitive premiums for high-cost needs. There will be no hoops, no red tape, no bureaucracy.
- Availability of your doctors will become very easy. If your doctor knows you well enough, you might even get him or her to make house calls again! They will definitely be able to work you into their daily schedule, no matter how busy.
Well, there is a common sense pitch for you to ponder. I know, from personal experience, this system will work. The opportunity and responsibility presents itself right now. It is time to be creative and develop a safe, affordable, caring system of medical treatment via thinking outside of the box. It is time for surgical debridement of the bureaucracy down to a lean and mean machine, very sensitive to our keen oversight and sovereignty, and cram that now healthy lean small government back into the box. There’s plenty for them to do, like protecting our borders, protecting us from each other in legal disputes, and protecting our rights like free speech, and balancing the budget and paying off debt, decreasing taxes and minimizing regulation to the level demanded by a healthy free enterprise system! Stay the heck out of medicine. You are done here!
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Get the Accountants and Attorneys out of the Doctor/Patient relationship!!!
Managed care is an unmitigated disaster, and the collusion between “Big Pharma” and managed care “pay to play” formularies are disgusting….