By Richard Amerling, M.D., of the Association of American Pysicians and Surgeons.
Our clandestine agent in the White House has obtained a first draft of President Obama's upcoming State of the Union address to Congress. We were told that Mr. Obama wrote this himself, though we cannot be certain. Somehow we doubt that Valerie Jarrett will permit much of this to reach the president's teleprompter.
My Americans, my Members, my press, my guests, welcome to the halls of my Congress. With two short years remaining in what many of you think is my last term as president, there is much yet for me to accomplish. After winning in 2008, I promised to fundamentally transform the nation. I am well on my way, but I am not yet there. FDR, who was the most successful nation-transformer before me, had four terms and a compliant Congress. Now that those of you sitting on the right side of the aisle nominally control Congress, my task is harder, and may require an additional term or two as president. The Office of Legal Counsel and the attorney general are looking into ways we can make that happen.
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As president, I have an obligation to do what is right for the nation, whether Congress acts or not. Make no mistake – the two-thirds of the electorate who did not vote in the midterm election support my policies. I know this from independent internal polling, and from Twitter and Facebook. The fact that so many of my Americans are unhappy with gridlock in Washington, D.C., gives me a mandate to take more executive actions with orders and memoranda, i.e., my phone and my pen.
One main area requiring immediate attention is the environment. No one doubts that climate change is occurring. We must dramatically reduce the use of carbon-based energy to stop the climate from changing. During my campaign, I promised that the cost of energy from carbon would "necessarily skyrocket." Well, this has happened with regard to coal-based electricity. New restrictions from the Environmental Protection Agency have made it all but impossible for coal-fired electrical plants to operate. But we did not anticipate the enormous success of "fracking" in pulling oil and natural gas from beneath the earth. This will result in spewing more carbon into the atmosphere. Moreover, the lower price of oil is destabilizing the economies of my allies overseas. I cannot allow this to continue. I have ordered my EPA, in conjunction with my Centers for Disease Control, to commence a 10-year study of the health effects of "fracking." Until that study is complete and the results analyzed, I am ordering a national moratorium on "fracking" to begin immediately.
My other priority, of course, is what you affectionately refer to as Obamacare. It has become clear that mistakes were made in crafting this landmark legislation. I have already addressed many of them through executive action, but more radical surgery is required. Specifically, we failed to compel the states to set up exchanges, and the majority of states did not set them up. But the federal exchanges were not authorized to dispense subsidies, so I told the IRS to go ahead and issue them anyway. Now the Supreme Court will decide whether or not to uphold the specific language of the law and eliminate these subsidies, which almost 90 percent of enrollees depend upon to pay the inflated premiums.
There is another problem with Obamacare that I didn't fully appreciate (though Jon Gruber spent countless hours trying to explain it to me): The insurance companies are making way too much money. All the extra federal mandates for coverage of everything caused premiums to "necessarily skyrocket." They had to raise deductibles to keep premiums within the stratosphere. They are now so high that few people activate their insurance. All this extra premium money, much of it taxpayer-subsidized, goes directly to the insurance companies' bottom line! I knew they were going to benefit, but this is ridiculous!
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To address these problems, I have ordered my secretary of health and human services to expand Medicare to cover all Americans, regardless of age. Many academic physicians have been clamoring for this for years. Consider it done! Private insurance will be allowed to continue to offer "medigap" policies after submitting requests to HHS. As of now, only the AARP has been approved. To make this affordable, any new "doc fix" to the Sustainable Growth Rate formula will be vetoed. SGR cuts in doctor pay will be retroactive, which should result in an immediate 40 percent cut in reimbursement. Doctors may want to opt out of Medicare, but this will no longer be an option. Participation in Medicare is henceforth mandatory, with forfeiture of license as penalty for non-compliance. I cannot allow a "two-tiered" system of health care in the U.S., where rich folks get special treatment. After all, these folks did not get rich by themselves. They benefited from public education, roads and other infrastructure. No special privileges for them! Please be assured I will work out exemptions for those in the Executive Branch, as well as for Congress, including their staff.
In closing, allow me to quote from my friend and mentor, the Rev. Jeremiah Wright: "God damn America." Goodnight.
Richard Amerling, M.D., is an associate professor of clinical medicine and an academic nephrologist at Mount Sinai Beth Israel in New York. Dr. Amerling received an M.D. from the Catholic University of Louvain in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health-care issues and is president of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the "Physicians' Declaration of Independence" and is a seasoned speaker and on-air contributor.