American Elephants


The News on the ObamaCare Front is That it’s Not Working, and is Not Going to Work. by The Elephant's Child

LOS ANGELES (MarketWatch)—

Once provisions of the Patient Protection and Affordable Care Act start to kick in during 2014, at least three of every 10 employers will probably stop offering health coverage, a survey released Monday shows.

While only 7% of employees will be forced to switch to subsidized-exchange programs, at least 30% of companies say they will “definitely or probably” stop offering employer-sponsored coverage, according to a study published in McKinsey Quarterly.

The survey of 1,300 employers says that those who are keenly aware of the health-reform legislation are more likely to consider an alternative to employer-sponsored plans, with 50% to 60% expected to make a change.  It also found that for some, it makes more sense to switch.

A third of employers would gain economically from dropping coverage, even if they compensated employees for the change through other benefit offerings or higher salaries, according to the study.  More than 85% of employees would remain at their jobs even if employer-sponsored coverage was no longer offered, although 60% would expect higher salaries.

The Democrats assured each other that ObamaCare would lead to single-payer government-run healthcare.  This has been their dream. It’s very clear that there is nothing there that will improve health care.  We have examples in profusion from Britain’s National Health Care (and their NICE rationing board), from Canada, from France, from Germany of absurdly long waits to see a doctor, to see a specialist, to schedule an operation. Why are Leftists so determined to push a system that makes everything worse?  It will be diminished care at vastly higher cost.  Why do they want this? The only answer I can come up with is power and control.

Late Monday, a White House spokesman took issue with the survey, citing other opinions about the promise of ObamaCare. But then the White House always has a ‘different’ story.

The health-care industry is currently spending billions to create electronic health records, but the tech-gamble that is supposed to save money and improve the efficiency of American medicine is looking more like another $30 billion boondoggle. In theory it was going to allow any patient to walk into any emergency room anywhere in the country, and have their entire medical history right at hand. Save money by avoiding duplicate tests. The thousands of new systems may never be able to communicate with each other.

According to my doctor’s office, it doesn’t seem to be working.  I was in yesterday, and they couldn’t find my records at all. The intrusive paperwork is about 5 times more than usual, and now, since it’s the feds, they want to know your ethnic background as well as everything else. If doctors and providers don’t meet the federal milestones, they may not get paid. The National Academy of Sciences Institute of Medicine issued a 273 page report about “seamless interoperability. They’re dubious. Privacy and security are big problems.

Hospitals are increasingly skeptical of the new ObamaCare Medicare payment scheme. The pay for performance scheme and “value-based purchasing” will see payments redistributed based on performance scores calculated according to the methodology chosen by the Obama Administration.  Payments will be reduced across the board to a new lower “base” payment, after which hospitals could receive “bonuses” for performing well on the quality measures. Evidence-based medicine is a theory that the proper treatment for any condition can be determined by bureaucrats and physicians will be rewarded for treating patients “correctly.”

How about some “evidence-based” lawmaking, in which Congressmen have to prove that they are capable of considering evidence thoroughly and completely before they get to actually make any regulations?



Regulated Medicine, by the Rulebook. Will That Be an Improvement? by The Elephant's Child

Basic fact: You cannot keep Medicare unless  you transform the current — and unaffordable system. The Left’s attack machine is out in full force, claiming that Republicans are plotting to end Medicare entirely.  (Add starving granny and all the usual themes).

Those who are far too young to be Medicare eligible (at age-65), may find it hard to be very interested in Medicare. We have deficit reduction, debt, the budget, out-of-control spending, the debt ceiling, and people keep talking in billions and trillions—which are numbers that are too big for comprehension.  Easy to throw up your hands and refuse to think about it.

To get control of spending, we have to start cutting it in the next budget, which will begin to reduce the deficit. Democrats are simply unwilling to take this seriously. We could argue motivation and psychology all day, and still fail to understand. To get the debt under control, we must tackle the entitlement programs — Medicare, Medicaid, and Social Security. We have promised payments to people that we cannot afford.

The Medicare Hospital Insurance Trust Fund is in deficit. The red ink amounted to $32 billion in 2010, and is expected to reach $34 billion this year.  The Medicare Actuary says that may be way too low an estimate.  It’s partly demographics — the first of the 72 million baby boomers begin turning 65 this year, and their numbers will increase dramatically every year until 2024, when their numbers begin to decrease gradually until around 2029.  To demographics, you must add the rising cost of health care, and now inflation.

The new head of the Democrat National Committee, one Debbie Wasserman-Schultz (Obama’s gift to Republicans) believes that the way to raise money for Democrats is to tell one improbable lie after another. “Republicans want to end Medicare,” she says. Republicans want to “throw seniors to the wolves.” Republicans are “anti-woman,” they “want to put all pain on people who can least afford it.”  “Democrats are focused like a laser on the economy.”

The Left’s approach is to downplay the problem — deficits are attributable to the economic recession and its effect on federal revenues.  They hope that ObamaCare will fix it.  When the reforms in the Affordable Care Act kick in, it should be possible to maintain the system., they claim. (Hope and Change never die). And when all else fails, ration care.

Economist and Democrat hack Paul Krugman says: “Medicare has to start saying no to expensive procedures with little or no medical benefits.” Who will decide what procedures have little or no medical benefits?  The Independent Pay Advisory Board, 15 unelected and unaccountable bureaucrats— disinterested experts with the factual knowledge, practical wisdom, and unwavering integrity to decide whether they will pay for a procedure or whether you are just plain out of luck.

Obama’s Regulatory Czar, Cass Sunstein, is trying to disavow his statements in a 2008 paper in which he said that the government should rely on the “value of a statistical life year.”  This would result in a significantly lower benefit for elderly people and significantly higher for children.  If, you have a case where there is one heart to be transplanted, and you have two candidates for that transplant, both in condition to survive if they receive a transplant, and one is very old, and one is very young — then it is possible to make an ethical choice for youth. But that is never the choice, and expanding an extreme and improbable  case into regulation for all care is deplorable.

The fact that so many on the Left— Donald Berwick, Tom Daschle, Ezekiel Emanuel, Peter Orzag, and now Cass Sunstein— have made it clear that they expect to make their new and reformed version of Medicare solvent by rationing care to seniors— ought to strike a chord of fear in everyone. We’re all going to get old, and most of us will not quietly drop off in the midst of life. We will get old, and our bodies will need more care. The idea that my doctor would tell me that there’s nothing more he can do for me doesn’t bother me, and I’ll go quietly.  The idea that a rationing panel will decide that I cannot have the medicine or the procedure that would give me many more years because I’m not worth it in “life years” disturbs me very much. Sarah Palin called them “death panels.” She was sneered at, but that’s what they plan on.

And when rationing care to seniors isn’t enough, then you ration care to everyone else. No expensive medicines.  No expensive procedures. Why, it might just turn out to be like Britain’s National Health Service.  Oh, Wait! They all said that was what they were aiming for.




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