American Elephants


Ladies, We’re Screwed! by The Elephant's Child
November 16, 2012, 6:02 pm
Filed under: Capitalism, Economy, Education, Health Care, Politics | Tags: , ,

From Reason TV, a look at some of the results of the election you may not have considered.



No Protection for Patients, Unaffordable, and Not Much Care. by The Elephant's Child

The Orwellian named “Affordable Care Act,” if allowed to go into effect, will soon fall apart of its own weight. It is not affordable. The goal of the far left has long been single payer health care, or socialized medicine. Liberalism has elevated compassion to a political principle, and they assume that with themselves in control everyone will get better, more affordable care. They overestimate their intelligence, their abilities, and their understanding.

They probably even meant it when they gave it the name of “Patient Protection and Affordable Care.” What they seek, of course, is power. They want to be the ones who do the deciding about who will get what care. Their arrogant belief that they can write a law to control the lives of American citizens is stunning.  The first clue is that they exempt themselves from the effects of the act.

What greater power could they arrogate to themselves than the power of life and death over the citizens of the country? In their desire to be compassionate, they insist that every woman shall have her fellow citizens pay for her birth control. $9 a month is too much to ask a protected group like feminists to pay for their own. On the other hand, those with kidney failure may be denied dialysis treatment because some bureaucrat thinks it’s too expensive. Decisions about what treatment you may have will now be made by government bureaucrats rather than by you and your doctor.

What doctor? There is already a national shortage of around 45,000 primary care doctors. ObamaCare has promised that “once everyone has insurance, emergency rooms will no longer be overcrowded, and we will save money on health care.” Hospital emergency rooms get overcrowded, the Left claims, because people without health insurance have no place else to go. A survey from the American College of Emergency Physicians says that the real problem isn’t caused by people who don’t have insurance — it’s caused by people who do have insurance, but cannot find a doctor to treat them.

Medical schools and teaching hospitals are not prepared to handle increasingly big numbers of potential doctors. Many physicians are expected to retire early when ObamaCare takes effect. Students are looking to other careers instead, medicine is no longer so attractive. John Goodman of the National Center for Policy Analysis, a leading health care analyst, has estimated that due to the law’s coverage  expansion, we can expect somewhere between 848,000 to 900,000 additional emergency room visits each year and cost more than a trillion dollars over the next decade.

A recent survey from the Doctor Patient Medical Association Foundation, June 2012, found that 83% of their doctors are thinking about quitting. 61% say the system challenges their ethics. 74% say they will stop accepting Medicare patients, or leave Medicare completely. 90% say the medical system is on the wrong track. The survey is here. Doctors I know are leaving. One has gone to Africa, one to Montana, another to work for the Diabetes Foundation, and one just quit and vanished. I am hearing about more doctors who do not accept insurance at all.  The hospital’s list of doctors who are accepting new patients is very short.

Obama claimed in 2009 that the ACA would only $900 billion and bend the cost curve down. In March, the Congressional Budget Office said the law would cost $1.76 trillion from 2013 to 2022, nearly double Obama’s estimate. Beginning in 2014, the first year it all comes into effect, the next ten years will cost more than $2 trillion and that is probably an under-estimate.

A survey by McKinsey and Co. found that nearly one-third of employers will likely to drop coverage for their workers once ObamaCare kicks in. An analysis by the Medicare actuary found that ObamaCare’s attacks on Medicare’s private insurance options will force nearly 8 million seniors out of the coverage they’ve chosen.

New taxes are a list of really bad tax policy. The Medicare payroll tax goes up for individuals with incomes above $200,000 in 2013. There is an additional 3.8 percent tax on investment income, a new 2.3  percent excise tax on medical devices that will reduce the size of the industry and that will be passed on to consumers in the form of higher premiums, and a tax on high-premium insurance plans that will also be passed on to consumers.

Spending increases at a time when the economy most needs less spending, and will be devastating to the economy. ObamaCare supposedly paid for the additional spending by cuts in Medicare. He has taken $500 billion out of Medicare that will supposedly just pay less for medical services than Medicaid does today. But that just means that fewer doctors will see Medicare patients, so they will have to go to the emergency room.

The Independent Pay Advisory Board  is an assumption that the federal government has the capacity and the know-how to micromanage American health care. It is an unaccountable and unelected advisory board that will oversee all aspects of how Medicare is run. It is the theory behind Accountable Care Organizations (ACOs) which are authorized in ObamaCare to give the federal government a new role in influencing how doctors and hospitals are organized to deliver care to old folks.

The administration’s leading advisers in developing the ACA were very impressed with the fact that the greatest expense in health care was in the final years in people’s lives. Eliminating or reducing those costs was a major idea behind their plans. Lots of treatment for the young and healthy who weren’t expensive, but the old and sick should just die and get out of the way.

James Pethokoukis summed it up masterfully:

Thanks to the U.S. Supreme Court decision upholding President Barack Obama’s health-care reform law, the election will–at its core–be squarely about Obamanomics, and whether American voters are happy enough with the results of four years of radical economic experimentation to give the go ahead for four more of the same.

That’s what Obamanomics is, of course. A grand, immensely expensive experiment to see if Obama’s central planners are any better at their jobs than their European counterparts;

if raising taxes on wealthy people and small business creates more wealth and more entrepreneurs;

if long-term economic growth comes from private-sector innovation or government spending;

if financial markets really care about unsustainable debt;

and, finally, if more regulation and taxes can provide America with a health care system that controls costs without a) reducing quality or b) eventually devolving into a rationing scheme.



You Passed the Bill, Now We’ve Found Out What’s In It. For Shame! by The Elephant's Child

The Department of Health and Human Services is designated as the agency to make all necessary regulations to flesh out the thousands of pages of ObamaCare. The Department has already received and spent the entirety of its $1 billion budget to implement state-based health care exchanges and now it’s asking for an additional $860 million to finish the project.

ObamaCare was sold as a way to rein in health care costs which were spiraling out of control.  It turned out that the runaway health cost crisis was a myth. The growth rate of national health expenditures has been declining for a decade due to better medical care and consumer choice. Health spending has been normalizing toward the rate of general inflation, since 2002. Makes the claim that we need government to put the brakes on an “out-of-control” health care system an embarrassing falsehood.

The Patient Protection and Affordable Care Act  (PPACA) was supposed to improve efficiency through the creation of Accountable Care Organizations (ACOs) and better incentives through the Medicare Shared Savings Program (MSSP). This was hyped to be a major “game changer.” The theory was that getting doctors and hospitals to operate under a single program (ACO) and share in the cost savings they achieve (the MSSP) would reduce their incentive to supply treatments that did not give good value. Didn’t work.

New research has shown that ACOs may raise costs for privately insured individuals by increasing hospitals’ and physicians ‘power to raise prices. The long-run trend toward the integration of hospitals and physicians in California has had exactly this effect, according to a study in Health Affairs (April 2010) by Robert Berenson.

ObamaCare created an Independent Payment Advisory Board (IPAB) that would recommend ways to reduce Medicare spending if Congress failed to accomplish this task itself.  This was the bright idea of Peter Orszag and Ezekiel Emanuel, writing in the Aug. 12, 2010 New England Journal of Medicine. Both these gentlemen in the Obama Administration were champions of the British National Health Service. They pointed out that most of the big costs for Medicare came in a patient’s final years, and often were not cost effective. IPAB permitted an unelected body to make substantial changes to Medicare, with no recourse. That stimulated substantial controversy. But closer examination suggests that the board would be ineffective anyway.

ObamaCare said that the coverage sold in the law’s newly created insurance exchanges must cover a package of “essential health benefits.”The provision was meant to scale back the expansion of mandated benefits that special interests have stuck in state insurance law, and keep the essential benefits package affordable. In December 2011, the administration decided to allow the states to define what qualified as an “essential benefit.” HHS is abdicating its power to make the states pay for their decision to expand their mandates.

ObamaCare was sold as a way to rein in costs, and used accounting gimmicks that were downright embarrassing. 10 years of taxes were counted against 6 years of “benefits” to produce big projected savings. The 2014 date for benefits to begin was deliberately chosen to hide the full costs and delay the impact until after the 2012 election.

Have you noticed the troubling quantity of things delayed, put off, hidden, or postponed until after the 2012 election?  You might want to take special notice of those.

The Congressional Budget Office (CBO) has just issued a new report that reveals that the current 10-year cost of ObamaCare is an astounding $1.76 trillion. That is nearly double the $900 billion that President Obama told a special session of Congress on Sept. 9, 2009, that ObamaCare would cost.  He claimed that the “plan will not add to our deficit.”

When 2014 arrives, the 10-year cost of ObamaCare is expected to be well in excess of $2 trillion.

The administration promised that family premiums would drop by $2,500 once ObamaCare and the insurance exchanges were up and running.  The Kaiser Family Foundation released a study that says family premiums are up by $2,200.

Everybody would be included and no one could go without insurance, yet 1,700 waivers have been granted, largely to Obama’s favored unions and their members, and to a few favored corporations.

New taxes on medical devices will cause a decline in medical innovation. The assault on the First Amendment’s freedom of religion exposes the president’s lie that freedom of conscience was enshrined in law and would be respected. HHS Secretary Sebelius said that a reduction in the number of human beings born in the  United Stats will compensate employers and insurers for the cost of complying with the new HHS mandate that requires all health-care plans to cover all contraceptives, sterilizations and abortifacients.

Other than that, those folks with pre-existing conditions who so desperately needed insurance haven’t been signing up.  Higher taxes, higher premiums, more uninsured.  Nancy Pelosi famously said that “we have to pass the bill so we can find out what’s in it.”  We are finding out and it’s not a pretty picture. The Supreme Court case is coming up at the end of the month.

ADDENDUM: According to the American Association of Medical Colleges, by 2020— just 8 years away—the nation will need an additional 91,500 doctors to meet medical demand. Ninety-three percent of physicians said they are considering retiring within the next five years. We are very close to a crisis.




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