American Elephants


About Perfect Responses: by The Elephant's Child

On the Sunday shows, host Chris Wallace interviewed Obama health care adviser Ezekiel Emanuel. He asked about the oft noted Obama lie about “If you like your health insurance, you can keep your health insurance.” and “If you like your doctor you can keep your doctor.” Emanuel responded that the promise was true enough — providing you’re willing to pay a lot more.

Lucianne Goldberg was, like many of us, disgusted, and today she delivered the killer response on Twitchy.

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Lucianne Goldberg
   @LucianneLinks

Note to the Emanuels: If you like your brother you can keep your brother just get him off TV. He’s a disaster.


Fully Functioning Website 0, More False Assurances 100. by The Elephant's Child

The promised deadline of December 1 has come and gone, and the “fully functioning” website is still off glimmering in the far distance, with a lot of burnt-out bulbs. Just another addition to President Obama’s long, long list of broken promises, false assurances and hope and change talk for low-information voters. It’s still all campaigning. He talks a good game, but doesn’t notice that no one believes him anymore, and in case they did his words are recorded for later review.

Ezra Klein, the liberal Washington Post reporter, a true believer, notes that “the site still suffers a disastrous outage rate judged by the standards of major retail Web sites — that’s not counting the time it spends down for scheduled maintenance.” The insurance companies who have to deal  with the mess the administration is creating are in a panic as the system transmits data that is full of errors, fails to transmit at all, and warns that even those few who have managed to sign up for coverage may show up at their doctor’s office in January to learn that they didn’t purchase the insurance they think they purchased.  Oh well, details.

We have learned that at least 30% of the website has never yet been written. It doesn’t exist, including the payment mechanism for subsidies. The effort to fix the website is based on the politics of it — the public, embarrassing part, rather than the serious back-end problems. Subsidies are improperly calculated, consumers are misidentified, relationships are misstated — National Review adds that one customer was surprised to learn that he had three wives instead of one wife and two dependents — and in many cases the information is not being transmitted to the insurers at all. If the information sent from the website to the insurance provider is not accurate or complete — there is no insurance and the website is all a lie as well.

The Washington Post quantifies the enrollment problems — it find that “errors cumulatively have affected roughly one-third of the people who have signed up for health plans since October 1.”

The errors, if not corrected, mean that tens of thousands of consumers are at risk of not having coverage when the insurance goes into effect Jan. 1, because the health plans they picked do not yet have accurate information needed to send them a bill. Under the 2010 law designed to reshape the health-care system, consumers are not considered to have coverage unless they have paid at least the first monthly insurance premium.

The “Tech surge”, “team of experts” according to reports consists of 6 people.

The White House, Barack O’Blameless — blames consumers:

Some of the errors in the past forms were generated by the way people were using the system, another senior official on the project said, such as clicking twice on the confirmation button or moving backward and forward on the site.

The primary promise was universal coverage. President O’Blameless emphasized over and over that the country has a “moral imperative” to cover those who could not find coverage on their own. Somewhere around 30 million to 47 million, depending on the numbers of illegals and those who are eligible for public assistance, but do not partake. The recession increased the uninsured by 6 million,  number that continues to grow. The CBO’s latest estimate says there will be 31 million uncovered Americans in 2019. So much for the universal coverage bit.

The second big promise was to reduce the cost of health care, specifically the cost of premiums. Bwa-ha-ha-ha. Health Care expert Avik Roy has found that costs for a family of four would increase by $7,450 by 2022. In some states costs will be far higher. The ObamaCare people say that the law will provide subsidies to offset the higher cost, but , of course being liberals, have no idea who is going to pay for it. The rich and big corporations?

The incentives are all wrong. Once they fulfill the dream of universal coverage, they have to figure out how to pay for it. The overriding incentive for government becomes controlling costs. The more they move toward “Single Payer”, the more the cost becomes an overriding problem. The ObamaCare people may have copied the mandates from Romney’s plan for Massachusetts, but the overall dream was Britain’s NHS, which Obama’s advisers really admired.

Most of the big cost in health care was for old people in their final years. Limiting their care was the driving force behind Obama’s Independent Payment Advisory Board (IPAB), unelected, unaccountable, which will decide what the Government will pay for and what they will not. Sarah Palin referred to it accurately as a “Death Panel.” And Obama has frequently suggested that perhaps the old folks should just get a pain pill instead of any expensive medical treatment.

The Daily Telegraph reports that 1,158 NHS care home residents have died of thirst or while suffering severe dehydration over the past decade. Some 318 died from starvation or severe malnutrition, and 2,815 deaths were attributed to bed sores. This does not include those who died in hospital. NHS’s medical director will spell out the failings of 14 hospital trusts in England who have been responsible, between them,  for 13,000 “excess deaths” through poor care, medical errors and failures of management. That’s what you get when the incentives are all about cutting costs, as it is in the liberal dream of Single Payer.

 



Misleading the Public and Selling a Lie. by The Elephant's Child

The New York Times loyally says that President Obama “misspoke,” but serially misspeaking over weeks and months and years fits more comfortably into another category. It isn’t just the failure of the Obamacare website Healthcare.gov to function, although that catastrophe has focused Americans’ attention directly on the Obamacare mess for the first time, it is the broken promises, the false claims and the lying about lies. The president has misled the American people about Obamacare, and then is trying to mislead the public about his deception. Ron Fournier tackles the facts:

In a speech Monday night to his political team, Obama said: “Now, if you have or had one of these plans before the Affordable Care Act came into law and you really liked that plan, what we said was you can keep it if it hasn’t changed since the law passed.”

No, no, no, no, no–that’s not what the Obama administration said. What it said was:

“That means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.” – President Obama, speech to the American Medical Association, June 15, 2009, during the debate over health insurance reform.

Obama had a brief window to address health care when Democrats controlled both houses of Congress, and he jumped on it. Democrat politicians worked it up in back rooms, foregoing any input from Republicans, passed it without a single Republican vote in either House or Senate. Democrats were painfully aware of the Clintons attempt to pass HillaryCare, to enormous public rejection. So from the beginning, they knew that a goodly percentage of the American people were opposed to any attempt to install government-run health care.

Their instinctive response was that the stupid American people didn’t know what was good for them, and no matter what they thought — health care would be far better run by the brilliant people in government. They did think that they could make better health care, but that was not the prime objective. The prime objective was wealth redistribution, and forcing people to be dependent on the government for their physical health so that Democrats would always control elections.

The current spin is that — well, yes, some people are losing their rotten old policies but they will get new  much better, more superior, more complete policies that aren’t nearly as expensive, with way better benefits. But that is clearly another lie. The stories are emerging. Policies are far more expensive, deductibles are way larger. You may not be able to keep your doctor.  Your policy is not portable — it won’t cover you in other areas or out-of-state. Insurers are required by the law to spend 80% of every dollar on insurance, and only 20% on overhead. The new policies are not better — they are more bloated, covering a grab bag of things you may never need.

Those covered by policies from their employers just get a break until ‘after the election,’ Obama always tries to avoid having the public aware of problems when it might affect their votes. This is a fundamentally dishonest presidency. I don’t think he can recover from this one. Nobody believes him anymore.

 



Free-Market Medicine v. ObamaCare by The Elephant's Child

We recently demonstrated how free-market medicine works with a post about the Surgery Center of Oklahoma, which is a shining example. ObamaCare, on the other hand, is the left’s attempt to gradually funnel us all into single-payer, government-run health care.

Please note that ObamaCare is not about health, nor is it about medicine. It is about insurance and who pays for what. They tell us that ObamaCare will reduce costs and promise you all sorts of free goodies. Obama partly won the election by promising free contraceptives. (Well, of course they are not free because the rest of us will have to pay for them. I should clarify that: the young women who are getting “free” contraceptives will be paying for the “free contraceptives” of all the women in the country who are using contraceptives. Probably paying more than the $9.00 a month’s supply costs at a discount pharmacy. But I guess that’s how you learn about basic economics.

ObamaCare: think of it this way — draw two stick figures with a space between. Label one ‘patient‘ and the other ‘doctor.’ Between the two stick figures, draw a small box. Label that ‘insurance companies‘. Then above the small box, draw a much bigger box. Label that one, oh, just ‘government’ to represent the over 100 agencies and offices and euphemistically named bureaus that will supervise and control the patients and the doctors, the insurance companies, the pharmacies, the suppliers, the hospitals. All those agencies have who-knows-how-many employees who all have salaries which are excessive, except by DC standards. That little exercise alone should tell you that ObamaCare is going to cost a lot more. Yet ObamaCare is all supposedly about how much it will save you. (Not really, it is really about making you dependent on liberal government, so you will always vote for liberals.)

So, while free-market medicine is about competition and creativity, innovation and plain old American free enterprise, ObamaCare is about folding you into the arms of bureaucracy, where you will forever be dependent on government, until they decide that it costs too much.  Medicine becomes not a matter of the care a doctor gives to a patient, but for the physicians, it becomes a matter of trying to get paid enough to cover costs. For hospitals and suppliers, it becomes a matter of trying to cut costs to comply with government budgets.  The British NHS provides a running example of what we will become in time. To wit:

A BID to save nearly £3billion by slashing appointments with a doctor and treating patients via computer will put lives at risk, ministers were warned.

Health Secretary Jeremy Hunt is planning a technological revolution that could spell the end of the traditional doctor’s surgery.

A new system of “virtual clinics” is being planned in which GPs connect with patients via iPads and Skype, an idea that NHS bosses are importing from India.

The reforms would save £2.9 billion “almost immediately” and improve the lives of most patients, for example by avoiding the need to find child care during appointments, Health Minister Dr Dan Poulter said last week.

However, critics are concerned the initiative would create a two-tier NHS in which the less technologically able, particularly the elderly, would be left behind….

The ideas, contained in a Health Department report called Digital First, include arming community nurses with iPads in rural areas and making more use of Skype video calling between GPs and patients. There will be more online assessments “augmented” with video calls.

Mobile phone “apps” will be used to access lab reports and health records and negative test results will be sent by text messages rather than delivered in person. Mr Hunt, who made a fortune by creating an internet company, believes that while mobile broadband technology is revolutionising most walks of life, there is a problem once ­people encounter the relatively antiquated systems of the NHS.

The Government is trying to fill a £20 billion NHS funding gap and health chiefs want to reduce “needless” appointments that clog up staff time.

Well, the NHS has kept patients parked in ambulances outside hospitals because they can have only a specified number of admissions a day, they’ve conveniently offed seniors in their final years with ‘”do not resuscitate ” notes on the charts, cut back on cleaning and linen changing and drinking water and food. The battle has become — how to cut costs, not patient care and saving lives.

The innovation and inventiveness that produce savings are eliminated by the overweening bloated weight of bureaucracy, once established, is always seeking more power and more control, and attempting to reduce the costs that they themselves created with their processes.



They Told Us, We Just Weren’t Paying Attention! by The Elephant's Child

Liberals have been telling us, for years, that they wanted Single-Payer Government-Controlled Health Care. Why they would think that this is a good thing is completely beyond me. But then Liberals have never been particularly known to pay attention to evidence.

They believe in Big Government, which proves my contention that they don’t pay attention to evidence. So I guess it follows that they would assume that government would do a better job of health care than all those medical people.  I guess when they look at Britain’s National Health Service, they only see people going to the doctor and not having to pay. Is that what they so admire? Or is it just the sheer power that they want so much?

We have government-run, single-payer health care in many countries, and it simply does not work. The systems are all going broke. England has been the longest participant, and bears the closest watching. Unsurprisingly, the bureaucracy of NHS is far larger than the number of people who actually do medicine. Liberals always look at what they hope it will be. Reality, on the other hand, is not so favorable.  There are always unintended consequences, and with liberals, they’re usually pretty major.




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