American Elephants

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.

War Stories by American Elephant
July 1, 2012, 8:06 pm
Filed under: Humor, Pop Culture | Tags:

Excuse Me, It’s a Tax—Not a Mandate—It’s a Tax. by The Elephant's Child

Here is Obama’s Chief of Staff Jack Lew, asserting the denial in the administration of the Supreme Court verdict. If the law forces those who are unwilling to buy government health insurance to pay a tax as a penalty — taxes are more easily disposed of.

Obama doesn’t want to be seen as a baldfaced liar; yet we have extensive evidence of his claim that he will not raise taxes on the middle class, that you can keep your health insurance if you like what you have, and that you can keep your doctor. All hooey. Seventy-five percent of the cost of ObamaCare will fall on those making less than $120,000 a year.   And that’s on top of the Tax Armageddon that arrive on January 1, 2013.

Cato says that taxes are of three types — income, excise, or direct.  Each type must meet specified constitutional constraints. Because the mandate penalty tax under PPACA does not satisfy any of the constraints, it is not a valid tax.So the law could be challenged on that basis. Or it becomes much easier for Congress to repeal. It’s going to be interesting.

Don’t miss the Solicitor General’s testimony before the Supreme Court. It’s a tax, a tax, a tax.

The Arrogance of the President of the United States. by The Elephant's Child

Well, while the rest of us are trying to understand just what Chief Justice John Roberts has done with his ruling, it doesn’t make any difference, you see. Obama has said firmly that the Supreme Court is wrong, it is not a tax, it is a mandate. He doesn’t care what the Supreme Court says. He is the President of the United States, the most important man in the world, and he says it is not a tax.

Funny, that’s what he did with the Arizona decision. The Supreme Court said that Arizona had a right to ask those stopped for possible violations for their papers. In other words, to prove their citizenship. Obama has essentially said that he doesn’t care for that decision, and the federal government will not respond to questions about immigration status from Arizona, unless it concerns a major crime.

And then there is the Department of Justice which has announced that they don’t care if Congress has found Attorney General Eric Holder in Contempt of Congress — they will not prosecute him.

These are not the only examples. There are many, many more where the Obama administration has just chosen to ignore or to refrain from prosecuting laws passed by Congress, or take Congress’ laws as a starting point for going far beyond Congressional intent.

For example, Congress has given the EPA authority to regulate under the Clean Water Act the “navigable waters” of the United States. The EPA is taking this as authority to control any trickle that eventually flows into the waters that are actually navigable. Refusing to open Yucca Mountain Nuclear Repository, after Congress found it the most satisfactory site in the country, with transparent claims of wanting to find a better place. If you start looking for laws that the administration just refuses to enforce — they are all over the place. This is an administration that does not recognize the separation of powers, but only the exercise of its own power.

Constitutional Law professor Randy Barnett at Georgetown Law was one of the architects of the legal case against ObamaCare. In this piece, he explains the origins of the unprecedented exercises of federal power as arising in the Great Depression when political progressives managed to be allowed to regulate any intrastate activity that substantially “affected”interstate commerce.

From then until today, most law professors have taught that the power of Congress to regulate the “national economy” is limited only by congressional restraint, which means that the power is unlimited. When, in 1995, the Rehnquist Court held that Congress could only regulate intrastate activity that was “economic” in nature, the legal intelligentsia threw a fit about “conservative judicial activism.” Until today, these same experts have maintained that this was the only limitation on congressional power, which is why they and the administration were so confident of victory. Since the Affordable Care Act “regulates” economic activity, it must be constitutional.

Today, the Supreme Court definitively rejected this position by holding that mandating economic activity is not the same as regulating it, and that some means Congress chooses to regulate commerce can be improper. Today the court reaffirmed the traditional view that there must be a judicially enforceable limit on the powers of Congress. From now on, Congress will need to take the limits of its own power seriously, because it can be assured that the court will be looking over its shoulder. …

Whatever happens at the polls, however, by affirming that the Commerce Clause and the Necessary and Proper Clause of the Constitution have judicially enforceable limits, today’s decision will be a landmark of constitutional law.

Read the whole thing. Over at Powerline, Attorney John Hinderaker offers a dissent, partly joined by Attorney Paul Mirengoff while examining the same complex problem — the continual expanding of government power beyond those enumerated in the Constitution by using the Commerce Clause as justification. He sees this ruling as very narrow, limited to those in which Congress wants to regulate inaction because it affects interstate commerce. John says “I see no reason to assume that Justice Roberts voted and wrote as he did for any reason other than that he thought he was correctly applying the relevant legal principles to the case before him.”

Scott Johnson, the third attorney at Powerline, pointed out that contrary to popular belief and its own self-image, the Court has rarely been much of a bulwark on behalf of individual liberty. Certainly it has acquiesced, not just today but for many decades, in a steady expansion of federal power beyond what is contemplated by the Constitution. Again, read the whole thing, it’s not long.

Those who seek power have little concern for individual liberty, but we have never before had a president who has so little concern. He is a far-left radical, and wants “radically transforming America” to be his legacy. Unfortunately, he doesn’t understand how old and tired his arguments are, and the extent to which they have always failed wherever they are enacted.

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