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.


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