American Elephants

Myths and Fables of Emergency Room Treatment. by The Elephant's Child

One of the prevalent myths out there is that the uninsured use emergency rooms for primary health care.  Once they have their own health insurance, they will have regular doctors.  Better care, costs will decline.  Unfortunately, it simply is not true.

Robert Samuelson writes in The Washington Post about “Obama’s illusions of cost control.”

One job of presidents is to educate Americans about crucial national problems. On health care, Barack Obama has failed. Almost everything you think you know about health care is probably wrong or, at least, half wrong. Great simplicities and distortions have been peddled in the name of achieving “universal health coverage.” The miseducation has worsened as the debate approaches its climax.

A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency-room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency-room use remained higher than the national average, an Urban Institute study found. More than two-fifths of visits represented non-emergencies. Of those, a majority of adult respondents to a survey said it was “more convenient” to go to the emergency room or they couldn’t “get [a doctor’s] appointment as soon as needed.” If universal coverage makes appointments harder to get, emergency-room use may increase.

Insuring the uninsured does not dramatically improve the nation’s health.  It results, according to the literature in modest health gains.  Claims that the uninsured suffer tens of thousands of premature deaths are open to question.

Obama based much of his Ohio health care speech on a woman who dropped her health insurance because of the cost.  She was then diagnosed with leukemia. Obama made much of her fear of an inability to find treatment and her fear that she would lose her home.  Yet she had already been accepted as a patient at the Cleveland Clinic, one of the great Medical Centers, and she was in no danger of losing her home and would get some of the finest care available.

Mr. Samuelson includes the following quotation:

“What we need from the next president is somebody who will not just tell you what they think you want to hear but will tell you what you need to hear.”

— Barack Obama, Feb. 27, 2008

What is So Wrong With Our Health Care System That it Requires 1,990 Pages of Mandates? by The Elephant's Child

Polls tell us that most Americans who have health insurance are quite satisfied with it.  Most Americans are well satisfied with the health care that they receive, including a lot of people who are uninsured.  So what is so wrong with our health care system that requires reorganizing one sixth of our economy?

  • Some Americans are uninsured and cannot afford health insurance.
    The first number was 46 million uninsured. Then it went down to 30 million when illegal immigrants were excluded from the list.  When you remove those who are already entitled to insurance from an existing program, and remove those who can afford health insurance but choose not to purchase it, you are left with somewhere around 9 to 12 million who need help. The current House bill  still leaves something over 20 million people still uninsured.
  • Some people are uninsured for only fairly short periods between jobs.
    Many of these folks find Cobra Coverage too expensive. Nothing in the bills addresses this problem.
  • There are huge amounts of fraud and waste in Medicare — estimated at $60 billion Completely  unaddressed.  Medicare funding is being sharply cut ($150 billion) to reduce the cost of the legislation.  Medicare is going broke.  That is also unaddressed.
  • Health insurance just costs too much.
    Private insurance premiums could triple under ObamaCare.  Government health insurance premiums could increase by $4,000 per family by 2020. Unaddressed.
  • Health care just costs too much.
    It will cost far more under ObamaCare. Things that are proven to reduce costs like medical liability (defensive medicine) are not only not included in the bills, they are specifically excluded.  Trial lawyers are second only to labor unions in their financial support for Democrats.  Some of the increased costs will come in the form of taxes.  The Senate bill proposes a brand new tax on medical devices like heart valves, pacemakers, stents, artificial hips, insulin pumps; a ten-year $400 billion tax on all implements that retail for $100 or more. It works out to an $11,000 surcharge on every worker employed in that industry. Consequences —massive job losses, squashed innovation.
  • Health insurance can’t follow a person to a new job, it’s not portable.
    This is completely unaddressed.
  • Health insurance cannot be purchased across state lines, and in some states there is little choice among insurers.
    Unaddressed, since the object of ObamaCare is to funnel everyone into single-payer government-run health care.
  • States must bear much of the cost of Medicaid, and they are going broke. ObamaCare funnels many more people into Medicaid, increasing costs to the states without reimbursing the states.  Unaddressed.

What is it that is known to cut costs, improve ways of doing things, increase innovation and preserve and prolong life?  In the vast history of the world, it has always been freedom and the free market. People create when there are potential rewards for their innovations.  Doctors devise new treatments when they are not restricted by 1,990 pages of rules and mandates that punishes them for not following the rules, but interacting with patients.  The word “shall” appears in the House bill 3,425 times — each time a mandate about what one must do.

Democrats believe that 111 new agencies, programs and bureaucracies filled with smart people (like their supporters and friends) can fix all the things that are wrong with health care.

Health care takes place only between doctor and patient — those bureaucrats wandering around the halls of Congress can’t fix your hurts, no matter how much they tinker with legislation.

It took years of study, learning and practice to produce the physicians who can fix our hurts and do their damnedest to cure our diseases and prolong our lives. Each of us is different.  We are not the same — but products of our genetics and our environment and our habits, and we cannot be healed by either Nancy Pelosi’s or Harry Reid’s efforts to control our lives.

Democrats have not learned from evidence.  People who have experienced government health care in countries around the world have urged us: “Don’t do what we did.” Democrats ignore countries who are going broke from their efforts to control health care.  They do not learn from countries that are unnecessarily killing their citizens by rationing care.  And so they are repeating those errors.  The Democrats will ration.  It is inevitable.  It is the only way they have left, because they will not do any of the things that would cut costs.

It was never about health anyway.  It is only about control.

So You Think You’ll Get Free Health Insurance? by The Elephant's Child
September 27, 2009, 2:32 am
Filed under: Economy, Health Care, Law | Tags: , ,

Are you one of those healthy young adults who has chosen to go without health insurance? Not for long. The Baucus bill will charge you a $1800 “fee” for not buying health insurance. Violators of this requirement could be charged with a misdemeanor and face up to a year in jail or a $25,000 penalty, according to a handwritten note sent by the Chief of Staff Tom Barthold of the Joint Committee on Taxation to Senator John Ensign (R-Nev.).

Democrats are uninterested in any free market solutions to holding down the costs of healthcare, so it is imperative that they have all healthy young adults buying insurance. Lots of people paying who make no real demands on medical care.

The theory is that and cutting Medicare will help to pay for all the added costs.The Medicare cuts — cutting reimbursement to doctors and hospitals and other service providers — will simply raise the cost of everyone else’s health care through cost shifting. And rationing, of course.  People like to claim that there is rationing now, and it is true that there are some drugs deemed to expensive if there is an alternate, and treatments deemed too new and untested. But that is not the kind of rationing that will be coming in a government run program.

The theory isn’t going to work anyway.

It’s Not Just About Our Health Care, It’s About Our Freedom. by The Elephant's Child

Progressives never anticipated the intensity of protests at town-hall meetings. They never anticipated the rapid drop in President Obama’s approval rates — now at only 27 percent.  The forces backing President Barack Obama’s health care overhaul have spent years polling and using focus groups to find the exact language that would win over  voters.

The effort began four years ago, when a center-left coalition of advocacy groups, union leaders and health-care experts teamed up to try to change the language of the health-care debate.  The Herndon Alliance, named after the northern Virginia suburb where proponents first met, included the AARP, Service Employees International Union (SEIU), the American Cancer Society and the liberal health-policy group Families USA, among others.

The alliance, now based in Seattle, hired the Democratic polling outfit Lake Research and California market-research firm American Environics.

The idea was to take a page from the Republican playbook, said Robert Crittenden, a physician and founder of the Herndon Alliance.  Republicans had become adept at using words to seize issues, turning the estate tax into the “death tax.” for instance.

If it took a PR firm and polling to turn the estate tax into the “death tax,” somebody really got cheated.  A tax on the savings one has struggled to put away all their lives that is taxed when they die, on savings that were already taxed when they were saved, is not long going to get away with the euphemism “estate tax.”  This is not rocket science.

I’m not sure just who the health care “experts” are supposed to be in this bunch.  If their proposals for remedying  the problems in American health care made sense — which they don’t — they wouldn’t need to find  poll-tested words to fool the public.

Words to use are: ‘public’ as opposed to ‘government‘; ‘choice and control’ instead of ‘competition‘; ‘quality, affordable health care‘ instead of ‘Universal coverage‘; ‘rules‘ instead of ‘regulations‘ and ‘a choice of private and public plans‘ instead of  ‘Medicare for all.’  Does this all begin to sound familiar?

Obama has been careful to use these tested words.  He is a young  president in a hurry,  as Peter Wehner says, “a man of preternatural self-confidence and soaring ambitions.  That combination, tethered to a liberal worldview, is inflicting considerable damage on his presidency.”

Obama’s chief of staff, Rahm Emanuel, famously advised,”You never want a serious crisis to go to waste.” This assumed that in the throes of a recession, with jobs evaporating, Americans would be so panicked that they would look to the wise government in Washington to rescue them quickly from the downturn.  That the public would yearn for prompt government action.  But most Americans are not so confident in government action, especially hasty action to irrevocably alter one seventh of the economy.

And voters are far, far, too familiar with government’s tendency to overspend in ways that severely damage their pocketbooks. Americans are basically fairly conservative.  They believe deeply in our Constitution, in the freedoms it ensures, in the separation of powers, and in the enumerated powers that we the people grant to the government.  And Americans are very aware that our representatives in the Nation’s capitol are inclined to forget the limitations on what they are allowed to do.  If you can find the passage in the Constitution that allows the federal government to take over our health care system, please point it out.

Obama wanted to pass his health care bill quickly. He did not want prolonged debate, or even discussion, yet that is what he is getting.  His arguments for ObamaCare are specious. He has argued that a new healthcare system is necessary to spur an economic recovery.  He has offered health care as an antidote to rising deficits.  Earlier this week, in a conference call with Jewish rabbis he claimed a moral imperative for revamping the nation’s healthcare system.

This is nonsense.  The bill before the House has been estimated by the CBO to cost over $1 trillion in the next ten years, and another trillion in the following ten.  Private, nonpartisan analysis has doubled that figure.  We have the best healthcare system in the world.  It is not in crisis.

We have problems with health insurance which are quite open to solutions far short of a government takeover.  ObamaCare is hardly an antidote to rising deficits. The budget deficit is already estimated at $9 trillion.  There is nothing in the house bill or in the several bills in the Senate that would not add to the deficit.  There is no one who is going without health care in the United States.  And contrary to what folks in Europe seem to think, we don’t have dead bodies lying around in the streets.

Democrats have attempted to demonize insurance companies, suggesting “profits” although the insurance companies have a lower profit margin (under 3 percent) than most American corporations. Obama suggested that Doctors take out tonsils just to make money, and secured a backroom deal with pharmaceutical lobbyists to cut some costs in return for a promise to leave them alone.  He has sent out his SEIU Union thugs to disrupt town halls, and sent Acorn members out to convince citizens to support his plan.

Perhaps his biggest mistake has been to attempt to demonize angry citizens who have turned out to protest at their representatives’ town-halls.  They have been called “brownshirts,” and “kooks,” and “flunkies of the RNC.” In his arrogance, Obama has chosen not to recognize the genuine anger being expressed by the public.  He forgets that it is the voters on whom he is declaring war.

Everything You Ever Wanted to Know About Pre-Existing Conditions. by The Elephant's Child

The problem of “pre-existing conditions” is one that is vastly misunderstood.  The house health care plan admits all, including those with pre-existing conditions.  Essentially, that means that someone can sign up for insurance right after they are diagnosed with severe heart problems and expect the insurance to pay for their heart bypass.  Or a young couple can decline insurance until they get pregnant and then expect insurance to pay for the obstetrician and the hospital delivery.  This after-the-fact freeloading is an expensive problem.

I am not a lawyer, but John Hinderaker at the Power Line Blog is, and he explains the problems and definitions very clearly.   Mr Hinderaker is commenting on an article in the Wall Street Journal in which John H. Cochrane of the University of Chicago offers a free market solution instead of the budget-busting proposal before Congress.  The same article is linked in the Power Line post.  I would urge you to read both pieces, for the more you understand, the more you can protect yourself.

There are free market solutions to almost every problem that the Democrat Congress sees as a problem that demands government control of our lives and our privacy by the wise minds in Washington D.C.

Scare Tactics? No, Real Life Evidence, Scary As It Is. by The Elephant's Child
August 6, 2009, 8:44 pm
Filed under: Capitalism, Freedom, Health Care | Tags: , , ,

In 2006, the State of Massachusetts adopted a health care plan that required every resident to get health insurance and required every business to provide it.  Otherwise, residents and employers would be fined.  This was the nation’s first state universal health insurance program.  It was to be the test ground to see how universal health coverage by the government would work here in the United States.  It was to be the model that could be replicated around the country.

Within weeks of the deadline to have everyone signed up, the state hadn’t accurately budgeted for the program. 95 percent of doctors weren’t accepting new patients.  Many doctors were leaving the state.  Rationing of services, reductions in benefits and growing waits for care began.  To keep the program solvent, Massachusetts cut payments to doctors and hospitals, reduced choices for patients, and was looking at increasing out-of-pocket expenses for patients.

By February of 2008, the state was asking the Federal government for help.  Only two years old, and already in trouble.

With the national health care debate now heating up, the obvious question is ‘what can we learn from the Massachusetts experiment?  The state treasurer says “Whatever you do, don’t do what we did.”

State treasurer Tim Cahill offered some startling statistics:

  • The program has so far cost 30 percent more than anticipated.  It already has a $9 billion shortfall projected over the nest two years.
  • Costs have risen 41 percent since the program’s inception, well outpacing the rise in healthcare costs nationwide, which stands at 18 percent.
  • We thought the program would mean that fewer people would go to hospitals, the highest costs that insurance plans have to pay.  That wasn’t true.
  • A Harvard study shows that 60 percent of residents are unhappy with the plan.  The unhappiest are those making $25,000 to $50,000 –those whom it should be helping the most.
  • To cut costs, the program has kicked out 30,000 legal immigrants.

Costs for Commonwealth Care (the subsidized program) soared from $158 million in the first year to $630 million in 2007, then doubled in 2009 to $1.3 billion.  Enrollment is now at 181,000 up from 165,000 in the early spring, and is expected to reach 212,000 next year.

Government managed health care has consistently failed.  The Indian Health Service — jokes say that if you get sick, do it before June, for that’s when they run out of money.  The VA has improved some, but much care is still substandard according to those who rely on it.  Hawaii flirted briefly with universal children’s insurance, and quickly dropped it as it was proving far too expensive. In 1994 Tennessee implemented managed care in its Medicaid program, with a system called TennCare.  They thought they would use the anticipated savings from Medicaid to fund and expand coverage for children and the uninsured.  It nearly bankrupted the state, reduced the quality of care and collapsed from it own deficiencies.

A government cannot promise to insure everyone, offer free care,  increase the quality of care and reduce costs.  It cannot happen.  It is a fantasy.

Fantasies work fine in the movies and in novels, but indulging in fantasy in real life can have real-life consequences.

%d bloggers like this: