American Elephants


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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