American Elephants

ObamaCare Raises Costs and Kills Jobs. Here’s Proof. by The Elephant's Child

Powerline offers definitive proof that ObamaCare raises costs and kills jobs. A reader of their blog who heads an investment group came across this disclosure in a prospectus issued in connection with the recapitalization of a family oriented restaurant chain. This is clearly not a political statement, it is a legally mandated disclosure to prospective investors, which renders the issuer liable if the disclosure is not true.

It is worth reading the whole thing. It exposes the false claims of the Obama administration fully and completely. Fewer full-time jobs, rising health care costs, and higher restaurant prices. This is what some of you voted for, though I cannot for the life of me understand why.

Are You Ready for ObamaCare Sticker Shock? by The Elephant's Child


The nice folks who created ObamaCare in some back room in Congress ignored virtually every actuarial principle that governs rational insurance pricing. Consumers will experience another series of price shocks later this year when some see their premiums skyrocket thanks to ObamaCare. Premiums are already reflecting some of their neglect.

One of the central provisions of ObamaCare is the 1). requirement that health insurers accept everyone who applies (guaranteed issue). And 2). cannot charge more based on serious medical conditions and 3). coverage mandates that force insurers to pay for many uncovered medical conditions.

Guaranteed issue gives folks the incentive to forgo buying a policy until they get sick and need coverage, and drop the coverage when they get well. ObamaCare imposes a penalty (a tax?) but it isn’t enough to keep people from gaming the system.

Some actuaries are predicting 50% increases in premiums. Large employer groups will be less affected because the law grandfathers in employers that self-insure.

President Obama repeatedly claimed that health-insurance premiums would be $2,500 lower by the end of his first term, they are actually about $3,000 higher. He also claimed during the fiscal-cliff negotiations, a claim that he kept repeating, that “We don’t have a spending problem.  We have a health-care problem.”

Back in 2009, he was claiming that health-care reform “is no longer just a moral imperative, it’s a fiscal imperative,” and ” one of the best ways—in fact maybe the only way— to reduce those long-term costs.” In March, 2009, in a White House speech kicking off the Affordable Care Act in May of that year, he took notice of “one clear, indisputable fact”, which was that “the explosion in health-care costs has put our federal budget on a disastrous path.” He added that controlling those costs “is essential to reducing budget deficits.

A year later just before the Democrats voted to pass what he called “one of the biggest deficit reduction measures in history.” Obama said “Everybody who’s looked at it says that every single good idea to bend the cost curve and start actually reducing health-care costs are in this bill.” He promised that the conversion to electronic health records would produce $81 billion in savings, and make for greater efficiency. Nope. Didn’t happen. There is increasing concern that the switch has actually added to costs.

One dirty little secret was that the health care industry was already controlling costs before the Democrat push for ObamaCare took off. The new diagnostic machinery was hugely expensive, but improved outcomes. New drugs, made affordable for the elderly, prevented more serious disease. Health savings accounts combined high-deductible insurance policies with a tax-free health spending account that rolls over at the end of the year. Democrats killed the incentives in the drug plan, making it cost more, and  ObamaCare declared war on that cost control effort by capping deductibles at $2,000 and making it harder to offer the savings accounts. ObamaCare’s ever-increasing list of benefit mandates will drive up costs.

Doctors take an oath to “first do no harm.” Obama adviser Ezekiel Emanuel has declared that doctors pay way too much attention to their oath.

ObamaCare Promises What It Cannot Deliver. by The Elephant's Child

The biggest problem with ObamaCare has always been the possibility that it would be implemented. The bill is so poorly conceived, so poorly written, that it is bound to be a disaster. What will happen when it is actually fully implemented remains to be seen, but everything the government itself was supposed to do has failed. Everything. Failed completely.

  • The CLASS Act: A pathetic attempt to create long-term care insurance was dumped by the administration after it became clear that it was impossible to do.
  • The 1099 provision: Was absurd. It required businesses to issue a 1099 form to any vendor from whom they purchased $600 of goods or services in a year. It was repealed after Business owners explained what an impossible burden it was.
  • Federal high risk pools: Created and funded, but nobody enrolled. Cost too much and was too complex.
  • Retiree health Subsidies: Large corporations and unions were happy to accept free money for what they were doing anyway (providing health benefits to retirees) but the money ran out in a third of the time expected.
  • CO-OPs: Congress put so many restrictions on what was supposed to be a non-profit health plan in each state that none have come into being despite billions being spent.
  • Small employer tax credits: The complexity and confusion of these credits meant than only a handful of companies applied.
  • Medical Loss Ratios:The MLR Requirements had the predictable effect of discouraging innovation and higher-deductible or “mini-med” health plans.
  • Medicaid expansions: The Supreme Court made these expansions voluntary for the states and it looks like fewer than half will do it.
  • Health IT: The HITECH bill was enacted separately from ObamaCare, and billion have been spent, but reports from the field indicate that the top-down efforts result in lower quality and less efficiency.
  • Limits on FSA funding: The families most disadvantaged by the new $2,500 limit on FSA funding are those with special needs children.
  • Limits on the Medical Expense Deduction: Beginning in 2013, a taxpayer will be able to deduct only those medical expenses that exceed 10% of income, up from the current 7.5%. Those most hurt will be the most medically needy families.

The screw-ups have been such a mess that Kathleen Sebelius has issued thousands of waivers issued to selected companies and unions. There were no qualifying standards for who got a waiver for what. All up to the kind of day Ms. Sebelius was having, I guess.

ObamaCare promises what it cannot deliver. The theory was that giving people health insurance would mean that they could get medical care that the uninsured are not now getting. There are not enough doctors, nurses and hospital personnel, in thousands.  The medical professions have become less desirable, large numbers of doctors say they will retire early, or just quit.

ObamaCare does not pay for itself. There is a huge increase in the demand for care, but no increase in supply. Since people will not be able to find doctors, emergency room use will skyrocket. Democrats lied about the cost, but it is far worse than the worst predictions.

ObamaCare mandates and subsidies will destabilize large sections of the economy. Already happening, as most major national restaurants are switching their employees to part-time to avoid having to pay for insurance that they cannot afford.

The incentives are all wrong. Insurers must charge the same premium regardless of expected costs. All plans will have the incentive to attract the healthy and avoid the sick. The incentive for providers becomes getting adequately paid. The incentive for insurers or government is cutting costs.

The individual mandate: If weakly enforced, people will have an incentive to stay uninsured when healthy, enroll after they get sick, then drop coverage when well again. If strongly enforced, it will strain every family budget. There is nothing in ObamaCare that will make medicine or insurance cheaper.

These problems are entirely inherent in the legislation itself, as it was devised.

What Do Doctors Think of ObamaCare? by The Elephant's Child
September 30, 2012, 11:16 pm
Filed under: Election 2012, Health Care, Law, Politics, Progressivism, Taxes | Tags: , ,

Dr, Jill Vecchio, speaking to an Americans for Prosperity rally

From a new report by the Physicians Foundation:

— 52% of physicians have already limited the access of Medicare patients to their practices or are planning to do so.

— 26% have already closed their practices to Medicaid patients.

— More than 50% of physicians will cut back on patients seen, will switch to part-time, switch to concierge medicine, or retire within the next four years.

— 62% believe Accountable Care Organizations (ACOs) are either unlikely to increase healthcare quality and decrease costs.

— 59% say PPACA has made them less positive about the future of healthcare in America.

— 57.9% would not recommend medicine as a career to their children or other young people.

— Over one-third of physicians would not choose medicine if they had their careers to do over.

— 77% percent are somewhat pessimistic or very pessimistic about the future of the medical profession.

ADDENDUM: Did anyone think that ObamaCare was going to save us money? Aside from the 158 new departments, bureaus, agencies and offices?  The Tax Foundation has estimated that compliance with ObamaCare is estimated at eight million man-hours.  It will keep 40,000 workers busy doing paperwork and sorting through a confusing pile of government regulations. And Obama claims that regulation is not a problem— just that Republicans are trying to de-regulate Wall Street so they can do it all over again. (No explanation of what he thinks “it” is.)

ObamaCare Is Already A Flop, And It Hasn’t Even Begun. by The Elephant's Child

Hundreds of thousands of American physicians and thousands of hospitals that fail to buy and install costly health-care information technologies by the deadline in just two years, will face penalties through reduced Medicare and Medicaid payments. Prescription records and patient histories will be required to be entered.

This mandate was part of the 2009 Stimulus legislation, and a major goal of health-care IT lobbyists and their allies in Congress and the White House.  Getting it all computerized so anyone could access the records would make medical administration ever so much more efficient, and lower medical costs by up to $100 billion annually.  Doctors have been obediently computerizing, but you will not be surprised that a new study indicates that physician reluctance was justified. The savings are just another myth of ObamaCare.

Since 2009, almost a third of health providers have installed at least some health IT technology. For a major hospital, the full range can cost $150 million to $200 million. But the software is generally not friendly to the user, and inefficient. The claim of savings is mostly hype.

To conduct the study, faculty at McMaster University in Hamilton, Ontario, and its programs for assessment of technology in health—and other research centers, including in the U.S.—sifted through almost 36,000 studies of health IT. The studies included information about highly valued computerized alerts—when drugs are prescribed, for instance—to prevent drug interactions and dosage errors. From among those studies the researchers identified 31 that specifically examined the outcomes in light of the technology’s cost-savings claims.

With a few isolated exceptions, the preponderance of evidence shows that the systems had not improved health or saved money. For instance, various studies found the percentage of alerts overridden by doctors—because they knew that the alerted drug interactions were in fact harmless—ranging from 50% to 97%.

The problem seems to be “true believers” in information technology — certain of their goals and unwilling to hear the concerns of skeptics. It will work— because we believe, a philosophy that has made the design of ObamaCare such a mess. There is even a government agency: the Office of the National Coordinator of Healthcare Information Technology, (an agency of the Department of Health and Human Services). File under the Eternal Life of Government Agencies.

It is already common knowledge in the health-care industry that a central component of the proposed health IT system—the ability to share patients’ health records among doctors, hospitals and labs—has largely failed. The industry could not agree on data standards—for instance on how to record blood pressure or list patients’ problems.

Instead of demanding unified standards, the government has largely left it to the vendors, who declined to cooperate, thereby ensuring years of noncommunication and noncoordination. This likely means billions of dollars for unnecessarily repeated tests and procedures, double-dosing patients and avoidable suffering.

Other news among the true believers: The doctor shortage may swell to 130,000. The U.S. health care law’s process for providing insurance subsidies to middle-income families will produce an IRS quagmire. There is no chance the exchanges will get it right. Compliance with ObamaCare is estimated at 80 million man hours per year. It wasn’t intended to be a jobs program and another huge cost. The true believers who are so sure that they know how to arrange the health care for over 300,000,000 Americans need to face up to the facts. They’re not that smart and their ideas don’t work.

Obamanomics 101: Understanding How the Obama Economy Works by The Elephant's Child

ObamaCare May Not be Unconstitutional, But It Is Very Bad Law. by The Elephant's Child

ObamaCare is much misunderstood. Its advocates talk about the free care they will receive, and fear that they might have a “pre-existing condition.” But ObamaCare is not about medical care or treatment. It is only about insurance.  It is designed to gradually funnel everyone into single-payer, government-run, insurance because that is the earnest intent of the liberals who designed the system. Government will control the entire financial end of the whole system — what you pay and what you get.

What the left is not good at, are the unintended consequences. They’re not good at thinking things through; at least that’s what the evidence seems to show. The costs of insurance will be far higher than estimated. Current estimates expect costs to be much higher than originally set out, and the program hasn’t even been put into effect yet. The only government program in history that has come in under the original estimates, is the Medicare Drug benefit, and Liberals removed the incentives that made thrift possible.

When the government says we’ll just pay for whatever you need, people don’t pay attention to how much something costs, and they go to the doctor for things they might well have treated at home. Result: soaring costs.

Great attention has been paid to rules and regulations, but physicians have been totally ignored, except for plans to hold down payments for their services. There aren’t enough doctors. There is a current shortage of thousands of physicians. Doctors hate ObamaCare and very large numbers plan to find some other occupation, or to retire. Medical schools and teaching hospitals, as they exist today, are incapable of turning out the numbers of doctors needed.

When all those folks who were uninsured are forced to buy insurance or pay a big fine, then the young healthy people won’t use medical care much, and will pay for the older folks who require more care. And you won’t have all those people with no insurance running up the costs for the nation’s emergency rooms. The uninsured are not signing up in droves. But the organization of emergency room physicians has pointed out that the greatest emergency room use is not by the uninsured, but by insured people who cannot find a doctor to care for them.

ObamaCare has taken $716 billion out of Medicare between 2013 and 2022, to pay for ObamaCare. That means a $260 billion payment cut for hospital services.  A $39 billion payment cut for skilled nursing services. A $17 billion payment cut for hospice services. A $66 billion payment cut for home health services. A $33 billion payment cut for all other services. A $156 billion cut in payment rates for Medicare Advantage programs. $56 billion in cuts for DSH Payments for low-income patients, and $114 billion in cuts in other provisions in Medicare,Medicaid and CHIP. What this means is that fewer doctors will be willing to treat Medicare and Medicaid patients. This is already a growing problem, and ObamaCare hasn’t even kicked in yet.

Should ObamaCare not be repealed, these problems will grow and fester. The government will have no option but to federalize the medical profession so doctors work for the government for a fixed salary. Otherwise there will simply be no doctors to serve patients. Where will they get those doctors? Medicine will no longer be an attractive profession, nor a rewarding one. Standards will necessarily decline, and the best students will no longer go into medicine. Where will the doctors come from?


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