American Elephants

Repealing ObamaCare, and The Problems Involved. by The Elephant's Child

medical_doctorsRepublicans are planning to repeal ObamaCare immediately.
They have a lot of good ideas about how to make a health care program more effective and less costly, like allowing health insurance to be sold across state borders. As it stands, each state has an insurance commissioner who approves or disapproves insurance policies for their particular state, so you get 50 different kinds of regulations.

An increase in competition always makes things cheaper and more efficient, because bad ideas get weeded out because they cannot compete. Freedom to solve problems and the promise of reward for solving them has resulted an an astonishing rise in the standard of living in the whole world.

All sorts of scholars have been working for 8 years to come up with better ideas for doing health insurance. The best idea, however, came from Thomas Sowell, and he stated it very simply:

If we cannot afford to pay for doctors, hospitals and pharmaceutical drugs now, how can we afford to pay for doctors, hospitals and pharmaceutical drugs. in addition to a new federal bureaucracy to administer a government run medical system?

The federal government has no business putting a bunch of bureaucrats in charge of American’s healthcare. The federal government has demonstrated over and over that they do not know how to do healthcare, with the VA, with Medicare, with Medicaid, and with the Indian Health Service.We don’t need top-down central planning.

ObamaCare wanted national records of healthcare practices so at  they would have more knowledge about how to make healthcare more efficient.They ordered hospitals to computerize, get rid of the handwritten notes of patient encounters. Medical centers spent enormous sums of money buying computer systems for each office and examining room. The basic idea was totally wasted because the computer systems can’t talk to each other. They were all different setups.

Patients weren’t all that happy about their private health records being available to anybody who could log onto the system. It also meant that doctors were spending their time interacting with computers instead of patients. Doctors hired scribes to take notes on the computer while the doctor actually interacted with the patient. Think about how much all that added to the cost of doing healthcare.

I think it was Medicare that ordered their physicians to limit patient encounters to 7½ minutes. Great way to cut costs, except the encounters are with real human beings with very different reasons for going to the doctor. Stupid.

Bureaucrats decided that the place to cut costs was in what medical professionals were charging for their services. You’ve seen your insurance records, the medical establishment charged $150 for the encounter, the insurance company allowed $47, and you paid half that in your co-pay. So, quite naturally, a good many physicians will not see people on Medicaid, Medicare, or the Indian Health Service, and so far veterans are stuck with the VA. You’re left hunting for someone who will see you, and are they the less accomplished doctors?

Bureaucrats think all doctors are rich, and some of them are. However, they spent a long time studying to be able to get into medical school, after that studying for their specialty, and interning. Most have huge school loans to pay off, and their offices have medical assistants, lab technicians, receptionists, nurses, a respectable office with all sorts of equipment and several examining rooms with all sorts of equipment. Doctors have years and years of training compared to ordinary bureaucrats, and at some point they expect to reach a point where they can live fairly well. Bureaucrats see them as the part of medical care that can be slashed to save money.

It’s not the doctors that cannot be afforded, it’s the bureaucrats. The federal government needs to get out of the business of running health care. They don’t know how to do it, they are no good at it. Turn it over to private enterprise, to find ways to provide care that the country can afford. The Left does not believe in private enterprise, they think competition is a bad thing, they believe that they are the smartest and most able people around, and they cannot understand why a heart surgeon should make more money than they do.

Consider the outcry against Trump’s nomination of Dr. Ben Carson to HUD because he had no experience in government. That’s a revealing, and typical, Leftist response.

Here’s a post from 2012 about the Oklahoma Surgical Center which would seem to suggest that there are real possibilities out there. I have not followed up to see if it is still as successful.

I am afraid that Republicans in Congress will just devise another government-run program that will have some better ideas, will not solve the problem of escalating costs, and when the Democrats return to power, as they will at some point in the distant future, we’ll do it all over.

Republicans believe in private enterprise, and freedom. When people are free and encouraged to find better ways and rewarded for so doing, miracles happen every day. How did you think Dr, Leonard McCoy got those amazing instruments that he used on the Enterprise?

Promises, Promises. Disturbing Facts About ObamaCare. by The Elephant's Child

Late on Friday, 34 Democrats, almost two-thirds of the caucus, joined Senate Republicans in approving an amendment to repeal a medical-device excise tax, a key funding apparatus for ObamaCare. As an amendment to the budget, it is non-binding, but it clearly indicates that some Democrats are open to repealing the more unpopular parts of ObamaCare. Obama’s policy priorities are no longer the most important factor in Democrats’ political calculus.

It’s pretty clear to those who face election next year the ObamaCare is not exactly popular.  Americans hate it. And as they slowly become aware of what it does and how it plays out, they hate it even more. There have been many different studies done over the past few years to model what premium increases are likely to be under ObamaCare’s new rules. Here’s where it is necessary to remember that the Medicare Drug Bill under George W. Bush, is the only known government program that came in costing less than projected.

Source: “The Price of Obamacare’s Broken Promises,” report by the House Committee on Energy and Commerce Majority Staff, Senate Committee on Finance Minority Staff, and Senate Committee on Health, Education, Labor & Pensions Minority Staff, March 2013.

United Health Care, the nation’s largest insurer projects that rates could increase for individuals and small businesses could more than double.

Another new study suggests that over one-third of the 9.1 million full-time jobs among America’s franchises could be cut back or eliminated by ObamaCare as small businesses struggle to maintain profitability while coming up with the money to pay for Washington-mandated health care coverage, according to the International Franchise Association.

A study by the Association of American Medical Colleges found that the country will have 62,900 fewer doctors than its needs by 2015, thanks in large part to ObamaCare. At the same time a survey by the Physicians Foundation found that almost 50% of doctors say ObamaCare has made them less optimistic about the future of health care and they would retire today if they could.

What does it mean when there aren’t enough doctors? In Canada, the wait for a colonoscopy is reportedly three years. In some places they are already talking group appointments.

After ten years, ObamaCare will still leave 30 million without coverage, according to the Congressional Budget Office. That number could be much higher if the law causes premiums to spike and encourages people to drop coverage in spite of the law’s mandate.

Politicians aren’t any good at business decisions, they are only so-so at political decisions. When they start developing a business to take care of the health of the whole country, we’re in for trouble.

Who Says Republicans Don’t Have Anything To Replace ObamaCare? by The Elephant's Child

The House of Representatives voted today 244-185 to repeal the Affordable Care Act, with five Democrats crossing the aisle to vote with Republicans. Widely reported on the news today, accompanied by the statement that repeal stood no chance in the Senate — also true — Harry Reid wouldn’t let it come to a vote, and enforces tough party discipline.

When Liberals speak about this, it is always accompanied by the statement that , well, they want to repeal it, but they don’t have anything to replace it . Why don’t they tell us what they want to replace it with?

We have to move back in time a bit, to the early Bush administration. Liberals, furious over losing the election, were whining that ‘we don’t have any ideas, why don’t we have any ideas? We need think-tanks like the Republicans have. Why don’t we have any think-tanks?’ So George Soros coughed up some money and they established The Center for American Progress, a progressive think-tank. Which has been involved ever since with issuing talking points and strategies for defeating Republicans.

Republicans do have think-tanks. lots of them.  But they are not interested just in talking points. Scholars do the studies that establish what works and what doesn’t. They dig into the numbers and determine costs, they consult industry experts, work with economists. Anyone interested in Republican ideas for reforming health care has only to consult the experts at Heritage, AEI, Cato, NCPA, Pacific Research Institute, or any one of dozens of other think-tanks, that have been studying the problem extensively.

Here’s Paul Ryan, with “the Optimist’s Guide to Repeal and Replace,”from the House Budget Committee. Here’s “Saving the American Dream: A Blueprint for Putting Patients First” from Heritage. The National Center for Policy Analysis: “Contract With America,” and “Universal Coverage Without Mandates” and most of these think tanks have health care newsletters that you can sign up for. From AEI, here is an article from their magazine The American: “How to Repeal and Replace; From a Tax to Tax Credits.” The Cato Institute has several books and a raft of studies on parts of the law and its consequences, and a newsletter as well. Denis Prager just had a post at Ricochet: “Do Republicans Really Have No Plan?”

There are many commonalities. Republicans believe in the free market, and that health care should  be determined by the patient and his doctor — not by some faceless bureaucrat in a Washington D.C. office. There is no “one size fits all” in health. People are different.

Kathleen Sebelius just wrote a piece for Investors Business Daily, under the remarkable headline “ObamaCare will Control Costs, Improve Care.” Uh huh. You take American Health Care, which everyone claims costs too much, add over 180 new agencies that will be in charge of regulating the massive government program. Then you add the 13,000 pages of regulations — and they’re not even done yet. Add something like 15,000 new IRS workers delegated to cope with all the new taxes involved.  Those 180 new agencies manned with unnumbered bureaucrats will tell your doctor, if you are lucky enough to have one, how to practice medicine, and which medicines they may prescribe, and which operations they may perform. Then you add the fact that we are already short by about 47,000 doctors, and medical schools are not equipped to educate many more.

To that you add the fact that, recently surveyed by the Doctor Patient Medical Association poll:

  • 90% of doctors say the medical system is on the wrong track.
  • 83% say they are thinking about quitting.
  • 61% say the system challenges their ethics.
  • 65% say government involvement is most  to blame for current problems.
  • 49% say they will stop accepting Medicaid patients.
  • 70% say reducing government would be best single fix.

Don’t let anyone tell you that Republicans have no ideas for reform. Their ideas are centered in what is good for doctors and patients and individual freedom. There are lots of links here— arm yourselves with the facts.

The most important fact you need to know is that the liberals who cooked up ObamaCare have carefully excepted themselves and their friends and co-workers from the program. They really do get to keep their insurance, which they do like, and their doctors. The rest of us can go hang.

The Final Verdict by The Elephant's Child

The House Voted to Repeal. What Does It Mean? by The Elephant's Child

The United States House of Representatives has voted 245–189 to repeal The Patient Protection and Affordable Care Act — ObamaCare — with every Republican and three Democrats.  This draws a bright shining line in the sand, and clearly states the difference between the two parties and their objectives.

Democrats want to create the perception that ObamaCare is inevitable and that the American people want it.  It is not inevitable and the American people, by large margins, do not want any part of it.  Democrats plan a vigorous campaign to try to regain the public trust; but fall short in everything from their methods of passing the bill with backroom deals and exclusion of Republicans, to the gimmicks in the bill to hide how much it will cost, and the suborning of insurance companies and pharmaceuticals to side with ObamaCare until they found out what was in it. It has been a remarkably sleazy effort, and simply a grab for power.

The latest in embarrassing efforts to sway opinion is HHS’s report yesterday entitled: “At Risk: Pre-Existing Conditions could Affect 1 in 2 Americans; 129 Million People Could be Denied Affordable Coverage Without Health Reform.” Sheila Jackson Lee famously announced that Repeal  would kill Americans.

If the report’s assertion that over 100 million Americans with pre-existing conditions risk being denied coverage if ObamaCare is repealed, then why weren’t 100 million Americans being denied insurance because of pre-existing conditions?  Very few individuals face such a risk today.  The principal reason for spending nearly a trillion dollars on ObamaCare was supposed to be the huge problem of uninsured people with pre-existing conditions.  So they eliminated the problem. Anybody with a pre-existing condition could get coverage, and only 8,000 people signed up.

It was only a case where a small problem which could have been fixed with a sensible solution was ginned up to be justification for an ideologically motivated, sweeping and disruptive policy change that creates huge problems ahead.

The damage has already begun, in little ways and big ones: people can no longer use their tax-free Health Savings Accounts for basic over-the-counter drugs.  Instead they must pay for a doctor’s apointment–and then get a prescription for a pharmacist-dispensed drug.  There is a new $2.5 billion excise tax on pharmaceutical companies. That cost will be passed on to consumers in higher prices.

Forty percent of doctors have said they will drop out of patient care in the next one to three years.  Sixty percent said ObamaCare will compel them to close or significantly restrict their practices to certain categories of patients— those on Medicare or Medicaid. And in all the 2000+ pages of the PPACA. there is not one dollar for the increased numbers of doctors that we will need.

In Massachusetts, health insurance premiums , prior to reform, were increasing at a rate 3.7% slower than the national average.  Since reform, premiums are increasing 5.8% faster than the average nationally. Emergency room use has gone up, not down, and private employer insurance costs have continued to increase.

People are beginning to find out what is in it.  Premiums $2,000 higher, a vast shortage of doctors, long waits, higher taxes, less innovation, fewer new drugs and so on and so on. The British warned us.  The Canadians warned us.  But those were only “scare stories” — weren’t they?

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