American Elephants

The Mounting List of Obama Administration Scandals: by The Elephant's Child

— The new head of the Veterans Administration, Robert McDonald, told reporters at a Christian Science Monitor breakfast that “When you go to Disney, do they measure the number of hours you wait in line? Or what’s important?”

“What’s important is what’s your satisfaction with the experience?”

American Legion National Commander Dale Barnett excoriated McDonald: “The American Legion agrees that the VA secretary’s analogy between Disneyland and VA wait times was an unfortunate comparison because people don’t die while waiting to go on Space Mountain.”

“We also disagree with the substance of his comment because wait times are very important to not just the satisfaction quotient, but in some cases the veterans health,” he said in a statement.

Well, clumsy, at best. Then there was the new study that established that between 1012 and 2015, less than 10 percent of new hires were actually physicians. Lots of lawyers and public affairs officials though.

The Wall Street Journal reported that there were 4,201 errors which mistakenly declared living veterans dead — terminating their benefits. A simple paper mistake for the VA, a nightmare for the vet who has to straighten out the mess.

— Congress is currently attempting to impeach IRS Director Koskinen. It seems the IRS is still trying to keep conservative organizations from gaining the tax-free status to which they are entitled. And as well, they were just never able to find the emails and other documentation that was requested under FOIA requests. A lower court had accepted the IRS statement that targeting had stopped, but it seems that no one has been held to account and the targeting continues today.

Kim Strassel notes that the “IRS team claimed that the fault for some of the scandal rests with the conservative groups for not pushing back hard enough.” They smugly claimed the conservative groups had blown their chance for nonprofit approval when they turned down the “fast track” status if they just agreed to give up their political speech rights. (A Treasury Dept idea.)

A new lawsuit asks a federal court to force the IRS to obey the law.

The IRS also improperly paid out $15.6 billion through the Earned Income Tax Credit Program. The OMB notes that this is a “high risk” program for improper payments, but the IRS says they are “taking steps” to reduce error.

— Federal Bureaucrats announced earlier this year they plan to change the way Medicare Part B pays for drugs. The goal is to save money by getting doctors to alter their treatment choices to the cheapest drugs available. More than 300 cancer clinics have closed over the past decade as Medicare has shrunk payments for cancer care. This would seem to be a venture in bad medicine, which is a usual result in socialized medicine. Those who see “single payer” as a desirable outcome should have some real second thoughts.

The Obama administration frames this experiment as a way to stick it to drug companies and save taxpayers money. They believe that doctors are not prescribing the “right” drugs—meaning the least expensive ones, even if they are the least appropriate. They suggest that doctors are motivated by money, and not their patients’ best interests.

Surely you have noticed how often the administration sneers at “Big Pharma.” The object is not to save lives, but to place the blame for getting rid of cancer-ridden patients before they cost too much money.

— Obama is planning to release another 22 or 23 long time Guantanamo detainees to about half a dozen countries. These are the “worst of the worst” and can be expected to return to the battlefield fairly promptly. Obama is motivated by the opinion of the European  Left who always opposed the Iraq War and assume that Gitmo is an American torture chamber, rather than the model prison it actually is. Not all of the foreign destination countries are ready to be identified, Obama wants to empty Guantanamo by this summer.

— Last year, Congress went to considerable trouble in crafting and passing a consensus bull to replace the outdated and unworkable No Child Left Behind. One of the goals was to reduce federal interference in education which remains a state and local issue. Obama is ignoring the law that he signed, and attempting to rewrite the implementation rules that claim powers specifically denied by the statutory language.

The law specifically states that the federal government may not use it to “mandate equalized spending per pupil for a state, local educational educational agency or school.” But that’s what the Education Department is attempting to do. Sen. Lamar Alexander, Chairman, confronted Education Department John King in a hearing telling him”The plain fact of the matter is that the law specifically says you cannot do it.”

This remains a nation of laws, no matter how much Obama tries to arrogate power to himself by simply claiming them. He says his agenda “can’t wait” for Congress to act.

— ICE (Immigration and Customs Enforcement) has spent at least $18.5 million to fly “unaccompanied children” caught crossing the border illegally, to locations inside the U.S. The numbers shed light on the extent of a program that concerns lawmakers and the federal courts that the federal government is effectively aiding smugglers. The administration has gone to great lengths to ensure the safety of minors, and claims their actions are appropriate. They are transporting minors to facilities run by HHS Office of Refugee Resettlement. ICE said about 10,000 children have been transported by charter flights.

— Obama’s Big Transgender Restroom Diversion is pure Saul Alinsky, the communist who has directed the Left in how to manipulate the American people. “Keep trying new things to keep the opposition off balance. As the opposition masters one approach, hit them from the flank with something new.” If there is a problem (no GDP growth) for which you have no answer, change the discussion and hit them with something new.

Members of the transgender population, about 0.3% of this nation, have managed to relieve themselves for generations in existing restrooms. Imagine the cost of revamping millions of public restrooms, and for such a tiny slice of the population. Now this has become a national cause, a provocation drummed up to divert attention from far more pressing issues.

— I posted “President Obama’s Legacy in 9 Simple Charts from the Federal Reserve“at the end of September last year. Not much has changed.

You Can’t Keep Medicare the Way it Is. That’s No Longer One of the Choices. by The Elephant's Child

A week ago the Medicare Trustees issued their annual report. It showed that Medicare is heading for insolvency even earlier than expected.  The Hospital Insurance Trust Fund (which funds Medicare Part A) will be insolvent in 2024, and the promised benefits that are not paid for will amount to $24.6 trillion.

Tacked on page 266 was a note from the Medicare Actuary.  An actuary is someone who is really good with math.  Specifically— a statistician who calculates insurance premiums, risks, dividends, and annuity rates. The Medicare Actuary said that the Trustees’ financial projections “do not represent a reasonable expectation for actual program operations.”

Late Friday, the Office of the Actuary released a separate analysis. He said: “the projections…should not be interpreted as our best expectation of actual Medicare operations in the future but rather as illustrations of the very favorable impact of permanently slower growth in health care costs, if such slower growth can be achieved.” (emphasis mine)

The big differences are rooted in the severe statutory cuts to Medicare provider reimbursement that are already in current law under ObamaCare. The Actuaries believe that ObamaCare’s cuts in payments to providers will harm seniors’ access to care if Congress allows them to go into effect.

The “Sustainable Growth Rate formula calls for scheduled reductions to physician payments, which would next year in 2012 cut the reimbursement to doctors by an astounding 30 percent.  The Trustees assume that the cuts will occur. The Actuaries say that if they did Medicare payment rates would fall to 57 percent of private insurance payment rates.  That’s similar to what is happening with Medicaid, the government’s biggest welfare program, where physicians are fleeing in droves. They just stop seeing Medicaid patients. Medicaid patients who can’t find a doctor go to emergency rooms. Costs skyrocket. Same thing will happen with Medicare.

Democrats, always uninterested in unintended consequences, assume that you can just pay doctors less than they require to cover their costs and they will spend a little less time with patients and all will be well. The real world doesn’t work that way. Doctors will just stop seeing Medicare patients. There is already a shortage of 45,000 primary care doctors nationwide, expected to grow to 150,000. Fewer bright students will go into medicine, Doctors will retire early.  If Congress delays the cuts, Medicare will just go broke faster.

ObamaCare also plans to reduce payment to hospitals and other providers.  This would cause 15 percent of hospitals, skilled nursing facilities and home health agencies to become unprofitable by 2019, and increasing to 40 percent by 2050. That means they go out of business.

Those fees are already well below what the private sector pays, however. For example, Medicare pays doctors almost 20 percent less than what private payers pay. It pays hospitals almost 30 percent less. In the future, that discrepancy will grow wider with each passing year.To achieve the necessary targets, the new law gives an Independent Payment Advisory Board the power to recommend cuts in reimbursement rates for providers of health care. Congress must either accept these cuts or propose its own plan to cut costs as much or more than the panel’s proposal. If Congress fails to substitute its own plan, the board’s cuts will become effective. In this way, the growth rate for Medicare spending is officially capped. Moreover, the advisory board is barred from considering just about any cost control idea other than cutting fees to doctors, hospitals and other suppliers.

Physicians and Hospitals can only do so much cost-shifting. Then there would be no more private rooms, but large wards, there would be reduced access to expensive technology. If some doctors and hospitals began offering concierge services to the more affluent, how long would that be legal? When would they nationalize physicians to force them to serve everyone? When would hospitals be nationalized? How soon will they force all private insurance companies out of business? The attention of doctors and hospitals would turn from patient care to the constant effort to get adequate repayment from government.  These are things that could well become unintended consequences of ObamaCare.

That’s what happens when you devise a bill based on ideas of “managed care.” The Accountable Care Organization rule book is already 200 pages long. They think that they can manage competition. The competition part is belied by words like mandate, control, consolidate, nonnegotiable, rules, regulations. The Obama administration’s deep unfamiliarity with the free market, and their contempt for the free market is notable.

Meanwhile, Democrats are in full-throated attack mode on Paul Ryan’s “Path to Prosperity.” Democrats have been claiming that Republicans are trying to starve Granny ever since Medicare was created as part of Lyndon Johnson’s failed Great Society.  They’re just taking the same old false accusations to new and disgusting lengths.

Pathetic. Really pathetic.

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