Free Markets, Free People

HHS


ObamaCare: It just gets better and better

And, of course, I say that facetiously.   As it stands now, it has fostered more government regulation, more bureaucrats and more intrusion in epic proportion:

"There’s already 13,000 pages of regulations, and they’re not even done yet," Rehberg said.

"It’s a delegation of extensive authority from Congress to the Department of Health and Human Services and a lot of boards and commissions and bureaus throughout the bureaucracy," Matt Spalding of the Heritage Foundation said. "We counted about 180 or so."

So, minimally (we all know they’re not nearly done) 13,000 new pages of regulation, 180+ boards, commissions and bureaus and, of course, scads of bureaucrats to fill them.

Then there are the new broad powers granted HHS and the IRS.

Yes, friends, that’s right, this is how you make health care less expensive and better, not to mention making government less intrusive.

Probably the funniest thing, in a sad and ironic way, is the fact that there are still millions of people out there who believe the propaganda that sold this crap sandwich to the public.    Someone among them I’m sure will someday be able to explain how adding costly regulations and layers upon layers of bureaucracy somehow helps reduce the cost of health care delivery.  

According to James Capretta of the Ethics and Public Policy Center, federal powers will include designing insurance plans, telling people where they can go for coverage and how much insurers are allowed to charge.

"Really, how doctors and hospitals are supposed to practice medicine," he said.

Wait, wasn’t one of the primary problems with the old system, per the Democrats, a problem of insurance companies telling doctors how to practice medicine?

See, solved by government, right?

In fact, one master has been replaced by another one, the newest master being the most inept, inefficient and corrupt of the two.  And, of course, no one has yet explained how all of this is going to ensure people have better access to a doctor.  Why?  Because, quite simply, having insurance doesn’t guarantee care.  And with the disincentives provided by massive increases in regulation (and the increase that will cost for compliance) and oversight via these board, commissions and bureaus, my guess is there will be fewer doctors in the future.

So prepare to enjoy the dawning of the age of ObamaCare and the attendant disappointment, shock and anger it will eventually engender among the public.  There are some things that one shouldn’t mess with, and people’s health care is one of them.

Forward.

~McQ

Twitter: @McQandO


Medicare Advantage: October surprise?

You remember the $500 billion Obama claimed would be “saved” from Medicare to help “pay for” the ObamaCare law?

Well, what that amounted to was slashing subsidies (i.e. reimbursement rates) for a popular supplementary program known as Medicare Advantage.

Problem: doing so will effect 12 million seniors.  Problem exacerbated: Seniors, who resist change especially to their health care coverage, are not likely to be happy.  Problem squared: Seniors will have to select a new program beginning October 15th, a few weeks before the election.

And both political parties know that seniors vote.  You can imagine the negativity of these cuts spreading like wildfire among senior communities in key states.

But, not to worry, our current most ethical and transparent administration in history has a solution:

Call it President Obama’s Committee for the Re-Election of the President — a political slush fund at the Health and Human Services Department.

Only this isn’t some little fund from shadowy private sources; this is taxpayer money, redirected to help Obama win another term. A massive amount of it, too — $8.3 billion. Yes, that’s billion, with a B.

And how will they deploy this money?

Benjamin Sasse and Charles Hurt explain:

But the administration’s devised a way to postpone the pain one more year, getting Obama past his last election; it plans to spend $8 billion to temporarily restore Medicare Advantage funds so that seniors in key markets don’t lose their trusted insurance program in the middle of Obama’s re-election bid.

The money is to come from funds that Health and Human Services is allowed to use for “demonstration projects.” But to make it legal, HHS has to pretend that it’s doing an “experiment” to study the effect of this money on the insurance market.

That is, to “study” what happens when the government doesn’t change anything but merely continues a program that’s been going on for years.

Obama can temporarily prop up Medicare Advantage long enough to get re-elected by exploiting an obscure bit of federal law. Under a 1967 statute, the HHS secretary can spend money without specific approval by Congress on “experiments” directly aimed at “increasing the efficiency and economy of health services.”

Past demonstration projects have studied new medical techniques or strategies aimed at improving care or reducing costs. The point is to find ways to lower the costs of Medicare by allowing medical technocrats to make efficient decisions without interference from vested interests.

Now Obama means to turn it on its head — diverting the money to a blatantly nonexperimental purpose to serve his political needs.

In an era of austerity, an executive department has what amounts to an 8 billion dollar taxpayer funded slush fund and has apparently chosen to use to help re-elect the president?

Really?

The good news is because of the attention brought to this ploy, just a couple of hours ago, the GAO spoke out about the planned use of the 8 billion dollars:

In a blow to the Obama administration on Medicare, government auditors Monday called for the cancellation of a costly bonus program for private health plans that congressional Republicans have criticized as a wasteful political ploy.

The nonpartisan Government Accountability Office said it’s not clear that the $8.3 billion Medicare Advantage bonus program will improve quality because most of the money is going to plans just rated average. The auditors did find, however, that the bonuses would temporarily ease the pain of unpopular cuts to insurance plans under President Barack Obama’s health care overhaul law.

The point of course, is it is a deferral of “pain” not any sort of look at an “experimental” means of improving health care.  It is election year politics with an 8 billion dollar price tag.

After all, the plan for ObamaCare was to have all the unpopular aspects of it kick in during 2013, after the election, after the President was unanswerable to the American people anymore and after he was provided with more “flexibility”.

The GAO is careful in its wording but read between the lines here:

GAO, the investigative agency of Congress, did not address GOP allegations that the bonuses are politically motivated. But, its report found the program highly unusual. It “dwarfs” all other Medicare pilots undertaken in nearly 20 years, the GAO said.

Most of the bonus money is going to plans that receive three to three-and-half stars out of a possible five stars on Medicare’s quality rating scale, the report said.

Available through 2014, the bonuses will soften much of the initial impact of the Medicare Advantage cuts, acting like a temporary reprieve.

This year, for example, the bonus program offset about 70 percent of the cuts in the health care law. Indeed, Medicare Advantage enrollment is up by 10 percent and premiums have gone down on average.

Or “Buying Seniors Off Until 2014”.  And yeah, if you’re still wondering, that’s politics.  The emphasized portions of both quotes are all you need to know to understand the “why” of my claim.  That reprieve would keep seniors from taking their angst and anger to the polls in November and the administration is eager to avoid that.

So, in the Chicago way, the Obama administration has figured out how to use tax money to help buy the next election.

Will the administration heed the GAO?  Will it cancel the program?

My guess is no – they’ll delay and prevaricate and do anything and everything they can to avoid killing the program.

At least until after the election.  Then?  Who cares.

Certainly not them.

Seniors, you’re being played for suckers.  You need to realize that.  And vote accordingly.

~McQ

Twitter: @McQandO


Observations: The QandO Podcast for 12 Feb 12

This week, Michael, and Dale talk about the controversy over the HHS contraception mandate.

The direct link to the podcast can be found here.

Observations

As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Podcast Alley. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here. For podcasts from 2005 to 2010, they can be accessed through the RSS Archive Feed.


The Health Care Czar speaks – “free” contraception for all!

Yes, Czar Kathleen (Sebelius, Czar Secretary of Health Care HHS and the final arbiter of all things ObamaCare) has declared that your insurer will now, without compensation or charge, do the following:

The Obama administration said Friday that health insurance plans must cover contraceptives for women without charge, and it rejected a broad exemption sought by the Roman Catholic Church for insurance provided to employees of Catholic hospitals, colleges and charities.

You may take a knee in thanks. Said Czar Kathleen:

“This rule will provide women with greater access to contraception by requiring coverage and by prohibiting cost-sharing,” Ms. Sebelius said.

Because, you know, the devices and services are delivered by magic fairies and don’t cost anyone anything.

No wonder Obama chose Disneyland as the venue for his speech yesterday.

The religious question aside, where in the world does this bunch get off deciding I have to pay for someone else’s contraception?

Because that’s what is going to happen … the bill, just like taxes to corporations, is going to find its way into my premium in some form or fashion (TANSTAAFL). 

The order is an administration interpretation of this:

The 2010 health care law says insurers must cover “preventive health services” and cannot charge for them.

“Preventive health services”.  Wow … how broadly can that be interpreted.  Well, broadly enough to include contraception as a “preventive health service” I suppose.

Which means, I assume, that the sky is the limit.  Creative interpretation is only limited by … not much, huh?

We have a czar.  She has an agenda.  She is the final, unaccountable “decider”.

What could possibly go wrong with that?

~McQ

Twitter: @McQandO


Obama Administration’s "Mystery Shopper" project to snoop on doctors shelved

This past weekend I pointed to a story in which it was disclosed that the Obama administration was planning to have what were characterized as "mystery shoppers" call doctor’s offices, misrepresent their health insurance status and attempt to find out whether the doctors (all primary care physicians) were taking new patients and if so whether they were taking Medicare or Medicaid patients.

Apparently the blowback was enough to have them shelve the idea (sunshine, what a concept).

The Obama administration will not move forward on a controversial proposal to have “secret shoppers” pose as patients to investigate how difficult it is for Americans to obtain primary care.

“On April 28th, the U.S. Department of Health & Human Services submitted a notice to the Federal Register regarding a proposed study that would examine access to primary care,” an HHS spokesman said in a statement.

“After reviewing feedback received during the public comment period, we have determined that now is not the time to move forward with this research project. Instead, we will pursue other initiatives that build on our efforts to increase access to health care providers nationwide.”

While the administration announced the program two months ago, it did not get widespread notice until a New York Times article that ran on Monday.

And that article spurred many to write about and criticize the plan.  Which brings me to this little gem from someone named “Max Read” under the category entitled “Conspiracy Theories” and entitled “Fun new right-wing meme last barely a day”.

Did you hear that Obama wants to spy on all the doctors to ensure that they’re utilizing proper Kenyan medical techniques? No? You must be getting your news from the liberal media establishment, then!

Uh, gee ”Max”, NYT?  And by the way, the point was to stop it and it was stopped.   So for most of the right-wing, a meme lasting a day is fine especially when it ends with the desired result.  Of course, government snooping and misrepresentation ought to be a fun new left-wing meme as well.  But apparently, with a Democrat in the White House, all that is fine and dandy.

Finally, as pointed out by our own commenter John in the previous post, their first excuse when confronted with the plan?

The White House defended the survey, saying a similar technique had been used on a smaller scale in President George W. Bush’s administration.

The irony is delicious.   The anti-Bush administration who rejected all that Bush did and stood for (even while essentially repeating, renewing or simply using most of it) uses that administration as an excuse to do something.  Even a 6 year old would not try that sort of an excuse on anyone.   And the more I watch US politics, the more I see the inner 5 year-old come out.

So, even though “Max” the Conspiracy Theorist isn’t particularly impressed (and tries way to hard to be snarky and amusing about it all), its nice to see that pressure and sunlight can quickly stomp an ill-conceived, intrusive and basically dishonest attempt by government to gather information from citizens into the ground.

In fact I’m very happy to see this “fun new right-wing meme” quickly die.  It means success.

~McQ

Twitter: @McQandO


HHS Secretary threatens insurers with “exclusion” if they don’t toe the government line

America’s new “Health Care Czar”, aka Secretary of Health and Human Services Kathleen Sebelius, has issued a letter to the insurance industry telling them not so politely to shut up or pay the consequences.

The letter, sent to Karen Ignagni, president of America’s Health Insurance Plans — the chief lobbyist for private health insurance companies – makes it clear in no uncertain terms that any complaints that ObamaCare is causing insurance premiums to rise is unacceptable:

"There will be zero tolerance for this type of misinformation and unjustified rate increases."

But that’s not the real problem, that’s just the warning.  Then there’s the threat:

"We will also keep track of insurers with a record of unjustified rate increases: those plans may be excluded from health insurance Exchanges in 2014."

One has to wonder though, whether Sebelius will also track the misinformation put out by the administration and her department.  Such as the implication that no such increases are caused by the law or that any such increases are “minimal”, i.e. in the 1 to 2% range.

That’s just poppycock.  

As Time magazine’s Karen Pickert points out, Sebelius ignores the fact that individual insurance plans cover different types of populations. So that government and "some" industry and academic experts think the new law will justify increases averaging 1 percent or 2 percent, they could justify much larger increases for certain plans.

Or as Ignagni, the recipient of the letter, says, "It’s a basic law of economics that additional benefits incur additional costs."

In other words, mandated coverage – with which the law is loaded – costs money.  Whether or not you want it isn’t the point.  You’re going to get it and as expected, that means the cost of your insurance premium will go up.  If, for instance, you’re carrying a minimal coverage policy with fewer benefits than those mandated by ObamaCare, your insurance coverage is about to change dramatically and so is the cost.

But insurers better shut up about the increased cost or, at least, not blame it on ObamaCare or, per the HHS Secretary’s threat, they’ll be “excluded” from the government takeover underway.

As Michael Barone notes today in his Townhall column:

The threat to use government regulation to destroy or harm someone’s business because they disagree with government officials is thuggery. Like the Obama administration’s transfer of money from Chrysler bondholders to its political allies in the United Auto Workers, it is a form of gangster government.

"The rule of law, or the rule of men (women)?" economist Tyler Cowen asks on his marginalrevolution.com blog. As he notes, "Nowhere is it stated that these rate hikes are against the law (even if you think they should be), nor can this ‘misinformation’ be against the law."

That, however, doesn’t apparently stop an administration with increasingly totalitarian tendencies from threatening insurers with the loss of their business if they don’t comply and keep their explanations to themselves.

This is outright thuggery.  As Barone points out, this certainly isn’t the first example we’ve seen, nor is it most likely to be the last.  This is pure and blatant intimidation.  There’s no place for this sort of nonsense in democratic republic one of whose founding principles is freedom of speech.

Secretary Sebelius should withdraw the letter immediately and apologize for the threat she issued to the industry as a whole.  She should also understand that she doesn’t get to decide what is or isn’t “misinformation” or how insurance companies choose to present the inevitable premium increases driven by ObamaCare to their customers.

If she feels there is misinformation out there that is actionable, then she has a court system on which to rely.  My guess is she knows she hasn’t a case and thus is reduced to threatening insurers instead, hoping they’ll be cowed into compliance.

Your “hope and change” government at work.  

~McQ


Health Care’s Giant New Bureaucracy

One of the persistent memes with this current round of health care reform is the counter-intuitive belief that adding 30+ million to the health care insurance roles and subsidizing them is going to save money. Another is that there won’t be more bureaucracy – that, in fact, this reform will streamline health care and again “save money”. Just as we’re supposed to “trust” the climate scientists who’re apparently not trustworthy, we’re supposed to believe a Congress which cranks out 2,000 page bills when they say it won’t be a bureaucratic nightmare.

But:

“The legislation lists 1,697 times where the secretary of health and humans services is given the authority to create, determine or define things in the bill,” said Devon Herrick, a health care expert at the National Center for Policy Analysis.

For instance, on Page 122 of the 2,079-page bill, the secretary is given the power to establish “the basic per enrollee, per month cost, determined on average actuarial basis, for including coverage under a qualified health care plan.”

The HHS secretary would also have the power to decide where abortion is allowed under a government-run plan, which has drawn opposition from Republicans and some moderate Democrats.

And the bill even empowers the department to establish a Center for Medicare and Medicaid Innovation that would have the authority to make cost-saving cuts without having to get the approval of Congress first.

That’s right – we’re supposed to believe that this huge shift in power and authority to the HHS will be done without adding a single worker, panel, council, department, “task forces” or agencies. There will be no new commissioners, advisors, council, staffers or contract employees. None.

But:

Haislmaier said one the greatest powers HHS would gain from the bill is the authority to regulate insurance. States currently hold this power, and under the Senate bill, the federal government would usurp it from them. This could lead to the federal government putting restrictions and changes in place that destabilize the private insurance market by forcing companies to lower premiums and other charges, he said.

Health and Human Services … doesn’t have any experience with this,” Haislmaier said. “I’m looking at the potential for this whole thing to just blow up on people because they have no idea what they are doing. Who in the federal government regulates insurance today? Nobody.”

The health care reform legislation would rely on the U.S. Preventive Services Task Force for recommendations as to what kind of screening and preventive care should be covered.

By the way, the U.S Preventive Services Task Force is the one which recently told women under 50 they really don’t need mamograms. Yeah – preventive services. They’ll try to prevent you from taking advantage of such services it seems.

And then there’s this:

Critics of the bill said this was an example of how the new bill could empower HHS to alter health care delivery, but Democrats argue they would rather have the government making these decisions.

“There’s an insurance company bureaucrat in between the patient and her doctor right now,” Rep. Debbie Wasserman Schultz, D-Fla., said on ABC’s “This Week.”

Yes, because everyone knows that government bureaucrats are so much more efficient and caring than insurance bureacrats – which explains the reason Medicare denials are much higher than insurance company denials.

If you want the equivalent of the Post Office or DMV running your health care in the future, support the Democrats and this bill. Because if you are satisfied with what they’re trying to pass, you’ve already bought into the idea that spending a trillion dollars will save money and lower the deficit and that government is always more efficient than the market in delivering anything.

~McQ