Free Markets, Free People

Health Care

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How centralized bureaucracies work

In another indicator of how low a priority veterans have with this administration, a whistleblower in Atlanta has revealed that VA employees were switched from processing VA applications to those of the Affordable Care Act, aka ObamaCare.

Scott Davis told the Atlanta Journal Constitution:

“We don’t discuss veterans. We do not work for veterans. That is something that I learned after working there. Our customer is the VA central office, the White House and the Congress. The veterans are not our priority. So whatever the initiatives are or the big ticket items, that is what we focus on.”

He later appeared on the Neil Cavuto show and claimed that 17,000 applications for VA Healthcare were destroyed.  He also said  they’re “also looking into a backlog of over 600,000 pending applications for VA Healthcare.” Davis said the applications were purged as a way to deal with pressure from Washington D.C.

Davis: What I think happened, Neil, is that there was pressure by people in Washington for us to hit our numbers. You’ve heard a lot about the 14-day turn around time for the hospitals. But what most people don’t know is that there’s a five-day turn around time for health applications. And if we don’t hit that five-day turn around time, it affects performance goals for people in senior leadership positions.

Cavuto: So if you don’t have that, and you’re not paying that out, it looks like you’re meeting your numbers and then some, right?

Davis: Absolutely. But what also happens, Neil, is that we’re currently neglecting not only the right thing to do, which is to process applications, not delete them. We have a huge system integrity issue at VA. For example, the VA right now can’t even tell the investigators what happened to those applications, because they can’t verify where they are, what happened to them, if they were deleted, why were they deleted, and why there was no paperwork showing the justifications for those deletions.

Cavuto: We’ve asked for a statement out of the VA on this and we have yet to get one, Scott. I’m trying then to give them the benefit of the doubt here. It seems like a crazy situation. Did you or any of your co-workers ever get so overwhelmed — not you specifically — but they just say the heck with it, more files, more applications, just dump them in the trash, we’re overwhelmed. Do you think that has gone on?

Davis: I know that there was rumors that suspect those activities before I started work thing in 2011. What I can tell you is that there’s so much pressure on the employees to get stuff done so management can meet goals, it’s easy to make mistakes, it’s easy to have mishaps. What happens is, instead of the VA focusing on doing what’s right for our nation’s veterans — meaning taking time, processing each application diligently and appropriately — pressure is placed on front line employees to overwork themselves, rush through the application process, to hit goals for members of management.

Cavuto: When you say to hit goals, is the goal a dollar goal or is it get the applications complete? Sometimes keep on top of this so there are no delays, or is it keep on top of it and get rid of something that could hurt our numbers?

Davis: Well, for what I’ve witnessed, it’s based on a performance goal.

Cavuto: How is that performance measured?

Davis: That performance is measured based on our ability to turn around an application from beginning to end within a five-day turn around. There’s an acceptable percentage that we have to have, which is in excess of 80% for all applications that comes into that office. What you find is that there’s extensive pressure on the staff to process applications, to focus our attention to applications based on specific campaigns. For example, I shared with your producer that we actually put incoming applications aside so we could focus on the ACA related applications that came in over last summer. That’s wrong. We should treat each veteran equally and focus on applications, as they come in, not because of special campaigns coming out of D.C.

His statement is precisely how veteran’s applications should be treated.  But they weren’t because of partisan politics and the heavy hand of the administration.   Naturally the VA  bureaucracy cooperated.  When your “customer” is Washington DC and not the veteran then that’s unsurprising.

This is outrageous, but my guess is, as they dig deeper into the VA, this is only the tip of the iceberg.

This is the face of government run health care.  It is fair warning.  Just as Soviet bureaucracies fudged whatever numbers necessary to “meet” the government’s “5 year plans”, the government bureaucracies here are not above doing the same.  The bonus system along with identification of Washington as their “customer” was all the incentive the bureaucrats needed to let veterans down … again.

~McQ


It’s not a law, it’s a rule

More outrage smoke from Ezekiel Emanuel on the Supreme Court women’s contraception ruling over at Politico lamenting unintended consequences.

Someone should lament the unintended consequences of the ACA, assuming they are unintended.

Blah blah, no personal choice, your company’s religious belief trumps yours, what a crime that companies have provided the majority of American’s health insurance since World War II when we could have had a super good program like ObamaCare is offering right now.  Don’t you just wish those evil Supreme Court justices had gone the way of progressive liberal goodness and niceness and made up law like Justice Roberts did when he magiced a penalty, unlawful, into a tax, lawful, instead of reading this new rule to see if it clashed with laws already on the books?

The ACA was crated to, uh, prevent you from being locked into your job you see.  Odd, I personally changed jobs, as a father of a family, which HAD pre-existing conditions, of a serious nature, some 9 times over the course of the last 35 years BEFORE the ACA, and oddly must have missed the handcuffs that kept me locked in my job(s).   The ACA is a cure all, it will prevent job lock, it will raise wages AND it will keep health care inflation under control.   Yeah, course it will.    It would have helped win the War on women, but not now because Sharia law!

Here’s a snip….

‘To minimize disruption and reassure most Americans, the Affordable Care Act kept employer-sponsored health insurance intact. The ACA includes an employer mandate enforced by a $2,000 per worker penalty: Employers with more than 50 full-time workers who do not provide insurance that satisfies a minimum requirement must pay.

The minimum requirement includes preventive services from vaccinations to cancer screening tests to cholesterol screening. It also includes contraception. The Hobby Lobby case basically says employers need not cover contraception in the health insurance it provides” (my emphasis)

The ACA includes contraception.   Zeke left out part of the history, conveniently because it’s easier to manufacture outrage when you leave out the incriminating realities.

So well crafted was this law, that women’s contraceptive health coverage wasn’t even included in it.   That would be the rule that the evil religious folks NOW can use to control women’s uterus’s!  I mean that would be the rule that means the evil religious folks have to pay for birth control.

Wasn’t there.

The ACA passed into law on March 23, 2010 – there was NO provision in the original law for birth control – here’s a FAQ from the National Women’s Law Center web site that explains it was added on August 1, 2011.   Added, not voted on, not sent to the House, Senate, President.   Just added.

“The health care law (the Affordable Care Act) requires certain preventive health services and screenings to be covered in all new health insurance plans without cost sharing. This means that, for the preventive health care services included, you will not be charged a co-payment for the services, and the costs of the services will not be applied to your deductible. The list of covered preventive services is extensive and includes services such as mammograms, pap-smears, and smoking cessation supports….(I snipped a link ‘for more info)

On August 1, 2011, the list was expanded to include birth control alongside other women’s preventive services, such as an annual well-woman visit.”

Maybe Nancy Pelosi should have read it first to see if that was in there.  Or maybe it was, we just couldn’t see it,  yet.

That was, not so soon, taken care of by Kathleen Sebelius and the good folks down at US Department of Health and Human Service, a year later.   Really, you’d have thought they’d have done it sooner, but maybe they finally read the ACA.

Free contraception for women.       They couldn’t possibly have left that out, that would be like a war on women or something, and not a Bush or Republican in sight to take the blame!  It’s important, right?  It couldn’t have been overlooked.    It’s important enough that the government just tried to use it to tell people with objecting religious convictions (dirrrrrrrrty Christians) ….they were going to have to provide contraception coverage.

And now because of the Jihadi Sharia loving 5 maniacs on the Supreme Court, women can’t have contraception, or contraception of their choice, or health care, or something!!!!!!!!

Well, not quite, in this case, specifically, the government mandated Hobby Lobby had to pay for methods they considered to be tantamount to ”abortion’ coverage.  Hobby Lobby actually agreed to cover some other forms of contraception, a pretty fair number, in fact, 16.

Robin Abcarian at the LA Times weighed in on the decision too.   According to Robin the Supremes should have looked at what the drugs and devices did and made their decision on that basis.   So long as when it was done the 5 male Justices that didn’t know for sure what 1 male and 3 female Justices didn’t know for sure, that is, when life begins, listened only to the 3 females because, uh, they have a uterus and ovaries.

Seems to me they probably did consider what those drugs and devices did as it really figures in their determination it was in fact a religious argument, or an argument of ‘faith’ if you will.

Here’s a summary from The Atlantic of what Hobby Lobby is thinking… and that’s where the argument gets religious for them.  Hobby Lobby views life as beginning at the point the egg is fertilized by the sperm.   The counter argument, and the Atlantic linked an authority appeal of ‘Most Doctors’ which turns out to be the Federal Government and a reference to the American Congress of OBGYNs, is that it begins at implantation  (and we all know from Roe v. Wade that what implants is a puppy, or goldfish,  or protoblob, until 9 months later a miracle occurs and a human is born.)    The Atlantic summary is okay, but to me they torpedo themselves right around the straights of IUD diagram because they rely on their experts to make a decision of faith for Hobby Lobby, and decide that Hobby Lobby’s faith is politely, crap.

Once again, note if the egg hasn’t implanted (yet), the now hysterical side of the argument has decided it’s not a pregnancy.   The IUDs prevent implantation and the pills in question prevent fertilization rather than stopping ovulation.   And that’s where faith/belief comes in because we didn’t get the instruction book from the Deity of your choice.  If you don’t have a deity, I’m not sure what you’re going to decide, but at some point LIFE begins and the two sides do NOT agree definitively when that is.

The 5 mad male Mullah’s on the Supreme Court decided to err on the side of Hobby Lobby’s beliefs.    Owing to the Religious Freedom Restoration act.   A law, already, on, the, books.   Which the new ‘rule’ seemed to contradict in the 4 instances specified.

More from Zeke:

“The closely held corporation limit is no limit at all. It turns out that more than half of U.S. employees work for closely held corporations. While many are small, many, like Hobby Lobby, are large. And it gives an incentive for more employers to become closely held corporations.”

It doesn’t stop contraceptives from being covered, it’s probably not going to lead to a massive rush by companies to drop contraceptive coverage, it’s not some fundamentalist plot to control women and (re)gain control over their reproductive systems.

It was a loss for the progressives though, because they made such a freaking big deal out of making sure the crazy faith holders at Hobby Lobby did as they were damn well told.    Hence the lamentations of their…uh, various genders.

As a final note, I can’t help thinking it is interesting to note that while 4 methods of “contraception” are no longer available to female Hobby Lobby employees, no one  of these outraged folks is particularly concerned that the Democrats left such an important item out of the original encyclopedic bill or that an Executive branch agency came along and created an entire entitlement completely out of whole cloth a year after “the law” was passed.

You’d almost think they had some plan to make sure they were going to remain permanently in control of those agencies, otherwise that sort of thing would be dangerous if the crazy faith holders ever got back into power and turned the tables on them.


A few things to note

I don’t mind at all saying “I told you so” when it comes to the alarmists and “climate change”.  You’ll remember a few weeks ago when the alarmists began screeching about the collapse of an ice shelf in Antarctica and how that was going to raise sea levels by feet, not inches and that there was nothing we could do about it?  Oh, and it was because of man-made global warming?

We found out subsequently, that the “rise in sea levels” might occur with this melting of the ice shelf, but that it would likely take a 1,000 years.  And, at that time, I put forward an article I’d written for QandO in 2009 where I noted that volcanic activity (aka geothermal activity) was responsible for an ice melt then.  I further posited that it was entirely possible it was responsible for the most recent ice shelf melt (since it is very close to the shelf itself) and had nothing to do with man.

Vindication:

Thwaites Glacier, the large, rapidly changing outlet of the West Antarctic Ice Sheet, is not only being eroded by the ocean, it’s being melted from below by geothermal heat, researchers at the Institute for Geophysics at The University of Texas at Austin (UTIG) report in the current edition of the Proceedings of the National Academy of Sciences.

The findings significantly change the understanding of conditions beneath the West Antarctic Ice Sheet where accurate information has previously been unobtainable.

The Thwaites Glacier has been the focus of considerable attention in recent weeks as other groups of researchers found the glacier is on the way to collapse, but more data and computer modeling are needed to determine when the collapse will begin in earnest and at what rate the sea level will increase as it proceeds. The new observations by UTIG will greatly inform these ice sheet modeling efforts.

Using radar techniques to map how water flows under ice sheets, UTIG researchers were able to estimate ice melting rates and thus identify significant sources of geothermal heat under Thwaites Glacier. They found these sources are distributed over a wider area and are much hotter than previously assumed.

The geothermal heat contributed significantly to melting of the underside of the glacier, and it might be a key factor in allowing the ice sheet to slide, affecting the ice sheet’s stability and its contribution to future sea level rise.

Oh my.  Who knew?  Uh, we did. Or at least we were able to apply facts and logic to the event and give a credible hypothesis as to why what was happening was happening.  Nice.

On another subject, the Bergdahl fiasco, it appears that Mr. Obama, who was perfectly fine about taking all the credit for his release when it appeared it would be to his political advantage (thus the Rose Garden announcement with the family), has now found someone he can throw under the bus since it has all gone wrong.  It’s Hagel’s fault:

FInal approval for the prisoner exchange that freed Sgt. Bowe Bergdahl was made by Secretary of Defense Chuck Hagel, members of Congress learned on Monday from administration officials.

‘They indicated (it was) Secretary Hagel (who made the final call),’ Rep. Buck McKeon (R-CA) said after a classified briefing, ABC points out.

‘It was the president of the United States that came out (in the Rose Garden) with the Bergdahls and took all the credit and now that there’s been a little pushback he’s moving away from it and it’s Secretary Hagel?’

Yup … I’ve lost count of all those who’ve found themselves looking at the underside of the Obama bus.  And for those who don’t think that this was an attempt to divert attention from the VA scandal, check this little tidbit out:

The final agreement was brokered in a week by Qatar and dovetailed with Obama’s announcement of a complete withdrawal from Afghanistan by the end of 2017. Engulfed in a scandal over hospital care for veterans, it also provided him an opportunity to demonstrate he was helping those who had served.

So it was Hagel’s final call?  Yeah, right. Again, the administration insults our intelligence.

Meanwhile we find more and more neglect and corruption in the VA, an agency that Mr. Obama criticized when his predecessor was in charge and vowed to clean up:

The agency said more than 57,000 new patients have waited at least 90 days for their first appointments and that about 13 percent of VA schedulers indicated they were told to falsify appointment-request dates to give the impression that wait times were shorter than they really were.

Remember, this is pure government run health care aimed at a very small population, relatively speaking.  And it is a disaster.

The agency also found evidence that in the past 10 years, nearly 64,000 veterans who sought VA care were simply never seen by a doctor.

“Simply”.  Not simply at all. This is mind numbing incompetence and corruption.  This was Ezra Klein’s ideal example for touting the benefits of government run (single payer) health care back when he was shilling so hard for the ACA.  Obama has done nothing to change the situation.  Congress, as usual has simply thrown money at it assuming that would fix it.  But its not just Obama’s problem.  This is a decades old institutional problem driven by a corrupt and incompetent bureaucracy that has given short shrift to the care of our veteran population.  This is the face of “government run healthcare”.

~McQ


Wait … didn’t they say if we didn’t pass ObamaCare this would get worse?!

Why yes, yes they did.  And they also told us it was because of the expense of this sort of medical care that the benevolent and non-intrusive federal government saw a reason to attempt to manage this through its new and wonderful law.

Surprise!

Nationally, nearly half of ER doctors responding to a recent poll by the American College of Emergency Physicians said they’ve seen more visits since Jan. 1, and nearly nine in 10 expect those visits to rise in the next three years. Mike Rust, president of the Kentucky Hospital Association, said members statewide describe the same trend.

Experts cite many reasons: A long-standing shortage of primary-care doctors leaves too few to handle all the newly insured patients. Some doctors won’t accept Medicaid. And poor people often can’t take time from work when most primary care offices are open, while ERs operate round-the-clock and by law must at least stabilize patients.

Plus, some patients who have been uninsured for years don’t have regular doctors and are accustomed to using ERs, even though it is much more expensive.

“It’s a perfect storm here,” said Dr. Ryan Stanton of Lexington, president of the Kentucky chapter of the ER physician group.”We’ve given people an ATM card in a town with no ATMs.”

I love the doc’s line about ATMs.  He’s nailed it on the head.

Now I won’t bore you with the fact that we foresaw this and wrote about it.  I mean we talked about doctor shortages, that an increase in those having insurance didn’t mean they’d be able to see a doctor and how doctors were dumping Medicare because of all the hassles and low payments.

But our ever faithful zealots on the left kept telling us that a) we didn’t know what we were talking about, b) human nature isn’t really human nature and c) now that everyone would have insurance all would be sunshine and roses and costs would magically come down (because, you know, the Democrats said they would).

Instead it is all mostly compost.  ERs are seeing a surge in patient visits and expect it to get worse.   Of course, that sort of care is much more costly than regular doctor office visits (according to the article, about $580 per visit more) but what they hey, they have subsidized insurance now … so you get to continue paying for it.

Another in a long line (and getting even longer) of predictions about the effect of a program that this administration has gotten completely bass ackwards.

Competence?

It just doesn’t exist in Washington DC and especially with this administration.

~McQ


Redefining incompetence

I remember well the liberal Democrat echo chamber calling G W Bush “incompetent”.  It was their mantra.  Their rehearsed talking point.  And the went on the weekend shows and in front of every camera they could find to repeat it.  Over and over and over.

If Bush was incompetent, what in the world does that make Obama?  This inept and incompetent White House just outed their own CIA station chief in Afghanistan in a picture of the Obama trip there over the Memorial Day weekend.  A trip clearly designed to distract from the growing VA scandal goes south in a heartbeat because of  … gross incompetence.

Anyone remember Valerie Plame?  That pales in comparison to this idiocy. Pales? It doesn’t even get on the radar screen in comparision.

And don’t get me started about the VA.

But speaking of VA, it does indeed again make the point that the government  - and especially under this particular administration – can’t run health care … period.  And no, I’m not saying a more competent administration could.  The VA has been plagued by problems for decades.  The fact that they’ve gotten worse under this President doesn’t at all surprise me.  But what may surprise you is this:

Since 9/11, the VA budget has increased by 235%, from FY2001′s $45 billion annual budget to FY2014′s $150.7 billion. On a percentage basis, the only Cabinet agencies that had larger budget increases over that arc have been State (271%) and Homeland Security (245%), the latter of which barely existed at the start of that period. In the Bush era, comparing the final budget with his signature (FY08) to the final Clinton budget (FY01), VA spending rose 88.3% to $84.7 billion. Defense spending rose 104% in the same period.

Barack Obama ran in 2007-8 on failures at the VA, promising more resources and better management. In comparison to that final Bush budget — don’t forget that Obama signed the FY2009 budget in March 2009 with the omnibus spending bill after a Democrat-controlled Congress refused to deal with Bush — VA spending has risen dramatically as well. The annual budget rose 78% in six budget cycles, with double-digit increases in four of the six years — while Defense spending was flat. No other Cabinet agency had a larger budget increase by percentage during Obama’s tenure. The closest was Agriculture (64%), followed by State (59%, which tends to discredit the canard about the Benghazi failure being caused by a lack of resources). Only HHS had a larger annual budget increase in terms of dollars spent, but it amounts to a 37% increase in spending from the FY2008 baseline. The amount of increase in the VA’s budget in the Obama era, $65.9 billion, exceeds the entire VA budget in the FY2004 budget.

So it wasn’t money.  As usual it was leadership.  How many freakin’ times do we have to hear this incompetent who is President say he learned about the latest scandal from television news?  For 6 years it has been all his and he has no idea what is going on in his own executive departments.  For that matter, neither do his secretaries.  The Health and Human Services absolutely blew the launch of the health care website.  Something that is done successfully everyday in the commercial world.  And where did Mr. Obama learn about it?  TV.  He certainly had no idea that it was a bust before then.

Why?  Because he didn’t bother to check.  Didn’t bother to ask hard questions or require a demonstration.  He didn’t lead.  He had already waved his magic hand and told them to get it done.  Words equal action in his world.

Same with the VA.  After lambasting the former administration for its failures in reference to the VA, he, in 6 years and billions of dollars, hasn’t improved it on iota.  And more grating than anything is he didn’t care enough to check.  He didn’t KNOW!  His secretary didn’t know!   An pattern of failure repeated in this administration since the beginning.  Instead the usual liberal panacea was applied: throw money at it and the problems will go away.  Just check out public education to see how well that’s worked – or the “War on Poverty”, etc.

Nope, this was a culture problem and a leadship problem.  The culture still survives and thrives and the leaders are nowhere to be found.  Oh the guys who are supposed to be in charge are still kicking, but they’re sitting in front of their television sets to see if there have been any new developments.  Meanwhile, this is going on and has been going on:

The VA department has been directly providing health care to millions of veterans for decades and evidence is growing that relying on the system can literally be a fatal decision. The Washington Examiner’s Mark Flatten reported May 12 that a Texas VA clinic implemented a cost-cutting measure in 2010 that required a patient to undergo three positive bloody stool screens before the government would approve a colonoscopy. Dr. Paul Krugman, who protested the policy while serving in the VA facility, told Flatten that “by the time that you do the colonoscopies on these patients, you went from a stage 1 to a stage 4 [colorectal cancer], which is basically inoperable.”

As many as 15,000 vets were subjected to this treatment. There is no way of knowing how many died because they spent their final days at home or in a private facility. Suffering and dying in obscurity due to a cost-cutting measure by a government-run health care system is the ultimate SNAFU, and nobody can guarantee it won’t be an commonplace under Obamacare.

Hell of a way to treat our veterans, isn’t it – but then when its all about bureaucrats and budgets, the focus isn’t on patients is it?  That’s government run health care in a nutshell.

Silver lining?  The VA, with a population of 9 million to serve, can’t get the job done competently and has, for the most part never been able to do so. THAT is the story of government run health care.  And all you need to cement that fact firmly in your head is to read the open letter one of our veteran triple-amputees penned this past week:

I remember candidate Obama promising to overhaul the VA and reduce the backlog.  You claimed that America’s support for its veterans is obvious by the way we treat our vets. You really nailed that one didn’t you?

Just like you were going to fix Detroit or fix foreign policy.  Your high school like approach to solving complex issues can’t be fixed by tweeting hashtags with propaganda to people who want to kill us. Anyone with an ounce of common sense can see you’re unfit to lead our nation, let alone act as our Commander In Chief.  What our country needs now, more than ever is real leadership, someone who doesn’t wait for a crisis, but is able to foresee an issue and deal with it before it happens. Unfortunately for America, you’ve been too busy campaigning and don’t have time to deal with the health care crisis of our veterans. The only thing you seem to care about is your own radical agenda, and now our vets are paying for your negligence with their lives.

As I sit here typing this out I’m dealing with my own VA nightmare which involves the Phoenix VA.  I have given 3 limbs for this country, but apparently that is not enough.  A “clerical error” made by a VA employee has resulted in nearly a year of abuse and mismanagement of my case. In other words, the VA is stealing over $7000 from my disability compensation that I earned when I lost 3 of my limbs for our country.

On this Memorial Day, as I battle your incompetent bureaucrats my family would like to thank you for once again failing our veterans. We can’t help but wonder about the disastrous socialized medicine program that we will surely be dealing with if Obamacare is allowed to be fully implemented. If our incompetent VA cannot handle government healthcare for a fraction of our population, who would be foolish enough to believe a massive health care system designed to provide health care for all American’s would be any different?  You can’t even find someone to build a competent website to work for your socialized medicine program when you had your name attached to it, so why would you care about our veterans when you could so easily push the blame off on someone else?

And the irony of it all?

The Department of Veterans Affairs says it will let more veterans obtain health care at private hospitals, VA Secretary Eric Shinseki announced Saturday.

That’s right … just like Canada used US private hospitals to bail its government run system out when it came to wait times, the VA is planning the same thing.  To anyone with an IQ above a donkey, that ought to tell you something.

~McQ


3/4 of ObamaCare enrollees? Previously insured …

Or so says a new McKinsey survey of the numbers:

One of the principal flaws in the coverage of Obamacare’s exchange enrollment numbers to date has been that the press has not made distinctions between those who have “signed up” for Obamacare-based plans, and those who have actually paid for those plans and thereby achieved enrollment in health insurance. A new survey from McKinsey indicates that a large majority of people signing up are now paying for their coverage. This is progress for the health law. But the survey still indicates that three-fourths of enrollees were previously insured.

Of course we’ve seen the propaganda push from the White House that has claimed the numbers (8 million enrolled) mean that the law is working.  As usual, the devil is in the details.  If the law was designed to provide coverage to those who were uninsured, 25% of the total enrolled fitting that description is hardly indicative of that claim’s efficacy.  And when you break down that 25% number, it’s even less indicative:

At most around 930,000 people have gained coverage from Obamacare’s under-26 “slacker mandate” (not 3 million, as is commonly suggested); another 3 million or so have gained coverage from the law’s expansion of Medicaid. Approximately 2.6 million previously uninsured individuals have obtained coverage through the ACA exchanges and the related off-exchange individual markets; however, the off-exchange purchases are mostly unsubsidized, and therefore can’t necessarily be credited to Obamacare.

Here’s a graphic that breaks the McKinsey survey’s results down into a more understandable form:

McK-enroll-Apr-2

In reality, what the law has essentially done rearranged the burden of payment among those enrolled while really not doing much at all in terms of reaching those for whom it was supposedly designed to help:

What the exchanges appear to be doing is mainly helping people who were previously insured. If you’re 62 years old, say, and your income is $30,000, and you were paying for your own coverage before, you’re now eligible for plans that are much cheaper for you, thanks to taxpayer-funded subsidies and higher premiums for young people.

Of course that means that other people are paying more. “My old plan was canceled under Obamacare,” an exasperated Californian told me last week. “The new Obamacare plan costs twice as much, and the deductibles are higher. And yet Obama is counting me as one of his 8 million people!” But hey—at least he has maternity coverage.

And I’m sure our Californian is eternally grateful for big brother deciding for him that maternity care was an absolute necessity for which he must pay.  But the point is the 8 million number remains very shaky (and that’s being kind) and it really doesn’t at all reflect what the White House would have you believe it reflects – that the law is working.

~McQ


Health Insurance Tax – another governmental attack on small business

So a day or so ago, I talk about how regulation and government intrusion is helping to kill entrepreneurship and, as a result, small businesses. The same problem, as we all know, is also exacerbating the unemployment picture.  A prime example?  That odious law known as ObamaCare.

The US Chamber of Commerce blog has this chart for us to peruse. It is all about the recently implemented “Health Insurance Tax”, aka “HIT”: As this awful law continues to be implemented when it is politically convenient for the Democrats, we see even more disaster lurking for those who are employed and actually “like their insurance and like their doctor”.  But HIT is already taking a toll.

The National Federation of Independent Business’ Research Foundation estimates that the Health Insurance Tax (HIT) will result in a reduction in private sector employment of 152,000 to 286,000 jobs by 2023, with 57 percent of the job losses coming from small businesses. This will amount to a reduction of U.S. real output (sales) by between $20 billion to $33 billion during the same time frame.

Just what we need – another “hit” to employment and a “hit” to GDP. But it is clear the Democrats don’t really care about that.  As one of our low information commenters is want to say “a few eggs must be broken” to make an omelet … or something. Any inanity will do when it is clear that a law is a bust and a failure. As the Chamber of Commerce blog notes:

The HIT, which went into effect on January 1, 2014, levies a tax on health plans sold on the fully-insured market. Eighty-eight percent of it is made up of small businesses. Revenue from the tax will rise by 41% in 2015 and reach $14.3 billion in 2018.

“Small businesses are crucial to rebuilding an economy that allows all Americans to prosper,” Katie Mahoney, Executive Director of Health Policy at the U.S. Chamber said. “We need to work to find ways to ensure small businesses and their employees have the tools to build on their current success, not hinder future growth.”

You’d think what she says would be fairly common knowledge, but apparently the deluded administration that runs this country thinks we’re coming out of the economic malaise it has worked so hard to keep in place, and thus its time for another little shot to the head of small business.

With the HIT – mission accomplished.

~McQ


White House says only 28% of 18-34 demographic has signed up for ObamaCare

The demographic that was key to holding down health care costs apparently came in well below the level necessary to ensure that:

Just more than a quarter of the eight million people who signed up for health plans under the Affordable Care Act are in the prized demographic of 18 to 34 years old, falling short of the figure considered ideal to keep down policy prices.

The data, released Thursday by the Obama administration, painted a more complete picture of enrollment in the plans. They show that about 28% of people picking plans on the state and federal insurance exchanges by April 19—after most states’ enrollment deadlines passed—were 18 to 34 years old, a generally healthy group. The proportion is higher than previous counts. But it is significantly below the 40% level that some analysts consider important for holding down rates by balancing the greater medical spending generated by older enrollees.

Insurers right now are setting rates for 2015, and the age data will be a key factor in their decisions. Some insurers say that despite seeing a late surge in younger enrollees, their sign-ups still skewed older overall than they had expected.

Because the “healthy” demographic sign-up fell well below expectations, the rates for 2015 are expected to be at a higher rate.  And, of course, there’s the further problem that “enrollment” doesn’t necessarily mean that the enrollee has paid for coverage.  As noted in earlier:

Data provided to the committee by every insurance provider in the health care law’s Federally Facilitated Marketplace (FFM) shows that, as of April 15, 2014, only 67 percent of individuals and families that had selected a health plan in the federally facilitated marketplace had paid their first month’s premium and therefore completed the enrollment process. Nationwide, only 25 percent of paid enrollees are ages 18 to 34

And finally, the assumption is that the 18 to 34 demographic will be a “healthy demographic” relatively speaking and will carry the cost for the more sickly among us.  That too may be an erroneous assumption:

While the 18-34-year-old cohort has been dubbed the “young and healthy,” a more accurate moniker might be “young and somewhat healthy.”  68 percent of 18-34-year-olds on the federal exchanges chose a silver plan.  As I’ve written previously:

Why does this matter for the death spiral?  Because so many enrollees choosing silver plans suggests that the risk pool may be sicker than is optimal. For enrollees at or below 250 percent of the federal poverty level, silver plans tend to offer the most coverage for the lowest price.  For persons under 250 percent FPL, ObamaCare offers help with copays and deductibles, but only if the consumer chooses a silver plan. The actuarial value for a silver plan is 70 percent (that is, a silver plan must, on average, cover 70 percent of a policyholder’s medical claims), but when the subsidies for cost-sharing are included, the actuarial value rises to between 73 and 94 percent. As one writer notes, “Why would someone opt for a silver-level plan over a cheaper bronze or catastrophic-level plan? The most plausible explanation is that the enrollee anticipates incurring significant medical expenses over the coming year, which is to say that he’s not healthy.”

Since income tends to be lower the younger one is, a lot of those 18-34-year-olds are probably in that <250 percent FPL range.  The inordinate number of 18-34-year-olds choosing silver plans suggests that the exchanges have attracted young and healthy people that are not that healthy.

Not only may they not be young and healthy, but they’ll most likely be receiving high subsidies which again sort of defeats the whole purpose of signing up that demographic, doesn’t it?  And it certainly calls into further question whether or not even the 28% that signed up will have any significant effect in helping to lower costs.

Bottom line? Well, to quote a well-known conservative talk show host, we’ve again been treated to a heaping helping of “bovine scatology”.   Not that anyone at all familiar with this president and his administration should at all be surprised.

~McQ


ObamaCare slapped by reality … again

And that reality is the American people aren’t buying the propaganda being pushed by the administration.  After its celebration of the dubious enrollment of 8 million and unilateral declaration that ObamaCare was a “success”, new poll numbers show no difference among the public’s opinion of the law than before their declaration:

What’s perhaps more telling is that, despite the rare good news of the past few weeks, their perceptions of the law remain basically as-is — that is, pretty dim. To wit:

  • Americans say 50-41 that the implementation of the law has been worse than they expected rather than better.
  • They say 44-24 that the health-care system is getting worse rather than getting better as a result of Obamacare.
  • They say 29-14 that the quality of care is getting worse rather than better.
  • They say 47-8 that their health-care costs are increasing due to the law rather than decreasing.
  • They say 58-11 that the overall cost of health care in the United States is increasing rather than decreasing.

Almost all of these numbers are basically unchanged from in recent months.

What is it politicians like to tell us about politics?  Ah, yes, perception is reality.  And as I pointed out when you mess with people’s health care, the reality becomes very personal.  It isn’t something that you view from afar and doesn’t effect you.  It is something everyone is interested in in some form or fashion.

The numbers above are their perception of that awful law’s impact on their lives.   The propaganda simply isn’t going to change that.   “8 million enrolled” is something the people really don’t care about.  Higher premiums, more red tape and fewer options for health care, not to mention having to give up their doctor and the health insurance they liked is something they care about.  That is the result of the law and it is the reason for the numbers.

As we’ve mentioned previously, the numbers you see above are numbers that exist before the most onerous regulations and requirements (now delayed until after the election) are finally put into effect.  If you think these numbers are bad, wait till after November.

The bottom line is ObamaCare sucks and the people know it and no administration sponsored dog and pony show is going to change that perception.  We see a lot of Democrats now trying to claim that ObamaCare really won’t hurt them in the mid-terms.

I invite them to look at the above numbers, understand that it is they who are going to get “credit” for the law, and rethink their claim prior to their coming unemployment.

That way it won’t come as such a surprise when they’re defeated.

~McQ


ObamaCare and the Big Lie

Peter Morici gives a little ground truth to the hyperbole of the left who’ve decided the best defense of ObamaCare is … to lie about it.

With 8 million Americans enrolled in health insurance through federal and state exchanges, President Obama has declared the Affordable Care Act a success. That’s disingenuous and big changes are needed to make the law work well.

Overall, the ACA’s goals were to provide reasonably priced medical care to the 45 to 50 million uninsured and slow health care cost increases. It is hardly clear those goals will be accomplished.

[...]

Many of the 8 million enrolled to replace individual and small business policies, canceled thanks to ACA rules, or to obtain federal subsidies only available through the exchanges.

So if the goal was to proved care to the ’45 or 50 million’ uninsured, how does enrolling 8 million, many of whom had lost their insurance due to the ACA, constitute success?

Well in the real world it doesn’t.  Only in Oz or Fantasyland do the rules of reality not apply (even if they really do and what those living there do is deny it) and allow them to make these claims with a straight face.

It’s election prep.  We’ve seen it countless times before.  It is an attempt to make lemonaide out of the lemons this abomination of a law has handed its creators.

This is just another version of the Big Lie that this particular administration has raised to an art form.  And with a compliant media to help them along (a media that seems without curiosity at the most important times) the Big Lie gets plenty of press.

Of course now that the press has helped spread the lie, the Dems will point to those media stories as “the truth” and use them to assure the usual left leaning low information voters that a) they need to turn out because ObamaCare is a “good thing” and b) if they don’t those mean old Republicans will take it away.

You can just see it coming.

Meanwhile, for most of America, the really bad stuff is being unilaterally put on hold until after the election – the most blatant display of partisan politics I’ve seen in some time:

The ACA requires health insurance policies to pay for a wider and more expensive scope of services than many individual and small business policies covered prior to the law.

In many counties, only a few insurers chose to offer policies on exchanges. Absent competition, insurers lacked incentives to bargain as hard as before with hospitals and other providers, further raising premiums and out of pocket costs.

The bronze, silver and gold policies offered by exchanges mostly vary in their deductibles. Folks selecting bronze and silver plans with high deductibles are now paying the full cost of doctor visits that only set them back a $20 or $30 dollar co-pay prior to the ACA.

Simply, for many families the ACA raises the combined cost of premium and out-of-pocket expenses.

About 50 percent of Americans are eligible for premium subsidies, but taxpayers are footing the bill and the burden of health care on the economy — already 50 percent higher than in Germany and Japan — is making it tougher for American businesses to compete and destroying jobs — something the Congressional Budget Office doesn’t bother to calculate.

But then, this was all predicted prior to passage and only a few bothered to listen.

Now we get to live with the “success”.

~McQ

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