Free Markets, Free People

Health Care

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ObamaCare’s technical failure only masks its worse failures

As a designed program it is a disaster. Why? Because it does few if any of the things it was supposed to do (remember: “if you like your insurance and want to keep it?”). Now the New York Times – a rah, rah supporter of the law – has found another “design flaw”:

As technical failures bedevil the rollout of President Obama’s health care law, evidence is emerging that one of the program’s loftiest goals — to encourage competition among insurers in an effort to keep costs low — is falling short for many rural Americans.

While competition is intense in many populous regions, rural areas and small towns have far fewer carriers offering plans in the law’s online exchanges. Those places, many of them poor, are being asked to choose from some of the highest-priced plans in the 34 states where the federal government is running the health insurance marketplaces, a review by The New York Times has found.

You have to chuckle a bit at the abject ignorance the Times often displays as evidenced by the fact that they don’t seem to understand that price controls/setting isn’t going to foster much competition among anyone. And, when government decides what each policy must contain, they’re not going to be cheap. Oh they may seem relatively cheap, but then there are those damnable deductibles, aren’t there?

Of the roughly 2,500 counties served by the federal exchanges, more than half, or 58 percent, have plans offered by just one or two insurance carriers, according to an analysis by The Times of county-level data provided by the Department of Health and Human Services. In about 530 counties, only a single insurer is participating.

The analysis suggests that the ambitions of the Affordable Care Act to increase competition have unfolded unevenly, at least in the early going, and have not addressed many of the factors that contribute to high prices. Insurance companies are reluctant to enter challenging new markets, experts say, because medical costs are high, dominant insurers are difficult to unseat, and powerful hospital systems resist efforts to lower rates.

“There’s nothing in the structure of the Affordable Care Act which really deals with that problem,” said John Holahan, a fellow at the Urban Institute, who noted that many factors determine costs in a given market. “I think that all else being equal, premiums will clearly be higher when there’s not that competition.”

The Obama administration has said 95 percent of Americans live in areas where there are at least two insurers in the exchanges. But many experts say two might not be enough to create competition that would help lower prices.

What was that word again? Oh yeah, “incentive”. What “incentive” is there for an insurer to enter a market simply to lower prices so no one can survive? Yeah, probably not much. And in rural areas where population is thin in comparison to urban areas, the cost of doing business may preclude the entrance of a third carrier because there’s no positive incentive to do so. I.e. they don’t see profit being higher than the cost of doing business. Imagine that?

But hey, it’s the law and law is magic, you know. It declares something will be so and it must be so. Right?

Well, that’s the “thinking” behind this law, such that it is … the law of the underwear gnomes come to life.

~McQ


ObamaCare launch is debacle of the leadership’s own making

Everything I read about this debacle that is ObamaCare’s launch is summed up pretty well in this paragraph:

In an era where Google is making self-driving cars and Amazon offers next-day delivery for just about anything, the White House plunged ahead with a system it knew to be defective and is relying on the technology of the 19th century as the fall-back. Five days before the exchanges launched, the Health and Human Services Department increased the Virginia information technology company Serco’s $114 million contract by $87 million—to help process paper applications. Are contingency plans in place to sign up via telegraph?

Pitiful doesn’t begin to describe the effort. Incompetent is too tame to encompass the leadership. Inept would be a compliment if describing the launch.

And yet we think these people, the people who designed and put this monstrosity together and thought it good enough to launch, can be trusted with our health care.

Really?

It makes one wonder about the collective intelligence of the citizenry.

P.S.  Thought you’d like to know that in the new liberal conventional wisdom, “death panels” are now a “good thing”, especially if the state has final say.

Gee, never saw that coming.

BTW, can anyone guess the greatest lie of the 21st Century to date?

“If you like your insurance and want to keep it, you can.”

~McQ


ObamaCare rollout: When you’ve lost MSNBC …

How bad is it?  Well, here’s a clip of “Morning Joe” on MSNBC.  In it, the group isn’t even polite about it – they simply point out that the administration is now engaged in lying about it’s rollout and the numbers involved.  Even they can’t find it in themselves to prevaricate about what’s been going on.  It’s a disaster and even the left can see that:

Usually, when something is so bad that it can’t be denied, even the left will finally admit it.  Here’s that point.  Two years after it was passed, two years of being able to enlist the help of world class contractors and putting a state-of-the art system together, what have we got?

The Edsel of systems.  In fact, that’s not fair to Edsel.  It at least ran.

Meanwhile, Kathleen Sebelius continues to cash her paychecks.

~McQ


ObamaCare – let the race to the bottom begin

Doctors in New York aren’t particularly happy about ObamaCare:

New York doctors are feeling queasy about ObamaCare — and many won’t participate in the new national insurance program because they fear they’ll go broke, The Post has learned.

“ObamaCare is going to send me more patients to see and then cut the payments to provide the care — that’s what’s going to happen,” predicted Donald Moore, a primary-care doctor in Prospect Heights, Brooklyn. “I will not accept it.”

Moore claims that President Obama made a big mistake by requiring uninsured residents to obtain medical coverage from for-profit insurers through the ObamaCare health exchanges instead of through public health programs like Medicaid.

Under tremendous pressure to keep costs down and profits up, Moore said he’s concerned that commercial insurers will pay doctors less for patient visits and services than either Medicaid or Medicare.

Many doctors, he argues, won’t be able to cover their costs with such skimpy fees.

Moore scoffed, “Who’s going to sustain the losses? The insurance companies? It’s basically going to be a race to the bottom.”

No kidding.  And that’s precisely what was predicted here long ago.  Just because you have insurance doesn’t mean a doctor is going to take you on as a patient.  Result?  The same solution – packed and overcrowded emergency rooms.  Hospitals going broke treating everyone who comes through the door on the pittance their insurer pays for the treatment.

And how do doctors feel about the beginning of ObamaCare?  Well they’re not sure at all how it works:

Despite a much publicized rollout, many other doctors said they haven’t decided whether to become ObamaCare providers, because they haven’t been notified by insurers or the state about ­reimbursement rates.

“I have not spoken with anyone who has made a decision to participate in the exchanges. We simply don’t have any information about which we can make a decision,” said Dr. Paul Orloff, president of the New York County Medical Society.

“We have no idea what the reimbursements will be or what the claims-form process will entail.”

Until they are, why would any sane medical practice take on new patients?

Finally:

The Medical Society of New York State is conducting a survey of doctor concerns about the program and asking whether they will accept patients who buy policies.

“There’s a real question about how many doctors will participate. Doctors are concerned about being left holding the bag,” said Sam Unterricht, an ophthalmologist and the president of the state medical society.

The clumsy launch of ObamaCare in New York and elsewhere — with computer glitches and sketchy information — worries the medical community, he said.

“It’s really shaky right now,” Unterricht said.

Spooked about the payments they’ll receive under ObamaCare, other doctors said they’ve stopped hiring staff for their medical practices.

“I’m apprehensive. I’m certainly not hiring anyone new,” said James Reilly, an obstetrician who has delivered 4,000 babies and heads the Richmond County Medical Society.

“We want to see the impact on the bottom line,” said Reilly, who has a 12-member staff and pays a hefty $200,000 annual medical-malpractice insurance premium.

Yes, the enthusiasm for the new system is, well, overwhelming, isn’t it?  Of course they want to see the impact on the bottom line – they’re small business owners.  Government is involved in price fixing and they’d like to see if they can live with the fixed price or not.  If any other entity was involved in doing what the government is involved in here, they’d have been arrested.

But hey, when government decides it can make legal for itself what is illegal for you (consider the lottery, for instance) then you know you’re on the fast road to total decline.  The sign posts are whipping by so fast, no one can even read them anymore.

~McQ


ObamaCare: Patience is not an American virtue

Experts tell you that you have about 2 seconds to have your webpage download (or at least begin to download) or the person who clicked the link is likely to move on.  We Americans are not a patient people.

So how has that impacted the ObamaCare debacle?  Well, since the disastrous launch of the exchanges, there’s been a huge drop off in attempts:

The number of visitors to the federal government’s HealthCare.gov Web site plummeted 88 percent between Oct. 1 and Oct. 13, according to a new analysis of America’s online use, while less than half of 1 percent of the site’s visitors successfully enrolled for health insurance the first week. …

Based on a sample of two million users — or 1 percent of all online users in the U.S. — which Millward Brown Digital has permission to track, it suggests that the rush of traffic administration officials cited as the cause of the site’s problems trailed off within a matter of days.

Of the 9.4 million unique visitors to the site during the launch’s first week, according to the analysis, roughly a third attempted to register, and a third of that number — 1.01 million — completed registration. Ultimately, roughly 36,000 Americans signed up for an insurance plan online, the report said.

Not that I’m upset, but 36,000 out of 9.4 million is just incomprehensible incompetence at work.

Yet Kathleen Sebelius still has the “full confidence” of the other incompetent in office – one Barack Obama.  No surprise there.  No accountability either.

Meanwhile for those that do manage to get through, sticker shock is sure to await them.

~McQ


The dirty little secret of the ObamaCare scam

Remember, it’s called the “Affordable Care Act” officially, but in reality, it is anything but that.   The purported purpose of the act was to provide a means for people and families to buy affordable health insurance if they weren’t insured.  But, in fact, reality is proving this to be the usual smoke and mirrors government usually manages to produce.   Not only is the insurance more expensive in many cases, it has a higher deductible as well.  From the Chicago Trib.

Adam Weldzius, a nurse practitioner, considers himself better informed than most when it comes to the inner workings of health insurance. But even he wasn’t prepared for the pocketbook hit he’ll face next year under President Barack Obama’s health care overhaul.

If the 33-year-old single father wants the same level of coverage next year as what he has now with the same insurer and the same network of doctors and hospitals, his monthly premium of $233 will more than double. If he wants to keep his monthly payments in check, the Carpentersville resident is looking at an annual deductible for himself and his 7-year-old daughter of $12,700, a more than threefold increase from $3,500 today.

“I believe everybody should be able to have health insurance, but at the same time, I’m being penalized. And for what?” said Weldzius, who is not offered insurance through his employer. “For someone who’s always had insurance, who’s always taken care of myself, now I have to change my plan?”

Do a little math. You are someone who hasn’t been able to afford health insurance in the past. The $1,000 a month you had to pay for your family is unaffordable. So you opt into this system assuming the premium will be lower (Well, you don’t “opt” in, you are required to enroll and pay). And to your joy, it is. Only $500 a month, something you can barely afford, but at last you have insurance.

But wait, there’s more:

To promote the Oct. 1 debut of the exchanges, the online marketplaces where consumers can shop and buy insurance, Obama administration and Illinois officials touted the lower-than-expected monthly premiums that would make insurance more affordable for millions of Americans. But a Tribune analysis shows that 21 of the 22 lowest-priced plans offered on the Illinois health insurance exchange for Cook County have annual deductibles of more than $4,000 for an individual and $8,000 for family coverage.

Those deductibles, which represent the out-of-pocket money consumers must spend on health care before most insurance benefits kick in, are higher than what many consumers expected or may be able to stomach, benefit experts said.

By comparison, people who buy health insurance through their employer have an average individual deductible of just more than $1,100, according to the Kaiser Family Foundation.

An $8,000 family deductible.  So instead of paying $13,100 a year for family coverage that you couldn’t afford (along with a $1,100 deductible you might have been able to struggle through)  you get to pay $14,000 (including deductible) before the insurance you have begins to kick in.

What a deal.  And that, of course, assumes that you can find a doctor that will take your insurance.  Of course that likely won’t matter since unless you have a health care emergency over $14,000 you’re going to be paying cash anyway.

Oh, and don’t even think about saying “screw it” unless you want the IRS on your rear end.

Haven’t enrolled yet?  Get on it, dude.  And good luck (you may up having to pay the penalty anyway because you can’t find a way to enroll):

CNN senior medical correspondent Elizabeth Cohen has been trying for two weeks to sign up for ObamaCare.

Unfortunately as she reported on Monday’s New Day, despite trying for fourteen days including at hours that were claimed to be “off peak,” she still hasn’t been able to establish an account.

~McQ


Competence, incompetence and the Obama administration

USA Today nails it:

President Obama’s chief technology adviser, Todd Park, blames the unexpectedly large numbers of people who flocked to Healthcare.gov and state websites. “Take away the volume and it works,” he told USA TODAY’s Tim Mullaney.

That’s like saying that except for the torrential rain, it’s a really nice day. Was Park not listening to the administration’s daily weather report predicting Obamacare’s popularity?

Park said the administration expected 50,000 to 60,000 simultaneous users. It got 250,000. Compare that with the similarly rocky debut seven years ago of exchanges to obtain Medicare drug coverage. The Bush administration projected 20,000 simultaneous users and built capacity for 150,000.

That’s the difference between competence and incompetence.

Yup … and all we’ve seen, for years with this current administration, is exercises in incompetence.

I remember when the word of the day for Democrats during the Bush years was “incompetence”.  They had to work very hard to try to sell it.

Well, the sales job now would be a walk in the park.  Except the parks are closed.

Incompetence – look in the dictionary and you’ll see this administration depicted.

Worst. Governance. Ever.

And that covers a lot of territory.

~McQ


Happy ObamaCare day …

The sun is out, the birds are chirping, the day is beautiful and … the government is shut down.  I’m not sure, but that may be adding to the beauty of the day.

Meanwhile this is ObamaCare’s first day. Unfortunately, ObamaCare isn’t quite ready.

On Monday, Health and Human Services Secretary Kathleen Sebelius pleaded for patience during a briefing with reporters, acknowledging there would probably be some site issues in the coming days and weeks as the administration moves forward on the sweeping program known as Obamacare. She likened the inevitable fixes to software updates on Apple products such as the iPhone or iPad.

“No one is calling on Apple to not sell devices for a year or to get out of the business because the whole thing is a failure,” she said. “Everyone just assumes there’s a problem, they’ll fix it, let’s move on. . . . Hopefully, they’ll give us the same slack as they give Apple.”

Apple.  She dares to compare this monstrosity to Apple?  Really?

Here’s the reason that comparison doesn’t even begin to hold water:

Health and Human Services Secretary Kathleen Sebelius has had since March 2010 to prepare for open enrollment’s October 2013 rollout. Besides churning out thousands of pages of regulations, what have she and her army been doing?

Someone performing as Sebelius has in the private sector would have been fired at least a year ago, when it become obvious that her implementation plan — having already missed critical deadlines almost two years ago – was still hopelessly behind.

However, this would have been an admission of failure during an election year.

Instead, Sebelius and the administration unilaterally, and illegally, delayed imposing the employer mandate requiring companies to cover “full-time” employees — defined as any employee who works an average of 30 hours per week — for one year. The political motivation behind this cop-out is so transparent, one wonders if the delay wasn’t hard-coded in the plan. There has been no change in the individual mandate, which requires individuals and families to have health insurance coverage beginning next year or face a fine. So the employer mandate delay combined with the still-present individual mandate will force more Americans into the state health insurance exchanges. The administration is likely intent on making the process of undoing the exchanges as difficult as possible.

Apple would a) meet their deadline and b) have the product ready for the launch or c) some heads would roll.

So why is Sebelius still at HHS?

Oh, that’s right … because we don’t hold people in government accountable for anything, do we?

Which, of course, is a big part of the reason we’re in the mess we’re in today.

Frogs marching or heads rolling (figuratively speaking) might begin to change a culture that know no matter how inept or incompetent they are, nothing of significance will happen to them. And after all, it’s your money they’re wasting, isn’t it?

~McQ


Rule of man, not of law? See ObamaCare (and much else)

Apparently our laws are arbitrary if you’re in a favored group.  All you have to do is appeal to the King for an exemption:

Back in 2009, when Democrats were writing the massive new national health care scheme, Iowa Republican Sen. Chuck Grassley offered an amendment. Obamacare created exchanges through which millions of Americans would purchase “affordable” health coverage. Grassley’s amendment simply required lawmakers, staff, and some in the executive branch to get their insurance through the exchanges, too.

To every Republican’s amazement, Democrats accepted the amendment. It’s never been fully clear why; the best theory is they intended to take the provision out in conference committee, but couldn’t do so because they lost their filibuster-proof 60-vote majority. In any event, Obamacare — the law of the land, as supporters like to say — now requires Congress to buy its health care coverage through the exchanges.

That has caused Democratic panic as the formal arrival of Obamacare nears. Right now, all lawmakers and staff are entitled to enjoy generously-subsidized coverage under the Federal Employees Health Benefits plan. Why give up that subsidy and go on the exchanges like any average American?

But that’s the law. It could be amended, but Democrats, who voted unanimously for Obamacare, couldn’t very well expect much help from Republicans, who voted unanimously against it. So over the summer Democrats asked President Obama to simply create an Obamacare exception for Capitol Hill.

And the King, looking down upon his faithful minions waved his hand and came up with a “solution” by executive fiat that uses tax dollars to circumvent the law:

Not long after — presto! — the Office of Personnel Management unveiled a proposed rule to allow members of Congress, their staff, and some executive branch employees to continue receiving their generous federal subsidy even as they purchase coverage on the exchanges. No ordinary American would be allowed such an advantage.

However, a rebellion was cooking:

Vitter watched the maneuvering that led to the OPM decision. He began work on what became the Vitter Amendment, which he likes to call “No Washington Exemption from Obamacare,” that would reverse the OPM ruling. It specifies that members of Congress, staff, the president, vice president and all the administration’s political appointees buy health coverage through Obamacare exchanges. If any of them earn incomes low enough to qualify for regular Obamacare subsidies, they will receive them — just like any other American. But those with higher incomes will have to pay for their coverage on the exchanges — just like everybody else.

Vitter hasn’t exactly thrilled his colleagues. “There has been a lot of pushback behind the scenes, including from many Republicans,” he says. Political types have complained that the requirement will cause “brain drain” on the Hill as staffers escape the burden of paying for their own coverage. “My response is, first of all, it’s the law,” says Vitter. “Look, this is a disruption. It’s exactly what’s happening across America, to people who are going to the exchanges against their will. To me, that’s the point.”

Ron Johnson, the Republican senator from Wisconsin, is one colleague delighted by Vitter’s move. The idea of equal Obamacare treatment for Washington is enormously popular around the country, Johnson points out, which means even lawmakers who don’t like it will be afraid to oppose it.

“I think most members don’t want to vote to reject the OPM ruling,” Johnson says. “But I think most members would vote to do that, if they were forced to, because it is so politically unpopular to have special treatment for members of Congress and their staff.”

Seems it should be unnecessary to again make it clear that Congress should have to obey the law – to the letter – just like everyone else.  That was what the original law said, no?  Yet they managed a workaround that defeated the intent of the law, didn’t they?

So now another amendment is now necessary?

And here I thought that these folks were servants of the people and not a ruling elite (by the way, the big excuse is there’ll be a huge “brain drain” if the law is left in place.  Let me be the first to say, given the shape our country and government are in at the moment, I’d welcome the ‘brain drain’).

Make ‘em obey the law.  Make them navigate the same atrocity they foisted on the public.  No exemptions, no exceptions.  And that goes for every law they pass.

Period.

~McQ


Let ObamaCare collapse on its own

While I took issue with John McCain’s refusal to do anything about defunding ObamaCare, my issue was with the refusal more than anything.  McCain had no alternative.  He just refused to do anything.

There is an alternative however.   And Daniel Henninger, in today’s Wall Street Journal, articulates it:

As its Oct. 1 implementation date arrives, ObamaCare is the biggest bet that American liberalism has made in 80 years on its foundational beliefs. This thing called “ObamaCare” carries on its back all the justifications, hopes and dreams of the entitlement state. The chance is at hand to let its political underpinnings collapse, perhaps permanently.

If ObamaCare fails, or seriously falters, the entitlement state will suffer a historic loss of credibility with the American people. It will finally be vulnerable to challenge and fundamental change. But no mere congressional vote can achieve that. Only the American people can kill ObamaCare.

No matter what Sen. Ted Cruz and his allies do, ObamaCare won’t die. It would return another day in some other incarnation. The Democrats would argue, rightly, that the ideas inside ObamaCare weren’t defeated. What the Democrats would lose is a vote in Congress, nothing more.

He’s right.  Defunding it simply leaves the question “would it have worked if you inbred Republicans hadn’t stopped it?  All indications are this abomination will collapse under it’s own fetid weight.  Why?  Because, as I said, it’s an abomination.

Consider this from Megan McArdle:

During the design and passage of the Affordable Care Act, its architects and supporters described a fantastic new system for buying insurance. You would go onto a website and enter some simple information about yourself. The computer system would fetch data about you from various places — it would verify income with the Internal Revenue Service, check with the Department of Homeland Security to ensure that you were a citizen or legal resident, and tap a database of employer coverage to make sure that you were not already being offered affordable coverage (defined as 9.5 percent of your income or less) by your employer. Provided you passed all those tests, it would calculate what subsidies you were eligible for, and then apply that discount automatically to the hundreds of possible policies being offered on the exchange. You would see the neatly listed prices and choose one, buying it as easily as you buy an airline ticket on Travelocity.

Before I went to business school, I used to work in an IT consultancy, and setting up this system sounded like an enormous job to me — a five- to eight-year job, given government procurement rules, not a three-year rush special. But Obamacare’s stewards seemed very confident, so I assumed that they must have it covered.

As time wore on, the administration has steadily stripped major components out of the exchanges and the data hub behind them as it became clear that they couldn’t possibly make the Oct. 1 deadline when all of this was supposed to be ready. The employer mandate was delayed, and then it was announced that at least some of the exchanges would be relying on self-reporting of income, rather than verifying with the IRS. . . .

How did we get to this point? The exchanges were the core selling point of Obamacare. (The Medicaid expansion was actually a bigger part of the coverage expansion, at least until the Supreme Court ruled that the administration couldn’t force states to take part, but it tended to be downplayed, because no one’s exactly a huge fan of Medicaid.) They were going to introduce competition to a fragmented and distorted marketplace, and make it easy for middle-class people to buy affordable coverage from a bevy of insurers. How can it be that one week before the deadline for opening, no one’s really sure the exchanges are going to work?

No exchanges, no ObamaCare.

Oh, and be amazed by the usual government planning:

I work for one of the largest Telecom providers in the country. I’m an engineer who designs dedicated data links (DS3s, OC3s, etc…) for major companies across the US.

For background, some of these circuits can be put up fairly quickly, but not the ones that I work on. The ones I design can take up to 90 business days to install.

Anyways, a few weeks ago, we got deluged with orders for circuits that needed to be installed by October 1st. These were circuits to support Obamacare.

Needless to say, they aren’t going to make that deadline. Some of the circuits are being held up due to construction builds that won’t be complete until the end of November. The others won’t make the deadline due to the complexity and the number of various companies involved.

Yes, these are the same people you handed your health care too.

Soooo … what will the administration do?  Well, delay it of course.  But again I point you to McArdle’s point.  We’re not simply talking about a simple IT project here.  It may never work.

Henninger’s point is very valid.  So I officially sanction Dale’s point of view in this case and say “let ‘em have it (good and hard)”.  Let them have the bureaucracy, frustration, increased cost and incompetence that has been the hallmark of the Democrats and this administration.  Then:

An established political idea is like a vampire. Facts, opinions, votes, garlic: Nothing can make it die.

But there is one thing that can kill an established political idea. It will die if the public that embraced it abandons it.

Six months ago, that didn’t seem likely. Now it does.

The public’s dislike of ObamaCare isn’t growing with every new poll for reasons of philosophical attachment to notions of liberty and choice. Fear of ObamaCare is growing because a cascade of news suggests that ObamaCare is an impending catastrophe.

And catastrophe it is.  Let is burn.  Let it crash, burn and kill this nonsense once and for all.

~McQ

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