Free Markets, Free People

ObamaCare


Observations: The Qando Podcast for 03 Oct 10

In this podcast, Bruce, Michael, and Dale discuss the Meg Whitman controvery in California, public pensions, and Obamacare.

The direct link to the podcast can be found here.

Observations

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Promises, promises: If you like your insurance … nothing changes.

Remember this promise (it begins at about the 1:10 mark):

Here’s the reality:

Harvard Pilgrim Health Care has notified customers that it will drop its Medicare Advantage health insurance program at the end of the year, forcing 22,000 senior citizens in Massachusetts, New Hampshire, and Maine to seek alternative supplemental coverage.

[...]

Under Medicare Advantage plans, the federal government pays private health insurers to sell customers over 65 years old enhanced policies, many of which offer prescription drug coverage not covered by standard Medicare. But the US Centers for Medicare and Medicaid Services has been seeking to reduce the amount it pays to private insurers for such programs.

Medicare told Harvard Pilgrim to notify customers that its Medicare Advantage program, known as First Seniority Freedom, was being canceled. In a mailing, the insurer was required to list alternative Medicare Advantage plans, including those offered by its competitors.

[...]

It will be “slightly more expensive’’ than the Medicare Advantage plans, but competitive with supplemental insurance plans offered by rivals such as Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, Bowman said.

Now I assume anyone who has read this blog for more than a day knows I’m not trying to argue for subsidized health insurance here.

Far from it. What I’m pointing out is the basic dishonesty that was rampant in the President’s promises about health care. An integral part of the plan to "pay for it" involved cutting out Medicare Advantage – an insurance supplemental plan that many seniors had and wanted to keep.

As you hear in the video, the promise wasn’t ambiguous or couched in rhetoric that gave a lot of wiggle room. Obama flat out says "if you like your insurance you can keep it. Nothing changes", or words to that effect.

A pure and unadulterated lie that he still tends to throw out there when trying to hype this white elephant Congress rammed through.

The simple fact – something anyone who took to understand where the Democrats were headed with this turkey – is that there was no way everyone could keep their insurance because the law was written to change the way insurance was delivered. And on the table, from the beginning, were cuts in Medicare that focused on eliminating what? An insurance program called Medicare Advantage.

It is one thing to watch a politician shade the truth a bit. It is quite another to watch one tell a bald faced lie (and I mean “lie” in the truest sense of the word, not how some tend to use it today). This one fits the latter category.

HT: Arley Ward

~McQ


The GOP’s temporary strategy to block Obama admin legislation

In a few words it can be summed up by "deny funding".

Republicans will try to block money requested by the Obama administration to implement Democrats’ signature Wall Street and healthcare reforms in a stopgap spending measure expected to clear Congress next week. The GOP is seizing on the administration’s funding request as an opportunity to send a message to voters that it wants to reduce government spending and provide a check on President Obama.

Given they don’t have the votes to repeal it and override the presidential veto which is sure to follow any such attempt, this is about their only choice. How effective it would be – both politically and in reality – remain unknown. As one might imagine, the blowback potential is significant.

The first test – since Democrats haven’t passed a budget – is a continuing resolution (CR) necessary to keep government funded beyond Sept. 30, the end of the fiscal year.  It is needed to prevent a government shutdown.  Republicans are planning to target those parts of the spending request which apply to funding parts of the new legislation:

The Obama administration has asked appropriators crafting the CR to include roughly $20 billion in new spending, according to GOP appropriators.

That request includes $250 million for doctors, nurses, physician assistants and other primary-care health workers. In asking appropriators for the money, the administration said the increase in health workforce funding is needed to meet the demands of the newly insured under the Democrats’ healthcare act.

The administration also requested $14 million for the Treasury Department so it can carry out the new Wall Street reforms.

Says Sen. Lamar Alexander:

“If the question is whether to approve money to fund certain parts of the healthcare law, that’s certainly one way to try to limit its impact,” he said.

Indeed, without majorities or the White House, this is the only avenue that’s really open to the GOP.

Of course that’s brought the usual obstructionist charges from Democrats:

Sen. Patrick Leahy (D-Vt.) blamed Republicans for the need to resort to a stopgap spending measure in the first place.

“I’d much prefer doing individual bills, but with the Republicans blocking everything, that’s hard to do,” Leahy said.

Yeah, bi-partisanship is a bitch, huh Senator – especially when you can’t just ram things through with an filibuster proof majority as you once could.  Someone get him a little cheese for that whine.

In the meantime this is the best way for the GOP to lessen the impact of the bad legislation this administration has passed, until they can gain the majorities and the White House and work toward repeal.

~McQ


Why health care reform makes the economy Obama’s fault

The “blame Bush” strategy for explaining the economy isn’t resonating with voters an LA Times story tells us.  And I think the reason is summed up very nicely by a 68 year old woman from Columbus, OH:

But Peggy Swope, for one, isn’t so sure. There are plenty of reasons the economy tanked, says the 68-year-old independent, and it’s not like Obama has done such a great job turning things around. "He was so fixated doing what he thought he needed to do on healthcare that he let everything else go," said Swope, a Columbus retiree.

Now we obviously can get tied down in arguments of whether or not Bush had a hand in the downturn and whether or not Obama really could do all that much.  But those arguments are going to fall on deaf ears because, as we’ve pointed out many, many times, in politics, perception is reality.  And I think Ms. Swope’s perception of why we’re still in the economic shape we’re in is one that is shared by a large number of voters.

And most voters aren’t interested in what got us there – that’s history, and besides, even if you believe Bush to be at least partly at fault, he’s been gone for almost 2 years.

What they are interested in is why it got worse and most importantly, why it doesn’t seem to be getting any better in the economy.  And blaming that on Bush is a hard sale – especially when Democrats spent all their time and effort on ramming health care through and essentially ignoring the economy as millions more Americans joined the unemployment line.

So:

Though most Americans remain critical of Bush’s record on the economy — 71% in a recent USA Today-Gallup poll said he deserved a great deal or moderate amount of blame for the slow growth and high jobless rate — more than half of those polled were unhappy with Obama’s performance. More to the point, they hold him responsible for fixing the problem, regardless of who caused it.

Bottom line: blaming Bush is a loser and viewed as nothing more than the usual sniping that politicians do at this point.  This economy now belongs to the Democrats and Obama. They chose health care over jobs.  Now they get to pay the piper.  Playing the blame game isn’t going to advance the Democrats chances anymore.  That era is ended.  They’re now stuck with the one they run.  And the voters are in no mood for the games of 5 year olds when it comes to the economy.

~McQ


Wow – how “unexpected”

OK, not really.  After all as our Speaker of the House said, “we have to pass the bill so we can find out what’s in it”, or words to that effect.  And sure enough, as we actually read the result of rushed monstrosity called ObamaCare, we keep finding more and more goodies hidden within.

For instance:

Colleges and universities say that some rules in the new health law could keep them from offering low-cost, limited-benefit student insurance policies, and they’re seeking federal authority to continue offering them.

Their request drew immediate fire from critics, however, who say that student health plans should be held to the same standards that other insurance is.

Among other things, the colleges want clarification that they won’t have to offer the policies to non-students.

Without a number of changes, it may be impossible to continue to offer student health plans, says a letter that the American Council on Education sent Aug. 12 to Health and Human Services Secretary Kathleen Sebelius, signed by 12 other trade associations that represent colleges.

I can certainly understand the point of the critics, can’t you?  “If we make an exception for those guys … etc”.  Heh.  My guess is this piece of garbage will add another 2500 pages of “exceptions” before this is all said and done.  And somewhere in there our lawmakers will find a way to exempt themselves as well.

Meanwhile the rush to sign up for ObamaCare has been incredible:

Just two people in New Jersey will begin receiving coverage Monday under new plans created by federal health care reforms.

NJ Protect plans are available to those who have been without insurance for at least six months and submit evidence of pre-existing health conditions.

Yup, just busting down the doors:

Vincz says more than 600 applications were downloaded and 268 information kits were sent out following the program’s announcement on Aug. 1.

~McQ

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Prepare for the new ObamaCare messaging

Ben Smith at POLITICO reports that Democrats are switching their messaging strategy when it comes to the ObamaCare legislation (and I’d guess one of the strategies is not to call it “ObamaCare”).  Seems they’ve conceded the argument that it will lower the deficit and cost less.  Facts are stubborn things and few have bought into the claims given the justification for them given by Democratic leaders.

So now they’ll go more nebulous instead.  Call it the medical care “hope and change” approach.  Now instead of lower deficits and less cost, they’re going to tout the law as a way to “improve” health care.

As one slide in the presentation – available here – says, “Many don’t believe health care reform will help the economy.”  That’s absolutely correct.  And, unlike Washington DC, most in flyover country passed their "Common Sense 101” course years ago while holding a job or running a business, raising a family and managing a household.  Most of them can spot a scam fairly easily and this was always in that category given the machinations necessary to make it “bend the cost curve down”.  Immediate taxes and delayed benefits were the first sign some game was afoot.  “Doc fixes” and half a trillion Medicare cuts that would never happen plus some double counting used to claim deficit reduction were the second.  And a new and extensive bureaucracy promised health care would be much more complicated and expensive.  Of course everyone loved the new individual mandate as well, not to mention the billions of dollars in mandates shifted to the states.

So this is the pig they’re trying to sell as “improved” as in “this law improves health care”.

How?

One slide says, “Tap into individual responsibility to blunt opposition to the mandate to have individual insurance.”  It then says, “Those who choose not to have insurance and use the emergency room for routine care are increasing the cost for the rest of us who have insurance.”

Interesting slide for the group most singularly responsible for attempting to make more and more people dependent on government throughout it’s history.  Suddenly it’s about “individual responsibility” while defending one of the biggest government takeovers of an industry in our history.

Oh, and, as pointed out with MassCare – ObamaCare’s little brother – the use of emergency room facilities went up with their mandated insurance law:

When the Bay State passed its health-reform law in 2006, 9 percent of non-elderly adults lacked insurance; that’s now down to 5 percent. The law didn’t reduce expensive emergency-room use as predicted. Instead, emergency-room visits have climbed by 9 percent, or about 3 million visits, from 2004 to 2008.

And, of course, so have costs with health care now consuming 35% of the state’s budget as compared to 22% before the law’s passage.  All predicted (back to Common Sense 101) and all coming true as expected.

Last, but certainly not least, Democrats will use a little class warfare to "please” voters, one assumes:

image

Obviously anyone with the cognitive ability to open a box of crayons knows that the rich can’t pay for all of this by any stretch.  Another in a long line of lies about “paying for” this monstrosity.  The second part of the slide is just a flat out lie.  Remember, ObamaCare is based on the primary care physician.  And that’s a medical care area that has a shortage now and that shortage is going to get worse:

The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP).

That’s right, dropped 51.8% since 1997.  So tell me again about that “unprecedented number of new healthcare providers” being trained?  Because I don’t know who they are, but they aren’t the supposed foundational specialty on which ObamaCare is based according to the AAFP.

And those doctors who are in primary care are cutting their hours.  Why?

Payment issues may have played more of a role. The overall decrease in hours coincided with a 25% decline in pay for doctors’ services, adjusted for inflation. And when the researchers looked closely at U.S. cities with the lowest and highest doctor fees, they found doctors working shorter hours in the low-fee cities and longer hours in the high-fee cities.

Yup, no pending crisis at all – aided and abetted by a government that has decided it will “lower costs” even though it is no longer going to emphasize that point to the proles.

And what about nurses?

In the July/August 2009 Health Affairs, Dr. Peter Buerhaus and coauthors found that despite the current easing of the nursing shortage due to the recession, the U.S. nursing shortage is projected to grow to 260,000 registered nurses by 2025.  A shortage of this magnitude would be twice as large as any nursing shortage experienced in this country since the mid-1960s.

Amazing what they try to put past you, isn’t it?  Which brings us to the irony of the day:

image

Yup – keep those claims “small and credible” like the lies about more health care providers – and for heaven sake “don’t over promise or ‘spin’ what the law delivers’ – like lower cost, the ability to keep your plan and your doctor and, of course, control over your own health care.

Because we wouldn’t want to see this new and “improved” law repealed or neutered, would we?

~McQ

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MassCare best previews life under ObamaCare

And it isn’t a pretty picture. It also emphasizes how wrong many of the claims that have been made for ObamaCare are. For instance, remember the claim made that when everyone has insurance it will cut the use of the emergency room dramatically.

When the Bay State passed its health-reform law in 2006, 9 percent of non-elderly adults lacked insurance; that’s now down to 5 percent. The law didn’t reduce expensive emergency-room use as predicted. Instead, emergency-room visits have climbed by 9 percent, or about 3 million visits, from 2004 to 2008.

Or, how about the claim that it would significantly lower the cost of medical care – to the patient and the government:

Health care now consumes 35 percent of the state budget, up from 22 percent in 2000. Patrick recently asked Washington for $473 million to help make the Massachusetts reform work — on top of the $1.2 billion in support the feds have already kicked in over three years, more than $3,000 per person in the state.

And physicians? Why they’ll be competing for your business as government cuts payments to hospitals and doctors:

Reimbursements are already so low under the state-subsidized plans (most of whose 152,000 enrollees pay nothing) that doctors are already refusing to accept new patients with that "coverage."

Oh, and if you like your doctor and your plan, you can keep both – guaranteed:

Yet small businesses are clearly finding it necessary to dump their employees on the public health plans. The Boston Globe recently reported on a broker who helps firms do just that; his practice is booming. He’s seen about 90 business owners terminate their plans since April.

MassCare is almost identical to ObamaCare – many of the same people who authored it were instrumental in putting the federal monstrosity together.  Reviewing the above 4 items, I’d say they’re 0 for 4 in their promises.  The sad thing is we had this example at a state level there to study and as usual, the media wasn’t able to manage the comparison during the weeks of hype surrounding the bill before its passage.

This is you life on ObamaCare.  More money, fewer choices, less care.

That’s what happens when the gullible buy into the “something for nothing” political promises of a pack of charlatans and snake oil salesmen.

~McQ

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Missouri says "no" to ObamaCare

In the most telling poll of all – a vote – the citizens of Missouri overwhelmingly voted not to participate in ObamaCare. 71% voted for Proposition C which prohibits Missouri from compelling people to pay a penalty or fine if they fail to carry health coverage.

Of course that obviously doesn’t mean that percentage isn’t going to or doesn’t carry health coverage. Instead it is a grassroots rejection of the premise that the federal government has either the power or authority to make them. And they’ve just prohibited their state from enforcing such a law.

 However:

The Missouri vote is likely to have little immediate practical effect because the mandate doesn’t take effect until 2014. If federal courts uphold the federal law as constitutional, it would take precedence over any state law that contradicts it.

And, of course, I loved this:

Opponents included the Missouri Hospital Association, which said that if the mandate isn’t enforced some who can afford insurance will get a free ride and pass the costs on to those who are insured.

Really? You mean like what is done now under Medicare and Medicaid?

But I think this Missouri state senator may have the best point:

“This really wasn’t an effort to poke the president in the eye,” said State Senator Jim Lembke, a Republican. “First and foremost, this was about defining the role of state government and the role of federal government. Whether it’s here in Missouri with health care or in Arizona with illegal immigration, the states are going to get together on this now.”

States have been getting the short end of the mandate stick for decades.  Yet many of them work under two constraints the federal government doesn’t.  One, most of them are required by law to have a balanced budget.  Unfunded mandates of the sort imposed by ObamaCare take a wrecking ball to that sort of requirement.  Secondly, the states can’t print money at their whim.  Therefore they must borrow any money to fulfill the mandates.

This and the Arizona law may be the first shots in a long war that sees the states again asserting their rights.  It will mostly be fought out in the courts and its outcome is going to be critical to the America we are a part of in the future. 

If the courts side with the Obama administration, then there’s just about nothing the federal government can’t do or  which it can’t involve itself.   And as we’ve seen in the last 18 months, it doesn’t take long, if the circumstances are right, for it to intrude to levels never before seen.

But regardless of the outcome in court, the Missouri vote is important.  The “Show Me” state is a rather purple state, so I think most expected the vote to be somewhat close with those rejecting ObamaCare winning out.  Instead, we see a huge margin rejecting the premise.

It should send a signal to both parties, and it should certainly have Democrats quaking in their boots about November.

Whether or not the parties will heed the message remains to be seen, but the voters of Missouri have pretty much voiced what I think the majority of this country feels – “thanks, but no thanks”.  Back off, downsize and cut spending.  And stay out of our lives and our health care.

~McQ

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Charting health care’s demise and government’s growth

Rep. Kevin Brady (R-TX) had his staff do a study of the ObamaCare bill after its passage to assess exactly what Democrats had blindly passed into law. He also asked his staff to put a chart together to represent the health care system under that law.

The result is mind-boggling and troubling. And if you figured the Secretary of Health and Human Services was the new defacto health care czar, backed by the IRS, you’re correct.

Below is a thumbnail of the chart to give you a flavor of its complexity. Brady admits only represents a third of what is in the bill after which it got too crowded. Said Brady, "it’s actually worse than this."

obama_chart

You can see a full size representation of the chart here.  As you peruse it read the legend carefully.  You’ll notice 3 areas color coded – “new government”, “expanded government” and “private”.  It also charts “new relationships”, such as regulations, requirements and mandates, reporting requirements, oversight and money flow.

Evident to anyone with the IQ of a mushroom is the incredible complexity of what our masters in Congress cobbled together in haste and passed before anyone could actually read the thing through and study the probable consequences.  The chart includes:

  • $569 billion in higher taxes;

  • $529 billion in cuts to Medicare;

  • Swelling of the ranks of Medicaid by 16 million;

  • 17 major insurance mandates; and

  • The creation of two new bureaucracies with powers to impose future rationing: the Patient-Centered Outcomes Research Institute and the Independent Payments Advisory Board.

As might be expected, ObamaCare fulfills almost all the promises of the critics – top driven, bureaucratic, complex, expensive and set up to ration health care.

The chart gives visual evidence of the type monstrosity that has been foisted upon the American public by Democrats.  Says Kevin Hassett:

This clearly is a candidate for most disorganized organizational chart ever. It shows that the health system is complex, yes, but also ornate. The new law creates 68 grant programs, 47 bureaucratic entities, 29 demonstration or pilot programs, six regulatory systems, six compliance standards and two entitlements.

Yes friends, the DMV teaming up with the Post Office, have now “organized” your health care and promise it will be “better and less expensive”.

And don’t forget – your new health care czar has the power to make judgments about health care that, by law, cannot be challenged either through an administrative process or the courts.  So you are stuck with whatever the Sec HHS decides.  That means:

A sprawling, complex bureaucracy has been set up that will have almost absolute power to dictate terms for participating in the health-care system. That’s what the law does to government. What it does to you is worse.

Based on the administration’s own numbers, as many as 117 million people might have to change their health plans by 2013 as their employer-provided coverage loses its grandfathered status and becomes subject to the new Obamacare mandates.

Those mandates also might make your health care more expensive. The Congressional Budget Office predicts that premiums for a small number of families who buy their insurance privately will rise by as much as $2,100.

Finally, and as noted above, there is to be a huge expansion in Medicaid “paid for” by cutting care to the elderly:

To pay for this expansion, the bill takes $529 billion from Medicare, with roughly 39 percent of the cut coming from the Medicare Advantage program. This represents a large transfer of resources, sacrificing the care of the elderly in order to increase the Medicaid rolls.

Another revenue source are the “Cadillac plans” – for those who have them and pay for them, the gig’s up:

Front and center among the new taxes is the 40 percent excise tax on those lucky people with so-called Cadillac health plans. The higher insurance costs that are driven by the government mandates will push many more ordinary plans into Cadillac territory.

As we’ve discussed, the bill relies on a constant revenue stream from these insurance plans from now on, assuming everyone will pay the 40% increased cost to keep their plans.  That’s not likely at all, and cutting these plans will effect millions – many of whom bought in lock, stock and barrel, to the promise “if you like your doctor and you like your plan, you can keep both”.

Look at this chart and tell me how you do that.

Yesterday a federal judge in VA ruled that the state of Virginia had “standing” to sue the federal government over the law.  That, of course, means nothing more than the lawsuit moves forward, but it is an important first step in repealing this monstrosity or at least the more intrusive and odious parts of it.  Obviously it doesn’t ensure success in that endeavor and the White House typically believes it is on the side of angels and the Constitution when it comes to running our lives.

We’ll see.  But clearly Nancy Pelosi was right when she said “we have to pass the bill to see what’s in the bill”.  Now that we have this chart, we know what’s in the bill – the largest power grab by the federal government since the income tax.

“Change” you can believe in, huh?

~McQ

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