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Free Markets, Free People

A doctor’s lament will become a patient’s nightmare

Thought you’d like to see this letter to a Congressman from a doctor in Decatur, AL.  He outlines the problems that ObamaCare has put on that profession and correctly identifies what is going on as a “war on doctors”.  The obvious losers in all of this will eventually be the patients, both current and future as the government further pushes itself between doctors and their patients.  It will also provide a disincentive to those who might possibly be entertaining entering the health care field as doctors in the future.

This has nothing to do with markets and voluntary exchange.  This is about government intrusiveness, regulatory overkill and rampant bureaucracy in action:

Dear Congressman Brooks,

As a practicing family physician, I plead for help against what I can best characterize as Washington’s war against doctors.

The medical profession has never before remotely approached today’s stress, work hours, wasted costs, decreased efficiency, and declining ability to focus on patient care.

In our community alone, at least 6 doctors have left patient care for administrative positions, to start a concierge practice, or retire altogether.

Doctors are smothered by destructive regulations that add costs, raise our overhead and ‘gum up the works,’ making patient treatment slower and less efficient, thus forcing doctors to focus on things other than patient care and reduce the number of patients we can help each day.

I spend more time at work than at any time in my 27 years of practice and more of that time is spent on administrative tasks and entering useless data into a computer rather than helping sick patients.

Doctors have been forced by ill-informed bureaucrats to implement electronic medical records (“EMR”) that, in our four doctor practice, costs well over $100,000 plus continuing yearly operational costs . . . all of which does not help take care of one patient while driving up the cost of every patient’s health care.

Washington’s electronic medical records requirement makes our medical practice much slower and less efficient, forcing our doctors to treat fewer patients per day than we did before the EMR mandate.

To make matters worse, Washington forces doctors to demonstrate ‘meaningful use’ of EMR or risk not being fully paid for the help we give.

In addition to the electronic medical records burden, we face a mandate to use the ICD-10 coding system, a new set of reimbursement diagnosis codes.

The current ICD-9 coding system uses roughly 13,000 codes. The new ICD-10 coding system uses a staggering 70,000 new and completely different codes, thus dramatically slowing doctors down due to the unnecessary complexity and sheer numbers of codes that must be learned.

The cost of this new ICD-10 coding system for our small practice is roughly $80,000, again driving up health care costs without one iota of improvement in health care quality.

Finally, doctors face nonpayment by patients with ObamaCare. These patients may or may not be paying their premiums and we have no way of verifying this. No business can operate with that much uncertainty.

On behalf of the medical profession, I ask that Washington stop the implementation of the ICD-10 coding system, repeal the Affordable Care Act, and replace it with a better law written with the input of real doctors who will actually treat patients covered by it.

America has enjoyed the best health care the world has ever known. That health care is in jeopardy because physicians cannot survive Washington’s ‘war on doctors’ without relief.

Eventually the problems for doctors will become problems for patients, and we are all patients at some point.

Sincerely yours,

Dr. Marlin Gill of Decatur, Alabama

This is the face of government run healthcare.

~McQ

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Imperial White House cancels Medicare Advantage cuts to help Dems in mid-terms

The White House has once again bowed to screaming Democrats worried about the mid-term elections and this time cancelled cuts to Medicare Advantage. As you recall, these cuts were made to pay for ObamaCare:

The Obama administration announced Monday that planned cuts to Medicare Advantage would not go through as anticipated amid election-year opposition from congressional Democrats.

The cuts would have reduced benefits that seniors receive from health plans in the program, which is intended as an alternative to Medicare.

Under cuts planned by the administration, insurers offering the plans were to see their federal payments reduced by 1.9 percent, which likely would have necessitated cuts for customers.
Instead, the administration said the federal payments to insurers will increase next year by .40 percent.

The healthcare law included $200 billion in cuts to Medicare Advantage over 10 years, in part to pay for ObamaCare.

The Centers for Medicaid and Medicare Services (CMS) said that the cuts weren’t necessary because of an “an increase in healthy beneficiaries under Medicare.” That, of course, makes little sense. Medicare is a mandatory insurance program for people 65 and older. How that demographic suddenly got “healthier” remains a mystery, but there you have the “reason” for the decision. Well, that and mid-term elections.

As for cost, someone needs to explain how ObamaCare is to be funded if the mechanisms set in place to pay for it keep getting delayed or cancelled.

When CBO analysts most recently looked at the gross cost of expanding Medicaid and giving subsidies to individuals to purchase insurance through the new exchanges — the bulk of the law’s spending — they came up with slightly more than $2 trillion for 2015 through 2024.

After deducting some offsets from the law — such as penalty payments from employers and individuals due to insurance mandates — CBO estimated the net cost at nearly $1.5 trillion.

The CBO hasn’t done a standalone deficit analysis on Obamacare since 2012, but at that time, its analysts estimated the law would reduce deficits by $109 billion, once all tax increases, cuts to Medicare and other savings are taken into account.

When referring to the “cost” of Obamacare, the fair thing to do is cite the $2 trillion figure — and no, that isn’t just because it’s a higher number. The gross figure represents how much the federal government will have to spend on expanding coverage through Obamacare, at least according to the CBO. If the government weren’t spending $2 trillion on insurance coverage, that’s money that could be going to reducing the deficit, spending more on infrastructure or a host of other theoretical policies.

As mentioned above, that $2 trillion cost had about $500 billion in offsets. But the penalty payments from employers and individuals has been delayed and now the $200 billion in Medicare Advantage cuts/offsets is cancelled, or so says the imperial presidency. That, of course, doesn’t change the cost, it only increases it.

Short term political pandering aimed at winning elections as usual from this administration. Ironically, it has been more effective than the Republicans in dismantling portions of the atrocity known as ObamaCare. So, thanks to the mid-terms, Republicans get one of the cuts they wanted reversed cancelled. Of course they won’t get credit for it – but then that’s the plan isn’t it?

And, this is all likely temporary anyway, even though the White House and Dems won’t spin it as so:

“The changes CMS included in the final rate notice will help mitigate the impact on seniors, but the Medicare Advantage program is still facing a reduction in payment rates next year on top of the 6 percent cut to payments in 2014,” said [AHIP] president Karen Ignagni.

But it will get them through the election cycle, won’t it?

~McQ

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Defining the alarmist problem

While doing a  review of Rupert Darwall’s book “The Age of Global Warming”, Charles Moore does an excellent job of succinctly identifying the alarmist movement’s core origins and core identity:

The origins of warmism lie in a cocktail of ideas which includes anti-industrial nature worship, post-colonial guilt, a post-Enlightenment belief in scientists as a new priesthood of the truth, a hatred of population growth, a revulsion against the widespread increase in wealth and a belief in world government. It involves a fondness for predicting that energy supplies won’t last much longer (as early as 1909, the US National Conservation Commission reported to Congress that America’s natural gas would be gone in 25 years and its oil by the middle of the century), protest movements which involve dressing up and disappearing into woods (the Kindred of the Kibbo Kift, the Mosleyite Blackshirts who believed in reafforestation) and a dislike of the human race (The Club of Rome’s work Mankind at the Turning-Point said: “The world has cancer and the cancer is man.”).

These beliefs began to take organised, international, political form in the 1970s. One of the greatest problems, however, was that the ecologists’ attacks on economic growth were unwelcome to the nations they most idolised – the poor ones. The eternal Green paradox is that the concept of the simple, natural life appeals only to countries with tons of money. By a brilliant stroke, the founding fathers developed the concept of “sustainable development”. This meant that poor countries would not have to restrain their own growth, but could force restraint upon the rich ones. This formula was propagated at the first global environmental conference in Stockholm in 1972.

Indeed, the resulting grouping was a natural one.  Eco radicals out to ‘save the world’ from evil capitalism (and man) and poor countries looking for a way to extort billions from rich countries without having to do anything of note to help themselves.

The G7 Summit in Toronto in 1988 endorsed the theory of global warming. In the same year, the Intergovernmental Panel on Climate Change was set up. The capture of the world’s elites was under way. Its high point was the Kyoto Summit in 1998, which enabled the entire world to yell at the United States for not signing up, while also exempting developing nations, such as China and India, from its rigours.

The final push, brilliantly described here by Darwall, was the Copenhagen Summit of 2009. Before it, a desperate Gordon Brown warned of “50 days to avoid catastrophe”, but the “catastrophe” came all the same. The warmists’ idea was that the global fight against carbon emissions would work only if the whole world signed up to it. Despite being ordered to by President Obama, who had just collected his Nobel Peace Prize in Oslo, the developing countries refused. The Left-wing dream that what used to be called the Third World would finally be emancipated from Western power had come true. The developing countries were perfectly happy for the West to have “the green crap”, but not to have it themselves. The Western goody-goodies were hoist by their own petard.

The UN was the natural forum for this push and the IPCC, headed by an railway engineer, the natural “scientific” instrument.  We know how that story has turned out to this point.  No global warming registered for 17 years and 6 months despite all the dire, but apparently scientifically groundless, predictions.  The irony, of course, is it is those who have been skeptical of all of this are the one’s called “deniers”.  And the alarmists have become so bankrupt and shrill that some of them are calling for the arrest of “deniers.” One supposes since the alarmist cause most closely resembles a religious cult, the call for arrest is on the grounds of heresy … or something.

Meanwhile, “green energy” – the eco radical solution to all – continues to not be ready for prime time, while fossil fuel becomes cheaper and more plentiful.

Yet somehow, the so-called “elites” have decided – based on what, one isn’t sure – that the threat to the globe is real.  More irony.  On the one hand, the eco radicals don’t care at all if it costs lives since they’ve been convinced for decades that it is man that’s the problem.  Less of us is a “good thing” in their world.   On the other hand you have the elites, aka, politicians, who see an opportunity to both expand government power and create revenue literally out of thin air.  The fight is over who will get the money.

Meanwhile the reputation of science – real science – will suffer because of this very political cause and the actions of some scientists to serve it.

Scientists, Rupert Darwall complains, have been too ready to embrace the “subjectivity” of the future, and too often have a “cultural aversion to learning from the past”.

And that is a complete disservice to science.  Given all of that, who are the real deniers here?

~McQ

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Observations: The QandO Podcast for 06 Apr 14

This week, Michael and Dale talk about Brendan Eich and Obamacare.

The podcast can be found on Stitcher here. Please remember the feed may take a couple of hours to update after this is first posted.

As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Stitcher. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here.

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There is absolutely no problem with voter fraud, say the Democrats … repeatedly

However, as with most such utterances by that crew, they’re simply wrong:

The North Carolina State Board of Elections has found thousands of instances of voter fraud in the state, thanks to a 28-state crosscheck of voter rolls. Initial findings suggest widespread election fraud.

765 voters with an exact match of first and last name, DOB and last four digits of SSN were registered in N.C. and another state and voted in N.C. and the other state in the 2012 general election.
35,750 voters with the same first and last name and DOB were registered in N.C. and another state and voted in both states in the 2012 general election.

155,692 voters with the same first and last name, DOB and last four digits of SSN were registered in N.C. and another state – and the latest date of registration or voter activity did not take place within N.C.

The second point is key, as double voting is election fraud under state and federal statutes. Punishment for double voting in federal elections can include jail time.

No one said the fraudulent voters were smart (seriously, same DOB, SSAN and name if you’re going to commit fraud? Brilliant!), but what they did was certainly election fraud. And this is one state.

The findings, while large, leave open the question of just how widespread double voting might be since 22 states did not participate in the Interstate Crosscheck.

But remember – voter fraud is just not a problem. The integrity of our voting system, per the Dems, is air tight. And no, the dead don’t vote:

In addition to the above, the crosscheck found that more than 13,000 deceased voters remain on North Carolina’s rolls, and that 81 of them showed voter activity in their records after death.

Well, not many of them.

~McQ

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Economic Statistics for 3 Apr 14

Challenger reports that layoff announcements in March were 34,399, down from 41,835 in February.

The Gallup US Payroll to Population rate fell -0.4 points to 42.7 in March.

The US trade deficit rose to $42.3 billion in February from $39.3 billion in January.

Weekly initial jobless claims rose 16,000 to 326,000. The 4-week average rose 1,750 to 319,500. Continuing claims rose 22,000 to 2.836 million.

The PMI Services Index rose 2 points to 55.3 in March.

The Bloomberg Consumer Comfort Index rose 1.5 points to -30.0 in the latest week.

The ISM Non-Manufacturing Index rose 1.5 points to 53.1 in March.

The JP Morgan Global Composite PMI rose 0.5 points to 53.5 in March.

The Fed’s balance sheet rose $9.5 billion last week, with total assets of $4.236 trillion. Total reserve bank credit rose by $4.7 billion.

The Fed reports that M2 money supply grew $20 billion in the latest week.


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Another reason you should never believe a thing this administration says

Because, as we’ve learned over the years, it’s likely either spin, just not true or both.

For instance, we have the President claiming victory for ObamaCare because it has 7.1 million enrollments.  Note the word – “enrollments”:

‘The goal we’ve set for ourselves – that no American should go without the health care they need … is achievable,’ Obama declared.

The president took no questions from reporters, but celebrated the end of a rocky six-month open-enrollment period by taking pot shots at Republicans who have opposed the law from the beginning as a government-run seizure of one-seventh of the U.S. economy.

‘The debate over repealing this law is over,’ he insisted. ‘The Affordable Care Act is here to stay.’

And, as is usual with this man, he simply declared he’d won and simply threw out “facts” that haven’t at all proven true. Essentially lies in a bigger lie:

‘“The bottom line is this,’ said Obama: ‘The share of Americans with insurance is up, and the growth in the cost of insurance is down. There’s no good reason to go back.’

Of course the “share of Americans” with insurance isn’t up (over 7 million lost their insurance when their plans didn’t qualify under ObamaCare) and costs are certainly not “down”.

Jay “Baghdad Bob” Carney took it from there (Carney is a perfect name for the position, he’s like a carnival barker):

‘At midnight last night we surpassed everyone’s expectations,’ he boasted, ‘at least everyone in this room.’

While he took great pains to emphasize that the total would grow – saying ‘we’re still waiting on data from state exchanges’ – he dodged tough questions about other statistics that reporters thought he should have had at the ready.

Those numbers included how many Americans have paid for their insurance policies, and are actually insured. Also, he had no answer to the thorny question of how few signups represented people who had no insurance before the Affordable Care Act took effect.

But as usual, when ever they drop something like this in a news cycle, the devil is in the details.  For instance, an unpublished RAND study that suggests that relatively speaking, very few of the enrollees were previously uninsured:

The unpublished RAND study – only the Los Angeles Times has seen it – found that just 23 per cent of new enrollees had no insurance before signing up.

And of those newly insured Americans, just 53 per cent have paid their first month’s premiums.

If those numbers hold, the actual net gain of paid policies among Americans who lacked medical insurance in the pre-Obamacare days would be just 858,298.

So effectively, assuming the numbers are correct, less than a million are newly insured.  And, as we’ve read in the past, most of them are Medicaid subscribers.

In other words, we’ve gone through all this hell, all this disruption, the higher costs, the lesser insurance plans, the IRS enforcement, etc. just to enroll 858,298 people – most of whom have ended up on a program that existed prior to this atrocity.

Perhaps the biggest laugh line of all, however, comes from David Axelrod, who declared that ObamaCare was totally going to change “the attitude that government can’t do anything“.  Of course he only felt comfortable saying that on MSNBC.  One can certainly understand why.

Meanwhile, for the most part, the RAND study goes unpublished and, for the most part, unexamined.  The King has declared victory – the big lie has been established – debate over.

~McQ

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