Free Markets, Free People

ObamaCare

ObamaCare tax a “job killer” say 16 Democrats who voted for it

Finally figuring it out?  Or finally admitting it?

Sixteen Democratic senators who voted for the Affordable Care Act are asking that one of its fundraising mechanisms, a 2.3 percent tax on medical devices scheduled to take effect January 1, be delayed.  Echoing arguments made by Republicans against Obamacare, the Democratic senators say the levy will cost jobs — in a statement Monday, Sen. Al Franken called it a “job-killing tax” — and also impair American competitiveness in the medical device field.

The senators, who made the request in a letter to Senate Majority Leader Harry Reid, are Franken, Richard Durbin, Charles Schumer, Patty Murray, John Kerry, Kirsten Gillibrand, Amy Klobuchar, Joseph Lieberman, Ben Nelson, Robert Casey, Debbie Stabenow, Barbara Mikulski, Kay Hagan, Herb Kohl, Jeanne Shaheen, and Richard Blumenthal.  All voted for Obamacare.

In the letter they say:

“The medical technology industry directly employs over 400,000 people in the United States and is responsible for a total of two million skilled manufacturing jobs,” the senators wrote in a December 4 letter to Reid.  “We must do all we can to ensure that our country maintains its global leadership position in the medical technology industry and keeps good jobs here at home.”

For whatever reason, however, these 16 can’t seem to understand how what they’re claiming here applies across the board to all taxes.  That is, they’re job killers.  ObamaCare’s taxes and mandates are particularly pernicious because they have many companies trying to figure out how to avoid them and that will mean fewer jobs, not more and certainly more costs in general.

But then no one ever said our political leadership was particularly sharp.  After all, somehow Maxine Waters is about to become the ranking member (senior Democrat) on the House Financial Services committee and Harry Reid remains the Majority Leader in the Senate.

Of course ObamaCare is full of job killing taxes as we’ve all become aware, and many of them will hit this year.  Add those to the “fiscal cliff” tax increases as well as sequestration and you can bet the Dems will see their “pro-choice” agenda fulfilled this next year – any developing economic recovery will be quickly aborted as exactly all the wrong things government can do to kill such a recover are done.

~McQ

Observations: The QandO Podcast for 25 Nov 12

This week, Bruce, Michael, and Dale discuss Israel and Obamacare.

The direct link to the podcast can be found here.

Observations

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

Election summary – time to move on

OK, look, I’m done with the election.  It’s over.  Romney lost.  Time to move on.

Most of us who follow politics understand the reasons and have a pretty good idea of why he’s going home and the Obama’s are staying in the White House.  Short version: They let the left define the election issues.  It was a masterful job of distraction aided and abetted by  a complicit media (hey, “60 Minutes”, you have NO credibility anymore). Period.

Guess what those issues weren’t?  The winning issues: Jobs.  Economy.  Debt. Deficit.  ObamaCare.  Benghazi. Fast and Furious.

Result?  Lost.

Lesson:  Don’t let your opposition define the issues.  A lesson as old as politics.  Romney’s campaign blew it.  It allowed the left to make it about “lady parts”, abortion, contraception, Bain Capital, class warfare and racism. They made being successful something of which to be ashamed.  And, of course, a couple of idiot GOP candidates at state level who came off like jackasses talking about “legitimate rape”, etc.  who made it even worse (because the complicit media made their stupidity national stories — unlike jobs, the economy, debt, ObamaCare, Benghazi and Fast and Furious.).

And that scared the usual suspects enough to turn out and vote (ye olde and reliable low information voters in swing states who scare easily) and dampened GOP turnout (didn’t even get the number out that McCain got for heaven sake).

That’s the election in a nutshell.

So?

So, now we put that behind us and deal with the inevitable aftermath.

~McQ

ObamaCare begins to have its predicted effect

A law the country didn’t want and upheld by a ridiculous Supreme Court ruling is now beginning to have it’s predicted effect:

Some low-wage employers are moving toward hiring part-time workers instead of full-time ones to mitigate the health-care overhaul’s requirement that large companies provide health insurance for full-time workers or pay a fee.

Several restaurants, hotels and retailers have started or are preparing to limit schedules of hourly workers to below 30 hours a week. That is the threshold at which large employers in 2014 would have to offer workers a minimum level of insurance or pay a penalty starting at $2,000 for each worker.

The shift is one of the first significant steps by employers to avoid requirements under the health-care law, and whether the trend continues hinges on Tuesday’s election results. Republican presidential nominee Mitt Romney has pledged to overturn the Affordable Care Act, although he would face obstacles doing so.

That’s really going to help the job situation, isn’t it?

When is government ever going to learn that its intrusion into the private affairs of men always has consequences, and, when they are outside the legitimate function of government in a free society, the effect is usually negative.

Congratulations Democrats, you’ve done it again.

~McQ

Job burnout for doctors — will it intensify under ObamaCare?

Apparently job burnout effects about 40% of US doctors a recent survey revealed:

Job burnout strikes doctors more often than it does other employed people in the United States, according to a national survey that included more than 7,000 doctors.

More than four in 10 U.S. physicians said they were emotionally exhausted or felt a high degree of cynicism, or "depersonalization," toward their patients, said researchers whose findings appeared in the Archives of Internal Medicine.

"The high rate of burnout has consequences not only for the individual physicians, but also for the patients they are caring for," said Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota, who led the research.

Now imagine the demand that 10 million newly insured that have been given mandated “free stuff” by ObamaCare will add to the load doctors are carrying (don’t forget, we’re supposed to be 90,000 doctors short by 2020).

Yup, again this really isn’t rocket science, but it also obviously hasn’t at all be thought through by our lawmakers, has it?

And the law of unintended consequences will take it’s due course because of that.

~McQ

Twitter: @McQandO

Facebook: QandO

The coming government made healthcare crisis

I’ve mentioned it before but a reminder (yes, it’s that nasty combination of human nature and economic laws being ignored that is about to assert itself):

Once the new healthcare law fully takes effect, all Americans will be entitled to a long list of preventive services with no out-of-pocket costs, but the healthcare system won’t have enough doctors to provide them. The shortage will create longer waiting periods that some patients will be able to cope with better than others. Lower income patients will be worse off, according to Independent Institute Research Fellow John C. Goodman.

And where will those who need more immediate care go?  Why emergency rooms, of course.  Wait, wasn’t the overload on emergency rooms touted as one of the primary reasons we needed this law?

So, we are going to add millions to the insured list and give them “free” stuff and expect doctors to maintain the level of care they now have with their patients (which many think could be better) and carve out time to administer the free stuff too?

I’m sure the government solution will be something like redefining an hour to 40 minutes and make each day 36 hours, huh?  Problem solved.

Reality?

No additional doctors, millions of new patients and free stuff – what could possibly screw up there?

The other questions is how will doctors react?   Well here’s how some are already reacting:

Many patients who can afford to do so will sign up for concierge care—medical practices in which patients pay a retainer fee for more personalized and responsive service, such as same day or next-day appointments. Physicians who open a concierge practice typically take about 500 of their patients with them, leaving behind 2,000 former patients to find a new doctor. (Those figures come from MDVIP and the Centers for Disease Control and Prevention, respectively.) “So in general, as concierge care grows, the strain on the rest of the system will become greater,” Goodman continues. “We will quickly evolve into a two-tiered health-care system, with those who can afford it getting more care and better care. In the meantime, the most vulnerable populations will have less access to care than they had before ObamaCare became law.”

Or said another way, the emergency rooms will be full to bursting and the fact someone has insurance will mean nothing unless a doctor is willing to take them on – something that will be less likely in the near future than it is now.

Finally, in case it slipped your mind, here are the 18 new taxes found in ObamaCare – something to remember when he and his flacks are out there claiming that he’s never raised taxes by a dime (his promise in 2008) on the middle class.

~McQ

Twitter: @McQandO

Facebook: QandO

What part of “health care is a finite resource” does the left not understand?

Regardless of all the promises made by ObamaCare, there are still only 24 hours in a day and there are a finiteobamacarethumb number of doctors available to fulfill the starry-eyed promises the law makes.

That’s reality, something the left routinely attempts to pretend doesn’t exist.

Some examples of the point – ObamaCare will put 30 million more people on insurance rolls  Yay, problem of health care solved, right?

No, of course not.  There will still be the same number of doctors and hours in a day.  As we’ve been saying repeatedly, getting insurance does not mean you’ll be able to see a doctor.

And then there are the new requirements placed on doctors by ObamaCare that further exacerbate the problem.

For instance:

Take preventive care. ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health (2003), scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician’s time each year, or 7.4 hours per working day.

So, a doctor either commits to 10 or 12 hours of work a day or she sees patients for other reasons for 2/3rds an hour a day.

Or try this:

Meanwhile, the administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Its new campaign is focused on women. Thanks to health reform, they are being told, they will have access to free breast and pelvic exams and even free contraceptives. Once ObamaCare fully takes effect, all of us will be entitled to a long list of preventive services—with no deductible or copayment.

Of course, none of that is “free”, but much of it will also tie up a doctor’s time.  Preventive care costs money – lots of money – and when you have someone else paying for it, even more people will try to take advantage of that.

The left thinks that’s a feature, not a bug.

Here’s the real-world problem, however:

If the screenings turn up a real problem, there will have to be more testing and more counseling. Bottom line: To meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.

In effect, it is government mandating treatment that fills up the doctor’s time when much of that treatment may not be necessary.  But that call has been taken out of the doctor’s hands with this law.  If a patient demands all their “free” stuff, then what?

I often harp on the fact that the left seems sublimely ignorant on how the laws of economics work.  Well, what ObamaCare has set up are exactly the same conditions that plague most government run healthcare systems:

When demand exceeds supply in a normal market, the price rises until it reaches a market-clearing level. But in this country, as in other developed nations, Americans do not primarily pay for care with their own money. They pay with time.

Prepare yourself for long waits for what you now consider to be routine problems.  If it is routine you will likely have less of a chance of seeing a doctor than you do now.  Best hope you can self- medicate or just wait out the problem.   If it is a serious problem, you’ll most likely still be in for a wait. 

Why?

As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare’s newly created health insurance exchanges.

Econ 101.  So what is likely to happen?

When people cannot find a primary-care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms.

Uh, wasn’t that a big part of the impetus behind creating ObamaCare?  To “solve” that problem?  In fact, it is likely to exacerbate it.

Of course the solution to the government made problem will be what?  Most likely more government.  Those patients who are in those plans that pay below-market reimbursement will complain to whom?  Politicians.  And vote hungry politicians will try to do what? "Fix” the problem they created.  And who will they make the bad guys?  Well, certainly not them – greedy doctors or insurance companies most likely.

You can see this coming from a mile off – well if your eyes aren’t full of moon dust and you have even a passing acquaintance with how the real world works.

As P.J. O’Rourke so aptly said, “If you think health care is expensive now, wait until you see what it costs when it’s free.”

Unless this monstrosity of a law is repealed, we’re about to find out.

~McQ

Twitter: @McQandO

Facebook: QandO

Pizza? This is about slow suffocation by government (update)

Rob Port brings attention to the Papa John’s story:

At Slate, Matthew Yglesias scoffs at Papa Johns’ founder John Schnatter saying the Affordable Care Act, Obamacare, will drive up costs for his company by roughly $0.20 per order, something his company will be passing along to customers.

“Stipulating for a moment that this is true, doesn’t it seem like a rather small price to pay?” asks Yglesias.

No, it’s not small at all.

Rob then covers just the Papa John’s part of this formulation:

Papa John’s operates 3,973 restaurants. I can’t figure out how many orders the company processes daily, but let’s assume a very conservative 100 orders per store. That’s 397,300 orders every day. Adding $0.20 to ever order in additional labor costs translates into just over $29 million in additional costs for Papa Johns customers annually.

But, of course, as you’ve already figured out, if that’s true for Papa John’s, it is probably true for most other companies in the US as well.

So as Rob says, “no, it’s not small at all”.  In fact, it is potentially a huge increase in the price people will pay for all goods and services.

Papa John’s isn’t alone in seeing a price increase in their futures. As the magazine relates, in its most recent earnings call, McDonald’s said the health care plan will cost their stores an extra $10,000 to $30,000. While the vast expansion of government power involved in the bill will result in more federal expenditures, the pizza magnate’s comment highlights the fact that it will create an across-the-board surtax on virtually all expenditures by families and individuals. This will mean an increase in the cost of living that will hit the poor a lot harder than the rich the president claims to want to tax.

In fact, as pointed out, it has the same effect as a tax on the poor.

Yet the left simply seems unable to wrap their heads around that.  Here’s a commenter to the article I took the paragraph above from:

It is shocking that the CEO of Papa John’s and this magazine commentator would begrudge the near-poor workers of that company health insurance — and better healthcare for a few cents per pie!! Our country is based on the premise that we all pay a little more to help those less fortunate — the key here is “a little more.” Does anyone really object to that??

Yes. Strenuously.  And by the way, this country was not founded on the premise “that we all pay a little more to help those less fortunate” and claiming that to be so is an attempt to rewrite history.  It was about providing everyone an equal opportunity under the law to succeed while protecting their basic rights to life, liberty and property.

So we have the probability that prices will increase in the future as companies charge more for their products to cover health care.  And that brings us to a pretty basic point, here made by Bethany Mandel at Commentary Magazine:

What this person and other liberals have wrong is this: It’s not about the price of pizza. If it were actually possible to improve healthcare for millions of Americans and insure millions more, conservatives would be on board. The basis of conservative opposition to ObamaCare is this: We do not think it will help the majority of Americans. The bill is titled the “Affordable Care Act,” but does nothing to make healthcare more affordable, nor will it improve health care. In reality, it provides a worse standard of care at a higher cost.

Under ObamaCare, 17 million Americans will be added to Medicaid’s rolls in order to move some Americans from the uninsured to the insured column. Are they actually better off?

I, of course, wouldn’t be “on board” if it had to do with government intervention, however I understand the point she’s trying to make.  What has been passed won’t a) reduce costs and make health care more affordable or b) improve health care. 

It is the “big lie” writ large.  The parameters defining health care delivery are finite, not infinite.  You have 24 hours in a day and x number of providers.  Is adding 17 million to the welfare portion of government health care (the one most providers refuse to take because of the supreme hassle and low reimbursement rate) really going to improve their lives?

As Avik Roy notes, even though we’ll be paying more across the board to make it possible, probably not:

In July 2010, at National Review Online’s Critical Condition blog, I wrote about a University of Virginia study, published in Annals of Surgery, finding that surgical patients on Medicaid endured a 97 percent higher likelihood of in-hospital death than patients with private insurance, and a 13 percent greater chance of death than those with no insurance at all. I noted several other clinical studies that showed similar results.

And that’s before the 17 million are added.  This is the mess we find ourselves in when agenda driven politicians pass laws they haven’t even read over and above the objections of the majority of the people.

It’s hard to call that a “representative democracy” isn’t it?

And, no, this still isn’t about pizza.

UPDATE: Morning Bell (Heritage Foundation) weighs in:

At least 60 percent of firms are estimating Obamacare will raise their health care costs, according to a new study released Wednesday by Mercer, a human resources consulting firm. One-third of those expect a cost increase of 5 percent or more.

The study states:

The employers that will be hit hardest are those with large part-time populations—employers in retail and hospitality services. Nearly half of these employers (46%) expect PPACA will push up cost by at least 3% in 2014—and another third don’t yet know what the impact will be.

An example of the impact from the CEO of CKE Restaurants:

The money to comply with the [Affordable Care Act] must come from somewhere. We use our revenue to pay our bills and expenses, to pay down our debt, and we reinvest what’s left in our business. That’s how we create jobs. There’s no corporate pot of gold we can go to, to cover increased health care costs. New unit construction will cease if we have to allocate moneys for that construction to the ACA. And building new restaurants is how we create jobs.

As we’ve said many times before, this isn’t rocket science and they’re called “economic laws” for a reason.  Unfortunately the left continues to ignore them (or pretend they don’t exist) with predictable results.

~McQ

Twitter: @McQandO

Gutting Medicare to pay for ObamaCare

Perhaps you remember the “clever” accounting trick (also known as double counting) that the Democrats used to claim that ObamaCare would save money?

You know, it would cut Medicare by 500 billion (after the election, of course).  You were supposed to believe that was a net cut in spending, remember?  Of course it wasn’t.  It was simply shifting the money to “pay” for other areas of ObamaCare.   There was no “net” savings.

Well the newest projection by the CBO is that it will actually be 716 billion over 10 years (2013 to 2022) and it will essentially gut Medicare.  Of course the old folks will have voted before it goes into effect.

The result of the shift of the funds?  The Foundry has it:

  • A $260 billion payment cut for hospital services.
  • A $39 billion payment cut for skilled nursing services.
  • A $17 billion payment cut for hospice services.
  • A $66 billion payment cut for home health services.
  • A $33 billion payment cut for all other services.
  • A $156 billion cut in payment rates in Medicare Advantage (MA); $156 billion is before considering interactions with other provisions. The House Ways and Means Committee was able to include interactions with other provisions, estimating the cuts to MA to be even higher, coming in at $308 billion.
  • $56 billion in cuts for disproportionate share hospital (DSH) payments.* DSH payments go to hospitals that serve a large number of low-income patients.
  • $114 billion in other provisions pertaining to Medicare, Medicaid, and CHIP* (does not include coverage-related provisions).

*Subtract $25 billion total between DSH payments and other provisions for spending that was cut from Medicaid and CHIP.

The effect will be fairly substantial and should be obvious to even the most staunch ObamaCare supporter:

The impact of these cuts will be detrimental to seniors’ access to care. The Medicare trustees 2012 report concludes that these lower Medicare payment rates will cause an estimated 15 percent of hospitals, skilled nursing facilities, and home health agencies to operate at a loss by 2019, 25 percent to operate at a loss in 2030, and 40 percent by 2050. Operating at a loss means these facilities are likely to cut back their services to Medicare patients or close their doors, making it more difficult for seniors to access these services.

In addition, as MA deteriorates under Obamacare’s cuts, many of those who are enrolled in MA (27 percent of total Medicare beneficiaries) will lose their current health coverage and be forced back into traditional Medicare, where Medicare providers will be subject to further cuts. The Centers for Medicare and Medicaid Services chief actuary predicted in 2010 that enrollment in MA would decrease 50 percent by 2017, when Obamacare’s cuts were estimated at only $145 billion. Now that the cuts have been increased to $156 billion (or possibly $308 billion, as the Ways and Means Committee estimates), MA enrollment will surely decrease even further.

But Obamacare’s raid of Medicare doesn’t stop with cuts; it includes a redirection of tax revenue from the Medicare payroll tax hike in Obamacare. The payroll tax funds Medicare Part A, the trust fund that is projected to become insolvent as soon as 2024. Obamacare increases the tax from 2.9 percent to 3.8 percent, which is projected to cost taxpayers $318 billion from 2013 to 2022. However, for the very first time, Obamacare does not use the tax revenue from the increased Medicare payroll tax to pay for Medicare; the money is used to fund other parts of Obamacare, much like the $716 billion in cuts are.

That in addition to the fact that Medicare still has 37 trillion in unfunded mandates.

Also note the tax increase in the last paragraph (yes, that would be a middle class tax increase) and how the funds will not support the program with the 37 trillion problem. 

Now we can argue all we want about the existence or non-existence of “death panels”, but here we have exactly what was predicted prior to this abortion of a law being passed.  Rationed care (“… cut back services to Medicare patients or close their doors, making it more difficult for seniors to access these services.”) driven by these cost cuts are defacto “death panels”. 

As the Foundry concludes:

With a raid on Medicare of this magnitude, President Obama’s assertion that his new law is protecting seniors and Medicare is astonishing. The truth is that Obamacare does the opposite.

But hey, this is the same President who claims his economic policy is working too.  See previous post for the reality of that claim.

The reason this cut takes place in 2013 is obvious.  If seniors were aware of its impact, you know how they’d vote. 

Whether you do or don’t support Medicare isn’t the point, it’s the bald faced lies that have been put forward claiming something that isn’t at all true.  And now the numbers are out that prove that.

Again, something which should be front and center as a major issue in this political season. 

But it won’t be.

Just watch.

~McQ

Twitter: @McQandO

Observations: The QandO Podcast for 22 Jul 12

This week, Bruce, Michael, and Dale talk about Supreme Court, The state of the nation, and the Aurora, CO shooting.

The direct link to the podcast can be found here.

Observations

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