Surprise! Surprise!

Surprise! Surprise! Suddenly, myriad reports are saying Obamacare is on the verge of collapse. Implementation of certain provisions effecting businesses are being delayed. Of course, those requiring us peasant to buy policies from the “insurance mafia” (See “A Pairadocs) are not. This will mean increased revenue to the Federal Government as people who can’t afford to comply are taxed to beat them into submission. The question becomes, “How much blood can the government get out of turnips that have lost their jobs and are loosing their homes?”

It was obvious from the beginning that “Obama’s plan” (the plan shoved down his throat by the insurance lobby) wouldnt work because it ignores the three main components of ever increasing healthcare costs, inflation, insurance, and government regulation.

Inflation is almost always created by government or by those who control the issuance of “money.” It is nothing more than the money supply being increased at a rate exceeding the ability to create goods and services. When more money is available, if the supply of goods and services doesn’t rise accordingly, then the prices of goods and services go up to meet the money supply. Unfortunately, many are not able to increase their incomes at the pace of the inflation, but that doesn’t apply to some like the medical profession. Doctors, hospitals, and other health care providers are able to raise their rates to keep pace with the inflation because people must have their services.

When insurance is widely available, there is more money available for medical care and it produces an effect similar to inflation. For all intent and purpose, it becomes a sort of localized inflation. Simply put, the money is there so medical professionals charge accordingly. A contributing factor is that many people think the insurance should cover everything. It should only be for major expenses not for routine problems and office visits. When it covers everything, it just becomes prepaid health care and is expensive.

Government regulation and, simply put, interference in health care provision drives costs up. As an example from my own experience. I had a contract engineering assignment to develop the manufacturing controls segment of an application for approval to market a medical device. When the engineering manager was explaining what was needed, he told me they already had a stack of about 3-4 feet of documentation for other aspects. I said such requirements must be infuriating. He said no. They were happy with it because they didn’t think any of the competition was going to bother, so they could charge anything they wanted, $10, $15, or more a pair. What was the product? O-rings. Rubber bands for tying a woman’s tubes for contraception. Pennies to make and dollars in profits. Add to that the record keeping and mark up costs at the hospital and who knows what will be added to the bill. And that’s just for a very simple product.

Here’s yet another source of big “healthcare” spending to drive inflation. I regret I lost the source. If anyone can link me to it, I’d appreciate it.

“The Obama administration has shoved an unprecedented expansion in taxpayer funding of abortion down our throats over the past four years. The nation’s largest abortion provider, Planned Parenthood, can attest to the explosion in taxpayer funds.

Planned Parenthood just recently released their annual report for 2011-2012. And 2011 was a big money-maker for the abortion giant.

They crowed about the number of abortions they performed in 2011 — a record 333,964 babies killed.

Cumulatively, their 3 year total brings their death count over that period just barely short of a million.

And your tax dollars paid for this slaughter.

Planned Parenthood received nearly half of their revenue, $542 million, in tax dollars. And now as things currently stand, they’re counting on an even greater influx of funds, with the help of their ally in the White House.

Because with his reelection safely behind him, President Obama isn’t even trying to hide his use of your and my tax dollars to line the pockets of the abortion lobby. In fact, Obama and his pro-abortion cronies in Congress took advantage of “must pass” legislation just this last December, and snuck in additional taxpayer funding of abortion in a military appropriations bill.

And they’re looking to do it once again with the looming debt ceiling and other budget bills.”

HEALTHCARE OBAMANATION

First posted in Blogspot on Friday, March 19, 2010

HEALTHCARE OBAMANATION

I started to write this several months ago, but I have been having difficulties with motivation for about five months. When I do sit down to write, I have difficulty. The reason I’m saying this is because a number of changes have been bounced back and forth since I analyzed the bill myself, but I’m confident the changes made little material difference.

My experience with counter-political groups in the past, particularly with their legislative committees, leaves me little concerned that any significant change has taken place. In cases of “controversial” legislation like this, laws the people don’t want but the money powers do, a great show is usually made about changes being made to the bill and different versions being sent back and forth between committees and between the Senate and the House. These changes are usually cosmetic, but they give Senators and Representatives (Gauleiters?) an opportunity to go back to constituents with claims that they fought hard to stop the bill in its original form. In the end, they “compromised” and voted for this “improved” plan as the only means to stop the original. This show also makes it extremely difficult for those of us who have lives to lead to keep up with those minor changes. It gives those pushing the bill a chance to attack opposition on insignificant “errors” in their analysis created by those minor changes. Knowing fully that I will be vulnerable, I’m still publishing this based on my original analysis of an earlier house Bill with some updates from other sources.

A lot has been written by both sides of the argument about “Obama’s” healthcare plan. Each side tries to analyze it from its own perspective and explain what is in it and what it will do. All is futility.

The plan, as represented by the Bill passed by the House of Representatives*, can’t be analyzed in terms of content or effect. It is a grotesque skeleton that will be fleshed out later by the new monstreaucracy it creates and by the courts that will hear what is likely to be a storm of lawsuits to try to limit or to expand its meaning and scope.

Much of the job of fleshing out; that is, actually creating the “health care” system falls on two people and the massive bureaucracy that will by necessary to do the actual work. When I first examined this atrocity, I thought it set up what was, in effect, a Health Care Dictator. A “Health Choices Commissioner” is created and is mentioned over 200 times, usually establishing his/her considerable powers, discretions, and dutes. However, as I delved further into the bill, I found that the Commissioner, while having incredible power in his own right, may be subservient to a higher level dictator – the “Secretary of Health and Human Services.”

Again, the “Health Care Commissioner and his duties are mentioned over 200 times in the bill. Among those duties are:

• defining what a “dependent” is, – the bill doesn’t even define something as basic as a dependent
• establishing rules for Exchange-participating health benefits plans
• establishing a “grace period” whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan [so much for not effecting your current plan]
• specifying age categories wherein limited age variation [premium] is permitted
• specifying, in consultation with State insurance regulators, variations permitted by premium rating area [note that it requires such consultation but doesn’t require the Commissioner to listen to the State regulators – it will probably be left to the courts to settle any jurisdictional arguments]
• specifying conditions for family enrollment variations (such as variations within catagories and compositions of families) as specified under State law and consistent with rules of the Commissioner [no specification in the bill as to which takes priority creating an area for ongoing legal battles]
• defining a “medical loss ratio” that must be met by a qualified health benefits plan

This is just a very small sampling. The defining, establishing, and specifying, not to mention requiring reports and, in turn, writing reports, goes on for most of the 200 plus times the Commissioner is mentioned.

As regards reports required of the “qualified health benefits plans,” I found this section fascinating.

The Health-care Commissioner is charged with establishing standards with which a “qualified health benefits plan” must comply “for the accurate and timely disclosure of plan documents, plan terms and conditions, claims payment policies and practices, periodic financial disclosure, data on enrollment, data on disenrollment, data on the number of claims denials, data on rating practices, information on cost-sharing and payments with respect to any out-of-network coverage, and other information as determined appropriate by the Commissioner. The Commissioner shall require that such disclosure be provided in plain language.” According to the bill, “plain language” means “language that the intended audience, including individuals with limited English proficiency, can readily understand and use because that language is clean, concise, well-organized, and follows other best practices of plain language writing.”

I find this section fascinating for several reasons:

Firstly, the number and nature of things the plan providers, and presumably, the health care providers must keep statistics on and report to the Commissioner. How can anyone even guess what the cost of this record keeping and reporting is going to be? Estimates of the cost of this bill have ranged from $800 million to $2 or 3.5 trillion. Is that just for the medical coverage or does it includes this massive record keeping and reporting? Is it only for the record keeping and reporting? I doubt that even the people who made the estimates could tell us.

Secondly, and this I find both fascinating and enlightening, is that “plain language” is defined as language that an intended audience which would include those whose English no so pretty much good. Would that include illegal aliens? Is ability to speak English not a requirement for naturalization? It must not be for the users of the system. What use would most patients have for such statistics? Is it intended for the health care providers? Maybe they’ve already anticipated driving all American doctors from the field and having to replace them with foreign doctors. On the other hand, maybe this is just a smokescreen to hide the inability of the bureaucrats and elected officials who are promising to “reform” health care and the insurance industry to speak the language of either.

Finally, and this should be good, the Commissioner is charged with developing and issuing guidance on best practices of plain language writing. Isn’t that a kicker? These people, famous for unintelligible bureauese, will be providing “guidance” for plain English writing. Of course they might be planing to subcontract the writing to technical writers in China or India. You know—the ones who wrote the manuals for your computer, home appliances, and the items you bought that said “some assembly required.” Maybe they’re planning to make Henry Kissinger Secretary of Plain English.

The “Secretary” is mentioned close to 1100 times. Again, when mentioned, the bill does not give detailed instructions to the “Secretary,” rather, as in the case of the “Commissioner,” it specifies the powers and duties of the “Secretary” which again entail considerable discretionary latitude.

A couple of examples:

• the Secretary is given the power to define and develop methodology for “Interim Rules for determining how to calculate the medical loss ratio which will subsequently be built on by the Commissioner
• receives recommendations from the Health Benefits Advisory Committee on benefit standards [Behold! A bureaucracy within a bureaucracy!]

There are then several paragraphs regarding the Secretary accepting or rejecting the recommendations which he apparently must do as a package. If he/she doesn’t accept, the package is sent back to the committee for revision. Most of those paragraphs is written in “plain English” I suppose, so I have no idea what they are saying. But finally, we get to this:

• the Secretary shall, through the rulemaking process consistent with subsection (a), adopt an initial set of benefit standards. [anyone want to guess what the “rulemaking process” is?]

There have been many articles written on this subject. I’m afraid if I try to summarize the ones I have it will be months more before I publish this. I’ll just include this summary of a Fred Lucas article in cnsnews. Lucas debunks many of Obama’s claims.

According to Obama, abortions would not be funded, but according to Lucas, the House bill mandates that government-run insurance exchanges provide at least one plan that covers abortion. Even if this interpretation is not correct, a number of amendments that would have specifically excluded abortion from government (taxpayer) subsidies have been rejected.

When asked if her amendment added to a Senate version of the bill would fund abortion , Senator Barbara Mikulski (D-Md) replied, “It would provide for any service deemed medically necessary or medically appropriate.” Apparently, all it would take is for a “doctor” to say carrying a child to full term would have adverse affects on the mother’s mental and/or physical health and, regardless of how strong your religious beliefs may be against the unnecessary taking of a human life, you will be forced to be an accessory through your tax dollars.

Then there is the Obama claim that the “healthcare” plan will be “deficit neutral.” The Office of Management and Budget has estimated the bill and the bureaucratic monstrosity it creates will add over a trillion dollars to the budget over the next ten years. Since that estimate, OMB has reduced its projection to some 800-900 billion. Supposedly, this is due to some changes in a possible compromise bill.

But, not content to let one lie stand alone, it now claims a deficit reduction will occur. I think I recall a number in the 1 to 2 hundred million. If that’s the case, then Congress should try to expand the bill to create a ten year cost in thousands of trillions of dollars. In ten years our national debt could be wiped out.

Back to reality. It is highly unlikely Obama plans to cut spending in other areas, so the only way to avoid added deficits to fund this outrageous program is to increase taxes. Obama said from the beginning of his campaign that he wanted change. I have said that his predecessors, Republican and Democrat alike, have stolen all of our dollars. Now Obama wants our to steal our change to fund his scheme.

Lucas points out that Obama claims of the number of uninsured Americans are overstated and gives evidence to support his contention. Interestingly, in a town meeting in Portsmouth NH in August, Obama said “nearly 46 million Americans don’t have health insurance coverage today,” but also said “46 million of our fellow citizens have no coverage.” Given that Obama, questions of birth certificates aside, said in Berlin that he is “a citizen of the world,” the two statements may not be synonomous.

Obama also claims that charges that illegal aliens will receive benefits are false and, in fact, the bill does exclude illegals, but attempts to introduce amendments to require verification of legal status have been rejected.

Obama also gave this half-truth to assure people that they would not have to change plans if they liked what they have: “If you like your doctor, you can keep your doctor,” Obama said. “If you like your private insurance plan, you can keep your plan. Period.” While it is true that the bill does not coerce change, Lucas says that it does provide incentives to employers to change their plans covering their employees. You can read the entire article at:

http://www.cnsnews.com/news/article/53695

Just a couple of more points:

 

 

I regret I can’t give credits for this. I received it in an email that did not give the source. 

 

 

 

 

From the Bucks County Courier Times Friday March 12, 2010

The Lies Won’t Stop

First published in Blogspot on Wednesday, March 24, 2010

The Lies Won’t Stop

I received this mistitled email from Congressman Patrick Murphy. My responses are in brackets.

March 23, 2010

Mr. Rick Lutz

Levittown, PA 19057

Dear Mr. Lutz,

Yesterday, we passed one of the most important bills in a generation.

[One of the most destructive.]

Despite the confusion and outright lies that have surrounded this bill, make no mistake: health insurance reform will provide crucial protections to ensure that Americans get the healthcare that they and their children need.

[This is, of course, one of the biggest lies. Promoters have been making myriad wild claims about the benefits of this “plan,” but, no one can say honestly if this will provide any benefits at all. As I pointed out in my post “Healthcare Obamanation,”, it’s just the skeleton that will be fleshed out by bureaucrats and healthcare dictators. The very “envelope” this email came in was a lie. It was titled “Reply From Congressman Patrick Murphy.” To my shame, I never sent an email to the Congressman (Gauleiter?), although I don’t know what good it would do since he has already said he doesn’t care what his constituents want. I did write a letter to the editor of the local rag.]

Forty million American families and four million small businesses will benefit from the largest middle-class healthcare tax credit in history. Barbara in Feasterville worked hard for forty years before losing her job at the age of 58. Overnight, Barbara was facing $1,300 in monthly premiums – more than her pension and more than she can afford. Her healthcare plan? Hope that she doesn’t fall seriously ill before she qualifies for Medicare. This tax credit protects Barb, and millions like her, by ensuring access to high-quality and affordable insurance.

[More benefit lies coupled with the vilest form of demagoguery–sob stories designed to deflect rational thought with emotion. I have several from the other side in my collection. These tell of the hardships of those living under similar government run healthcare programs who are forced to leave their homelands to seek care in the U.S.A. I was above using them in my blog.]

Small businesses are not required to purchase insurance but will get tax credits if they do. Insurance reform provides $40 billion in small businesses tax credits to help companies cover up to half the cost of providing insurance for their workers.

[More than likely small businesses will find themselves driven under as has so often been the case with government “reform.” Their businesses will be absorbed by the giant chains and corporations.]

Seniors will see stronger and improved Medicare benefits. And you don’t have to take my word for it: AARP has endorsed the bill stating that it “cracks down on insurance company abuses and protects and strengthens guaranteed benefits in Medicare, the program millions of our members depend on and in which millions more will soon enroll.”

[I was a member of AARP for maybe a year. I joined to get discounts that might be voluntarily offered by businesses I deal with. I soon started receiving mail from AARP touting some lobbying efforts they were making to get more from the taxpayers for “seniors.” I quickly concluded they were nothing but a bunch of socialist gimme gangsters out for what they could steal. I dropped my membership. An endorsement from them is hardly a confidence builder. BTW, you can find the AARP in the list of corporate members of the CFR, Americas Ruling Party, in my americasenemies blog.]

Tony in Levittown needs an expensive medication to treat his thyroid condition and is pushed into the Medicare Part D donut hole earlier and earlier each year. Tony, along with 11,200 other seniors in Bucks County, will benefit from lower prescription drug costs, as the Part D “donut hole” is closed. And seniors’ Medicare program is put on a stable financial footing, ensuring this vital program will be there to serve seniors today and those of future generations.

[Many of us who are “seniors” now may not be alive to see the eventual “fruits” of this bill, or rather of the plan that will be written by the Healthcare Commissioner and the Secretary of Health and Human Services, if it hasn’t already been written, as I suspect, by the largest insurance companies in the nation and maybe the world. I do believe that those of future generations will be able to confront Murphy with “Liar! Liar! Pants on fire!]

Insurance companies no longer have free reign over our health insurance system, as we prohibited the egregious practices they’ve gotten away with for far too long. Insurers can no longer turn people away, or charge more, because someone has arthritis, diabetes, is a cancer survivor, is pregnant – or has any other “pre-existing condition.” And they can no longer pull the rug out from families by taking away their coverage just when someone gets sick and needs coverage the most. These important changes will benefit everyone and those on the frontlines of our healthcare system agree: the doctors, nurses, and hospital associations have all endorsed the bill.

[Egregious is a good word to apply to both the demagoguery and ignorance of the insurance business displayed by this paragraph. Insurance companies not covering pre-existing conditions has been a big part of “Uncle Tom” Obama’s inflammatory rhetoric. If the politicians understood how insurance works they would know that insurance companies can’t cover pre-existing conditions. The whole idea behind any insurance program is shared risk. We buy insurance to cover things that might happen to us that could be financially ruinous and hope we never have to use it. Some people decide to take the risk and spend their money on other things. If insurance companies are forced to take people who wait until they have a problem to get insurance, then there is no incentive for anyone to buy insurance. All anyone would have to do is wait until they’re sick. This would ruin the insurance industry. It simply couldn’t operate that way. I would ask the Congressman and Obama this, if I die tomorrow, and my wife applies for a $250,000 life policy on me the day after tomorrow, can the insurance industry refuse to write the policy on the grounds of a pre-existing condition? But maybe that’s the reason for the police-state mandate that all must have health coverage. Incidentally, I’ve yet to find a doctor, nurse, pharmacist or any other healthcare worker who thinks this is a good plan. More than likely the “leadership” of their associations has been bought.]

And children will be able to stay on their parents’ insurance until they are 26 years old, helping out recent high-school or college graduates like Valerie from Dublin who is unable to find a job that offers benefits.

[Poor Valerie! If only she could have grown up in a free society where the economy had not been destroyed by big government she might have had other options than flipping burgers or, if she has her masters, managing a flipping location for a burger chain.]

When my two kids grow up, they will know that their dad stood up to the special interests to fight for Barb, Tony, and every middle-class American family whose wallets are being stretched thin by crushing healthcare costs. They will be able to look upon yesterday as the day Congress stopped kicking the can down the road and finally tackled one of the greatest challenges of our day.

[Why you hypocritical windbag. Our wallets have already been emptied by you big spenders in Washington who toady to those special interests while ranting about fighting them. You who have already looted our wallets, pockets, closets, and anywhere else we might have hidden a dime to transfer it to those special interests through bailouts and cap and trade. I would imagine your benefits package for serving Daddy Big Bucks will include health benefits for your whole family – maybe for life. When you’ve crushed healthcare for the rest of us, you’ll probably still be able to get care in special hospitals not open to us peons.]

If you’d like to learn more about what this bill means for you and your family, I encourage you to visit my website at http://www.patrickmurphy.house.gov. There you can read the legislation, find detailed summaries of the bill, and find out more about what’s in it for you. Also, please do not hesitate to contact me if I can help in any way. You can reach my office in Washington at (202) 225-4276, or either of my district offices in Doylestown at (215) 348-1194 or Bristol at (215) 826-1963.

[Thanks, but I’ll opt out of the extra helping of meadow muffins at your website for now. However, if you are sincere about helping me in anyway, how about this:

• return some of the money the Federal government has stolen from us over the years
• cut the government in half (as a starter) to permit business, especially wealth producing businesses like manufacturing, farming, construction and the like to flourish once again
• restore Republican principles, not the principles of the Republican party which I know is as unprincipled as the Democratic, but the principles of representative government
• end special privileges for collectives such as corporations and unions and treat all citizens equally
• kill the leader principle that you and the Democratic party seem to have embraced so that it might finally be buried as it should have been in 1945 along with The Leader*
• restore the Constitution as the supreme law of the land]

*[To be fair, despite all of the fanfare about opposition when they knew, as we did, that it would pass, the Republinazi party was no better under Adolph Bush than is the Demonazi party under Adolph Obama.]

Sincerely,

Patrick J. Murphy

MEMBER OF CONGRESS

PJM/lm

Was the Congressman ”replying” to this letter to the editor or was his email just labeled that way to keep it out of the spam folder where it belonged?

Editor
Bucks County Courier Times

Dear Editor:

John W. Whitehead’s commentary on Tuesday points to similarity between the willingness of the German people to follow “The Leader” and the willingness of the American people to accept, almost without question, the dictates of an overblown and uncontrolled government in Washington and to follow our “leaders” like sheep.

A guest opinion in the same issue praises Patrick Murphy for leadership and for “fighting for us.” If “us” is the money powers, then his votes for bail-outs, cap and trade, and the healthcare obamanation supports the latter assessment. I can attest to the accuracy of the former. He has said it was his “duty” as a “leader” to vote as he chooses despite the wishes of his constituency. He has rebuked the republican principles on which our country was founded and embraced the leadership principle that destroyed Germany. Murphy should be reminded he is elected to represent us and not to lead us.

Sooner or later we must decide if we want Congressmen to represent us or Gauleiters to lead us. The decision may soon be out of our hands…if it isn’t already.

Rick Lutz
Levittown, PA 19057

I plan to list all who voted for healthcare ruination in my americasenemies blog. Murphy has earned special mention in that post. 

Ugly Face of ObamaCare Revealed

First posted in Blogspot on Saturday, May 8, 2010

Ugly Face of ObamaCare Revealed

This is part of a memorandum published by the Office of the Actuary of the Department of Health & Human Services. The copy I took from the Internet was in PDF form that did not allow copying, so what I took verbatim I had to retype. I don’t have time to retype the whole document to try to pull out all important details, so I stuck with their own summary. I’ve also incorporated parts of a report on the subject in AllVoices by Hardy Wright from an email he’d received. Memorandum content is in italics, my comments are in regular type, those from Hardy’s report in brackets [] as are page numbers.

This memorandum summarizes the Office of the Actuary’s estimates of the financial and coverage effects through fiscal year 2019 of selected provisions of the “Patient Protection and Affordable Care Act” (P.L. 111-148) as enacted on March 23, 2010 and amended by the “Health Care and Education Reconciliation Act of 2010” (P.L. 111-152) as enacted on March 30, 2010.

Included are the estimated net Federal expenditures in support of expanded health insurance coverage, the associated numbers of people by insured status, the changes in Medicare and Medicaid expenditures and revenues, and the overall impact on total national health expenditures. Except where noted, we have not estimated the impact of the various tax and fee provisions of the impact on income and payroll taxes due to economic effects of the legislation. Similarly, the impact on Federal administrative expenses is excluded. A summary of the data, assumptions, and methodology underlying our national health reform estimates will be available in a forthcoming memorandum by the OACT Health Reform Modeling Team.

Possibly the most significant factor here is that federal administration expenses are not included. If the government intends to read, analyze, and act on the tons of reporting that will be required, we’re probably looking at many more hundreds of billions. But that’s just the direct cost of bureaucracy to the taxpayers. Add to that cost what will likely be an equivalent monstrous cost to the medical and insurance providers to fill out and file all of the mandated plans and reports – costs that will, must, be passed on to the health care consumer.

In addition, the actuary admits that the costs do not reflect the full 10-year cost for the new legislation. The strange reasons given are: …these transition effects and the fact that most of the coverage provisions would be in effect for only 6 of the 10 years of the budget period, the cost estimates shown in this memorandum do not represent a full 10-year cost for the new legislation. What I can’t understand is why they can’t make an estimate for the “transition” period and why would there be costs (hidden?) for the four years that the coverage provisions would not be in effect.

Earlier estimates of the cost of this bill ranged from over $800 billion to about $2.2 trillion. The new figures, as reported by Wright are lower:

[Health Care Costs Increase: National health expenditures under the health reform act would increase by a total of $311 billion (0.9 percent) during calendar years 2010-2019. [Page 4]]

The bulk of the reduction from the original estimates is realized by slashing medicare which could reduce senior access to healthcare. As Hardy reports:

[Over One-Half Trillion in Medicare Cuts: The Medicare actuaries found that the new health law cuts $575 billion [Page 4] from Medicare]

Seniors’ Access to Care Jeopardized: As a result of the cuts to Medicare, the actuaries found that, absent legislative intervention, [providers]m ight end their participation in the program (possibly jeopardizing access to care for beneficiaries). [Page 10]]

One of the reasons health care providers might end their participation in the program is: (iii) lower payments and payment updates for Medicare services. [Page 4]

A still more astonishing admission by the actuarials is shown below. It’s astonishing because it’s exactly what many opponents of the legislation had been arguing and for which they were called liars, extremists, kooks, partisan politicians, and even racists for opposing this plan Obama was selling for the insurance companies.

The actual future impacts of the PPACA on health expenditures, insured status, individual decisions, and employer behavior are very uncertain. The legislation would result in numerous changes in the way that health care insurance is provided and paid for in the U.S., and the scope and magnitude of these changes are such that few precedents exist for use in estimation. Consequently, the estimates presented here are subject to a substantially greater degree of uncertainty than is usually the case with more routine health care legislation.

In estimating the financial impacts of the PPACA, we assumed that the increased demand for health care services could be met without market disruptions. In practice, supply constraints might initially interfere with providing the services desired by the additional 34 million insured persons. Price reactions — that is, providers successfully negotiating higher fees in response to the greater demand – could result in higher total expenditures or in some of this demand being unsatisfied. Alternatively, providers might tend to accept more patients who have private insurance (with relatively attractive payment rates) and fewer Medicare or Medicaid patients, exacerbating existing access problems for Medicaid enrollees. Either outcome (or a combination of both) should be considered plausible and even probable initially.

The latter possibility is especially likely in the case of the substantially higher volume of Medicaid services, for which provider payment rates are well below average. Therefore, it is reasonable to expect that a significant portion of the increased demand for Medicaid would be difficult to meet, particularly over the first few years. (More amazing truth – higher costs and less service.)

As I pointed out in the Healthcare Obamanation post in this blog, nobody can say what this beast will look like when it’s grotesque skeleton is fleshed out. In some cases, the actuaries don’t even try:

We have not attempted to model that impact or other plausible supply and price effects, such as supplier entry and exit or cost-shifting towards private payers. A specific estimate of these potential outcomes is impracticable at this time, given the uncertainty associated with both the magnitude of these effects and the interrelationships among these market dynamics. We may incorporate such factors in future estimates, should we determine that they can be estimated with a reasonable degree of confidence….

The last sentence of the above paragraph is evaluated by Hardy as follows:

 

[Long Wait Lines Resulting From A Shortage of Doctors and Hospitals: …For now, we believe that consideration should be given to the potential consequences of a significant increase in demand for health care meeting a relatively fixed supply of health care providers and services. In other words, Americans should be prepared for doctor and hospital shortages under the new law. [Page 20]]

Further support of Hardy’s conclusions can be found in this paragraph: As stated in the section on Medicare estimates, reductions in payment updates to health care providers, based on economy-wide productivity gains, are unlikely to be sustainable on a permanent annual basis. If these reductions were to prove unworkable within the 10-year period 2010-2019 (as appears probable for significant numbers of hospitals, skilled nursing facilities, and home health agencies), then the actual Medicare savings from these provisions would be less than shown in this memorandum. Similarly, the further reductions in Medicare growth rates mandated for 2015 through 2019 through the Independent Payment Advisory Board may be difficult to achieve in practice.

That Seniors, all Americans for that matter, will see a considerably reduced availability of health care is no surprise to me. The more I see the government regulating and controlling all aspects of our lives “for” us, the more I’m reminded of an experience I had while hitch-hiking through Yugoslavia in 1967.

It took me three rides to get the relatively short distance from Sarajevo to the coast. The last was with a Czechoslovakian couple. You may remember that Czechoslovakia was one of the “peoples’ paradises.” Everything was well regulated and controlled. Wages and prices were fixed so that everyone could afford everything. The only catch — there was nothing! These folks had waited 11 years on a list to buy their new car.

Now it’s the American people’s turn. Our Socialist/Fascist government is going to regulate all aspects of our healthcare so that all Americans can afford all of the healthcare we need. The minor inconvenience of waiting 11 years for that heart operation is such a small price to pay.

The whole campaign by Obama’s Washington Mob was a pack of lies as I hope this is showing.

As I pointed out in “Healthcare Obamanation,” most of the people who voted for it had no understanding of how insurance works. Constant attacks on the insurance industry for not accepting “pre-existing” conditions were nothing but the lowest form of Obamagoguery. Now Hardy reveals the truth:

 

[False Promise to Those With Pre-Existing Conditions: By 2011 and 2012 the initial $5 billion in Federal funding for [high risk pools] would be exhausted, resulting in substantial premium increases to sustain the program. [Page 16]]

They also continue to make the claim that the bill will lead to a balanced budget in ten years. The bulk of the balancing act appears to be substantial new taxes and fees which, no matter who they appear to be levied on, we will eventually pay. I’d bet the farm we’ll get the taxes, but I won’t hold my breath waiting for a balanced budget.

…..Federal revenues will be increased through an excise tax on high-cost insurance plans; higher Hospital Insurance payroll taxes for high-income taxpayers; a new tax on investment revenues and other unearned income, and other provisions.

Some of those paying will be the people with health benefits at work. Hardy notes: [Millions Will See Their Health Benefits Taxed for the First Time: It should be noted, however, that an estimated 12 percent of insured workers in 2019 would be in employer plans with benefit values in excess of the thresholds [before changes to reduce benefits] and that this percentage would increase rapidly thereafter. [Page 13]]

The next sentence in this passage really hit me. The effect of the excise tax on reducing health care cost growth would depend on its ongoing application to an expanding share of employer plans and on an increasing scope of benefit reductions for affected plans. If I’m interpreting this correctly, one of the purposes of the tax is to reduce money available for healthcare.

The lies and deception never stop. Hardie’s article points out:

[New “Medicare Tax” Doesn’t Go To Medicare: The Reconciliation Act amendments introduced a new 3.8-percent “unearned income Medicare contribution” on income from interest, dividends, annuities, and other non-earnings sources for individual taxpayers with incomes above $200,000 and couples filing joint returns with incomes above $250,000. Despite the title of this tax, this provision is unrelated to Medicare; in particular, the revenues generated by the tax on unearned income are not allocated to the Medicare trust funds. [Page 9]]

You can view Hardy Wright’s article to pick up anything I missed at:

http://www.allvoices.com/contributed-news/5693063-health-care-more-costly-than-anticpated

A PAIRADOCS

First posted in Blogspot on Tuesday, May 11, 2010

A Pairadocs

I sent Hardy Wright’s post to an internet friend. She and her husband are doctors. I received this reply:

Rick, I don’t think this was at all unanticipated by people very familiar with the inner workings of the health care industry, especially those who understand the money flows.

Probably the single most problematic monkey wrench for health care centralizers is that they are counting on a large pool of healthy Americans currently uninsured to switch gears and start paying their tribute to the insurance mafia. The problem is that most of these people are just getting by as it is and can’t rationalize paying out $3000 or more a year in premiums (and, typically, the policy includes a very large deductible and sizable co-pays, so, in effect, they can’t afford to use it and it becomes, by default, simply catastrophic insurance).

Something related to elderly care cutbacks that concerns me, as I have already observed this trend several times in the last 10 years with family members and friends of our family suffering from terminal or degenerative diseases, is the covert agenda to hasten death in those who should still have a few years or more left to live if given proper care. There is a big push to institutionalize these people in nursing homes or hospice where, without a doubt, their health will rapidly decline from absent or inadequate protocols for the administration of essentials such as needed fluids. From there, they can expect that any sign of discomfort or dementia will be treated with “terminal sedation”. Terminal sedation involves sedating patients into a state of unconsciousness so they no longer want to take in food or water and thus die months or years sooner they would otherwise would have. The way this is being handled is highly paternalistic and violates all standards of patient autonomy since patient consent is not a prerequisite. Terminal sedation is easily foisted on patients and family members because most are very intimidated by physicians and usually don’t know the first thing about basic medicine having been made woefully medically illiterate by our societal system of dumbing down.

I certainly don’t advocate wasteful and expensive health care for the elderly or anyone else, for that matter. What I am talking about is the loss of compassion that reflects rampant greed and self-absorption. It is completely debasing our essential humanity and distorting our view of the importance of family and community.

OBAMACARE SIMPLIFIED

Obamacare Simplified
First published in Blogspot on  Tuesday, August 3, 2010

Obamacare Simplified – an Addendum to “Healthcare Obamanation”

Prior to writing “Healthcare Obamanation,” I spent many hours trying to make sense of it before concluding it couldn’t be done, that its meaning would have to be determined by the courts (after flesh was put on the bones). I may have erred. The Ohio Project was able to analyze it and create an easy to follow road map of the healthcare program created. A copy was printed in The Ohio Republic blog. Unfortunately, the link to the expandable version of the chart is no longer available, so I’m going to try to put it here

Obamacare Made Simple

.Anyone who is confused by the legislation should take a close look at the map in order to get a clearer understanding.

(I’m going to come back to this to try to get a copy that will magnify more clearly.)

(Still trying without much success.)