Tuesday, November 10, 2009

ObamaCare: Medicare Gone Wild. Or anti-health "care"

Speaker Pelosi rammed narrowly through the U. S. House of Representatives the nearly-2,000 page document she calls healthcare reform.  Please see my post "The End of the Rule of Law (Part two)" which outlines some of the complexity of her bill.    The Speaker traded, excoriated, bribed, threatened her fellow Representatives in her quest to win.  And she squeaked out a bill with one Republican bribed with higher Medicaid payments to his state of Louisana and a deal on abortion.  The Senate is the next challenge.  And a big one at that.

The Congressional Budget Office today (October 8, 2009) "scored" the latest iteration of whatever the Democrats are trying to push onto America in their takeover of  the entire healthcare industry.  Whatever they come up with will ultimately bankrupt this country, so pray for nothing important.  And interestingly enought the Senate Finance Committee proposal will "cost" (courtesy of CBO before footnotes) $829,000,000,00 and cut the deficit by $81,000,000,000, in part by pushing some expense onto states, except of course the states of powerful Democrats: Nevada gets a five-year exemption; New York, Massachusetts and a bunch of other Democrat-controlled states get special treatment for unions; in  corrupt and Democrat-controlled New Jersey, its pharmaceutical companies will get a $1,000,000,000 special tax credit; Democratic-controlled Massachusetts (again, courtesy of failed Democratic presidental candidate John "Heinz" Kerry) and Michigan get $5,000,000,000 in special union reinsurance

Latest news for senior citizens from the president who promised their healthcare will not change one iota, except for the $124,000,000 taken from Medicare Advantage which covers 25% of us, it will be killed.  Except for $400,000,000 slashed from regular Medicare to pay for Medicaid and new tax subsidies to help others purchase health insurance mandated by Congress.

This political dispute is no longer about healthcare it's about egos and "political will". And it seems Rahm Emanual is losing, and it's been said he doesn't lose easily. Even after a full-court press of lobbying by Emanual's mouthpiece, President Obama, he's falling. Even Democrats are challenging him. From the left on the "necessary" government monoploy and on the right, from "Blue Dogs" not wanting a government takeover. Quandry. And their nemesis, Citizen Sarah Palin scored with the "Death Panels". But Emanual is not to be outdone. With focus groups and polling no doubt he'll rebrand "death panel" to be "Life Panels". Now isn't it better?

Senate Finance Committee Chairman Max Baucus, a Democrat, wants to tax young, healthy people who might not want to buy health insurance somewhere between $3,800 or $1,900 depending on where he is today on votes.  Chairman Max' bill was endorsed by...him and only him.  Now every Democrat in DC is scrambling to buy enough votes to have some bill passed, and start the absolute control of all healthcare in the U. S. by Democrats.  "But don't call it a tax" said, President Obama in one of his myriad appearances on the left-wing media.  A tax by another name is a "penalty" or "mandate" or "something" but not a tax.

Democrats want to pay for its new monopoly over healthcare by slashing Medicare payments by $500,000,000,000 while baby boomers turn 65 and increase Medicare enrollment by 30%.

Tennessee tried in 1994 an ambitious healthcare reform including universal coverage and public option. [Wall Street Journal, Monday, August 17, 2009, page A 2. http://online.wsj.com/article/SB125026043441032205.html] Result: It almost ate Tennessee for lunch, capturing one-third of its budget it was so costly. Initially set at $2,600,000,000 to cover poor people and those who were rejected by insurance companies, it hit $8,500,000,000 by 2004. People covered by their employers insurance went for TennCare instead, 1.4 million people leaving only 6% uncovered (because of an income cap). Tennessee started backtracking, cutting those covered and slashing reimbursement, driving many providers from the program. Initial "cost savings" to pay for it initially succeeded by reducing visits to emergency departments. But that didn't last, by 2005 TennCare threatened Tennessee's very solvency. It reduced participants and leveled out the losses, to $7,660,000,000 covering 1,280,000 people. Many not covered have CoverTN which pays basic medications and tests for $125 a month with a maximum of $25,000 a year. Diagnosis: Failure.

Why should we want to extend a failing U. S. Government program? Medicare is one. It is losing money. MEDPAC -- the Medicare Payment Advisory Commission -- reports that hospitals lose 5.9% for every dollar they receive treating Medicare patients (getting back only 94.1% of costs). Privately-managed health insurance companies treating non-Medicare patients SUBSIDIZE Medicare. Regardless, in the four years from January 2003 to December 2007, Medicare trustees reported that the unfunded liabilities of Social Security and Medicare grew by a stunning $10.4 trillion. The average annual growth was $2.8 trillion. According to the Medicare Trustees “intermediate assumptions,” $38 trillion (260% of current GDP) would have been needed at year-end 2008 to fund over the next 75 years projected shortfalls for Medicare hospital coverage and to meet the federal government’s statutory obligation to pay its share of other Medicare benefits, including prescription drug coverage. And at 2016 or 2017 -- 7 or 8 years -- at today's calculations the "trust fund" will run out. ZERO. So money will come from everyone's taxes to pay for the burgeoning numbers of seniors. And they don't die fast enough (only about 5% of them a year) to get off the roles. Hey government, great management. And let's see something live 42 million people are now covered by Medicare, around the number President Obama wants to add to his government-run, single-payer system. Go Obama!

If Obama really cared about reining in the out-of-control healthcare costs, he'd:

1) Allow a tax deduction for individuals' health insurance premiums so they can shop where they choose for a policy that fits each of them and take payments for health insurance from companies by stopping tax deductions for them. Freedom in capitalism.

2) Rein in trial lawyers who force expensive medical settlements for accidents by healthcare providers which a) finance their yachts and jets and b) drive up costs and c) force these providers to defend against frivolous law suits by ordering more tests, scans and diagnostics than would be otherwise necessary. Actual negligence should be handled by a special healthcare court system, much like that for bankruptcies, instead of expensive adversarial conflicts. A lot cheaper than buying yachts and jets, and facts would predominate, not a lawyer's ability to persuade.

3) Cut coverage mandates dictated by politicians which pander to a voting bloc lobbyist or grab campaign contributions and include: hair implants, chiropractic, speech therapy, podriaty, vision, massage, marriage counseling, substance abuse, infertility, erectile disfunction, and equality of mental with physical health. (In 1965 there were a small handful of these politician-directed mandated coverages, now there are upwards of 1,000.)

4) Allow cross state-border marketing of health insurance plans, with the consumer being allowed to choose.

5) Allow clinics to be established in retail locations, like Wal-Mart and encourage entrepreneurs to establish them and hospitals for specialties; yes, it might force some hospitals out of business, but in exchange for more efficiency and effectiveness.

There's a start Mr. President, to lowering the price of healthcare. There'll be more here coming.

www.whitehouse.gov/realitycheck ("reality check" being a segment on the O'Reilly Factor, television news' number one show), paid for by taxpayers is our president's attempt to bully his fellow citizens into accepting his left-wing attempt at taking over American healthcare. He is using his powerful seat to shut-up dissent and silence anyone disagreeing with him, saying he knows what's best for the American people who'll "be glad that we [meaning 'I'] acted to change an unstustainable system" that government created initially. Yessuh, yessuh, master you know best.

The United States of America spends $2,400,000,000,000 on healthcare, slightly more than the entire GDP of the United Kingdom (the world's sixth largest). Government mandated and managed Medicare has contributed greatly to this vast spending. So certainly covering another 25 or 50 million people under the same management will cut costs. What are you snorting this time, Barack?

Just an interesting factual tidbit. 5% of Medicare beneficiaries die each year and spending during the last year of each life accounts for 27.4% of all Medicare spending. (As of the latest comprehensive report in 2001.)

Not that it matters, since this has nothing to do with facts, only with the mad grasp for power, but France -- the epitomy of Obama's dream society -- is pushing back against out-of-control spending on its Assurance Maladie single-government payer health insurance. Adopting American techniques like co-pay and bringing in business managers to rationalize government workers' hours and cut jobs. No matter where Obama wants to take America isn't working in France. Costs there and in the UK are rising as in the U. S. "Obama-lite" former Republican governor Mitt Romney's experiment in universal coverage was supposed to cost $472,000,000 last year but hit $628,000,000! A failure. The only way to rein in healthcare costs is to rein in healthcare costs. Cosmetic surgery, dentistry and laser eye surgery all are free-market and not paid by most insurance. Result? Better technology and lower or the same prices over time. Proof only to rational not left-wing ideologic people. We should give the free market a try.

Just to put things in perspective, since President Obama asked gently to "overhaul" the healthcare industry in America, and turned over the natty, irrelevant details to Congress, lobbying has intensified to $133,000,000 in the second quarter alone.

From the party that wants to own your healthcare (WSJ, July 22, 2009, page A 6):[Democratic-controlled] New York City, State to Pay $540 Million in probe of Medicaid Charges, that they knowingly submitted false claims to Medicaid. This is the largest ever recovered settlement, and covered 1990 through 2001.

From the New York Times, June 12, 2009 page A 15, "Obama takes his health care case to the public", Obama said: "If the private insurance companies have to compete with a public option, it will keep them honest..." Thus Obama let slip out that he believes insurance companies are not honest. And later, he said, "We've got to admit that the free market has not worked perfectly when it comes to health care." Oh, yes like Medicare and Medicaid!

But if Congress and the president really had our best interests in mind, and weren't simply lusting for more power, they'd stop, look and analyze the results of Massachusetts' 2006 healthcare plan. See a Wall Street Journal article (July 11-12, 2009, page A 10) http://online.wsj.com/article/SB124726287099225209.html.

And it looks like Obama is cloning the first President Bush's "read my lips, no new taxes" by moderating the possibility of taxing healthcare benefits and setting up Congress, especially Republicans, to take the blame. (As in, "the Devil made me do it".) Obama in part beat McCain in the 2008 election by pledging, promising and guaranteeding that no one making under either $250,000 or sometimes $200,000 would have a penny of their taxes raised. (Unless they smoke.)

The headline Friday, June 19, 2009: Senator Edward Kennedy's healthcare bill specifically (section 3116) exempts members of Congress. Doesn't that and that alone tell you something? Oh, federal employees won't be in it either, same section.

Senator Ron Wyden, Democrat from Oregon has a better idea than either Senator Kennedy or President Obama who simply want to take over American healthcare, facts and markets notwithstanding. It is obvious they don't to hear any other sides. But read here:

http://online.wsj.com/article/SB124545885464333145.html. If you care about the upcoming healthcare clusterfxxk read this article carefully.

And Safeway has used a market-based approach to make its non-union employees more healthy and keep their healthcare costs flat. An important strategy that our politicians will not read. Don't bother the Democrats with facts...
http://online.wsj.com/article/SB124536722522229323.html and http://online.wsj.com/article/SB124476804026308603.html

Now to the rest of the story:
Stop smoking, save 475, 000 lives.
Lower blood pressure, save 395,000 lives.
Slim down, save 215,000 lives: 31% of us are clinically obese with a Body Mass Index over 30.  3.8 million Americans are over 300 pounds and 400,000 are over 400.  The cost of diabetes alone is $200,000,000,000.

All together healthier living could save 1,250,000 lives a year. Cost? Not much, just a little self-discipline. This includes less alcohol (boo) and more fish (yea).

Universal health insurance might save 18,000 lives. And funny thing, Obama's doctor said that government, single-payer healthcare is his preferred choice, but the "scoring" by the Congressional Budget Office indicated that 16 million more people would be covered for sums between $1,000,000,000,000 and $1,500,000,000,000, leaving Obama some 29 PEOPLE million short of "universal".

Akrasia, the Greeks call it, weakness of will. But in America, our government would rather spend $1,200,000,000,000 to $1,500,00,000,00 instead of challenging voters to do something they might rather not do. Our country is self-indulgent thanks to our spineless politicians thirsting after cushy jobs afraid to tell people to "Knock it off." (Remember Medicare has $38,000,000,000,000 in unfunded liabilities! With increases in costs 34% HIGHER than the rest of healthcare snce 1970.)

Education not regulation, but some taxation (it worked beautifully on cigarettes, only sorry much of that dough went to buy trial lawyers their new jets) and pricing insurance on life styles, and rejiggering incentives. Today providers of healthcare get paid for doing things. If people paid their own healthcare costs, and prices were higher to smoke and be fat, many would stop and exercise. Pretty simple and cheap. But no, Obama and his Stepford Congress wouldn't get more power over other peoples' lives, so "no" to that simple, cheap solution. So let's go and spend $1,200,000,000,000 to $1,500,000,00,00 instead. And to pay for it, let's laugh off Obama's "savings", he must be back on cocaine to believe that. But he is asking for us -- taxpayers -- to believe in his no-detail savings plan, "Oh, sure, politician we believe you." His real answer, tax. Tax. Tax. Everything. Employer-sponsered health-care plans (no matter he destroyed Senator McCain for saying the same thing.) Non-profit hospitals which don't give away enough care. Alcohol. Limit Health Savings Accounts, or just eliminate them because rich people might get something. More tax on beer and wine. Sugary beverages, including pop, fruit juices, iced tea, sports drinks, flavored milk. Maybe not water.

But one way Democrats will save a little of that obscene expense is by...RATIONING healthcare based not on doctors' opinions but those of bureaucrats. These shamans of healthcare -- bureaucrats -- now will not pay for "virtual colonoscopies" computed tomography (CT) scans of the colon because of cost. Cancer death #2 in the U. S.! Cure rate: over 90% if diagnosed early; 8% -- certain death -- later on. My guess is that Congress will pass a law (after some pressure, and after some campaign contributions) to force Medicare to cover these potential life-saving scans. That is the preview of ObamaCare...healthcare by campaign contribution. Or: "Pay or Die." But it'll be up to bureaucrats thus breaking the sacred bond of doctor and patient dating from Hippocrates. Like all else Democrat, everyone is equal (except the political royalty) and so computers and bureaucrats can make the diagnosis and perform the therapy.

A couple of interesting articles from the Wall Street Journal:
http://online.wsj.com/article/SB123681586452302125.html, The Wall Street Journal, Thursday, March 12, 2009, page A15: "Obama's $80 Billion Exaggeration".

http://online.wsj.com/article/SB123682034697503187.html, The Wall Street Journal, Thursday, March 12, 2009, page B4,

But of course President Obama and Congress will not do anything that does not expand their power over others, does not prove capitalism and free-enterprise wrong, and does not attract campaign contributions. So what will ObamaCare do, for example, to doctors? "How ObamaCare Will Affect Your Doctor" (WSJ May 12, 2009, page A 17. http://online.wsj.com/article/SB124208383695408513.html). Now Medicare on average pays physicians 20% - 30% less than private plans because of its price and wage controls. When many more patients are covered, and companies will offload their workers like mad from private plans to the government, costs will be impacted by cutting doctors' pay another projected 15% - 20%, with lower-paid primary care physicians hurt most, at the same time they'll be required to purchase costly information systems. Remember that doctors are in the higher-income levels, so their taxes at the same time will be greatly increased. And their diagnostic and therapeutic time will be cut by paperwork. Obama, of course, sees his bureaucracy as better equipped with computer-driven expert systems being better able to diagnose and care in a cost-effective manner. But will it hire and employ physicians and other providers and have them join unions? This hasn't been discussed, but why not?

None of this makes sense.

But hey, how about this: Obama's pick for Health and Human Services secretary--Kansas Gov. Kathleen Sebelius used to work as the chief lobbyist for her state's trial lawyers association.  Malpractice awards are $20,000,000,000 to $40,000,000,000 a year (laywers typically get 30% to 40% of it).  But fear of lawsuits is where the cost of "defensive medicine" skyrockets: studies indicate $100,000,000,000 to $178,000,000,000 a year tops, $66,000,000,000 at a minimum.

Incentives of Medicare are to treat, to do things to get paid. Providers don't get paid if their patients are healthy and get healthier. This is the definition of perverse incentives.

But for the Democrats how is ObamaCare doing so far? Quite well, thank you very much. Drug makers have increased their favor-currying (lobbying) to $47.4 million the first quarter. Ditto, hospital organizations, insurance companies, doctors and labor unions.

Republicans have a better plan, but it won't get off the ground because it relies on the private sector. People become responsible for their care. They get money now given in tax credits to their employers. (Which by itself -- a third-party, detached payor -- increases useage and costs.) Republicans will mandate health insurance to be sold across state lines but leave it up to the private-sector companies to define coverages and premiums.

But Democrats see its 45-year Senator from Massachusetts, brain injured far left-winger Edward Kennedy as its key. While Kennedy can't make it into DC, his ethically-challenged friend Christopher Dodd (D., Conn.) will be his mouthpiece. Would the senator from Massachusetts like his obviously "extraordinary" care rationed because it's too expensive. NO! And a question is, exactly who is paying for his healthcare? Medicare?

But wait! There seem to be two roadblocks to a smooth transition to government healthcare. First, they have to figure out how to pay for it. Apparently rich people don't have enough money. And President Obama has promised...promised...("cross my heart hope to die...") that any plan won't increase the budget deficit. Well, dude, what about the $1,200,000,000 to $1,500,000,000 it'll cost? Second, whether they'll create a new public health-insurance plan to compete with private plans. Let's see now. Obama and most of the Democratic Congress believe the free-enterprise system doesn't work. Look at the U. S. Postal Service and Amtrak, for example. So this is a no-brainer for the anti-business morons running our country.

And one might ask, how's medicare doing? according to revised government estimates, not well. Its fund for hospital care will run out of money in 2017, (two years earlier than last year's estimate. [Social Security, too, will run out in 2037, four years earlier than last year's estimate!]

Our president's Council of Economic Advisors released a report, "The Economic case for Health Care Reform," June 1, 2009. It outlines five issues. 1) Federal deficits undermine this country's stability and healthcare must be "reformed" to cut deficits. Obama's plan is to borrow $1,200,000,000,00 to $1,500,00,000 to fund losses while government takes the healthcare industry over. Check the U. S. Post Office and Amtrak to see how government'll slash deficits by taking over arguably the largest industry in the world (perhaps next to government). 2) "Skyrocketing costs" are not, as it indicates, skyrocketing falling to a 6% increase in 2007 against 13%, for example, in 1980. It might be highlighted that costs started heading up fast when Medicare was passed. 3) Families are burdened by healthcare costs. Not as much as the Democrats want you to believe. Food and energy have decreased and housing has stayed flat as a percentage of households' incomes, indicating that healthcare is not increasing its burden and forcing families to give things up for healthcare. Americans can afford more healthcare spending because as a nation we are richer than others. 4) We should copy Europe. But no. Much of the increase in U. S. healthcare spending comes from innovation in high-tech equipment and medications. Almost all of which is financed by the U. S. in the U. S. Our diagnostics are better. As is our healthcare. We have little waiting for diagnosis and treatment, unlike Canada and Europe. We could go back to the 1980's and have 60% survival rates from heart attack instead of today's 90+% 5) CEA advises shrinking healthcare industry spending by 1.5% a year, thus creating higher unemployment and concomitant lost wealth and higher costs from the 1.4 million jobs in healthcare now. And cutting money going into the industry will shrink the number of providers thus guaranteeing long waits for healthcare and steadily increasing deaths. The untold story of ObamaCare!

And an aside, speaking of Canada. Need an MRI? Wait: one year. Then, surgery needed? More months wait. Need ER? Only half the patients are treated on a timely basis. Now the trends are: head to America for healthcare; or go to a private, non-governmental clinic, 50,000 in Vancouver BC and growing quickly. It's getting to be, the rich get good care.

An example of "rationing" NOW in the U.S. is Centers for Medicare and Medicaid Services (CMS) overseer of Medicare and Medicaid for the Dempartment of Health and Human Services, refusing to pay for virtual colonoscopies, a less-invasive procedure for colon cancer detection. And of making the rules for home oxygen therapy so complex that they seem to hope patients will give up and die. Only two quick examples. But the way CMS "cut" healthcare is to take away compensation for doctors, nurses and other providers. And you ain't seen nothing yet!

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