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Obamacare: A legacy unraveling

Obamacare: a legacy unraveling

While the majority of the population slept our misdirected government engineered major changes to their legacy legislative effort, Obamacare. Most startling of the alterations, many will be able to keep their traditional plans intact deep into 2017. Thirty other changes, through Executive edicts, have been implemented to make this egregious law more palatable to voters in 2014 and subsequently for the presidential election in 2016. Driven by political considerations candidates running for Democrat seats in the House and Senate are running away from this catastrophe in evolution. Many ardent supporters of Obama are having second thoughts concerning his agenda, as the President tweaks the legal nightmare he has inflicted on the nation. Dozens of mandates have been modified, extended and or simply circumvented to keep the Affordable Care Act afloat. Insufficient numbers of paying subscribers have signed up in the Exchanges. Reportedly four million have enrolled. Those in the know question the mix of this group. White House officials are mum whether these new Exchange patrons have been moved off Medical Assistance to this newest of subsidized programs. This leaves a small window of possibility that a few paying customers joined. Many are asking the question whether the Affordable Care Act is on life support. Omens of failure are omnipresent. Insurance premium nightmares are being reported throughout the country, rising by as much as 100%. Those who have not lost their jobs are seeing their hours cut by 25% or more. Clever means have been purported to deny patrons of this disaster the very elements advertised by the President and his minions. Obamacare was never about improving health care in America. Instead it was designed to usurp one-sixth of the economy and create a unitary payer system with the central core controlled by the Washington D.C. bureaucracy. Confusion has been introduced into the health system, at every level, which completely defeats its endgame, better medical care for all. Affordable care Act has been found to be not so affordable. From the perches of many Obamacare is unraveling and could sink under its own weight. In subsequent articles the dangers of Obamacare will be discussed.

Mark Davis, MD author of Obamacare: Dead on Arrival, A Prescription for Disaster. http://amzn.to/1d4poKi. https://www.createspace.com/3801630

platomd@gmail.com President of Davis Book Reviews and Healthnets Review Services. www.healthnetsreviewservices.com

Do Social Security and Medicare show that Obamacare can be successful?

The loyal defenders of President Barack Obama and the Affordable Care Act (ACA) keep pointing to Social Security and Medicare as examples of successful government programs whenever someone points out that government doesn’t do anything very well. The nearly perfect record of dismal performance in federal programs is a key reason that critics doubt that the massively flawed rollout of health insurance reform lovingly referred to as “Obamacare” will eventually turn into a success.

Liberal commentator Juan Williams proudly notes how “popular” both Social Security and Medicare are, citing them as having received 70 percent support among those asked whether they like the programs or not. But just because lots of people like a given federal program doesn’t mean it is a beneficial or successful program.

It is certainly true that Social Security and Medicare are very popular and proponents vigorously oppose balancing the budgets of the two programs by reducing benefits. But, again, by the “popularity” standard, programs that create dependency like welfare, food stamps, and free cell phones are successes, too.

However, reality paints a far different, and much less rosy picture of Social Security and Medicare.

These programs are not giveaways funded by taxpayers, they are funded primarily by payroll taxes on employers and the employees who benefit from them. Even so, because of mismanagement and a failure to adapt to changes in demographics, both programs are broken and broke, running annual deficits.

This is the typical sort of success we find in “successful” government programs, and we have to wonder if there isn’t a better solution to most problems the government thinks it can solve. And the answer is, “yes, there is.” The private sector can do it better, as evidenced by multitudes of successes over our 230-plus-year history.

What too often happens is that when government sees the private sector not completely solving a problem, it thinks it can do better, and a new federal program is born. But the ultimate result is that the federal government does no better at trying to solve the problem than the private sector, and often does much worse.

In contrast to the self-funding process involving the beneficiaries of Social Security and Medicare, other programs give handouts to both those who need help and to those who really don’t need it, and these recipients pay little or nothing in taxes to support the giveaways.

These programs are rife with waste, fraud, and abuse, because government does not manage them efficiently. You can make a very good argument that government is inherently unable to manage these expansive programs competently.

Giving people money is one of the first priorities of politicians; it’s how they buy popularity, which translates to votes.

But as examples go, Social Security and Medicare, while intended to be self-sustaining without support from general tax revenue, are not examples of good government programs because they have been mismanaged and neglected.

Social Security began running a deficit in 2010, will run a deficit near $75 billion this year and the projected deficit will reach $344 billion in 2035 if something isn’t done. Social Security is beginning to fail in its ability to take care of seniors because government has failed to properly operate the program.

A panel determines Medicare reimbursements, a panel that meets in secret and relies heavily on the recommendations of the American Medical Association. Many doctors already do not treat Medicare patients because the low reimbursements don’t cover costs. Medicare providers have to balance low Medicare payments by shifting lost dollars to insured patients.

So that’s a brief glimpse into Juan Williams’ idea of successful government programs. Is this what the ACA also promises, or will it somehow be different?

Even if we believe the ACA is a good idea, even if it had been competently designed and implemented, and even if we overlook the disgraceful manner in which it was created and jammed through Congress before being read by the Democrats who enacted it, it is still a government program that supposes it will be more effective at running 18 percent of the nation’s economy, and one of the most important personal concerns Americans have, than the private sector.

And now $716 billion will be taken out of Medicare to fund Obamacare, meaning reimbursements and senior care will suffer, or the deficit will increase.

Obamacare attempts to do by force what Republicans attempted to do by choice through initiatives focused on the problem areas of the then-current system, and Democrats opposed and defeated those efforts.

Despite Supreme Court Chief Justice John Roberts’ phantasmagoric redefining the fines imposed by Obamacare as taxes, the U.S. Constitution did not intend for, and does not authorize government to commandeer one-sixth of the economy.

Those who think government is the answer to everything need to remember that the only reason there is a government of the United States of America is because the people – remember “of the people, by the people, and for the people?” – created it by assigning government limited powers in certain specific areas.

It is perverse in the extreme for the people now to be controlled by that which they voluntarily created.

Random thoughts on the passing scene

Some of those who think the American health care system needed to be trashed and reformed in the image of the Canadian system might be interested in the opinion of Bacchus Barua, a senior economist with Canada's Fraser Institute.

"Healthcare in Canada is anything but free," he states, noting that the average family of four pays more than $11,000 a year in taxes for hospital and physician care. However, he explains in an article for The American "surely such expenditure is justified if Canadians receive a stellar healthcare system in return for their tax dollars. Unfortunately, that simply isn't the case."

Specifically, he lists some problems with his country’s system:

** Canada has fewer physicians, hospital beds, and diagnostic imaging scanners, and performs fewer medical interventions than its American and European counterparts.

** Canada has one of the lowest physician-to-population ratios in the developed world.

** A recent survey found that Canadians must wait an average of about 4 1/2 months for medically necessary elective procedures after referral from a general practitioner.

** The wait for diagnostic imaging technologies like MRIs is over two months on average.

** Patients in Canada are likely to wait two months or more to see a specialist, six days or more to see a doctor when sick or needing care, and four hours or more in the emergency room.

** Due to the lengthy waits, about 40,000 Canadians leave the country for treatment elsewhere each year [like the U.S.].

** Public drug plans covered only about a quarter of the new drugs approved for sale in Canada between 2004 and 2010.

He concludes: "These realities serve to dismiss the mythical notion that a Canadian-style healthcare system" is highly desirable.

We are headed in that direction.

*****

During the mortgage banking crisis the federal government pressured large banks like JPMorgan Chase to take over the bad mortgage loans sold by failing banks Washington Mutual and Bear Stearns. Now the government is fining JPMorgan $13 billion for helping the feds deal with the crisis. Can you say “shakedown?”

*****

Planned Parenthood involves itself with topics other than planning parenthood on its Facebook page, discussing topics like why some types of sexual activity are painful, transgender issues, and promoting Obamacare. Not exactly family planning.

An article on the Internet site bighealthreport.com reports that on Planned Parenthood’s Facebook page for teens it answers the question: “Is promiscuity a bad thing?” and that the organization defended doing so with the statement, “there’s nothing bad or unhealthy about having a big number of sexual partners.”

Isn’t this the mentality that has led to 40 percent of our babies being born out of wedlock, and males with multiple children from multiple “baby mamas?”

This “advice,” such as it is, increases the likelihood of HPV and cervical cancer among females, in addition to STDs. “Even the Guttmacher Institute, the former research arm of Planned Parenthood, considered ‘a person to be at direct risk for STDs if he or she had had two or more partners during the 12 months preceding the interview’ during one of their research studies,” Big Health Report said.

The article notes “a person with low self-esteem has been shown to engage in sexual relations earlier, and engage in riskier, unprotected sex with multiple partners.” Does that sound like “nothing bad or unhealthy” to you?

Seriously? This is what we get for $542 million in federal subsidies?

*****

The “government shut down” really amounted to about 17 percent of the government being “shut down,” and that is somewhat like going to a mall that has 100 stores and finding only 83 that are open for business. So, while things were uncomfortable for some folks, it bore no resemblance whatsoever to the government actually shutting down.

Of course, if the mall management blocked off stores that otherwise would be open, things would be more uncomfortable. No sensible businessperson would do that, but a petty, politics-dominated administration would, and did.

*****

The emotional push to raise the minimum wage to $15 dollars an hour for those working the least skilled jobs in the fast food industry puts the spotlight on a fundamental misunderstanding of basic economics.

Advocates think the wage ought to be based upon concerns totally unrelated to the job and the business the job is a part of. “I flip burgers at Burger King, and can’t support my family on what I make, so raise the minimum wage,” is the mentality behind this ill-advised movement. In their mind, if a PhD. in English, mathematics, biochemistry, or any other field somehow ended up ringing up Happy Meals at MacDonald’s, the wage ought to be based upon his/her training, or some arbitrary “living wage” concept.

A job is worth whatever the employer says it is worth. Anyone who doesn’t like the wage is free to not take the job, or to look for a better one. If the employer can’t find people to work at the selected wage, he or she will have to raise it. Anyone who tries to find a better job, but can’t, needs to pipe down and do the job the employer allowed them to have until they can find a better one.

The five disgusting Ps of the Obama/Reid Government Shutdown

We are led to believe the government shutdown is one of the worst things to afflict the country since … well, pick something.

But that’s just more exaggeration from the left in Washington and in the media. The vast majority of Americans would not notice the shut down absent the barrage of horror stories we’ve been treated to, and one other factor.

Shutdowns aren’t that unusual. Since 1976 there have been 17. Six occurred during the Carter administration, 8 during the Reagan administration, one during the elder Bush administration, and 2 during the Clinton administration.

Most lasted less than a week, but in the Carter administration 4 lasted 10 days or more, and the longest of all those shutdowns in 1996 lasted 21 days. On average, government shutdowns last about 6.5 days. There has been a lag in shutdowns since 1997 in the second Clinton term, through the George W. Bush administration, and through the first Obama term.

There is obvious discomfort among furloughed federal workers. However, the House of Representatives voted Saturday to fund back pay, which is what usually happens in shut downs. So, the real pain will be felt by some of the American people, due to the aforementioned “other factor.”

Three things are true about this shutdown: First, the Republican-led House passed three bills to restore government funding. Second, each House measure also sought to delay or defund the Affordable Care Act (ACA). And third, Senate Majority Leader Harry Reid refused to act on the House measures and President Barack Obama threatened to veto them.

From this we see: a) House Republicans want to reopen the government and passed three measures to do so, and also wanted to save the American people from the ACA with its broken promises, serious problems, and goodies given to large employers and Members of Congress and their staffs. And b), to Sen. Reid and President Obama, putting the furloughed employees back to work, activating the inactive government functions and opening closed facilities are far less important than implementing the highly flawed ACA.

Mr. Obama is comfortable in his “It’s good to be the king” self-indulgence. But, he’s not “the” king, or even “a” king; he is merely the President of the United States, which is certainly an important and powerful position, but the Executive Branch of which he’s the head is just one-third of our government.

Those who took civics or other classes in American government know that among the ingenious features of the U.S. Constitution are the separation of powers and the system of checks and balances, which were designed to prevent any one branch from acquiring more power than the other two.

Mr. Obama – who was reportedly a constitutional law lecturer – believes that the president is the most important figure in the government, ignoring the Constitutional prohibition of any branch gaining the degree of power and control he desires.

Democrats hold this perspective about the ACA:

*It was passed by Congress and signed by the president.

*The Supreme Court found it constitutional.

*There was an election that confirmed the country’s support for Obamacare.

*Thus, the matter is settled: the ACA is the law of the land. End of discussion.

This scenario is rife with weaknesses. Every Republican in the House also won election in 2012, and nothing prevents a law being repealed or amended. And remember that at one time slavery was the “law of the land,” and Congress made a huge error in abolishing the sale of alcohol through the 18th Amendment.

Congress can right wrongs in the law, as it did with slavery; it can repeal bad laws, as it did with the 18th Amendment. And, it can repeal, defund, or amend the error-ridden ACA.

Because Republicans did not lie down and let the Democrats have their way, we have been treated to the aforementioned “other factor,” the 5 Ps: the petulant, peevish, petty, and punkish political behavior that characterizes the shut down.

Faced with an obstinate opposition party, President Obama convened his strategy team from a nearby elementary school, where members of the third grade gathered on the playground to formulate a plan.

Noting that monuments and memorials were not closed during previous shutdowns, they recommended this tactic to cause pain: Close national parks and monuments, as well as some facilities that receive no federal funds and are not federally owned, like Mount Vernon. Close Florida Bay and Biscayne Bay to commercial fishing. Place barriers to block the World War II Memorial that has no gates and is wide open to visitors. Tell people who rent slips for their live-on boats or own homes on Lake Mead they can’t stay there. Block scenic overlooks, like at Mt. Rushmore, by placing traffic cones that prevent drivers from pulling over to view the monuments. Perfect third grade strategy.

Wesley Pruden, writing in The Washington Times, quoted an angry Park Service Ranger, who confirmed that attitude: “It’s a cheap way to deal with the situation,” he said. “We’ve been told to make life as difficult for people as we can. It’s disgusting.”

You see, if the shutdown doesn’t hurt people, it doesn’t help the Democrats.

Did you slip and fall into your garbage can? There’s a code for that!

The Affordable Care Act has forced insurance costs higher, encouraged many employers to bail out of providing health plans for their employees or cut employees or reduce hours to below the full-time threshold to avoid the higher costs, and has unleashed thousands of pages of new regulations. But intrepid federal bureaucrats charge ahead with even more requirements for providers, one of which is a revamping of the codes used to identify the medical services that providers use to bill insurers.

Currently, there about 18,000 such codes and one might be fooled into believing that is enough. But the devoted folks who get paid to generate new codes have been hard at work revamping the code system and the new list contains nearly 8 times the former number, checking in at 140,000 medical codes. The feds reason that more specific information is needed to adequately communicate what doctors and hospitals do for their patients, as well as what patients may have done to require a visit to a provider.

New codes describe precisely what bone was broken, or which eye was blackened, and tell insurers whether your injury occurred in, for example, an opera house, an art gallery, on a squash court, or in one of nine locations in and around a mobile home.

Some of them push the limits of propriety. Code R46.1 is for "bizarre personal appearance," while code R46.0 is for "very low level of personal hygiene." Others tell insurers whether an injury caused by walking into a lamppost was the "initial encounter," or a "subsequent encounter."

There is a group of codes that clarify whether you were injured while sewing, ironing, crocheting, doing handcrafts, knitting, or my personal favorite, playing a brass instrument. (Brass players are now churning out imaginative scenarios for how these injuries might have occurred.) There is also a code indicating that a patient's injury occurred in a chicken coup.

Speaking of birds, there are 72 codes for patients who have run afoul of these creatures, and being bitten by a parrot has a different code than if said parrot flies into you, or if you are bitten or flown into by a macaw or a goose. There are nine different codes for each of the six different species of bird.

The folks that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say "the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines," and their use is scheduled to be required in two years. Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services explains that "It's for accuracy of data and quality of care."

As a side note, healthcare reform, known more commonly as Obamacare, is deemed so important that the furloughs that befell air traffic controllers did not extend to Obamacare regulators and code generators, according to Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, who said that his office has not cut its workers’ hours and pay as a result of the automatic budget cuts that went into effect in March. This information should help convince doubters that the pain of the sequester is a conscious political choice of the administration, and not a requirement of the sequester.

While federal bureaucrats are busy, busy, busy improving the healthcare system with mountains of new regulations and charge codes, some of the people who actually provide care are taking different approaches, some of them good, and some not.

A recent Deloitte Center for Health Solutions survey of over 600 doctors reveals that 6 in 10 may retire earlier than they had planned, and will do so in the next three years, due to the effects of the Affordable Care Act on how they practice medicine.

Further, many providers will leave the private sector to work for hospitals or accountable care organizations, and others are fighting back against massive government interference in the doctor-patient relationship by reverting to an older direct primary care model that eschews health insurance in favor of fee-for-services, such as an office visit for $20 or a house call for $100. Some offer a membership plan where patients pay a set fee per month for physician services.

Getting away from health insurance, government regulations and other requirements reduces costs substantially, allowing doctors to provide services at affordable prices, and has the further advantage of allowing doctors to escape "assembly line medicine," all of which may benefit the relationship between providers and patients. In contrast to Obamacare, this is a real improvement in the system.

Finally, even supporters of this Rube Goldberg-like contrivance are starting to realize its boundless weaknesses. Senator Max Baucus, (D-Mon.), one of the Affordable Care Act’s designers and strong backers, told Health and Human Services Secretary Kathleen Sebelius during a Senate committee hearing that he sees "a huge train wreck coming down."

It's a shame Sen. Baucus and the other blind supporters didn't do their homework before the measure passed the Congress, and save the country much pain and suffering. But perhaps it’s not too late to reverse course.

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Obamacare: A legacy unraveling

Do Social Security and Medicare show that Obamacare can be successful?

Random thoughts on the passing scene

The five disgusting Ps of the Obama/Reid Government Shutdown

Did you slip and fall into your garbage can? There’s a code for that!

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