The Big Con

[philunderwood]

www.qando.net/?cat=23

ObamaCare–estimates of cost off by $50 billion a year

Published August 10, 2011 | By Bruce McQuain

Even before this particular find, costs for the implementation of ObamaCare were shown to be higher than doing nothing. Now we learn that in addition to that, there’s an additional $50 billion a year cost that will come due:


Federal payments required by President Barack Obama’s health care law are being understated by as much as $50 billion per year because official budget forecasts ignore the cost of insuring many employees’ spouses and children, according to a new analysis. The result could cost the U.S. Treasury hundreds of billions of dollars during the first ten years of the new health care law’s implementation.

“The Congressional Budget Office has never done a cost-estimate of this [because] they were expressly told to do their modeling on single [person] coverage,” said Richard Burkhauser in a telephone interview Monday. Burkhauser is an economist who teaches in Cornell University’s department of policy analysis and management. On Monday the National Bureau of Economic Research published a working paper on the subject that Burkhauser co-authored with colleagues from Cornell and Indiana University.

Employees and employers can use the rules to their own advantage, he said. “A very large number of workers” will be able to apply for federal subsidies, “dramatically increasing the cost” of the law, he said.

I’m sure that will come as an “unexpected” surprise to those who preached the entire point of implementing ObamaCare was to “bend the cost curve down”. Now it appears it will not only fail to do that, but instead bend that curve upward.

Bottom line:


In May a congressional committee set the accounting rules that determine who will qualify for federal health care subsidies under the 2010 Patient Protection and Affordable Care Act. When the committee handed down the rules to the Congressional Budget Office, its formula excluded the health care costs of millions of workers’ spouses and children. The result was a final estimate for 2010 that hides those costs.

“This is a very important paper,” Heritage Foundation health care expert Paul Winfree told TheDC. These hidden costs, he said, “will almost certainly add to the deficit, contrary to what the Congressional Budget Office and others have estimated.”

Your incompetent and clueless government at work.

And we wonder why we have such an outrageous deficit and debt problem?

~McQ

[philunderwood]

Two Different Worlds: Part II

By Thomas Sowell

www.JewishWorldReview.com |

A few weeks ago, I had what seemed to me a small medical problem, so I phoned my primary physician. However, after we discussed the problem, he directed me to a specialist.

After the specialist examined me, he directed me to a different specialist elsewhere. When I was examined and tested in the second specialist's office, he immediately phoned a hospital, asking to have an operating room available in an hour.

No more than 5 hours elapsed between my seeing the first specialist and the time when I was on an operating table.

This was quite a contrast with what happens in countries with government-run medical systems. In such countries, it is not uncommon to have to wait days to see a physician, weeks to see a specialist and months before you can have an operation. It is very doubtful whether I would have lasted that long.

In the intensive care unit, where I was sent after the first of two operations, I was hooked up to high-tech machines and had a small army of people looking after me around the clock. Would a government-run medical system have provided all this, especially for a man in his eighties?

In some countries with government-run medical systems, individuals are not even permitted to pay out of their own pockets for medications that the government has ruled are too expensive for people in their age bracket or medical condition.

That same mindset has already become evident in the United States, where a very expensive cancer drug has been refused federal approval to be sold, because it helps only a limited number of people and at very high costs.

But what if you are one of those limited numbers of people — and you are willing to pay what it costs, with your own money?

You are free to take your life's savings and gamble it away in a casino, if you want to — but you are not free to use your life's savings to save your life.

This is not an isolated paradox. This is the logical consequence of a vision of the world that prevails all too widely among the intelligentsia, and not just as regards medical care.

In that vision, people can draw on the available resources only to the extent that the government considers appropriate, in the light of other claims on those resources. This treats what the people have produced as if it automatically belongs to the government — and as if politicians and bureaucrats have both the right and the wisdom to override the personal decisions that the people want to make for themselves.

This issue involves a difference between a world in which people can make their own decisions with their own money and a world in which decisions — including life and death medical decisions — are taken out of the hands of millions of people across the country and put into the hands of politicians and bureaucrats in Washington.

One of the big claims for government-run medical systems is that they can "bring down the cost of medical care." But anyone can bring down the cost of anything by simply buying a smaller quantity or a lower quality.

That is why countries with government-run medical systems have waiting lists to see doctors, and even longer waiting lists to see specialists or to get an operation. That is why those countries seldom have as many high-tech medical devices as in the United States or use the newest medications as often.

In those things that are crucially affected by medical care, such as cancer survival rates, the United States leads the way. In things that doctors can do little about — such as obesity, homicide or drug addiction — Americans shorten their own lives, more so than people in other comparable societies.

This enables advocates of government-run medical care to cite longevity statistics, in order to claim that our more expensive medical system is less effective, since Americans' longevity does not compare favorably with that in other comparable societies.

For those who think in terms of scoring talking points — as distinguished from trying to get at the truth — this kind of argument may sound good. But should something as serious as life and death medical issues be discussed in terms of misleading talking points?

[philunderwood]

www.qando.net/?tag=medical-care

When controlling cost becomes primary, the care given becomes secondary

Published October 26, 2011 | By Bruce McQuain

The concept in the title isn’t a difficult one to grasp, yet it seems to be one that eludes any number of people who think government can cut medical care costs and improve care simultaneously.


A growing number of states are sharply limiting hospital stays under Medicaid to as few as 10 days a year to control rising costs of the health insurance program for the poor and disabled.

So what does that mean? Well, it’s a vicious circle that ends up costing more, because of one tiny problem:


In Arizona, hospitals won’t discharge or refuse to admit patients who medically need to be there, said Peter Wertheim, spokesman for the Arizona Hospital and Healthcare Association. "Hospitals will get stuck with the bill," he said.

That will most likely be the case for all hospitals.

And the result?


Advocates for the needy and hospital executives say the moves will restrict access to care, force hospitals to absorb more costs and lead to higher charges for privately insured patients.

Econ 101.

And what will happen?

Cost will continue to spiral upward for everyone.

And continue to do so.

Meanwhile:


For fiscal 2012, the association estimated state Medicaid spending will rise 19%, largely because of the end of the federal stimulus dollars.

The program served 69 million people last year.

That number will go up as millions are added under ObamaCare.

Your “cost cutting” government at work.

~McQ

[philunderwood]

Obamacare Abominations

By John Stossel

www.JewishWorldReview.com |

President Obama says his health care "reform" will be good for business.

Business has learned the truth.

Three successful businessmen explained to me how Obamacare is a reason that unemployment stays high. Its length and complexity make businessmen wary of expanding.

Mike Whalen, CEO of Heart of America Group, which runs hotels and restaurants, said that when he asked his company's health insurance experts to summarize the impact of Obamacare, "the three of them kind of looked at each other and said, 'We've gone to seminar after seminar, and, Mike, we can't tell you.' I think that just kind of sums up the uncertainty."

Brad Anderson, CEO of Best Buy, added that Obamacare makes it impossible to achieve even basic certainty about future personnel costs:

"If I was trying to get you to fund a new business I had started and you asked me what my payroll was going to be three years from now per employee, if I went to the deepest specialist in the industry, he can't tell me what it's actually going to cost, let alone what I'm going to be responsible for."

You would think a piece of legislation more than a thousand pages long would at least be clear about the specifics. But a lot of those pages say: "The secretary will determine ..." That means the secretary of health and human services will announce the rules sometime in the future. How can a business make plans in such a fog?

John Allison, former CEO of BB&T, the 12th biggest bank in America, pointed out how Obamacare encourages employers not to insure their employees. Under the law, an employer would be fined for that. But the penalty at present — about $2,000 — is lower than the cost of a policy.

"What that means is in theory every company ought to dump their plan on the government plan and pay the penalty," he said. "So you don't really know what the cost is because it's designed to fail."

Of course, then every employee would turn to the government-subsidized health insurance. Maybe that was the central planners' intention all along.

An owner of 12 IHOPS told me that he can't expand his business because he can't afford the burden of Obamacare. Many of his waitresses work part time or change jobs every few months. He hadn't been insuring them, but Obamacare requires him to. He says he can't make money paying a $2,000 penalty for every waitress, so he's cancelled his plans to expand. It's one more reason why job growth hasn't picked up post-recession.

Of course, we were told that government health care would increase hiring. After all, European companies don't have to pay for their employees' health insurance. If every American employer paid the $2,000 penalty and their workers turned to government for insurance, American companies would be better able to compete with European ones. They might save $10,000 per employee.

That sounded good, but like so many politicians' promises, it leaves out the hidden costs. When countries move to a government-funded system, taxes rise to crushing levels, as they have in Europe.

Whalen sees Obamacare as a crossing of the Rubicon.

"We've had an agreement in this country, kind of unwritten, for the last 50 years, that we would spend about 18 to 19 percent of GDP (gross domestic product) on the federal government. This is a tipping point. This takes us to 25 to 30 percent. And that money comes out of the private sector. That means fewer jobs. This is a game-changer."

He means it's a game-changer because of the cost. But the law's impenetrable complication does almost as much damage. Robert Higgs of the Independent Institute is right: If you wonder why businesspeople are not investing and reviving the economy, the answer lies in all the question marks that Obamacare and other new regulations confront them with. Higgs calls this "regime uncertainty." It's also what prolonged the Great Depression.

No one who understands the nature of government as the wielder of force — as opposed to the peaceful persuasion of the free market — is surprised by this.

[philunderwood]

www.qando.net/?tag=bureaucracy

ObamaCare: It just gets better and better

Published July 5, 2012 | By Bruce McQuain

And, of course, I say that facetiously. As it stands now, it has fostered more government regulation, more bureaucrats and more intrusion in epic proportion:


"There’s already 13,000 pages of regulations, and they’re not even done yet," Rehberg said.

"It’s a delegation of extensive authority from Congress to the Department of Health and Human Services and a lot of boards and commissions and bureaus throughout the bureaucracy," Matt Spalding of the Heritage Foundation said. "We counted about 180 or so."

So, minimally (we all know they’re not nearly done) 13,000 new pages of regulation, 180+ boards, commissions and bureaus and, of course, scads of bureaucrats to fill them.

Then there are the new broad powers granted HHS and the IRS.

Yes, friends, that’s right, this is how you make health care less expensive and better, not to mention making government less intrusive.

Probably the funniest thing, in a sad and ironic way, is the fact that there are still millions of people out there who believe the propaganda that sold this crap sandwich to the public. Someone among them I’m sure will someday be able to explain how adding costly regulations and layers upon layers of bureaucracy somehow helps reduce the cost of health care delivery.


According to James Capretta of the Ethics and Public Policy Center, federal powers will include designing insurance plans, telling people where they can go for coverage and how much insurers are allowed to charge.

"Really, how doctors and hospitals are supposed to practice medicine," he said.

Wait, wasn’t one of the primary problems with the old system, per the Democrats, a problem of insurance companies telling doctors how to practice medicine?

See, solved by government, right?

In fact, one master has been replaced by another one, the newest master being the most inept, inefficient and corrupt of the two. And, of course, no one has yet explained how all of this is going to ensure people have better access to a doctor. Why? Because, quite simply, having insurance doesn’t guarantee care. And with the disincentives provided by massive increases in regulation (and the increase that will cost for compliance) and oversight via these board, commissions and bureaus, my guess is there will be fewer doctors in the future.

So prepare to enjoy the dawning of the age of ObamaCare and the attendant disappointment, shock and anger it will eventually engender among the public. There are some things that one shouldn’t mess with, and people’s health care is one of them.

Forward.

~McQ

[philunderwood]

www.qando.net/?tag=medicare

Gutting Medicare to pay for ObamaCare

Published August 2, 2012 | By Bruce McQuain

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

[philunderwood]

Within the last couple of years I’ve had four knee surgeries and the last one, which was the simplest, has cost me more out of pocket than the other three combined, due to cuts in what Medicare covers, so it’s happening already.

[Ritty77]

Knees?

None
One
Two √

Move along.