Obamacare already has more Ignored Complaints than they have in the NHS

Posted by PITHOCRATES - February 8th, 2014

Week in Review

People hate government bureaucracies.  They can’t stand getting their driver’s license renewed.  They hate getting the necessary approvals before making an improvement on their property.  They especially hate having to deal with the IRS.  Giving the choice we would all gladly have our dentists fix our cavities then endure those ordeals.  Without Novocain.  Because it is so frustrating dealing with a slow-moving, inefficient and inept government bureaucracy.  Which is why people don’t want national health care.

Obamacare is already showing what a slow-moving, inefficient and inept government bureaucracy it is.  From the abysmal rollout.  To those 22,000 people trying to get that slow-moving, inefficient and inept government bureaucracy to correct the mistakes that bureaucracy made.  They submitted complaints through the proper channels.  Where they promptly disappeared in the system and went ignored.  Something we can expect more of with this new slow-moving, inefficient and inept government bureaucracy.  As it is a common feature of a national health care system (see NHS watchdog accused of ‘throwing away’ complaints by Laura Donnelly posted 2/3/2014 on The Telegraph).

An NHS watchdog has been accused of failing thousands of patients and bereaved relatives after admitting it fully investigated less than 400 of 16,000 patient complaints made last year.

The figures emerged as a leaked report, seen by The Telegraph, discloses a litany of errors investigating a death at the heart of the Morecambe Bay hospital scandal, where up to 16 babies died amid poor care.

Last night bereaved parents said the Health Service Ombudsman – the body with ultimate responsibility for complaints against the NHS – was “a disaster for patients” while health experts said the organisation was “virtually ignoring” the desperate pleas of families seeking explanations for poor care.

The watchdog’s own records disclose that during the year 2012/13, less than three per cent of complaints which came to them were “fully investigated”.

Unlike Obamacare these complaints are not about data entry errors.  These complaints are about substandard care resulting in patient harm.  And death.  But what happens when the bungling bureaucracy investigates itself?  They tend to circle the wagons to protect their beloved bureaucracy.  While failing the people.  Which will happen with Obamacare.  Where they are already circling the wagons to protect their beloved bureaucracy over data entry errors.  Imagine the callousness that will enter the system when people suffer harm and death from substandard care.

Of course we can trust the government to prevent this from happening.  After all have they let us down yet in the investigation of their ineptitude and callousness over Benghazi?  And let us not forget how they got to the bottom of IRS targeting conservative groups to silence them during the 2012 election.  That thing where there wasn’t even a “smidgen of corruption.”  Yet the woman in charge of that pleaded the Fifth Amendment.  Which defendants do for only one reason.  So they don’t incriminate themselves.  But there wasn’t even a “smidgen of corruption” here.

Is it any wonder 22,000 people can’t get someone to respond to their complaints?  Or that government bureaucracies rarely do a good job when they investigate themselves?  So get ready for a similar fate the British people are suffering with their NHS.  But instead of 16,000 complaints being ignored there will be about 80,000 complaints that will be ignored.  Or more.  As we have about 5 times the population the UK has.  And we don’t have the 66 years of experience in doing national health care they have.

www.PITHOCRATES.com

Share

Tags: , , , , , , , , , , , , ,

Medicare Receipts, Medicare Outlays and the Medicare Deficit

Posted by PITHOCRATES - March 5th, 2013

History 101

The Seller is the Medical Provider and the Customer is the Insurer—not the Patient

Health care prices are out of control because there are no market forces in health care.  Buyers and sellers never meet.  As the consumer of health care services doesn’t pay for them.  And the provider of services neither bills nor collects from the recipient of those services.  Instead billings and payments go through a third party.  The insurer.  Or government.

The buyer is the insurer.  Not the patient.  Who is the recipient of what the buyer pays for.  Because the recipient is not paying the recipient does not care about prices.  Or the number of tests and procedures a doctor orders.  Because if you’re not paying what do you care how much anything costs or how many costly tests or procedures you have?  You don’t.

The seller is the medical provider.  The doctor, hospital, laboratory, nursing home, etc.  Their customer is the insurer.  Who pays their bills.  Not the recipient of their services.  The patient.  Because the patient is not paying medical providers can charge high prices without hurting their patient.  And they can order excessive tests and procedures without hurting their patient.  Financially, at least.  Which they often do because medical providers don’t get paid for all the services they provide.  Some people without insurance can’t pay their bills.  And insurers often refuse to pay or discount some of the bills they receive.  Also, the government is always reducing Medicare reimbursements.  Forcing medical providers to be more creative in getting paid for services rendered.

As Medicare Outlays and Receipts grew Further Apart the Medicare Deficit Soared

Medicare began in 1965.  Medical care for people 65 and older.  And like the private health care market there are no market forces in Medicare.  Worse, government bureaucrats run it.  Which throws open the doors to waste and inefficiencies.  And cost overruns.  Because private insurers have bottom lines to meet.  Government bureaucrats don’t.  All they have to do when they do a poor job managing something is to raise taxes.  Which they had to as Medicare ran a deficit in all but one year of its existence (see Table 2.4—COMPOSITION OF SOCIAL INSURANCE AND RETIREMENT RECEIPTS AND OF EXCISE TAXES: 1940–2017 and Table 3.1—OUTLAYS BY SUPERFUNCTION AND FUNCTION: 1940–2017 at FISCAL YEAR 2013 HISTORICAL TABLES BUDGET OF THE U.S. GOVERNMENT).

Medicare Receipts Outlays Deficit 1970-2011

Medicare ran a $912 million surplus in 1974.  We made it zero to keep the Y-axis positive.  The difference in graphs is negligible and unnoticeable at the scale shown.  The right axis shows the Medicare payroll tax rate.  Medicare outlays and receipts are pulled from the above referenced source.  The Medicare deficit is calculated by subtracting Medicare Receipts from Medicare Outlays.  However, for simplicity we show that negative number as a positive value on the graph (the graph shows the magnitude only of the deficit).  The graphs are pretty flat during the Seventies so we drop them off in the following chart.

Medicare Receipts Outlays Deficit 1980-2011

The Medicare tax rate has been holding steady at 2.8% since 1986.  This tax rate has provided a growing rate of Medicare receipts.  But Medicare outlays have grown at a greater rate.  Outlays remained flat for a few years in the Nineties thanks to the Medicare Sustainable Growth Rate (SGR) included in the Balanced Budget Act of 1997.  Which basically discounted doctors’ Medicare billings.  Doctors provide the same services.  Only the government paid them less.  After some fierce opposition this provision (the doc fix) went away.  For it was either that or doctors would leave the Medicare program en masse instead of operating at a loss.  Leaving the government with a lot of seniors without any doctors.  So Medicare outlays resumed their upward growth.  With receipts growing at a lesser rate.  As outlays and receipts grew further apart the Medicare deficit soared.

Obamacare Spending will be out of Control because Medicare Spending is out of Control

The Medicare tax is a flat tax.  Which means the more you earn the more you pay.  Unlike Social Security that has a maximum taxable earnings amount.  The Social Security tax rate is 12.4% of the first $113,700 you earn.  Bringing the FICA tax (Social Security and Medicare) total to 15.3%.  When they passed the Social Security into law they promised that the Social Security tax would never exceed 3% of the first $3,000 you earn.  Just to give you an idea of how horrible the government’s projections were.  They have raised taxes far beyond what they promised and it still isn’t enough.  Medicare is running greater and greater deficits.  So Medicare is in trouble.  And with Obamacare pulling some $700 billion from Medicare things aren’t going to get any better any time soon.

Medicare is national health care.  And the government is running it very poorly.  The Medicare outlays in 2011 were $485.6 billion (or about 13.5% of all 2011 federal outlays).  And that was generated from treating only 12.8% of the population.  How bad will these numbers be if Obamacare evolves into a full-fledged national health care service?  If you divide the 2011 Medicare outlays by 12.8% you get $3.79 trillion.  This amount would be for 100% of the population receiving medical care as if they are 65 or older.  Currently those 65 and older consume about 35% of all health care spending.  So if we multiply $3.79 trillion by 65% (1-35%) we get $2.47 trillion (or about 68.4% of all 2011 federal outlays).  Which adjusts this amount as if everyone receiving health care is under 65.  As the amount of those 65 and over receiving health care will fall under Obamacare thanks to those unofficial death panels.  And they’re going to need those death panels.  Because with the government running Obamacare it will be an abject failure.

A crude guesstimate.  But it’s probably not that far off.  For national health care is very, very expensive.  And as we’ve learned from Medicare, it’s also very, very inefficient.  Because there are no market forces in health care.  Which is why Medicare spending is out of control.  And why Obamacare spending will be out of control.  Requiring massive new taxation.  Rationing.  And cost cutting.  As in death panels.  For letting people die instead of treating them will be the only way to bring down costs.  Unless they force health care providers to work without pay.  Another way to cut costs.  Compel health care providers to work against their will.  For why should anyone profit off the suffering of others?  Which may be the next dictate handed down in Obamacare.

www.PITHOCRATES.com

Share

Tags: , , , , , , , , , , , , , , , , , , ,