The Left wants a Health Care System like Britain’s NHS despite the NHS having Crippling Deficits

Posted by PITHOCRATES - April 19th, 2014

Week in Review

Obamacare is not going well.  The say it is.  But it isn’t.  The White House can all of a sudden give us a number like 8 million enrollees when they said earlier they couldn’t tell until the insurance companies tell them.  And the other big question is this.  Are these enrollees?  Including all people who enrolled whether they paid or not?  Or are these only the people who paid?  Or are most of these people enrolling in Medicaid?  Those who won’t ever pay?  If that 8 million aren’t paying customers Obamacare is doomed.

So the financial foundation of Obamacare is likely very perilous.  Where the sick and poor are probably signing up more than the healthy with money.  And the delay of the employer mandate to sometime after the midterm election takes a bad financial foundation and makes it worse.  For they can’t keep delaying the funding parts until after elections.  Because someone has to pay for all of the subsidies.  As well as the high cost of the old and sick.  Which alone may bankrupt Obamacare (see Labour considers raising national insurance to fix £30bn NHS ‘black hole’ by Toby Helm posted 4/19/2014 on the guardian).

Radical plans to increase national insurance contributions to plug a looming £30bn a year “black hole” in NHS funding and pay the spiralling costs of care for the elderly are being examined by Labour’s policy review.

The Observer has learnt that the idea is among options being considered to ensure NHS and care costs can be met under a future Labour government, without it having to impose crippling cuts on other services in successive budgets.

Senior party figures have confirmed that a scheme advanced by the former Labour minister Frank Field – under which funds from increased NI would be paid into a sealed-off fund for health and care costs – is being examined, though no decisions have been taken.

Recent figures based on data from NHS England and the Nuffield Trust and produced by the Commons library suggest that NHS costs alone will go from £95bn a year now to more than £130bn a year by 2020.

Some have suggested that they designed Obamacare to fail.  So they can get what they really want.  Single-payer.  Or national health care.  Like they have in Britain with their National Health Service (NHS).  Which is running an enormous deficit.  Based on the above numbers it currently is 31.6% (£30bn/£95bn).  Which is just unsustainable.  But this is what an aging population will do.  When you have more people leaving the workforce consuming health care benefits paid for by fewer people entering the workforce.  Which should be a huge warning for the United States.  Because they have an aging population, too.

At the current exchange rate that £30 billion comes to $50.37 billion.  Is this what the US can expect?  No.  Because they have five-times the population Britain has.  So their deficit will be approximately five-times as big.  Or $251.85 billion.  That’s a quarter of a trillion dollar shortfall PER YEAR.  At least.  And $2.52 trillion over a decade.  So unless the Americans can somehow make their people less sick so they won’t consume health care resources the deficit alone for Obamacare will be more than twice the original CBO projection for the total cost over 10 years.  Which means the Americans will have to do what the British must do.  Increase taxes.  Charge for some health care services in addition to these higher taxes.  Or impose crippling cuts to services.  Hello rationing.  And longer wait times.

This is the absolute worst time to impose a single-payer/national health care system.  Just as the baby boom generation fills our health care system in their retirement.  It might have worked if we had kept having babies the way we did before birth control and abortion slashed the birthrate.  But we didn’t.  And now we have a baby bust generation stuck footing the bill for a baby boom generation.  Fewer paying for more.  And the only way to make that work is with confiscatory tax rates.  Or death panels.  Because you have to raise revenue.  Or cut costs.  There is just no other option.  Or people can work longer, pay out of pocket for routine, expected expenses and buy real insurance to protect themselves from catastrophic, unexpected medical expenses.  Which is actually another option.  And probably the only one that will work.

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Canadian Hospitals suffer from Overcrowding in British Columbia

Posted by PITHOCRATES - March 22nd, 2014

Week in Review

The left likes to say we’re idiots here in the United States.  Because every other advanced economy has national health care.  Of course, every other advanced economy doesn’t have the best health care system in the world.  No.  That honor goes to the United States.  And perhaps NOT having national health care is the reason why we have the best health care system in the world.  For those national health care systems have their problems.  Even the system north of the border the American left yearns to have.  The Canadian single-payer system (see New B.C. seniors advocate to focus on needs of growing elderly population by ROB SHAW posted 3/19/2014 on The Vancouver Sun).

Isobel Mackenzie, a longtime Victoria seniors care administrator, was named Wednesday as the province’s first seniors advocate, more than 16 months after the office was first announced…

There are more than 700,000 seniors in B.C. and that’s expected to double to 1.4 million over the next 20 years…

Mackenzie said she’s not sure if her office will get involved in how hospital overcrowding is affecting seniors care, and sidestepped a reporter’s question at her press conference Wednesday about the case of an elderly man who had spent eight hours waiting in a hospital emergency room…

“Obviously, health care is a priority and home care – giving support to people so they can stay at their home and healthy,” she said.

Logan said the government tried an “experiment” of providing funding to United Way but they’ve been “overloaded with requests.”

All of the advanced economies share something in common.  They all have an aging population.  Thanks to birth control and abortion people in the advanced economies stopped having babies after the Sixties like they used to have.  Which is why the seniors are now the largest growing sector of the population.  We have fewer people entering the workforce to pay the taxes that support a greater number of people leaving the workforce.  And thanks to modern medicine, these people are living long into retirement.  Which is why Canadian hospitals in British Columbia are overcrowded.  Which lead to longer wait times and the rationing of care.  Things common with national health care.  And these things are only going to get worse as their aging populations age further.

This is the future of Obamacare.  For the Affordable Care Act is already proving unaffordable to those who have to pay.  And people are losing the health insurance and the doctors they liked and wanted to keep.  A lot of doctors are opting out of Obamacare.  Leaving fewer in the system to treat a larger number of patients.  Which will, of course, lead to longer wait times and the rationing of care.  Just like in Canada.  And in every other advanced economy with a national health care system.  Which is why the United States is the only advanced economy without a national health care system.  Because Americans don’t want longer wait times and the rationing of care.  And they don’t want the Affordable Care Act.

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Obamacare: Obama lied and People will Die

Posted by PITHOCRATES - December 14th, 2013

Week in Review

There are about 414 million people in the United States.  And Obamacare is supposed to insure them all.  But that’s not all.  The Affordable Care Act was going to make health insurance less costly while covering more people.  As well as providing more extensive coverage.  Obamacare promised more for less.  And if you liked your health insurance, your doctor and your medication you could keep them.  It just sounded too good to be true.  And, as it turned out, it was too good to be true (see Does the pre-existing condition program foretell broader problems for Obamacare? by PHILIP KLEIN posted 12/13/2013 on the Washington Examiner).

The program, known as the Pre-Existing Condition Insurance Plan, or PCIP, was a temporary measure within Obamacare meant to be a bridge to provide coverage to those with pre-existing conditions between the law’s 2010 passage and Jan. 1, 2014, when all plans will be required to offer coverage to those with pre-existing conditions…

What’s interesting about PCIP is that it ended up attracting much fewer Americans than expected while also costing more than expected. The reason was that those who did enroll ended up being those with extremely high medical costs — even by the standards of a program for those with pre-existing conditions.

By March 2013, HHS suspended enrollment in the program because it couldn’t afford to cover any new applicants.

As the New York Times reported in May, “The administration had predicted that up to 400,000 people would enroll in the program, created by the 2010 health care law. In fact, about 135,000 have enrolled, but the cost of their claims has far exceeded White House estimates, exhausting most of the $5 billion provided by Congress.”

The same story explained that HHS announced it “was cutting payments to doctors and hospitals after finding that cost overruns are threatening to use up the money available…”

But given the dismal enrollment numbers to date, it’s worth asking whether the exchanges could end up encountering similar problems to PCIP — only on a much bigger scale.

The plan that had only targeted 400,000 enrollees only got 135,000.  About two-thirds short of their target.  Why?  Insurance that covers preexisting conditions is very expensive.  Because it will pay a lot of claims.  The money people pay in as premiums pays those claims.  But the cost to cover these people is so great it took another $5 billion of taxpayer money.  And even then the program ran out of money with only 135,000 signing up for this insurance.  Showing the futility of buying insurance for a group with preexisting conditions.

Insurance by definition protects the financial assets of a policy holder from a possible loss.  This is the key that makes insurance actually insurance.  Not everyone that pays a premium for this protection will suffer a loss.  So there is a surplus of premiums to pay for the few that do.  The PCIP sells policies to a group of people who will all suffer a loss.  So people aren’t paying a premium to protect themselves from a possible loss.  They’re paying a premium to pay for a known loss.  And everyone in the pool will be paying and submitting claims.  So that the cost of insurance eventually equals the cost of health care per policy holder.  Which makes the insurance redundant.  And unnecessary.  While only serving to increase actual costs by introducing a third party into the process.

This is why the PCIP needed the $5 billion in taxpayer subsidies.  For without it people would not save any money by buying this insurance.  As many haven’t.  Even with the subsidies.  The taxpayers paid about $37,000 per person in addition to the cost of the premium pool.  Based on the number of months since the Affordable Care Act became law that’s about $842 per person per month in subsidies.  Based on the horror stories of what the young and healthy have to pay for their Obamacare health insurance the premiums for the PCIP are probably greater than the subsidies.  And it’s still not enough to cover their costs.  Which is why they’re cutting people off and cutting payments to doctors and hospitals.

Which will happen for the rest of us.  Once the enrollment numbers fall far short of their projections.  As they are.  And claims exceed premiums.  As they will.  Leaving them little choice but to cut costs.  Raise premiums.  Charge more for prescriptions.  Increase wait times.  And ration health care.  Not what President Obama promised.  Then again, he lied.  PolitiFact called it the Lie of the Year.  And because of the president’s lie people will have poorer quality health care.  Who may succumb to their health problems as they wait those longer wait times.  And can no longer afford the prescriptions that kept them healthy.  All because President Obama lied.

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Hinchingbrooke Hospital breaks free from the NHS Bureaucracy and Improves Health Care

Posted by PITHOCRATES - October 13th, 2013

Week in Review

Britain has government-run national health care.  The National Health Service (NHS) provides free health care to all Britons.  And the medical tourists who travel to the country for free health care.  Straining the NHS budget.  At a time when Britain’s aging population is stretching their limited resources thin.  Leading to longer wait times.  Longer travel times as they close local hospitals to consolidate their resources in fewer locations.  And rationing.

Even with their longer wait times, travel times and rationing of services they are still running a deficit in the NHS.  To address these chronic cost overruns they are trying to find £20 billion ($30.54 billion) in efficiency savings over three years.  But there is a beacon of hope for the NHS.  At Hinchingbrooke Hospital (see Set doctors and nurses free to use their common sense – as Hinchingbrooke Hospital does by Charles Moore posted on The Telegraph).

Last month, I visited Hinchingbrooke Hospital, near Huntingdon, the only NHS Trust in the country operated by a private partner…

I spent half a day at Hinchingbrooke, talking to doctors, nurses, administrators and patients, and seeing several wards…

One can visit a large organisation without being aware of big problems. Indeed, one of the great difficulties of the NHS is that internal communications are so bad that people can work well in one area without being aware of utter disaster a few yards away. In the case of Hinchingbrooke, under previous management, maternity was very good while the colorectal unit was shameful. So what follows is not definitive; but I feel I learnt something.

Uniquely in the NHS, Hinchingbrooke’s executive board is dominated by clinical practitioners (doctors and nurses, to you and me). The chief executive is an obstetrician. Only three of the 14 board members have non-clinical backgrounds.

In the only trust that has a private partner doctors and nurses determine how best to treat patients.  Instead of the faceless bureaucracy in the rest of the NHS.  Or what the proponents of Obamacare hope to force onto the American people.

One of the key working methods, borrowed from Toyota, is “Stop the Line”. Anyone in the hospital can stop the line if he or she believes that there might be a “serious untoward incident” or danger to a patient…

A similar, lesser action is a “swarm”. If you are urgently worried about something, you can summon all the relevant people together immediately. Unlike “whistle-blowing”, which is inevitably retrospective and often involves grievance and disloyalty, these ways of acting are instant and preventative. You are encouraged to use them. Someone stops the line in Hinchingbrooke most days.

Nurses work differently from most parts of the NHS. They all wear uniform, even if in managerial roles, and they are encouraged to take part in management without abandoning clinical work…

But what struck me about Hinchingbrooke was not that it was brilliantly original – simply that it was free to act according to common sense. Involve staff in decisions. Make sure that doctors and nurses can run things. Learn from commercial examples of how to improve services. Let the right hand know what the left is doing. Encourage innovation. Don’t “benchmark to the middle”, but to the top. And little things: get A&E nurses to wear identifiable name-badges; get rid of hospital car-park fines. Most of this is simple, but, in the leviathan of the NHS, it is not easy. And at present there are about 2,300 NHS hospitals in the United Kingdom, and only one Hinchingbrooke…

This is far behind the public. As you understand better if you spend a morning in Hinchingbrooke Hospital, the public want health care free at the point of use, but have no ideological prejudice about who delivers it, or how. They rightly judge by results – are they, their spouses, parents, children, well or ill? Are the staff medically competent, efficient and kind? They are not sentimental about the most shocking producer interest ever to have gained power in this country.

The one hospital where things are greatly improving is the one hospital that is moving away from bureaucratic national health care and towards private health care.  Like it once was in the United States.  While President Obama and the Democrats want to move the American health care systems towards the bureaucratic national health care of the NHS.  Where there are longer wait times.  And service rationing.  Well, everywhere in the NHS but Hinchingbrooke Hospital.

Do President Obama and the Democrats care that they will destroy the American health care system?  No.  Because it’s not about health care.  It’s about creating the “most shocking producer interest ever to have gained power in this country.”  Yes, it’s about the power.  Social Security and Medicare made the elderly dependent on government.  Giving the government power over the elderly.  If they can’t raise taxes they just threaten to cut Social Security and Medicare benefits.  National health care, though, makes everyone dependent on government.  Giving the government power over everyone.

Until the day they can no longer maintain that power.  And that day has come in Britain.  Their aging population is breaking the system.  Which is in essence a Ponzi scheme.  The masses in the workforce pay in via taxes.  And the few sick consume health care services at the top of the pyramid.  While a bloated bureaucracy makes sure to take very good care of itself.  But the aging population is shrinking the workforce paying the taxes.  And swelling the number of sick consuming the health care services.  Inverting the pyramid of the Ponzi scheme.  As it will in America thanks to Obamacare.  Because the United States has an aging population, too.

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