FT219: “Obamacare will give us rationing and long wait times like America’s other national health care: the VA.” —Old Pithy

Posted by PITHOCRATES - April 25th, 2014

Fundamental truth

Our Veterans have been Wounded and Maimed and we thank them for their Service with the VA

Where do the rich and famous go when they go to a hospital?  They can afford the best.  So you will hear hospitals like Cleveland Clinic, Mayo Clinic, Johns Hopkins, Mount Sinai, etc.  The crème de la crème of the best health care system in the world.  But one name you won’t hear?  Any VA hospital.

Rich and famous people have something our veterans don’t.  Choice.  They can choose to go to the crème de la crème of the best health care system in the world.  While our veterans have no choice but to go to the dregs of the best health care system in the world.  Very often the worst place you can go in the United States for health care.

It’s sad, really.  For our veterans have given more than any other American.  They have put themselves in harm’s way.  Had people shoot at them.  Lob hand grenades at them.  Had mortar rounds and artillery rounds land near them.  And had improvised explosive devices (IED) detonate around them.  Our veterans have been wounded and maimed and faced the hell of combat.  And our thanks for their volunteering to do this for us?  The VA.

Our VA Hospitals are so bad because they know our Military will be good Soldiers and Wait

There aren’t a lot of VA hospitals around.  So some veterans have to travel to get to one.  And when they get there they have to wait.  As there are a lot of other veterans in the waiting room with them.  Because there aren’t a lot of VA hospitals around.  But that’s not the only waiting they’re going to do.

If they need surgery or treatment there will be even more waiting.  A lot more waiting.  Because there aren’t a lot of VA hospitals around.  Or a lot of VA health care providers.  Or a lot of VA diagnostic equipment.  Which means they have to ration out health care in our VA hospitals.  And when you ration health care you make people wait longer for treatment.  An alien concept for the rich and famous.  Who get what they want when they want it.  Because they have choice.

Our veterans, on the other hand, continue to be good soldiers, Marines, sailors and airmen.  And wait.  Just like the old military joke to ‘hurry up and wait’.  Where they will get up before dawn to wait on the tarmac for 4 hours to board an aircraft.  So we’ve trained our military personnel well in waiting.  Perhaps this why our VA hospitals are so bad.  Because they know our military will be good soldiers, Marines, sailors and airmen.  And wait.

VA Hospitals are run so poorly that Veterans are dying as they wait for this National Health Care

The sad thing is that some of our veterans are waiting so long that they are dying (see A fatal wait: Veterans languish and die on a VA hospital’s secret list by Scott Bronstein and Drew Griffin posted 4/24/2014 on CNN).  Because rationing leads to longer wait times.  And longer wait times lead to more deaths.  And this is why the VA hospitals (America’s national health care) are the dregs of the best health care system in the world.

The American left wants national health care.  They want VA hospitals for everyone.  Except them, of course.  For they will be going to the hospitals the rich and famous go to.  But it’s VA hospitals for the rest of us.  Where they will ration health care.  Increase wait times.  And provide some of the most inefficient health care service.  Another reason veterans have to wait so long is that the VA still uses paper records.  Like they did before the 1970s.

The left settled for Obamacare.  They wanted national health care but accepted Obamacare as a stepping stone to national health care.  For they think the government can run health care better than the private sector.  Even though they’ve been running the VA for decades without ever modernizing it.  The government runs the VA hospitals so inefficiently that veterans are dying as they wait for this rationed national health care.  But these same people who can’t bring the VA into the 20th century say they can improve the crème de la crème of the best health care system in the world.  But if they do the VA poorly they will do all national health care poorly.  Because the government just can’t do anything well.

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The NHS drops Life-Saving Drug as it would lead to more Rationing and longer Wait Times

Posted by PITHOCRATES - April 22nd, 2014

Week in Review

In 1954 almost 35% of all workers belonged to a union.  Since then that number has fallen to about 11.3%.  As the high cost of union contracts chased manufacturing out of the country.  Today the majority of workers belonging to a union work in the public sector.  Where they enter contract negotiations with the taxpayers to secure better pay and benefits than most taxpayers have.  Of course during these negotiations the taxpayers have no say.  As politicians and unions hammer out these contracts.  Unlike trade unions.  Where the people paying the workers actually have a say.

This is another reason why national health care is the Holy Grail for the left.  They want to unionize all those health care workers.  Pay them more.  And deduct union dues from their pay to fund their political activities.  Leaving less money for patient health care.  But they’re okay with that.  But they’re not okay with a pharmaceutical company charging a lot of money for life-saving drugs.  Which, also, leaves less money for patient health care (see Breast cancer drug turned down for NHS use due to high cost by Sarah Boseley posted 4/22/2014 on the guardian).

A Herceptin-style drug that can offer some women with advanced breast cancer nearly six months of extra life has been turned down for use in the NHS because of its high cost.

In draft guidance now open to consultation, the National Institute for Health and Care Excellence (Nice) blames the manufacturers, Roche, who are asking for more than £90,000 per patient, which is far more than any comparable treatment…

“We apply as much flexibility as we can in approving new treatments, but the reality is that given its price and what it offers to patients, it will displace more health benefit which the NHS could achieve in other ways, than it will offer to patients with breast cancer.”

Paying health care providers more will not improve the quality of health care.  Unless health workers are doing a half-assed job now.  Which I don’t believe they are.  But Roche is helping people with death sentences live another six months or so.  That’s a pretty remarkable thing.  If the NHS can’t afford this wonder drug perhaps they should use their own.  Of course they can’t.  Why?  Because they don’t have one.  For they didn’t pour hundreds of millions of dollars in developing this drug and the all those drugs that failed.

Developing a miracle drug is costly.  Money the pharmaceuticals pay up front.  Because their employees don’t work for free.  Which is why these drugs cost so much.  That high price pays for all of the costs that went into this drug.  For all of the drugs that failed.  And provides a return for investors.  Who give these pharmaceutical companies hundreds of millions of dollars up front just in the hope they may develop a miracle drug.  Which is the only way we should invest in these miracle drugs.  Because these investors will only take a chance on a good thing.  Unlike government.  Which has a history of backing the wrong investment time after time.  And pouring good money after bad.

It’s a tough choice to make.  Take health care benefits away from other patients to pay for a miracle drug for those dying from cancer.  Or let people die 6 months or so sooner.  One thing for sure, though, unionizing our health care workers won’t give either of these patients more health care benefits.  It will only leave less money for everything else.  Leading to rationing.  And longer wait times.  Because less money will pay for fewer things.  Making those other things scarcer.  Forcing people to wait longer and pay more for treatment.

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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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Cuba is Slashing Jobs from the American Left’s Favorite Health Care System

Posted by PITHOCRATES - April 12th, 2014

Week in Review

The American left loves Cuba.  A communist/socialist regime just a short boat ride from Florida.  Where they put people before profits.  And the left likes people.  Just as much as they hate profits.  And best of all Cuba has a national health care system.  American film maker and darling of the left Michael Moore even made a movie about how great that health care system is.  Sicko.  Which showed how there are no health insurance companies in Cuba. No.  Just a government that loves its people.  A large number of who for some reason risk their lives to float their way to Florida.  To escape that beautiful paradise Moore rhapsodizes about but never chooses to live in.  Which probably has something to do with this (see Cuba slashes more than 100,000 health care jobs by The Associated Press posted 4/7/2014 on the Star-Telegram).

Cuban authorities say they have eliminated more than 100,000 jobs in health care, considered one of the pillars of the 1959 revolution.

The cuts come as President Raul Castro tries to streamline government as part of a broader economic reform package.

The weekly labor newspaper Trabajadores said Monday that 109,000 health care positions have been cut…

Cuba’s health care sector is entirely run by the state. Authorities have said that like other areas of the economy it is plagued by inefficiency, redundancies and bloated payrolls.

This is what Michael Moore and others on the left want for America.  A health care system plagued by inefficiency, redundancies and bloated payrolls.  Which, of course, consumes so many of the limited health care resources that there is little left for patients.  This is national health care.  This is a government bureaucracy doing what it does best.  Incompetence and corruption.  And the left is fine with this as long as they get their hands on those health care dollars.  So they can create a vast, inefficient bureaucracy that is full of high-paying jobs to consume those health care dollars.  Allowing anyone working for the national health care service to get rich.  Just like those health insurance companies the left so hates.  Only without being able to do what the private health insurance companies have been able to do.  Create the world’s best health care system.

For the American people aren’t risking their lives to float to Cuba to get that health insurance-free national health care.  At least, not yet.  But with further economic reform President Castro may end up one day with a privatized health care system as the Americans move in the other direction.  Which could very well create a health tourism paradise in Cuba after all.  For Americans wishing to escape what President Obama and the Democrats are doing to the health care system they liked and wanted to keep.

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The Democrats think they can do National Health Care better than Britain despite the Obamacare Website Rollout Disaster

Posted by PITHOCRATES - March 30th, 2014

Week in Review

Those on the left settled for the Affordable Care Act.  It’s not what they wanted.  But they think it can, in time, give them what they want.  Single-payer health care.  Or a true national health care system.  Like they have in Britain.  Oh how the left would love to have a no nonsense National Health Service (NHS) in the United States.  A system totally funded by general taxation.  Because that would be better than Obamacare.  And far better than what Obamacare replaced.  Now those who think that are either lying to the American people.  Or are completely ignorant to what’s going on in the NHS.  For the highly esteemed NHS is on life support (see £10 each can save the NHS by Norman Warner and Jack O’Sullivan posted 3/30/2014 on the guardian).

A care and cash crisis is sending the NHS bust. In its present form, a shortfall of £30bn a year, or more, is expected by 2020. Paying off the nation’s deficit means five more years of further deep public expenditure cuts, whoever is in government. So, over-protecting an outdated, cosseted and unaffordable healthcare system inevitably means starving other vital public services, unless we choke off economic growth and worsen the cost of living with big tax increases. That might be worth contemplating if the NHS was offering brilliant care. But it isn’t.

Just look at the thousands of frail elderly people who get the care they need only by queuing in A&E and spending weeks in hospital – the most expensive and often the worst way to look after them. And let’s not forget that the NHS is sleepwalking through an obesity epidemic.

These are truths hidden from public view. Many politicians and clinicians are scared to tell people that our much-loved 65-year-old NHS no longer meets the country’s needs. Frankly, it is often poor value for money, and the greatest public spending challenge after the general election…

Our specialist hospital services should be concentrated in fewer, safer, better-equipped and more expert centres with 24/7 consultant cover and improved transport links…

A new integrated “National Health and Care Service” would pioneer a “co-producing” health partnership between state and citizen, with annual personal health MOTs agreeing responsibilities over the year for both services and the individual. At the heart of this relationship would be an NHS membership scheme, charging £10 a month (with some exemptions) collected through council tax for local preventative services to help people stay healthy.

This is one of several new funding streams urgently needed to renew impoverished parts of our care system but preserving a mainly tax-funded NHS that is largely free at the point of use. We have to escape the constraints of general taxation if we want a decent system…

Just 3.5% of the annual 500,000 deaths lead to payment of inheritance tax. We must expect the elderly, after their deaths, to contribute more. NHS free entitlements, such as continuing care, could be reduced or means-tested and hotel costs in hospital charged, as in France and Germany.

Britain has an aging population.  Fewer people are entering the workforce to pay the taxes that fund the NHS.  While more people are leaving the workforce and consuming NHS resources.  So less money is going into the NHS while the NHS is spending more and more money on patients.  Leading to a deficit that they can’t pay for without killing the economy.  Or taking money away from other government services.

If the NHS was providing quality health care they could probably justify taking money away from other areas.  But it’s not.  The one argument for passing Obamacare was that it would reduce the burden on emergency rooms.  But it’s not doing that in Britain.  The wait times are so long to see a doctor or get a procedure that people are going to the emergency room (A/E in Britain) and waiting for hours instead of waiting for months.  Further increasing costs and wait times.  And frustrating patients.

So what is the solution to a failing national health care system?  Close hospitals and make people travel further for treatment.  And charge them £10 ($16.64) monthly in addition to some of the highest tax rates they already pay to fund the NHS.  So, to summarize, to make national health care work in Britain they need to close hospitals, make people travel further for care, charge them more money and make them wait longer for treatment.  Which is basically the argument against the Affordable Care Act.  It would lead to rationing.  And longer wait times.  Worse, the quality of care will decline.  As it has in Britain.  As it will in the United States.  For we also have an aging population.  And we have about five-times the people they have in Britain.  Which will make our problems five-times worse than theirs.

What’s happening in the NHS is no secret.  Any proponent of national health care no doubt looks at Britain and their NHS.  So they must be familiar with how it’s failing.  Yet they press on for a similar system in the United States.  Why?  If it won’t improve our health care system why do they want national health care?  This is the question we should be asking the Democrats.  Why?  Of course they will say Britain just isn’t doing national health care right.  After all, they’ve only been doing it for 66 years.  So what do they know about national health care?  While we, the liberal Democrats will say, will get national health care right from the get-go.  Because we are just so much smarter than everyone else in the world.

Of course the British could, and should, fire back with, “Yeah?  How did that Obamacare website rollout go?  You’d think that someone who is so smart that they could do national health care right from the get-go could actually build a sodding website that works.”

But, of course, they didn’t.  And the website was the easiest part of Obamacare.  A one and done thing.  And if they couldn’t do that right do we really want these people anywhere near our health care?  No.  Especially when the British are struggling with national health care after trying it for 66 years.  For national health care is apparently more difficult to do than building a sodding website that works.

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It Appears Obamacare was Designed to Fail so they could give us a Single-Payer System

Posted by PITHOCRATES - March 23rd, 2014

Week in Review

The Democrats have longed for national health care.  Because if the government controls health care they control one-sixth of the U.S. economy.  Which means one-sixth of the U.S. economy would flow through Washington.  That’s a lot of money.  And a lot of that can flow into politicians’ pockets.  Allowing them to spend more than they ever had before.  And the best thing about it is that once they get control of it they can scare the people into raising taxes.  “Unless the people tell their Congress members to raise tax rates we will have to make cuts in the national health care budget.  Which means some people won’t get the tests they need.  The treatment they need.  Or the surgery they need.”  Imagine the fear that’ll put into the American people.

So when President Clinton entered office his administration tried to give us national health care.  Hillarycare.  But the people said in no uncertain terms that they didn’t want national health care.  By voting Republicans in everywhere during the 1994 midterm election.  That was the end of Hillarycare.  And President Clinton moved to the center.  While the Democrats noted that if they were going to pass national health care into law they would have to be devious.  Which is what Obamacare apparently is.  A devious plan to get us to a single-payer system against our will (see Why Is the ObamaCare Mandate So Toothless? posted 3/19/2014 on Investors).

Health Care: Some think Democrats designed ObamaCare to fail so they could get to a single payer system. Seems a bit extreme. But it does help explain why they made the individual mandate so easy to avoid…

In fact, of the 30 million uninsured expected in 2016, 19 million will be exempt from the individual mandate, according to the Congressional Budget Office…

On top of this, ObamaCare includes various “hardship exemptions” — some of which appear to be so laughably easy to qualify for that it’ll be a shock if any uninsured pay the tax penalty…

The form even encourages people who “aren’t sure” to “ask for an exemption…”

What’s more, those who don’t qualify for an exemption could avoid the penalty simply by not paying it. Democrats specifically barred the IRS from charging civil and criminal penalties, imposing liens or seizing assets and bank accounts to collect unpaid ObamaCare penalties. It can take it only from a tax refund…

This leaves the question of why Democrats would make a key pillar of the ObamaCare structure so incredibly weak.

Were they worried about the political consequences of making the unpopular mandate too strict, not realizing it would undermine their reform? Or did they know that an ineffective mandate would ultimately wreck ObamaCare, hoping its demise would push the country toward a single payer system?

In other words, were Democrats dangerously incompetent or unbelievably cynical? Neither is a particularly good defense, but each underscores the need to scrap ObamaCare entirely and start over.

The health insurers were all for Obamacare.  At first.  Mandatory health insurance?  Cha-ching.  Easy money.  The government forcing people to buy their policies?  It’s like they died and went to insurance heaven.  But government is full of devious bastards.  The health insurers let their greed cloud that fact.  And now they may pay the ultimate price.  For with all of these mandate exceptions the young and healthy aren’t buying health insurance they won’t use.  Only sick people who will use that health insurance are buying it.  So the health insurers have far too much going out in claims and far too few premiums coming in.  Which won’t help a health insurer stay in business.  But, then again, that may have been the plan all along.

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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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More Budget Cuts increase Wait Times to see Doctor in the National Health Service

Posted by PITHOCRATES - February 23rd, 2014

Week in Review

The problem with national health care is that it is zero-sum when it comes to budgeting.  There is one big pie of funding that they divide throughout the system to pay for all of its parts.  But anyone who has ever paid attention to a budget debate in Washington has seen that there is never enough in the pie.  And no one is ever satisfied with their slice of the pie.  Worse, every department will spend every last cent in their appropriation lest they reduce next year’s appropriation by the amount of any unspent funds in this year’s appropriation.  No matter how wasteful that spending is.  Such as for conferences in Las Vegas.  Or extravagant office parties at home.

Britain’s National Health Service (NHS) is straining under the cost of an aging population.  More people are leaving the workforce than are entering it.  Which means fewer people are paying taxes.  Just as the number of people using the resources of the NHS is growing.  Forcing the NHS to do more with less.  Which has everyone complaining about their chunk of the NHS budget (see ‘Unprecedented’ cuts see GPs warn half of Britain will be unable to get appointments by Charlie Cooper posted 2/23/2014 on The Independent).

More than 34 million people will fail to secure an appointment with their doctor at some point this year, the GP’s professional body has claimed, blaming “unprecedented” cuts to funding for family practices.

The Royal College of General Practitioners said that the profession was “on its knees” and called for GPs to get a larger share of the NHS budget.

However, the Department of Health dismissed their findings – which would imply that more than half the UK population will miss out an appointment this year – as “complete nonsense” and accused the college of “sensationalising” the issue.

General practice has seen its share of the NHS budget – which totalled more than £109bn in England last year – significantly eroded in recent years, from 11 per cent in 2005/06 to 8.5 per cent in 2011/12…

“GPs and practice nurses want to provide high quality care for every single patient who seeks a consultation, and over the last decade we have increased the number of patients we see each year in England by 40m,” she said. “However [we] can’t keep doing more for less…”

“The GP survey showed the vast majority of patients are satisfied with their GP and rated their experience of making an appointment as good,” the spokesperson said, adding that GPs had been given an extra £50m to modernise services and stay open longer.

Whenever you want to see your doctor you need to make an appointment.  In the NHS that could take a few weeks.  Which is driving a lot of people to the A/E (accident and emergency departments).  Because they are sick now.  And don’t want to wait 2 weeks to see a doctor to get an antibiotic for their strep throat.

If you read the comments following the linked article you can get a feeling of what the British people think about the NHS.  And an idea of what Obamacare may lead to.  They love their NHS.  But are exasperated by it.  Some think the doctors are too greedy.  But there isn’t a mad rush to become a doctor to relieve the doctor shortage.  So whatever the pay is it isn’t enough to get people to join the profession.  Which ultimately increases the wait times to see a doctor.

The problem is that aging population.  People who remember a kinder and gentler NHS remember one before the baby boomers retired and overloaded the system.  Who are living longer into retirement.  Consuming more of the NHS’ limited resources than people did before the baby boomers retired.  Had Britain (and every other advanced economy) not reduced its birthrate around the Sixties they would not have this problem now.  But they did.  So they are.  As we will, too.  And every other advanced economy with an aging population will.  Making it a very bad time for national health care.  Yet President Obama and the Democrats have given us Obamacare at precisely this time.  Which is guaranteed to make health care in the United States worse.  If you don’t believe that just read the comments following the linked article.

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For an Idea of what National Health Care would be like just ride Metro-North

Posted by PITHOCRATES - February 23rd, 2014

Week in Review

People don’t want national health care.  Which is why President Obama lied when he said “If you like your health care plan, you can keep it.”  Because if he told the truth and told people they would lose the health care plans and doctors they liked and wanted to keep they would have opposed the Affordable Care Act (aka Obamacare) with a passion.  For they would have seen the Affordable Care Act as nothing but a prelude for national health care.  A health care system run by government.  And we know how well government runs things (see The Perils of Metro-North by Lynnley Browning posted 2/20/2014 on Newsweek).

The high-profile trains, run by the state of New York entity Metro North Commuter Railroad, convey middle-class commuters but also a sizable chunk of the 1 percent, all along a 74-mile stretch between New Haven, Conn., and New York City — to hedge funds in Connecticut and to global banks, consulting, design and advertising firms in Manhattan. But these days, the rail’s increasingly delay-plagued service to one of the planet’s largest metropolises seems less an odd contrast of Third World and First World and more a taste of Dante’s Inferno…

Epic frustration and stress have reached an inflection point for the estimated 136,600 weekday riders on Metro-North’s New Haven Line, the transportation lifeblood of America’s monied and professional class living in Connecticut and working in New York (though some riders reverse commute to hedge funds in Greenwich and banks in Stamford). Long plagued by outdated cars, sketchy, aging tracks and accusations of mismanagement, the commuter rail has seen its dwindling reputation tarnished further in recent months by mishaps and delays, some lasting hours in freezing, unheated cars…

The entire line needs $3.6 billion in urgent repairs, according to the Regional Plan Association, an independent think tank.

Trash and piles of metal parts line many tracks. Smelly cars dating to the 1970s shake passengers in stiff seats from side to side like livestock. Floors are perpetually grimy, and train cars are in short supply. Expensive equipment sits idle. “One day the toilet flooded and the water was just seeping into the vestibule,” recalls Noelle Villanueva, a trader at First New York Securities who commutes from Fairfield, Conn., a large commuter town.

Engineers – the people driving the trains – occasionally “overshoot” their stops and, if the tracks allow it, have to back up, leaving commuters like Lamorte to wonder if the people behind the wheel are asleep, or drunk. Trains come in unannounced on the wrong platform, sending riders to scamper like voles across crumbling overhead passageways to the correct platform. A 117-year-old bridge spanning the Norwalk River, in Norwalk, Conn., sports gaping holes beside the tracks. “They have a rescue boat, but the guy’s usually 1,000 feet away, fishing, so you’ll be dead by the time he gets to you,” says Bill, an ironworker for Metro-North. (He declined to give his last name, citing a fear of retaliation…)

Commuters are increasingly wondering when someone else might die. Late last July, as temperatures soared near 100 degrees, a train near Westport broke down in the afternoon, leaving passengers, including several pregnant women, trapped in unairconditioned cars whose doors and windows would not open…

The lack of communication – think digital signs at stations that almost uniformly announce “Good service” – irks riders, some of whom pay $400 a month and more.

Passenger rail is a horrible economic model.  The costs are so great that it is virtually impossible for it to work without government subsidies.  But in places like the island of Manhattan there are few viable transportation options.  For though costly it can move a lot of people into and out of a very congested city.  But the problem with passenger rail in big cities is all the other big city problems that come with it.  Unions, lack of competition, corruption, etc.  It’s so bad that even when some of the 136,600 weekday riders pay $400 a month (the equivalent of a car payment) the money is so mismanaged that wear and tear adds up on the system over time to the tune of $3.6 billion.  Which is why people don’t want national health care.  They don’t want a health care system operated like Metro-North.  Which is why they are so mad at President Obama for his lie about Obamacare.  And taking away the health care plans and doctors they liked and wanted to keep.

www.PITHOCRATES.com

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The Abysmal Rollout of Obamacare going According to Plan to bring us to National Health Care?

Posted by PITHOCRATES - February 16th, 2014

Week in Review

The roll out of the Affordable Care Act (i.e., Obamacare) has given us a plethora of unintended consequences.  From freezing new hiring.  To pushing full-time workers into part-time.  To people losing the health insurance and doctor they liked and wanted to keep.  To higher insurance premiums. To higher deductibles.  To higher co-pays.  Taking a health care system that the vast majority of people were satisfied with and making it worse.  To accommodate a small percentage of the population who were uninsured.  If that wasn’t bad enough it doesn’t even look like some of the people who signed up for Obamacare are paying their insurance premiums (see Next problem for Obamacare: deadbeat enrollees by Rick Newman posted 2/14/2014 on Yahoo! Finance).

The  New York Times has discovered  that only about 80% of people purchasing health insurance through the federal online marketplace or a similar state-run exchange paid their first month’s premium. There’s no single source of such data, but the Times canvassed insurers participating in the program, such as Aetna (AET), Wellpoint (WLP), Humana (HUM) and Blue Shield of California. All said that the first-month payment rate ranged from 75% to 80% or so, far lower than for typical plans. If enrollees don’t pay the first month’s premium, their insurance never goes into effect.

That doesn’t mean, however, that one-fifth of the people signing up for Obamacare are blatantly refusing to pay. Technical problems with some of the exchange websites may have left people enrolled in an insurance plan without knowing it. Some may never have received a bill or confirmation of their enrollment. Others may have unwittingly signed up for two different policies, while paying for only one.

To make the Affordable Care Act work required a huge health care cost transfer from the old and sick to the young and healthy.  The young and healthy, incidentally, made up a sizeable portion of the uninsured.  Because they were young and healthy and felt invincible.  And invincible people don’t need to buy insurance.  So Obamacare needed the individual mandate to force these people to buy insurance against their will so they could pay for the old and sick.

Of course when they raised the price of health insurance to cover pre-existing conditions it wasn’t the young and healthy that ran to the Obamacare exchanges.  It was the old and sick.  Adding too many old and sick to the insurance pool.  And not enough of the young and healthy.  Those who would pay without consuming any benefits.  Because they are young and healthy.  Causing the insurers to pay more out in benefits than they receive in premiums.  Forcing them to raise their premiums.  Which will, of course, kick off the death spiral as people drop out because they can’t afford those higher rates.  Which will, in turn, force the insurers to raise their rates again.  Hence the death spiral.   And as bad as all of that was now it looks like about 20-25% of those who ‘signed up’ either didn’t or are simply choosing not to pay.  Making the financial predicament of the insurers far worse.

Of course if your plan was to force single-payer (i.e., national health care) onto the people against their will then everything is going according to plan to destroy the private insurance market.  Leaving only the government to step in and provide single-payer (i.e., national health care).  Which should fill everyone with confidence after seeing how well they rolled out the Affordable Care Act.  And no doubt will impress us even more with the rollout of single-payer (i.e., national health care).

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