The Medicaid Expansion included in Obamacare may prove to be its Achilles Heel

Posted by PITHOCRATES - July 15th, 2012

Week in Review

Part of Obamacare includes an expansion of Medicaid.  The state’s health care programs for the poor.  As we know health care is very expensive.  Which has been the driving force behind Obamacare.  To cut these high costs.  And they’re going to do this by transferring a lot of these costs to the states.  Which has got them really nervous.  Because health care is very expensive (see Governors divided over Medicaid expansion by Michael A. Memoli posted 7/14/2012 on the Los Angeles Times).

America’s governors have long used their semiannual gatherings to lock arms in opposition to dreaded unfunded federal mandates and emphasize a pragmatic approach to problem-solving in stark contrast to a hyperpartisan, even dysfunctional Washington.

But the makings of a real divide loomed over the summer meeting of the National Governors Assn. here, as state leaders grappled with the fallout of the Supreme Court ruling that granted unexpected leeway with regard to a key component of President Obama’s landmark health law: whether to accept billions of federal dollars in return for expanding coverage for the poor through Medicaid…

But a greater number of governors on both sides approached the unexpected ruling with caution, largely out of concern for the long-term effect on state budgets that had been stretched to the brink by the economic downturn.

Through the Affordable Care Act, the government is set to spend an estimated $1 trillion over the next decade to help states insure Americans who make less than 138% of the poverty line, or about $15,400 annually, through an expansion of Medicaid. The provision was expected to extend coverage to about 17 million people, on top of the approximately 50 million Americans who are currently covered by the program…

But other governors are worried that already struggling states may be left in the lurch in the future.

It’s clear why these governors are wary about this Medicaid expansion.  An increase of Medicaid patients from 50 million to 67 million is an increase of 34%.  States are slashing other spending to cover their Medicaid spending.  As the Medicaid rolls are already overwhelming some states.  And the thought of increasing their Medicaid spending by 34% is making them very nervous.  For anything can happen in Washington.  Including the cutting of federal subsidies.  Which could leave some states with spending obligations they just won’t have the ability to pay.

Could this be part of some grander design?  Well, of course.  The proponents of Obamacare wanted a full-fledged taxpayer-financed national health care system.  Something the people vehemently rejected.  So they introduced a personal and an employer mandate to put the private insurers out of business.  More and more people will drop coverage because the fine will be cheaper to pay thus forcing insurers to raise premiums on the fewer remaining policy holders.  Which will encourage more people to drop their coverage.  And so on until the last private insurers shut their doors.  Leaving the federal government as the health care provider of last resort. 

The expansion of Medicaid will force states to spend more than they can afford to.  Requiring ever more federal assistance.  It will be just a matter of time until the federal government will have to step in and be the health care provider of last resort.  And before you know it they will have their full-fledged taxpayer-financed national health care system.  While the taxpayers stand in shocked disbelief wondering what just happened.  And muttering “government for the people my ass.”  Unless the states refuse this power grab by Washington.  And say ‘no’ to that federal money and not expand their Medicaid programs.  Perhaps making the Medicaid expansion the Achilles Heel of Obamacare.

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Rich Liberals Champion the Poor to Maintain their Privileged Lives

Posted by PITHOCRATES - April 2nd, 2011

Per-Vote-Subsidy replaces Corporate and Union Money

Canada has a spoils system when it comes to public financing of political campaigns.  The big pile of public money ‘donated’ by the Canadian taxpayer is divided between the parties by vote.  The more votes a party gets, the more tax subsidies that party gets.  The Canadian prime minister, Stephen Harper, wants to do away with these subsidies (see Harper vows to scrap per-vote subsidies by CTV.ca News Staff posted 4/1/2011 on CTV.ca).

Currently, political parties receive a $2-per-vote subsidy, but Harper has long opposed the system, which was brought in by the Liberals when corporate and union donations were banned.

He said Friday that political parties already enjoy “enormous tax advantages” and taxpayers should not have to support parties they don’t support with their votes. Harper added that the subsidy only helps to ease the way for frequent elections.

Interesting.  Unlike the United States, Canada does not allow corporations or unions donate to political parties.  And when that ban went into place, the liberals brought in the per-vote-subsidy.  It takes money to win political contests.  And when you shut down two big sources (corporations and unions), that money has to come from somewhere else.  So the liberals decided to get that money from the taxpayer.  Fair, right?  I mean, without these subsidies, political power falls to the rich.  And that’s not fair, is it?

The Liberals are the Rich trying to Buy Political Power

When they banned corporate and union donations that left private donations.  From actual people.  So I guess we would have to see how that money flowed to see whether the per-vote-subsidy is fair and serves its purpose.  To keep the rich from wielding political power over the poor (see Analysis: Fears about scrapping per-vote subsidies wildly off target by Patrick Brethour, Vancouver, posted 4/2/2011 on The Globe and Mail).

Data compiled by the website Punditsguide.ca show that funds raised by the parties largely come from small donors, in amounts that would make few Canadian households cringe…

Take the Conservative Party in 2009, which raised… an average [per person] donation of $174.60…

The story is pretty much the same with the other parties: the NDP, with an average donation of $169.11; the Bloc Quebecois, average $102.63; Green Party, $123.21; and the Liberals, with an average of $239.23, the highest of the major federal parties.

Looking at the average per-person donation, it appears the liberal donors are richer than the conservative donors.  Kind of goes against everything the liberals tell us.  That conservatives are nothing but a bunch of rich fat-cats who want to use the poor as footstools.  Either that or conservatives are just cheap bastards.

The same picture emerges when looking at the distribution of donations by size. For the Conservatives, about 10 per cent of the funds raised came from those giving between $1,000 and the maximum of $1,100; conversely, two-thirds came from those giving $400 or less. The NDP were similar, with 7 per cent coming from the highest donated amount, and 70 per cent coming from donations $400 and under. The Liberals – who have fulminated against the perils of the rich controlling the political process – were actually the party most dependent on big donations, with 35 per cent of their cash coming from donors giving between $1,000 and $1,100, while sub-$400 donors accounted for just 38 per cent of the funds the party raised.

In fact, the Liberals outperformed among big donors, raising $3.2-million to the Conservatives’ $1.7-million. The Tories made up that ground, and more, with small donors.

And what do these numbers tell you?  Liberals rely on rich people for their political donations.  Conservatives rely on the little guy, the average working person who can barely afford to donate $200.  And the big corporations and the big unions pour money into liberal political parties.  In ‘soft ways‘ these days.  In Canada.  In the United States.  All around the world.  So much money that it was hard for the little guy to fight against it.  Leaving political power in the hands of the rich.  Much like the liberals say they want to prevent with the per-vote-subsidy.  But, in fact, that’s exactly what they want to do.  Leave political power in their rich hands.

You see, the crony capitalists and the snooty rich don’t like the little guy.  They like the good life that few can enjoy.  And sometimes they need special favors from government to continue that privileged life.  Which is why they donate to liberal parties.  But when they banned ‘hard money’ donations from corporations and unions, liberals had to scramble for other financing.  Because the majority of people don’t support their views.  So they need to ‘force’ donations through these per-vote-subsidies.  For it is the only way they can continue to rule against the will of the people.

The People who Supported Obamacare get Obamacare Waivers

It’s always about the money.  Whenever you’re confused about some political debate, just ask yourself this simple question.  Where’s the money?  Take health care, for example.  The goal of Obamacare was to provide everyone with high-quality yet affordable health care insurance.  Sort of like paying for a Big Mac and getting filet mignon.  Impossible, yes, but that’s what they told us. 

Big Business and the unions were all behind it.  Everyone (employers and unions) wants to dump their health care costs.  That’s why they were anxious for that public option.  Well, they didn’t get the public option.  Not yet.  First Obamacare has to put the private insurers out of business.  Once it does that then the government can step in as the insurer of last resort and, presto, they’ll get their national health care.  But leaves a costly problem for the here and now.

To ‘pass’ CBO, they had to include some onerous requirements.  The new law forced everyone to buy insurance.  The insurers had to cover preexisting conditions.  And they forbade insurance companies to recover their full overhead expenses.  Suddenly affordable insurance was going to become unaffordable.  Or people were simply going to lose their insurance because they couldn’t afford the premiums that were necessary to comply with the requirements of Obamacare.  So many of those who supported this legislation want no part of it.  For themselves, that is.  It’s okay for us.  But not for them.  So they’re asking that the law does not apply to them.  Only us (see List of health reform waivers keeps growing by Jason Millman posted 4/2/2011 on The Hill).

The number of waivers the Obama administration has awarded for a provision of the year-old healthcare reform law grew by 128 in March.

With the new waivers, that means 1,168 businesses, insurers, unions and other organizations have received one-year exemptions from a healthcare reform provision requiring at least $750,000 in annual benefits.

Nancy Pelosi said we needed to pass Obamacare to learn what was in it.  Apparently another 128 insurance plans learned what was in it this past March.  And they want out.  Like the majority of Americans.  Which really begs the question why Obamacare?  It isn’t popular.  They had to pass it quickly before anyone could read the bill.  None of the unions want it.  So why have it?  Because liberals want it.  And why do politicians want anything?  Follow the money.

The Free Market provides High Quality and Low Prices

Hillary Clinton tried to socialize our health care.  Now Obamacare is a short step from doing just that.  Because they said only government could step in and fix our health care system.  That the so-called free market had failed.  Really now?  Because that’s the one thing that has been missing from our health care system.  Market forces.  Doctors providing medical services for a fee that their patients actually pay for.  Not a third party insurance bureaucrat.  But the actual patient.  Until now, that is.  And that free market?  It works.  It’s providing a fully funded quality system that people of average means can afford (see High-end medical option prompts Medicare worries by Ricardo Alonso-Zaldivar, Associated Press, posted 4/2/2011 on the Sun Journal).

Every year, thousands of people make a deal with their doctor: I’ll pay you a fixed annual fee, whether or not I need your services, and in return you’ll see me the day I call, remember who I am and what ails me, and give me your undivided attention.

But this arrangement potentially poses a big threat to Medicare and to the new world of medical care envisioned under President Barack Obama’s health overhaul.

The spread of “concierge medicine,” where doctors limit their practice to patients who pay a fee of about $1,500 a year, could drive a wedge among the insured. Eventually, people unable to afford the retainer might find themselves stuck on a lower tier, facing less time with doctors and longer waits.

People actually paying to see a doctor?  Imagine that?  Just like in the old days.  Before there was a health care crisis.  The patients are happy.  The doctors are happy.  And making a very nice living.  You can’t get much more of a win-win situation, can you?  Who could find fault with this?

The trend caught the eye of MedPAC, a commission created by Congress that advises lawmakers on Medicare and watches for problems with access. It hired consultants to investigate.

I guess the government could.  Big Brother is everywhere.  And he is looking at this free market solution.  And Big Brother is not amused.  People paying for their own medical care?  That’s a problem for those in government.  A big problem.

Several members said it appears to be fulfilling a central goal of Obama’s overhaul, enhancing the role of primary care and restoring the doctor-patient relationship.

Yet the approach envisioned under the law is different from the one-on-one attention in concierge medicine. It calls for a team strategy where the doctor is helped by nurses and physician assistants, who handle much of the contact with patients.

John Goodman, a conservative health policy expert, predicts the health care law will drive more patients to try concierge medicine. “Seniors who can pay for it will go outside the system,” he said.

MedPAC’s Hackbarth declined to be interviewed. But Berenson, a physician and policy expert, said “the fact that excellent doctors are doing this suggests we’ve got a problem.”

You see, one-on-one concierge medicine is bad because it lets doctors work freely with patients.  The government would prefer something along the current lines.  You treat patients.  And then we’ll think about paying you.  And how much we’ll pay you.  Like in the Medicare program now.  That way you’re our bitch.  But if you work outside the system, you and your patients will be free.  And we don’t like that.  Why?  Follow the money.

Follow the Money for the Money Never Lies

Politics is always about the money.  Always has been.  Always will be.  Because it takes money to gain and maintain political power.  Whether you’re running a political campaign.  Or supporting a campaign with your union dues in exchange for political favors (such as legislation that limits competition so unions can maintain their high wage and benefit packages).

Liberals are a minority of the population.  Wherever you are.  The majority of people don’t belong to a union or work for the government.  This majority has jobs.  They take care of their family.  And want Big Brother to leave them alone.  Union dues from a small percentage of the population can greatly influence elections, though.  They can’t donate directly.  But that money finds its way to liberals.  Liberals in the U.S. desperately need this money.  In fact, union dues have become so important to the ruling liberal elite that they created an entire new class of union-paying people.  The public sector union class.  Who has but one purpose.  To launder tax dollars from taxpayers to the Democrat Party.

The 2010 mid-term elections shook up the political establishment.  Conservative governors are fighting back against this new political class.  And the liberal left is attacking these governors.  Even President Obama sent activists to Madison, Wisconsin, to protest against Governor Walker as they voted to make their public sector workers live more like the rest of the people in Wisconsin.  This is why Obamacare is so important to the left.  Health care is 17% of GDP.  That’s a lot of money.  That’s why the public option is so important.  Why nationalized health care is so important.  Because of this money.  Liberals want this money to pass through Washington.  Where they can easily skim a little off the top for their political needs.  And to live well.  Without actually having to work.  Like that majority that pays all those taxes.

Life’s greatest question can be easiest answered by following the money.  For the money never lies.

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Death Panels in/out of Medicare, Obamacare still Betting on Death to Cut Costs

Posted by PITHOCRATES - January 5th, 2011

Death is more Cost Efficient than Life

First they denied it.  Then they backtracked when everyone could see they were included.  Then they pulled them.  Then they tried to sneak them back (see Administration reverses on end-of-life counseling by Ricardo Alonso-Zaldivar, The Associated Press, posted 1/5/2011 on The Washington Post).

Medicare coverage for voluntary end-of-life planning was part of the original House version of the overhaul legislation in 2009, but it was dropped after Sarah Palin and other Republicans raised the specter of “death panels” deciding the fate of vulnerable seniors. Those charges were later debunked by several non-partisan fact-checking groups.

I keep hearing this.  That they’re not death panels.  They’re actually good things that people want.  But I have to ask this.  Why are they constantly trying to sneak this legislation in?  I mean, Obamacare itself is controversial and unpopular.  The people already hate it.  So why are they hiding these so called death panels that aren’t death panels?

I can think of only one reason.  Cost control.  With Social Security, Medicare and Medicaid all projected to go bankrupt in the not so distant future, there’s no way that Obamacare can escape that same fate.  Unless sick people die quicker.  Before the government spends a fortune trying to extend their lives. 

Yes, it’s a grim prospect.  But that’s the only way you can save cash-strapped programs that incur costs from sick and dying people.  You stop spending money on sick and dying people.  That way you can take in more money than you pay out.  Do that and these programs (Obamacare, Social Security, Medicare and Medicaid) can stay solvent.  And there is only one way to do this.  You have to ‘let’ people die.  You get them to choose death.  By persuading them that it’s for the best.  For them.  Their family.  And for the country.  In other words, death panels.  Because death is more cost efficient than life.

Obamacare Welfare:  Wealth Transfer from the Responsible to the Irresponsible

This is what they want to hide from the people.  Because it’s just too ghoulish.  It’s something the Nazis did.  Getting rid of undesirables.  Or the stuff of science fiction like Soylent Green.  Only without the cannibalism.  So far, that is. 

I joke, of course.  Then again, no one knows what’s in the Obamacare legislation.  No one read it.  At least, no one that voted for it.  After all, it was the now deposed Speaker of the House, Nancy Pelosi, who said we’d have to pass Obamacare to learn what was in it.  So anything can be in it.  We just don’t know.  But we’re learning.

The new regulations have already exploded private health care costs.  Even though they said it wouldn’t.  In fact, everything was supposed to get cheaper.  But when you force private insurers to cover preexisting conditions, they have to act accordingly. 

With preexisting coverage, no one will buy insurance.  They’ll save their money for car payments.  New entertainment centers.  Jet skis.  You know, fun stuff.  Then, if a kid gets leukemia or some other catastrophic diagnosis, then they’ll buy insurance.  Get the picture?  The only people buying insurance will be those with catastrophic medical expenses.  People who will be consuming millions in benefits but only pay a pittance in premiums.  And that ain’t insurance.  That’s pure welfare wealth transfer.  From the responsible.  To the irresponsible.

The House Rules Enabled Corruption and Backroom Deals

And this is just asinine.  So how did they pass something this stupid into law?  Well, have you seen the House rules (see New rules in the House of Representatives by Felicia Sonmez posted 1/5/2011 on The Washington Post)?  Here’re some of the rules back then.  When Congress slipped Obamacare into law.

  1. 1.  No “Constitutional Authority Statement” was required.  A similar statement was required only for bills reported out of committee and was included in the committee report.
  2. 2.  Only bills reported out of committee were required to be “made available” three days before a vote, and they were not required to be posted online.
  3. 3.  Spending increases could be paid for by spending cuts or tax increases.
  4. 4.  Committee chairmen did not have term limits.
  5. 5.  Legislation was not required to be posted online before it was marked up.
  6. 6.  The “Gephardt Rule” allowed the House to automatically raise the debt limit when a joint budget resolution was adopted.
  7. 7.  The Constitution has never been read in full on the House floor.

This is not what the framers of the Constitution had in mind.  Not even Alexander Hamilton (the biggest of the ‘big government’ Founding Fathers).  In fact, he would be as shocked as his arch nemesis, Thomas Jefferson (who thought any central government was too much central government).  (Just to prevent any confusion, Jefferson was in France during the Constitutional Convention and did not participate.  His assault against the Constitution escalated after ratification.)

The Constitution means something.  It’s the Rule of Law for the central government.  The Constitution has to authorize everything the central government does.  Why?  Because that’s the law.  And we’re a nation of laws.  At least, we used to be.

The fact that Congress has never read the Constitution in full on the House floor is worrisome.  Why haven’t they?  Are they trying to bury the restrictions it places on Congress?  It would appear so.  And that lawmakers look at it as more of a nuisance than as the foundation of our nation.  Something that checks their power and spending sprees.  Which tax and spend Big Government types just don’t like.

The other rules just invite corruption and backroom deals.  The very thing Jefferson warned about.  And he was right.  Because that’s what it took to pass Obamacare.  They bribed Congress people to vote for it.  The Cornhusker Kickback bribed Nebraska Senator Ben Nelson.  The Louisiana Purchase bribed Louisiana Senator Mary Landrieu.  And a laundry list of bribes to other people and organizations.  Hidden in the bowels of the health care reform bill.  Which was fast-tracked into law before anyone read it.  Thanks to the rules of the House.

The New 112th Congress to Revise House Rules to Stop the Corruption and Backroom Deals

But all is not lost.  The new 112th Congress is proposing to change the rules.  They even plan to read the Constitution in full on the House floor.  It may be the first time some will learn what’s in it.  And that’s good.  Here are some of the other changes (these numbers correlate to the numbers above):

  1. 1.  All proposed bills must be accompanied by a “Constitutional Authority Statement” that notes the specific section of the Constitution that empowers Congress to enact the legislation.
  2. 2.  All bills must be posted online for three days before they are put up for a vote.
  3. 3.  Spending increases have to be offset by cuts of an equal or greater amount elsewhere and cannot be paid for by tax increases.
  4. 4.  Committee chairmen have a six-year term limit.
  5. 5.  The text of legislation must be posted online 24 hours before it is due to be marked up in committee; the House Rules Committee is exempt from this rule.
  6. 6.  A new rule eliminates automatic debt-limit increase upon passage of joint budget resolutions.
  7. 7.  A full reading of the Constitution will take place on Thursday, the second day of the 112th Congress.

It’s a start.  It might stop some of the Founding Fathers from spinning in their graves.  Probably not Jefferson, though.  It’s going to take a whole lot more to soothe his distraught spirit.

Revised House Rules a Good First Step.  Repealing Obamacare a Good Second Step.

So maybe with the new Congress and the new House rules (if adopted) will prevent another corrupt bill like Obamacare from sneaking through backrooms and into law.  Good.  But that’s just a start.  Now we have to address Obamacare itself.  We need to repeal it.  For a plethora of reasons (see New Congress Begins Fight to Repeal Obamacare and Get Health Care Reform Right by Kathryn Nix posted 1/4/2011 on Heritage’s The Foundry).  Many already know some of these reasons.  But it’s good to keep talking about them.

The negative effects of Obamacare will be felt by all Americans. The new law includes several new taxes and penalties for businesses that threaten to kill job growth and further damage the economy. Budget gimmicks and double counting of savings mean Obamacare will increase federal deficit spending significantly.

Obamacare does nothing to reform the systemic problems and unfunded liabilities represented by Medicare and Medicaid. Instead, the new law uses savings in Medicare to fund a new entitlement that experts expect to greatly exceed its projected cost. Obamacare does not fix Medicaid, which already performs poorly, but adds more to its ranks as a means to reduce the uninsured.

Obamacare increases premiums and overall health spending in the U.S. Instead of allowing insured Americans to keep their current coverage, the new law will cause millions to change or lose their health plans. Last but not least, Obamacare will increase federal control of every aspect of the health sector, increasing the role of bureaucracy in the practice of medicine and interfering in the doctor–patient relationship.

If you want more detail, you can find them in Impact of ObamaCare at The Heritage Foundation.   

If we repeal Obamacare, the death panels become a moot point.  And our deficit and debt crises become that much easier to manage.  As will the Social Security, Medicare and Medicaid crises.  So let’s do it.  Repeal Obamacare.

Give Grandma a Chance

Obamacare is bad.  We should repeal it.  Death panels and all.  Instead of putting all our eggs into the ‘death’ basket, we should give living a chance.  But we need to get away from welfare.  And move into insurance.  Pay our own way for expected, routine costs.  And buy insurance to protect our finances from unexpected, extraordinary costs.  And allow insurers to compete across state lines, tort reform, etc.  You know, the usual, sensible stuff.

Come on.  Give Grandma a chance.  Repeal Obamacare.

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