Obamacare to create Great Doctor Shortages, Long Wait Times and Rationing of Health Care Services

Posted by PITHOCRATES - November 30th, 2013

Week in Review

How did African slavery arrive to the new world?  The New World was vast continents.  And there were just not enough settlers to farm on the scale required.  With a huge shortage of laborers the colonial powers tried enslaving the local population.  But it proved difficult to keep them enslaved.  As they were well familiar with the land.  And the indigenous population.  If they escaped they could disappear into the land and into the indigenous population.  Something an African slave could not do as well.  If at all.  Strangers in a strange land.  Unable to communicate with the indigenous population.  And unable to hide among them.  Who were probably just as hostile to them as they were to the white man taking their land.  Making escape from bondage much more difficult for the African slave than it was for the indigenous slave.  So the African slave proved to be a good fit for the colonial powers.  Allowing them to fill the shortage of labor by forcing the black man into bondage.  To provide their labor against their will to meet the demand of the ruling colonial powers.

Now there is a new demand that the government will struggle to meet (see Lack of Doctors May Worsen as Millions Join Medicaid Rolls by ABBY GOODNOUGH posted 11/28/2013 on The New York Times).

Dr. Ted Mazer is one of the few ear, nose and throat specialists in this region who treat low-income people on Medicaid, so many of his patients travel long distances to see him.

But now, as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: it does not pay enough…

His view is shared by many doctors around the country. Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.

Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. The Congressional Budget Office predicts that nine million people will gain coverage through Medicaid next year alone. In many of the 26 states expanding the program, the newly eligible have been flocking to sign up…

In California, with the nation’s largest Medicaid population, many doctors say they are already overwhelmed and unable to take on more low-income patients. Dr. Hector Flores, a primary care doctor in East Los Angeles whose practice has 26,000 patients, more than a third of whom are on Medicaid, said he could accommodate an additional 1,000 Medicaid patients at most.

“There could easily be 10,000 patients looking for us and we’re just not going to be able to serve them,” said Dr. Flores, who is also chairman of the family medicine department at White Memorial Medical Center in Los Angeles…

The health care law seeks to diminish any access problem by allowing for a two-year increase in the Medicaid payment rate for primary care doctors, set to expire at the end of 2014. The average increase is 73 percent, bringing Medicaid rates to the level of Medicare rates for these doctors.

But states have been slow to put the pay increase into effect, experts say, and because of the delay and the fact that the increase is temporary, fewer doctors than hoped have joined the ranks of those accepting Medicaid patients. “There’s been a lot of confusion and a really slow rollout,” Ms. Folberg said, “which unfortunately mitigated some of the positive effects…”

Dr. Paul Urrea, an ophthalmologist in Monterey Park, said he was skeptical of “blue-sky scenarios” suggesting that all new enrollees would have access to care. “Having been in the trenches with Medi-Cal patients who have serious eye problems,” he said, “I can tell you it’s very, very hard to get them in to see those specialists.”

Dr. Urrea said that when he recently tried to refer a Medicaid patient with a cornea infection to another eye specialist, he was initially informed that the specialist could not see the patient until February. “And this is a potentially blinding condition,” he added.

Travel long distances to see a doctor?  Long wait times?  A shortage of health care providers?  Low reimbursement rates?  Overwhelmed doctors?  A shortage of specialists?  You’d think your were reading about the UK’s National Health Service (NHS).  But this is just what the Affordable Care Act (aka Obamacare) is doing to Medicaid.  Which it will soon do to the rest of the American health care system.

So not only is the Affordable Care Act making health insurance unaffordable it will create doctor shortages that will lead to longer wait times.  Some waits stretching out over two months.  A wait so long that a patient may go blind from a treatable eye infection.  This is national health care.  People succumbing to their diseases as they wait for treatment that is being rationed out.  Which they have to ration as the number of patients far outnumber the number of doctors available to treat these patients.

So this is what Obamacare will do to the American health care system.  Give us longer waiting times.  Rationed care.  And people succumbing to their illnesses because of the long wait to see a doctor.  Funny as the Afford Care Act was to give affordable health insurance to all.  So everyone could live in a utopia where if they were sick they could go to a doctor and have everything covered.  Just pray you’re not one of those who can’t afford to pay the higher premiums and higher deductibles of Obamacare.  Because these people are being dumped into the overcrowded and underfunded states’ Medicaid systems.  Which will only get worse under Obamacare.  Especially with doctors leaving the Medicaid system.  Retiring early.  Or moving into concierge medicine.  Leaving ever fewer health care providers to tend to the swollen Medicaid ranks.

Not a good time to be a doctor.  For you have to be wary of a government that can’t find enough doctors to voluntarily meet the health care demand.  Especially one that has a Senate ‘rubber-stamp’ for its judicial appointments.  Thanks to Harry Reid and the nuclear option.  Changing the rules of the Senate by eliminating the filibuster for judicial appointments.  Which opens the door for a lot of illegal and unconstitutional law.  Such as new health care mandates issued by the executive branch that exceed its constitutional authority.  Which will be challenged.  But once these cases hit these Obama-packed courts you can guess the outcome.  Illegal and unconstitutional mandates will become law.  Which no doubt concern doctors in a health care system that has a doctor shortage and an explosion of new patients.

If a doctor wants to remain a doctor and get paid for his or her services he or she may find new requirements.  Such as mandatory salary caps.  Forced acceptance of Medicaid patients.  With ‘opting out’ made illegal.  Compelling doctors to work against their will.  Now forcing people to work against their will is nothing new.  When Roman taxes rose so high to pay for the bloated Roman state people quit their jobs to avoid paying taxes.  Then the Roman state made that illegal.  Bonding these people to their jobs.  And when they died their children were forced to continue in their place.  Giving Europe feudalism.  Where the masses worked the land against their will.  For the law prevented them from ever leaving the land they or any of their progeny were born on.  Could this happen to the American health care system?  If the state controls the health care industry and the courts, yes.  Which is why it is not a good time to be a doctor.

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Health Insurers to lose $1 Trillion in Revenue if Supreme Court Says the People can’t become $1 Trillion Poorer

Posted by PITHOCRATES - May 19th, 2012

Week in Review

Oh no.  The health insurance companies will lose money if the Supreme Court rules that Obamacare is unconstitutional.  Those poor health insurance companies.  Here the government is trying to help the people they hate more than anyone else and the Supreme Court has to rain on their parade (see Obamacare repeal would cost insurers $1 trillion by Sarah Kliff posted 5/15/2012 on The Washington Post).

Next month, America’s health insurance plans may lose $1 trillion in revenue…

The figure comes from Bloomberg Government, where number crunchers have taken a look at what happens if the Supreme Court strikes down the Affordable Care Act and its expected expansion of health care coverage to 32 million Americans. They find that, should the Affordable Care Act be found unconstititional [sic], insurance companies will lose $1 trillion in revenue between 2013 and 2020…

The majority of that loss – $880 billion – would be from the 16 million Americans expected to purchase coverage on the individual market…

The Bloomberg Government study estimates that, of the $1 trillion in revenue, health plans would keep $174 billion.

Cost insurers are NOT going to lose $1 trillion in revenue if the Supreme Court rules Obamacare unconstitutional.  This is 2012.  The $1 trillion in revenue is projected between 2013 and 2020.  This revenue doesn’t exist.  And, therefore, can’t be lost.

This projected revenue will be from the individual mandate forcing people to buy health insurance.  So the insurance companies will be $1 trillion richer.  And the American people will be $1 trillion poorer.  This is perhaps the first time someone has felt sorry for the poor health insurance companies suffering at the hands of greedy consumers who are unwilling to buy their products.  So they applaud the poor health insurance companies projected sales as the government forces the American people to enrich the insurance companies.  And feel sad when the mean old Supreme Court says the government can’t force the American people to become poorer so the insurance companies can become richer.

Of course the insurance companies aren’t going to become richer under Obamacare.  They’ll never see that $174 billion in profits.  For insurance companies will be going out of business left and right.  Because Obamacare forces them to pay for preexisting conditions.  An ingenious plan to put the health insurance companies out of business. 

Currently the fine for not buying health insurance is pretty low.  Less than the cost of an insurance policy that covers everything but the kitchen sink.  As mandated by Obamacare.  From birth control to abortion to every kind of preventative screening there is.  Making these policies very, very expensive.  So people will choose to pay the less costly fine.  Until they get very, very sick.  Then they will buy health insurance.  And the insurer will have to pay for every bill that comes in for that preexisting condition.  Because Obamacare forces them to.  Forcing them to raise their premiums.

Of course when they do others will choose to pay the less costly fine instead of the more costly insurance policy.  They will drop their coverage.  Until they become very, very sick.  Meanwhile, the insurance companies will have to raise their premiums because fewer people are paying premiums.  And on and on this vicious cycle goes.  Until the insurance companies have only sick people with policies.  So they’ll spend more on health care bills than they will ever collect in premiums.  Until they go bankrupt.  As designed.  So they can expand Obamacare into a full-blown national health care system like they wanted all along. 

Like I said, ingenious.  As well as devious.

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Obamacare – Lies and Politics to transform One-Sixth of the U.S. Economy into a Welfare Program

Posted by PITHOCRATES - March 11th, 2012

Week in Review

Here’s the skinny on Obamacare.  And it isn’t good.  For it transfers health insurance into a massive welfare program.  That ultimately will be paid for by the state.  Which means we the taxpayers will pay for it with massive new taxes.  After Obamacare shuts down the private health insurance industry.  Which it appears to be designed to do (see Obama’s health care law: A trek, not a sprint by RICARDO ALONSO-ZALDIVAR, Associated Press, posted 3/11/2012 on Yahoo! News).

The Affordable Care Act gradually reorganizes one-sixth of the U.S. economy to cover most of the nation’s 50 million uninsured, while simultaneously trying to restrain costs and prevent disruptions to the majority already with coverage.

If the government takes over one-sixth of the U.S. economy this won’t be the same USA anymore.  It won’t be free market capitalism here.  But a European social democracy.  Like the European nations suffering from the European sovereign debt crisis.  Caused by excessive government spending.  And excessive government borrowing to pay for that spending.  Which will happen under Obamacare.  Because you can’t provide more for less.  More health care will cost more.  And when the private health insurance industry fails when they can’t provide more for less that leaves government as the sole provider in the health care market.  The ultimate plan for Obamacare.  As it has to be.  Because you can’t provide more for less.

“We really haven’t seen the main game,” said Drew Altman, president of the California-based Kaiser Family Foundation, a nonprofit information clearinghouse on the health care system. “The major provisions that will affect the most people and cost the most money don’t go into effect until 2014 or later.”

The timing of Obamacare is further proof that it will be a disaster for health insurers and for those buying health insurance.  If it was good they would have implemented it before the 2012 election.  So Obama could campaign on its successes.  But knowing it was a failure they pushed back implementation until after the 2012 election.  So that failure wouldn’t dash all hopes for an Obama second term.

Millions of people are getting preventive care that now must be provided at no additional cost to patients. Birth control for women soon will be on that list. Insurance premium increases are getting more scrutiny.

You can’t provide more for less.  Forcing health insurers to provide free birth control without charging more in premiums to pay for this will put the private insurers out of business.  Unless they allow insurers to increase premiums.  Then everyone will pay more so women can use birth control without paying for it.  A product that shuts down a natural biological function of the human body.  Which isn’t insurance on more than one level.  First of all, it’s not financial protection against an unexpected catastrophic health care expense.  For there is nothing unknown about this expense.  Second, getting pregnant is the proper thing for female body to do after sex.  Stopping this process is not a health issue.  It’s a lifestyle choice.  And therefore shouldn’t be paid for by the same thing we use to pay for cancer treatments.  An unexpected catastrophic expense.

A highly promoted program that provides a lifeline to people denied coverage because they already had medical problems has probably saved lives. But enrollment in the Pre-Existing Condition Insurance Plan has been disappointing, with only about 50,000 people nationwide.

Glenn Nishimura, a consultant from Little Rock, Ark., checked it out and found his premiums would come to about $6,300 a year.

“It’s out of my price range,” said Nishimura. It makes more financial sense to take care of his high blood pressure and high blood sugars by paying out-of-pocket and gambling that his health will hold up, he reasons. In three years he’ll be eligible for better coverage under Medicare.

This individual mandate, the main target for the law’s critics, also takes effect in 2014. Without it, many experts fear that the new exchanges, the state-based markets for private insurance, won’t work. Healthy people would be tempted to postpone signing up until they get sick, raising costs for everybody.

You can’t provide more for less.  And there’s nothing that costs more in the health insurance industry than paying for preexisting conditions.  Because if you’re covering a preexisting condition it means that the preexisting medical condition wasn’t covered before it existed.  Meaning the person did not buy health insurance when they were younger and healthier.  And paid nothing into the health insurance pools to help offset the costs of those who fall ill with an unexpected and catastrophic illness.  Only now that they are sick and facing large medical bills do they want health insurance coverage to pay these bills.  Which isn’t insurance.  It’s welfare. 

The individual mandate addresses this.  But it’s unconstitutional.  For the government doesn’t have the right to make people buy anything.  And, no, it’s not the same as car insurance.  Because if you don’t drive a car you don’t have to buy car insurance.  And if the Supreme Court upholds this unconstitutional individual mandate it will have the same effect as a massive tax increase.  And kill economic activity.  At a time the nation is still reeling under the Great Recession.  Massive new government expenditures and a fall in economic activity, and therefore a fall in tax revenue, will put the U.S. ever closer to those European social democracies wallowing in the European sovereign debt crisis.  And in case you’re wondering what that would mean it would be a bad thing.  A very, very bad thing.  Unless you like riots in the streets.  As they had them in Greece, France, and the UK.  And elsewhere wherever they tried to cut back some great government welfare program.

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