Tag: regulation

Finding out what’s in it: This article, mostly about the impending Supreme Court decision on whether individuals in states with no state-run health exchanges can receive federal health insurance subsidies, contained this significant little bit of information about the overall failure of Obamacare:

Sixteen states and the District of Columbia established state-based exchanges. But more than half of these exchanges are already inoperable or are facing budget shortfalls. Even after spending $4 billion in federal grants, the track records of state-based exchanges have been nothing short of calamitous. In fact, at least three state-based exchange efforts — Maryland, Oregon and Massachusetts — are now the subjects of federal investigations.

This astonishing track record bears repeating: Only 16 out of 50 states chose to create state health exchanges, even though the law stated that by not doing the citizens of the remaining 34 states would not get federal subsidies (the whole point of the Supreme Court case). Yet, of those 16 that did create exchanges, more than half have failed to work or have gone over budget, after wasting more than $4 billion in federal funds. On top of that, three are now under investigation.

And obviously, according to many mainstream press reports, if the Supreme Court upholds the actual language of the Obamacare law — written and voted for solely by Democrats — and voids federal subsidies in the remaining 34 states, it must be the Republicans fault. They had the nerve to not agree to this law, and refused to vote for it!

But then, this all fits in with the modern logic of our cultural elites, who also think a man can be a women and a white person black, merely because they say so.

Trying to avoid what’s in it: Faced with the possibility that the Supreme Court could declare that the Obamacare subsidies are illegal in most states, House Republicans have come up with a new bill to revise the law.

In the tentative responses discussed in separate closed-door meetings Wednesday, House GOP leaders said they would continue the subsidies for a year. Then, states could receive federal block grants for the following two years that they could structure into any kind of health care aid they wish. All of the health law’s regulations would end for those states, including popular ones like assuring coverage of children until age 26. In 2017 — when Republicans hope to control the White House — the entire health law would be eliminated.

The law would also immediately repeal the Obamacare tax on medical devices as well as the Obamacare advisory board designed to ration care to save money.

We know already that Obama will veto this plan, which to my mind is a good thing. The only solution that will work to fix Obamacare is to repeal it in toto. Partial fixes, even ones that last only a few years, can only cause more harm and will increase the chances that legislators will chicken out of full repeal when it is finally time to kick in.

Finding out what’s in it: An audit by the inspector general of Health and Human Services (HHS) has found that the agency has no internal system to verify that $2.8 billion in Obamacare subsidies were paid correctly, or even to the right people.

The [inspector general] said the agency did not have a system to “ensure that financial assistance payments were made on behalf of confirmed enrollees and in the correct amounts.” In addition, [HHS] relied too heavily on data from health insurance companies and had no system for state-based exchanges to “submit enrollee eligibility data for financial assistance payments.”

The government does “not plan to perform a timely reconciliation” of the $2.8 billion in subsidies. [emphasis mine]

Not only have they given out billions without proper record-keeping or proper verification, the agency has no intention of fixing the problem. “Ain’t my job, man!”

Finding out what’s in it: A new poll has found that Obamacare, five years after it was passed, is more unpopular now then ever before.

Which is why the Republicans should do nothing to fix it should the Supreme Court rule against Obamacare subsidies in states with no health exchanges, and instead stick with full repeal followed by specific fixes to the previous laws.

I am even more convinced that full repeal is the right political approach after reading this leftwing reporter’s take on the situation. He thinks the above plan is stupid, knows the Democrats and Obama will never agree to it, but also knows that the public does not blame Obamacare in any way on the Republicans. As he notes,

And one of the reasons why Democrats should not assume that a ruling for the plaintiffs in King will totally backfire on Republicans is the cynical, but powerful, source of leverage that Thune is tapping into here: Democrats passed health care reform, and thus Democrats will get blamed for anything bad that happens to the health care system.

The above poll confirms this. The Republicans had better recognize this if they want to take full political advantage of it.

Finding out what’s in it: Doctors are finding that they better not criticize Obamacare in public or they will face retribution from its bureaucracy.

For physicians in this position, public advocacy against the ACA could be in violation of employment contracts or could be a source for dismissal. Most doctors’ contracts also include a two-year noncompete clause that essentially requires the doctor to move out of town once he or she leaves a specific job. So, running afoul of your employer by criticizing the ACA could result in not just losing your job but also forcing you to leave your hometown.

And that’s not all. Many doctors are also afraid of losing insurance contracts. The vast majority of doctors who are still private-practice owners are dependent on a handful of large insurance contracts for revenue. Speaking out against insurance companies — which were complicit in the ACA’s passage and are some of its primary beneficiaries — can result in cancellation of those contracts.

Finding out what’s in it: More health insurers have now calculated the costs for the first two years of Obamacare and have realized that they need double digit premium increases.

The real political bottom line here, should the Republicans not go squishy and agree to take the blame for something they had no part in, is this:

The consequences of this inevitable failure of the ObamaCare model puts Democrats in a tough spot. They have to decide whether it’s better to have this hit in October 2015 right before the primaries, or try to delay the inevitable and possibly have it hit in 2016 right before the general election. Of course, just because premiums spike upward this year doesn’t mean they won’t escalate sharply in 2016 for the 2017 plans too.

Obamacare was imposed on us by Obama and the Democrats, entirely on their own. All of its problems were caused by them alone. The last thing the Republicans in Congress should do is to help them tinker with Obamacare to try to fix it. Instead, the Republicans should loudly increase their calls for repeal and an effort to start over, from scratch.

Finding out what’s in it: Obamacare has forced doctors to increasingly replace medical care with administrative duties, much of which has been forced on them by the law’s requirement that they switch to electronic records.

The newly elected Barack Obama told the nation in 2009 that “[electronic records just won’t save billions of dollars”—$77 billion a year, promised the administration—“and thousands of jobs, it will save lives.” He then threw a cool $27 billion at going paperless by 2015.

It’s 2015, and what have we achieved? The $27 billion is gone, of course. The $77 billion in savings became a joke. Indeed, reported the Health and Human Services inspector general in 2014, “EHR technology can make it easier to commit fraud,” as in Medicare fraud, the copy-and-paste function allowing the instant filling of vast data fields, facilitating billing inflation.

That’s just the beginning of the losses. Consider the myriad small practices that, facing ruinous transition costs in equipment, software, training and time, have closed shop, gone bankrupt or been swallowed by larger entities. This hardly stays the long arm of the health care police, however. As of Jan. 1, 2015, if you haven’t gone electronic, your Medicare payments will be cut, by 1 percent this year, rising to 3 percent (potentially 5 percent) in subsequent years.

Then there is the toll on doctors’ time and patient care. One study in the American Journal of Emergency Medicine found that emergency-room doctors spend 43 percent of their time entering electronic records information, 28 percent with patients. Another study found that family-practice physicians spend on average 48 minutes a day just entering clinical data.

Forget the numbers. Think just of your own doctor’s visits, of how much less listening, examining, even eye contact goes on, given the need for scrolling, clicking and box checking.

The last point is absolutely true. I have found that with most doctors today, they spend most of my visit working their computer than looking at me. It is very bad medicine, which is why my best doctors refuse to do it. Either they have an assistant do it for them (raising costs of course) or they wait until the visit is over (which of course eats into the time available to see patients).

But who are we to argue with Obama and the Democrats? As well-meaning liberals, they know best and everyone else should just shut up and obey their orders.

Link here. Read it all, but here is a good quote to get you started:

The problem is that the deductibles on many Americans’ health insurance policies have shot up so high that as a practical matter they can’t afford care. If a couple had a deductible of, say, $500 in the past, and it’s now $3,000, that couple has to spend a lot of money out-of-pocket before reaping the benefits of coverage. And the higher the deductible, the more likely a person is going to skip some sort of needed treatment or medicine because he or she can’t afford the up-front costs. “About a quarter of all non-elderly Americans with private insurance coverage do not have sufficient liquid assets to pay even a mid-range deductible, which at today’s rates would be $1,200 for single coverage and $2,400 for family coverage,” the Wall Street Journal reported in March.

So now, many of the same groups that agitated for Obamacare are agitating for new government spending or tighter controls on the insurance industry and businesses to “solve” the problem. But perhaps the first question to ask is: How did those deductibles get so high in the first place?

The answer is Obamacare.

Bluntly, almost all the high costs and deductibles we see now in health insurance and healthcare that have appeared in the last five years have occurred because they were specifically mandated by Obamacare. So of course, according to the warped logic under which the modern Democratic Party operates, we should immediately expand Obamacare even more! Meanwhile, the Republican leadership is scrambling to prop up Obamacare due to their terror that everyone will blame them for its problems, even though they opposed Obamacare from the beginning, never wrote one word of the law, and contributed not a single vote in favor.

You can’t make this stuff up.