Archive for February, 2011

ObamaCare Is Already Damaging Health Care

Friday, February 25th, 2011

Many of its changes don’t kick in until 2014. But the law is forcing dramatic consolidation and reducing choice in the industry.

By LLOYD M. KRIEGER ,  The Wall Street Journal,   February 23, 2011

The Republicans who now control the House of Representatives hope to repeal or defund ObamaCare, but the law has already yielded profound, destructive changes that will not be undone by repeal or defunding alone. Active steps and new laws will be needed to repair the damage.

The most significant change is a wave of frantic consolidation in the health industry. Because the law mandates that insurers accept all patients regardless of pre-existing conditions, insurers will not make money with their current premium and provider-payment structures. As a result, they have already started to raise premiums and cut payments to doctors and hospitals. Smaller and weaker insurers are being forced to sell themselves to larger entities.

Doctors and hospitals, meanwhile, have decided that they cannot survive unless they achieve massive size—and fast. Six years ago, doctors owned more than two-thirds of U.S. medical practices, according to the Medical Group Management Association. By next year, nearly two-thirds will be salaried employees of larger institutions.

Consolidation is not necessarily bad, as larger medical practices and hospital systems can create some efficiencies. But in the context of ObamaCare’s spiderweb of rules and regulations, consolidation is more akin to collectivization. It means that government bureaucrats will be able to impose controls with much greater ease.

With far fewer and much larger entities to browbeat, all changes in Medicare and Medicaid policies will go through the entire system like a shock wave. There will be far fewer individual insurers, doctors, hospitals, device makers, drug manufacturers, nursing homes and other health-care players to resist.

There is little mystery how the government will exercise its power. Choices will be limited. Pathways to expensive specialist care such as advanced radiology and surgery will decline. Cutting-edge devices and medicines will come into the system much more slowly and be used much less frequently.

This is why simply defunding enforcement of the individual mandate and other upcoming directives will not be enough: Given all this consolidation, limits on treatment choices are already becoming hardwired into the system. Lawmakers must take concrete steps to stop and reverse this.

On the provider end, this means enacting tax and other economic shields for insurers and providers that choose not to succumb to the financial pressure encouraging consolidation. It means unwinding all of the rules—about data compilation, reporting and compliance requirements, and information technology—designed to increase overhead to the point that only massive and easily regulated provider organizations can survive.

Legislators will have to scrub the 2,700-page ObamaCare law line by line to remove all of the disincentives for medical practices, hospitals and others to remain smaller and independent.

On the consumer end, reform means re-establishing choice at all levels of the system. Lawmakers at a minimum should change the individual mandate so that people can choose what type of coverage they buy. To do this, legislation has to ensure that all consumers have access to a menu of options for varying types of coverage, and that they are free to purchase policies across state lines. There should also be tax breaks for people who purchase medical care not covered by their insurance, so there is reasonable chance of escaping government-imposed limits on treatment choices.

System-wide, collectivization will be dismantled only by limiting the power of government agencies to determine what care gets funded. That means new legislation to supersede Section 1311 of the Patient Protection and Affordable Care Act, which requires herding everyone into “qualified plans” and forcing doctors (via fines, penalties and nonpayment) to follow care guidelines determined by the secretary of Health and Human Services.

ObamaCare is already doing great damage, even years before its individual mandate and other controls kick in. Its systematic undoing is an urgent necessity.

Dr. Krieger, a plastic surgeon, invests in health-care companies.

Wisconsin: Pure & Simple Arithmetic

Saturday, February 19th, 2011

There are 5.6 million people living in the state of Wisconsin. The state is spending $32 billion per year. That’s $5,714 per person. The per-capita income of the state (how much each person living in Wisconsin earns per year) is only $25,000. Thus, the people of Wisconsin are spending 20% of their total income on their state government. You can add another 23% to pay for the federal government… and another 2%-3% for local government. When you add it up, you’ll find government now makes up more than 45% of the economy. The same is true almost everywhere in the United States.  

It should be obvious to all that when we’re spending more than     45% of our GDP to govern ourselves, we are doomed.

What really matters to each & every Citizen here is the plain truth:     The people of Wisconsin cannot afford their government.

That’s not a political statement.

That’s an economic fact.

2 years damage, now add in Obamacare costs

Saturday, February 19th, 2011


January 2009 Today % chg Source
Avg. retail price/gallon gas in U.S. $1.83 $3.104 69.6% 1
Crude oil, European Brent (barrel) $43.48 $99.02 127.7% 2
Crude oil, West TX Inter. (barrel) $38.74 $91.38 135.9% 2
Gold: London (per troy oz.) $853.25 $1,369.50 60.5% 2
Corn, No.2 yellow, Central IL $3.56 $6.33 78.1% 2
Soybeans, No. 1 yellow, IL $9.66 $13.75 42.3% 2
Sugar, cane, raw, world, lb. fob $13.37 $35.39 164.7% 2
Unemployment rate, non-farm, overall 7.6% 9.4% 23.7% 3
Unemployment rate, blacks 12.6% 15.8% 25.4% 3
Number of unemployed 11,616,000 14,485,000 24.7% 3
Number of fed. employees, ex. military (curr = 12/10 prelim) 2,779,000 2,840,000 2.2% 3
Real median household income (2008 v 2009) $50,112 $49,777 -0.7% 4
Number of food stamp recipients (curr = 10/10) 31,983,716 43,200,878 35.1% 5
Number of unemployment benefit recipients (curr = 12/10) 7,526,598 9,193,838 22.2% 6
Number of long-term unemployed 2,600,000 6,400,000 146.2% 3
Poverty rate, individuals (2008 v 2009) 13.2% 14.3% 8.3% 4
People in poverty in U.S. (2008 v 2009) 39,800,000 43,600,000 9.5% 4
U.S. rank in Economic Freedom World Rankings 5 9 n/a 10
Present Situation Index (curr = 12/10) 29.9 23.5 -21.4% 11
Failed banks (curr = 2010 + 2011 to date) 140 164 17.1% 12
U.S. dollar versus Japanese yen exchange rate 89.76 82.03 -8.6% 2
U.S. money supply, M1, in billions (curr = 12/10 prelim) 1,575.1 1,865.7 18.4% 13
U.S. money supply, M2, in billions (curr = 12/10 prelim) 8,310.9 8,852.3 6.5% 13
National debt, in trillions $10.627 $14.052 32.2% 14

Just take this last item: In the last two years we have accumulated national debt at a rate more than 27 times as fast as during the rest of our entire nation’s history. Over 27 times as fast!

Your Medicare taxes don’t cover your costs

Tuesday, February 15th, 2011

Citizens paid Medicare taxes for years and think they deserve full benefits.  But realistically, the money people paid into Medicare doesn’t come close to paying the cost of their medical care.

A couple retiring in 2011 and earned $89,000 a year paid $114,000 in Medicare payroll taxes.  But they receive $355,000 in medical care, or three times what they paid in taxes.                             

$355,000 – $114,000 = $241,000 unpaid benefits

Very few Americans realize the size of the gap.  Many workers believe their Medicare taxes pay for their own insurance after they retiree.  But the money is actually used to pay the bills of seniors currently on the program.  That mistake complicates the job for politicians building political support to deal with $Trillion deficits.

Medicare costs are a major and unpredictable part of the government’s budget problems. Recent debt reduction proposals called for big changes to Medicare.   Some plans call for phasing out the program, replacing it with a fixed payment to help future retirees buy a private plan of their choice.

Medicare is legalized theft that the Government got away with for the past 45years.

Soon there won’t be enough Citizens to fleece. 

The Medicare system is totally unsustainable.

17th Amendment Repeal: How to stop a runaway federal government

Saturday, February 12th, 2011

For the benefit of the Department of Homeland Security, Southern Poverty Law Center, MSNBC, all progressives, socialists and outright communists – this article is not about anti-government organizations. It is about organizations filled with members who love the United States of America and are sick and tired of watching its leaders ignore the Constitution, trample individual freedom and impose near-despotic rule.

The emergence of tea party and 9/12 groups across the country are just the first bubbles in a pot that has begun to boil. Thousands of groups have formed and are now monitoring local governments, conducting regular education sessions for their members, locating, grooming and funding candidates, and preparing to rid the nation’s leadership of all officials who display anti-Constitution tendencies.

In Maine, for example, a group has formed called The Fourth Awakening, which says:

Our purpose is to restore the Republic gifted to us in 1776 by our Founding Fathers whose vision we cherish and whose vision we intend to reclaim in full. In essence we reject the ideology of the Marxist progressives, we reject big government; we reject the subversion of our Constitution, our religious and personal rights. …

This group hopes to create a national movement among the states through which each state will create what they call an “Electoral Assembly” which will provide greater participation by citizens in the oversight of candidate selection, elections, lawmaking, rulemaking and the implementation of government.

While many of the ideas expressed by this group may be unrealistic, their passion for a return to the original Republic designed by the founders is quite clear.

Another group in Wyoming is trying to launch a campaign calling on states to initiate nullification legislation. Nullification is the constitutional theory that since states created the federal union, states have the last word in determining whether they will honor laws created by the federal union.

Thomas Woods explains how states can reject unconstitutional federal laws in “Nullification: How to Resist Federal Tyranny in the 21st Century”

This theory has been tested several times in U.S. history. Current efforts are likely to meet the same fate as previous efforts, but the effort is another bubble in the boiling pot of dissatisfaction with the direction of the federal government.

The nullification initiative hit the nail on the head in its explanation for the campaign:

The sovereign states lost congressional representation of states’ interests in 1913 with the passage of the 17th Amendment, which removed the constitutional right of each state legislature to choose two representatives of state interests, to be seated in the U.S. Senate.

The 17th Amendment is the problem. The solution is to repeal the 17th Amendment. There is no need for states to create “Electoral Assemblies.” There is no need to reinvent the “nullification” wheel. There is a great need to repeal the 17th Amendment, which is likely to be the only realistic way to stop a runaway federal government.

The founders who fought tooth-and-nail for four months in Philadelphia did so because they loved freedom and hated despotism. They knew the only way to prevent a government from becoming despotic was to create multiple power sources and force them to compete, and to require eventual agreement before any new law could be imposed upon the people.

The purpose for having a bicameral legislature was to have two separate constituencies examine proposed legislation. The House of Representatives represented the people; the Senate – chosen by state legislatures – represented the states. These two sources of power had to agree on all legislation before it could go to the president. The president, another power source, had to agree before any proposal could become law.

The 17th Amendment obliterated this carefully designed system by removing the states from participation. What remained was a bicameral legislature representing a single constituency, divided only by party affiliation. Thus began the tug-of-war between two political persuasions for control of the power government possesses. Before the 17th Amendment, the purpose of government was to protect the inherent rights of its citizens and to defend them from all enemies foreign and domestic. After the 17th

Amendment, the purpose of government evolved into the enforcement of political theories the ruling party believed to be most suitable for the people.

Stated differently, before the 17th Amendment, people were free to do whatever they wished so long as their freedom did not infringe upon the rights of others. After the 17th Amendment, the federal government became the mechanism through which the party in power could impose its ideas about how people ought to live.

A coalition of organizations has now formed and is now spreading across the nation with the single goal of repealing the 17th Amendment. Tea party and 9/12 groups as well as property-rights and fair-tax groups, gun-rights groups and many others are joining forces to repeal the 17th Amendment in order to once again give states a seat at the federal table.

Only by restoring the states to the federal government process can there be any hope of stopping a runaway federal government.

Read more: How to stop a runaway federal government

 Comment #1   You’re excellent posts are proof that the America I dreamed about still exists.     Miss Wonbit Ch

28 governors want ObamaCare fast-tracked to Supreme Court

Friday, February 11th, 2011

In the wake of the Obama administration’s health-care overhaul being ruled unconstitutional last week, 28 governors are now urging the president to press for the fast-tracking of the relevant appeals to the Supreme Court.

In a letter to the president, the governors write: “We respectfully ask that you direct the United States Department of Justice to support an expedited appellate process for each case to reach the United States Supreme Court as soon as possible in order to resolve the significant constitutional issues presented, which we all agree are of national importance.”

The governors indicate their request for expedited review takes no position on the Patient Protection and Affordable Care Act, commonly called “Obamacare,” but seeks only to obtain the high court’s final determination without going through what could be a long process of appeals.

The letter tells Obama: Given the daunting and costly financial and regulatory burdens that our states and the private sector will face in implementing PPACA over the coming years, particularly during this unprecedented budgetary time, public interest requires expediting a final resolution of the litigation to give certainty as soon as possible. We should not endure years of litigation in the circuit courts, when the Supreme Court can promptly provide finality. This resolution can help prevent the states and the private sector from undertaking potentially unnecessary measures and expenses. More importantly, our businesses, health-care providers, and citizens of our great nation need to know as soon as possible whether all or part of the law will be upheld or stricken, so they know their options and obligations.Signing the letter were Govs. Robert Bentley of Alabama, Sean Parnell of Alaska, Jan Brewer of Arizona, Rick Scott of Florida, Nathan Deal of Georgia, C.L. “Butch” Otter of Idaho, Mitch Daniels of Indiana, Terry Branstad of Iowa, Sam Brownback of Kansas, Bobby Jindal of Louisiana, Paul LePage of Maine, Rick Snyder of Michigan, Haley Barbour of Mississippi, David Heineman of Nebraska, Brian Sandoval of Nevada and Chris Christie of New Jersey.

During a health-care roundtable today in Washington, D.C., sponsored by the Aspen Institute, former Gov. Ed Rendell, D-Pa., indicated he would join the GOP effort if he could.

“Were I governor of Pennsylvania still, I would have joined in that because it is important to the country and important to the states that we get an expedited decision,” Rendell said.

In a telephone interview with Bloomberg News, Tracy Schmaler, a Justice spokeswoman, referred to previous statements that the Virginia lawsuit “should follow the ordinary course of allowing the court of appeals to hear it first.”

Joe Kovacs 2-9-11 

An ObamaCare Appeal From the States

Thursday, February 10th, 2011

Twenty-one governors representing more than 115 million Americans have written to Kathleen Sebelius asking for more flexibility on health-care reform.

Unless you’re in favor of a fully nationalized health-care system, the president’s health-care reform law is a massive mistake. It will amplify all the big drivers of overconsumption and excessive pricing: “Why not, it’s free?” reimbursement; “The more I do, the more I get” provider payment; and all the defensive medicine the trial bar’s ingenuity can generate.  

All claims made for it were false. It will add trillions to the federal deficit. It will lead to a de facto government takeover of health care faster than most people realize, and as millions of Americans are added to the Medicaid rolls and millions more employees (including, watch for this, workers of bankrupt state governments) are dumped into the new exchanges.  

Many of us governors are hoping for either a judicial or legislative rescue from this impending disaster, and recent court decisions suggest there’s a chance of that. But we can’t count on a miracle—that’s only permitted in Washington policy making. We have no choice but to prepare for the very real possibility that the law takes effect in 2014. 

For state governments, the bill presents huge new costs, as we are required to enroll 15 million to 20 million more people in our Medicaid systems. In Indiana, our independent actuaries have pegged the price to state taxpayers at $2.6 billion to $3 billion over the next 10 years. This is a huge burden for our state, and yet another incremental expenditure the law’s authors declined to account for truthfully. 

Perhaps worse, the law expects to conscript the states as its agents in its takeover of health care. It assumes that we will set up and operate its new insurance “exchanges” for it, using our current welfare apparatuses to do the numbingly complex work of figuring out who is eligible for its subsidies, how much each person or family is eligible for, redetermining this eligibility regularly, and more. Then, we are supposed to oversee all the insurance plans in the exchanges for compliance with Washington’s dictates about terms and prices. 

The default option if any state declines to participate is for the federal government to operate an exchange directly. Which got me thinking: If the new law is not repealed by 2013, what could be done to reshape it in the direction of freedom and genuine cost control? 

I have written to Kathleen Sebelius, secretary of Health and Services (HHS), saying that if her department wants Indiana to run its program for it, we will do so under the following conditions: 

• We are given the flexibility to decide which insurers are permitted to offer their products. 

• All the law’s expensive benefit mandates are waived, so that our citizens aren’t forced to buy benefits they don’t need and have a range of choice that includes more affordable plans. 

• The law’s provisions discriminating against consumer-driven plans, such as health savings accounts, are waived. 

• We are given the freedom to move Medicaid beneficiaries into the exchange, or to utilize new approaches to the traditional program, instead of herding hundreds of thousands more people into today’s broken Medicaid system. 

• Our state is reimbursed the true, full cost of the administrative burden to be imposed upon us, based on the estimate of an auditor independent of HHS. 

• A trustworthy projection is commissioned, by a research organization independent of the department, of how many people are likely to wind up in the exchange, given the large incentives for employers to save money by off-loading their workers. 

Obviously, this is a very different system than the one the legislation intends. Health care would be much more affordable, minus all the mandates, and plus the consumer consciousness that comes with health savings accounts and their kin. Customer choice would be dramatically enhanced by the state’s ability to allow more insurers to participate and offer consumer-driven plans. Through greater flexibility in the management of Medicaid, the state might be able to reduce substantially the hidden tax increase that forced expansion of the program will impose.  

Most fundamentally, the system we are proposing requires Washington to abandon most of the command-and-control aspects of the law as written. It steers away from nanny-state paternalism by assuming, recognizing and reinforcing the dignity of all our citizens and their right to make health care’s highly personal decisions for themselves. 

So why would Ms. Sebelius and HHS agree to this de facto rewrite of their treasured accomplishment? A glance at the recent fiasco of high-risk pools provides the answer. When a majority of states, including Indiana, declined to participate in setting up these pools, which cover those with high-cost, existing conditions, the task fell to HHS. As widely reported, it went poorly, with costs far above predictions and only a tiny fraction of the expected population signing up.  

If the feds can’t manage this little project, what should we expect if they attempt it on a scale hundreds of times larger and more complex? If it were only Indiana asking, I have no doubt that HHS would ignore us. But Indiana is not alone. So far, 21 states—including Pennsylvania, Texas and Louisiana—have signed the same letter. We represent more than 115 million Americans. Washington’s attempt to set up eligibility and exchange bureaucracies in all these places would invite a first-rate operational catastrophe. 

If there’s to be a train wreck, we governors would rather be spectators than conductors. But if the federal government is willing to reroute the train to a different, more productive track, we are here to help. 

Mitch Daniels, Republican Governor of Indiana.