Posted on 11/10/2012 7:22:21 AM PST by Kaslin
The morning after Tuesday's vote, there is one thing every commentator agreed on. The election of Barack Obama guaranteed that his signature piece of legislation — health reform — can now go forward. Republicans are powerless to stop it.
Yet there is something all these commentators are overlooking. There are six major flaws in ObamaCare. They are so serious that the Democrats are going to have to perform major surgery on the legislation in the next few years, even if all the Republicans do is stand by and twiddle their thumbs.
Here is a brief overview.
ObamaCare is not paid for. At least it's not paid for in any politically realistic way. As is by now well known, the legislation will lower Medicare spending over the next 10 years by $716 billion in order to fund health insurance for young people. This reduction will primarily consist of lower payments to physicians, hospitals and other providers — reductions that are so severe that they will seriously impair access to care for senior citizens.
In the last two Medicare Trustees reports, the Office of the Medicare Actuaries has predicted that these cuts will force one in seven hospitals out of the Medicare system in the next eight years. Payments to doctors under Medicare will fall below Medicaid levels in the very near future and will fall continuously behind Medicaid in the years ahead. From a financial point of view, seniors will be less desirable patients to doctors than welfare mothers. Harvard health economist Joe Newhouse envisions that seniors may have to seek care in the same places that now cater to Medicaid beneficiaries: at community health centers and in the emergency rooms of safety net hospitals.
During the election campaign, Barack Obama claimed that his administration had found $716 billion of "savings" and Democrats generally claimed that the money would come out of the pockets of doctors, hospitals and insurance companies, with no bad effects on seniors. In fact, no "savings" have been found and seniors will indeed be affected by low reimbursement rates — just as low-income patients must deal today with the fact that almost one in three doctors is not taking any new Medicaid patients.
But if the current crop of politicians is afraid to admit that they have taken something away from senior voters, what do you think future politicians are going to do when real pain starts setting in? The betting in Washington is that the cuts will be restored. That will mean that ObamaCare will hugely add to deficit spending, indefinitely into the future.
ObamaCare promises what it cannot deliver. To most politicians, acquiring health insurance means that people will be able to get medical care that the uninsured are not now getting. Yet in order for the country as a whole to get more medical care, there must be more doctors and nurses and hospital personnel — something that ObamaCare does not create.
Adding to the problem is that the law will require all of us to have access to a long list of preventive services without deductible or copayment. Economists at Duke University calculated that if every American actually got all of the recommended screenings and tests, the average primary care physician would have to spend 7 ½ hours of every working day doing nothing else but giving preventive care to mainly healthy patients!
What we will be facing is a huge increase in the demand for care, but no change in supply. As the waiting times grow, providers will tend to see those patients first whose insurance pays the highest fees. Those in plans that pay below market will be pushed to the rear of the lines. These will be the elderly and the disabled on Medicare, poor people on Medicaid and (if the Massachusetts model is followed) the newly insured in subsidized plans in the health insurance exchanges. In other words, access to care is likely to diminish for our most vulnerable populations.
ObamaCare mandates and subsidies will destabilize entire sectors of the economy. The law will require employers of workers earning $15 an hour or less to provide very expensive health insurance ($15,000 for a family) or pay a $2,000 fine. For these employees, the cost of family coverage is equal to more than half their income and there are no new subsides to help the employer or the employee bear this cost. Yet, if these workers don't get insurance from an employer the government will pay almost all the cost of the insurance through Medicaid or in the new health insurance exchanges.
For this reason, employers in the restaurant and hotel businesses, for example, are moving to part-time employment — in order to escape the mandate. And if one firm manages to avoid a 50% increase in labor costs, that firm's competitors cannot afford not to do the same.
The problems are really economy-wide. We could see entire firms dissolve and recombine, just in response to health insurance subsidies, rather than based on economic considerations.
ObamaCare creates perverse incentives that threaten the quality of care. Within the newly created health insurance exchanges, insurers must charge the same premium, regardless of expected health care costs. Since this necessarily means they will profit from healthy enrollees and incur losses on the less healthy, all plans will have a perverse incentive to attract the healthy and avoid the sick. Moreover, after enrollment, the incentive will be to over-provide to the healthy (to keep the ones they have and attract more just like them) and under-provide to the sick (to encourage the exodus of the ones they have and discourage enrollment of any more of them). That's not good if you are sick.
A weakly enforced mandate will undermine the health insurance marketplace. The fine for being uninsured will be small, relative to the cost of insurance. And there is not much the IRS can do to people who ignore the mandate, other than withhold refund checks. It cannot garnish wages or attach assets, for example. Hence, people will have an incentive to stay uninsured while they are healthy (and avoid paying hefty premiums), enroll after they get sick (to get their medical bills paid) and then drop coverage after they are well again. Yet if everyone does this, only sick people will have health insurance and the premiums will be completely unaffordable.
A strongly enforced mandate will strain almost every family budget. For the past 40 years, health care spending has been growing at twice the rate of growth of our incomes, on the average. Nothing in ObamaCare is likely to change that. Yet if we are required to buy coverage and denied the right to scale back benefits, choose higher deductibles, etc., health insurance premiums will crowd out more and more of the average family's budget. Eventually, health insurance costs will threaten to crowd out every other form of consumption!
Again, these problems have nothing to do with Republican opposition. They are inherent in the legislation itself. Democrats will be forced to face them whether they want to or not.
This is the most important two sentences in the article. We have created another huge entitlement system that will bankrupt our country along with Medicare, SS, and Medicaid. The politicians will respond to public pressure and not make the prescribed cuts in much the same way they enact the "Doc fix" every year to Medicare. Eventually, as intended by Obama, we will be forced to go to a single payer system. Obamacare was always intended to be an interim step.
There is still one way to get rid of Obamacare, as soon as the first person is taxed for it. That person will then have standing to challenge the law, on the basis that tax bills must come from the House, and the Obamacare bill was gutted in the Senate and filled with Harry Reid’s text.
This ruling about standing was made in Florida, purposely by the Justice Department, to keep anyone from challenging Obamacare on that basis until 2014, when the first penalty/tax will be paid.
Roberts’s vote not as cuckoo as it sounded. He stopped the Commerce Clause from becoming a catchall and established the Obamacare penalty as a tax.
Implementing Obamacare is the best outcome now. Liberals would have never accepted that it wouldn’t work if it got overturned. Now they will see the proof as it falls apart, doctors and other medical people rebel, the lines get long and the costs skyrocket.
People learn most lessons the hard way. Prepare for the hard way in a lot of areas, including Obamacare.
All this is true, but misses the point - The PPACA (Obamacare) is not SUPPOSED to “work”. As I posted here at the time of its passage, it is a purely Leninist work of destruction.
These six things barely scratch the surface of what’s “wrong” with it. It doesn’t even discuss the IPAB, which (supposedly) prevents future Congresses from legislating (you know, the Congress which possesses “all legislative powers herein granted?).
Long before the PPACA actually has to “work”, the system will be in ruins and the people will be begging for what the PPACA was ACTUALLY designed to deliver - full seizure of all healthcare related businesses and the final smashing of the Class Enemy.
Looking for a positive in Obama retaining power is like looking for a positive in hurricane Sandy destroying your neighborhood. One of the few positives is that it may make ObamaCare easier to repeal. I don’t believe that Romney would actually have repealed ObamaCare. Four (eight???) years of ObamaCare under a “Republican” president would have made that unconstitutional law far harder to repeal. Assuming that a real conservative takes the White House in four years, with the expected weak economic growth due to liberal government and ObamaCare, repeal will be much more manageable than in a post-Romney world. Considering the destruction we face over the next four years, that is not a positive vision, but it is better than the destruction plus keeping ObamaCare.
Absolutely.
The biggest problem is that the Health Care Exchanges cannot possibly be up and running by 2014 let alone be ready to enroll people and pay providers. Many states will balk at creating the exchanges so the burden will be wholly on the federal government. Imagine the chaos in 2014 when millions of people lose their employer sponsored plans, cannot possibly afford private plans, make too much to qualify for Medicaid and the much touted Exchanges do not yet exist. Not only will these people not have any health insurance they will be fined for their predicament. If that doesn’t bring mobs with torches and pitchforks to Washington I don’t know what will.
I'd like to believe that....but thanks to the complicit leftist media, the commiecrats will double down on blaming the 'greedy' insurance companies and medical firms for the high costs and failures.
The same people who apparently accepted the notion that Benghazi was caused by a stupid YouTube video will not learn the truth. They'll accept all kinds of lies as long as they think they're getting 'free' health care, and that the nasty conservatives just want to take away their rights.
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Disagree, the Liberals will not accept that Obamacare won’t work. As the author notes, they will support the major surgery necessary to keep it functioning somehow until we go to a single payer system. They will not let go of the Holy Grail. It is too important to the cult called the Democrat Party.
I need to change my signature now that Obamacare will never be repealed and America’s fate is sealed.
I need to change my signature now that Obamacare will never be repealed and America’s fate is sealed.
The Democrats said as much, that this is just a stepping stone to single payer. I forget which Democrat Senator said it, but after passing Obamacare, one of them reassured the liberals who wanted single payer by saying that they were building a house, and you don’t build it in one step. First you have to build the foundation, then the walls, then you can add the roof and the rest of it.
He stated that Obamacare was just the first installment on the way to single payer. He was completely open on the fact.
The other method of passing an amendment requires a Constitutional Convention to be called by two-thirds of the legislatures of the States. That Convention can propose as many amendments as it deems necessary. Those amendments must be approved by three-fourths of the states.
Obamacare is not the law of the land. The bill had to be passed before it could be read. Therefore, it is not proper law no matter what the MSM and Progresso's say.
By my count there are 36 state legislatures which are either Republican controlled, tied, or are red states, possibly conservative Democrat. To me the public opposition to Obamacare should be enough to secure their passage of an amendment to nullify it in some way. Are there any chance 2 of the below more Democrat-leaning states would sign on and give us the necessary 38 states?
http://en.wikipedia.org/wiki/List_of_United_States_state_legislatures#State_legislatures
California
Connecticut
Delaware
Hawaii
Illinois
Maryland
Massachusetts
Nevada
New Jersey
New Mexico
New York
Rhode Island
Vermont
Washington
I’ll try to look up polls etc. on those states to see how strongly they oppose Obamacare.
Most Americans oppose it so even if they’re Dems, you’d think they’d go along with that.
Apparently amendments can also be ratified by state conventions, not just state legislatures. I’m not quite sure how such a convention works, but it was used once to ratify an amendment. A convention of states has never been used to propose an amendment before, but it is the alternative way to do it other than having the House and Senate propose them.
http://www.usconstitution.net/constam.html
The Constitution, then, spells out four paths for an amendment:
Proposal by convention of states, ratification by state conventions (never used)
Proposal by convention of states, ratification by state legislatures (never used)
Proposal by Congress, ratification by state conventions (used once)
Proposal by Congress, ratification by state legislatures (used all other times)
Stop that.
America lost this election because of two things:
1) We have lost enough jobs through outsourcing, that the balance of power is now virtually even.
2) Romney was a Mormon.
We can stop the loss of US jobs, and probably will. Democrats are at least partially protectionist. In this I will support them.
Romney however was a huge mistake.
We won’t get too many more. We need to plan much more carefully now.
All that said, there are not better places to run to. If America collapses - everyone will.
Fix America.
NO!
Did the Election Save ObamaCare?
Yes at a cost of a few million more jobs lost.
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