America’s Obamacare Nightmare Is Just Beginning

Submitted by Robert E Moffit via TheNationalInterest.org,

This week the U.S. Supreme Court ruled that the federal government could continue to subsidize health-insurance coverage through Healthcare.gov, the federal exchanges. An ecstatic President Obama declared that Obamacare is “here to stay.”

No, it’s not.

A judicial victory doesn’t automatically translate into a political victory, let alone a policy success. Once they’ve quaffed their celebratory champagne, the president and White House staff will need to suit up and get ready to play some hard-nosed defense.

Here’s why. The driving force behind health reform has been the desire to control rising health-care costs. From 2008 onwards, President Obama promised that his reform agenda would reduce the annual cost for the typical American family by no less than $2,500. After a while, it became a rather tiresome talking point. But it was pure nonsense from the start.

Health-care spending increases were slowing down well before Congress enacted Obamacare. But with the onset of Obamacare, health-insurance premiums in the exchanges jumped by double digits, while deductibles increased dramatically. If you liked your doctor, you would be able to keep you doctor, the president insisted, but maybe not, in reality, depending upon whether or not your physician networks narrowed. Looking toward 2016, health insurers say premium costs will soar.

In the days, weeks and months leading up to the King v. Burwell decision, commentators obsessed over the roughly 6.4 million persons who could lose health-insurance subsidies. With the Court’s ruling, they can keep the federal subsidies. But that doesn’t come close to ending the debate.

Roughly 6.4 million persons in thirty-four states could have been negatively affected if the Court struck down the federal exchange subsidies. But there is a much wider universe of persons adversely affected by the law: the roughly 15 million persons in the individual and small group market who don’t get—and won’t get—the federal government’s health-insurance subsidies. Under Obamacare, millions of Americans are forced to pay more for their government standardized coverage, regardless of whether they like it or not, whether they want it or not, or whether or not it forces them to pay for medical procedures that violate their ethical, moral or religious convictions.  

So, the debate will intensify over the primary issue: costs. In every state, the fundamental components of state health-care costs—the demographics, the underlying costs of care delivery and the competitiveness of the markets—are juiced up by expensive federal benefit mandates and individual and group insurance rules and regulations. These all drive costs skyward. As my Heritage colleagues have demonstrated, this regulatory regime forces young people to pay up to 44 percent more in premiums. Washington’s subsidies simply try to hide the true costs of the law; they don’t control them.

The law remains unworkable. The complicated insurance subsidy program itself has been a mess. H&R Block reported that about two thirds of subsidy recipients had to repay money back to the government because they got bigger than allowable subsidies. With the individual mandate, the administration has been granting lots of exemptions to insulate most of the uninsured from any penalty. That’s rather predictable; after all, even candidate Barack Obama argued that an individual mandate was unfair and unenforceable.

As for the employer mandate—another fractured cornerstone of Obamacare—the administration has delayed it for one year. Even liberal supporters now want to repeal it, fearing damage to the labor markets.

And what about those big “savings” from the Medicare payment reductions? They were earmarked to help cover the costs of the insurance subsidies. Yet the Medicare Actuary and the CBO have both routinely dismissed the massive Medicare payment cuts as either unrealistic or unsustainable.

Meanwhile, other problems mount. The state exchanges are financially troubled. Coverage is still insecure, especially when loss of employment is tantamount to a loss of a health plan. Bureaucracy, red tape and paperwork plague the system, increasing costs and frustrating doctors and patients alike. All of those problems are getting worse, not better.

This is the second time in two years that President Obama has declared the debate over Obamacare to be “over.” Here’s a better prediction: America is entering into the next phase of an equally contentious but broadly educational debate over the direction of the nation’s health-care future.

In a free society, debate is over only when the people decide it’s over.

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48 Comments
kokoda
kokoda
June 26, 2015 9:25 pm

Big increases coming this fall

Westcoaster
Westcoaster
June 26, 2015 9:41 pm

Obamacare was designed to keep the greedy bastard companies like Kaiser, Blue Cross, Health Net, Humana, and others in on the gravy train, mostly on the taxpayer’s dime. In fact the healthcare industry wrote the damn bill!
The much better solution (as in the rest of the developed world) is single-payer healthcare, which would actually hold costs down. The system as it is makes zero sense and is unsustainable. What we need is Medicare for all and blow out that provision that Medicare “can’t negotiate drug prices” (thanks to Billy Tauzin, who left Congress to head up Big Pharma!)
What other industry won’t give you a firm price before you agree to service? Karl Denniger rants about this all the time and he’s right, why should the new Hep C cure cost $40,000 in the U.S. but $300 in India for the same pill?

robert h siddell jr
robert h siddell jr
June 26, 2015 10:09 pm

In 2015, Social Security and Medicare costs are about equal but Medicaid cost (even in 2005) was Social Security PLUS Medicare costs (ref the wiki “Medicaid” Budget Chart). I think Medicaid-Obamacare subsidies should be combined and considered as one item (health welfare). Taxpayers cannot afford the Social Security Program now much less Medicare…and absolutely can not also afford Medicaid-Obamacare. These programs are really being paid for by printed money from thin air which displays as inflation (to become hyperinflation within months or at most a year). The USA is a gigantically profligate country compared even to Greece and our dollar crash later this year (perhaps 500% inflation) will be vastly worse than the puny Greek recession in comparison (the BRICS will not offer US loans). The Middle Class will have to go Cold Turkey but the Welfare Maggots will get Obama’s premium attention and choicest cuts at first but then shortly will have to go cold turkey also. I have no doubt that the Urban Jungle savages will begin dining on American “bushmeat” also called Long Pork.

gm
gm
June 26, 2015 10:15 pm

only reason I have health insurance is due to riding a motorcycle . thinking im selling the bike and telling them to fuck off !

dc.sunsets
dc.sunsets
June 26, 2015 10:17 pm

Westcoaster, O-care was designed to FAIL. The purpose is to create a groundswell for Single Payer. That’s the plan of the Hard Left.

The money-grubbing Mid-Left, however, is funding their reelection campaigns from the big insurers, larger medical device/drug manufacturers and Wall Street (which owns a lot of those firms’ stock) so they are toeing a different line, the Crony Capitalist model proven so lucrative by the Military Industrial Congressional Complex.

The RINO contingent is in it with the Mid-Left, so I suspect Crony Capitalism will be the order of the day until the system bankrupts the Fed Gov.

Bankruptcy will simply look like skyrocketing interest rates on T-bonds. We’re not there yet, and maybe we have another 5-10 years before it happens, but I doubt it.

Denninger is an annoying person on many fronts but he does GET that the borrowing binge is on the rapidly rising part of an exponential curve. Single Payer won’t solve the underlying problem of too much borrowing and far too many jobs (in so-called health care) being dependent upon Medicare and Medicaid.

Your single payer system will simply reveal two things: bureaucracies fook up everything they touch, and vast amounts of employment in the Medical-Industrial-Complex, from excess doctors to legions of paper-pushers in hospitals and insurers, are a dead-weight loss.

If we must have a “government run” medical system (which is actually what we have, it’s called fascism where the means of production are ostensibly privately owned but the rules by which they operate are entirely political-system-produced), I sincerely hope a cash system remains legal.

Either that, or I plan on medical tourism where necessary. I don’t want a Belgian system where doctors “retire” (as in MURDER) patients without patient consent once said patient is deemed no longer viable.

taxSlave
taxSlave
June 26, 2015 10:18 pm

Westy – we do not need single payer.

We need free market.

More government to fix the consequences of government distortions results in more consequences that need to be fixed.

Lunatics are running the nut house.

Fuck all idiots that believe in government meddling.

Zarathustra
Zarathustra
June 26, 2015 10:26 pm

A free market for health care won’t work either until physicians are liberated from the threat of suit by attorneys. Today there is so much expensive drugs and equipment that physicians routinely over-treat patients, lest they be accused of doing the opposite. This is neither good for doctors or patients. We need an environment where patients are honestly informed about the likelihood of successful treatment, especially near the end of natural life anyway.

dc.sunsets
dc.sunsets
June 26, 2015 10:29 pm

robbert s, hyperinflation is impossible in an environment of vast amounts of existing IOUs.

“Money” creation is being driven by issuing more and more bonds. As I’ve harped on before, it’s a dynamic system; today the Fed can monetize a billion dollars in bonds and it creates almost a billion in spending because interest rates are near zero and the incremental billion is absorbed by the Fed and the markets. People believe, therefore they get away with it.

Once the bond market accelerates its turn down (and interest rates up), if the perception is that the Fed Gov is trashing the future purchasing power of those bonds, their value dives and their interest rate spikes.

This is of little consequence if there are few outstanding bonds, but once there is an ocean of them, even small increases in the interest rate causes vast losses in bond value across the entire ocean.

Today, to carry the analogy, if the PERCEPTION is that the Fed and Congress are conspiring to F-up the future value of the dollar, then while Congress tries to borrow an incremental billion dollars, a hundred billion in the ocean of debt can disappear as interest rates rise.

Because of this, it is IMPOSSIBLE to create hyperinflation. For all practical purposes, the Fed would have to monetize ALL of the outstanding debt, possibly including corporates, muni’s, everything. It AIN’T GOING TO HAPPEN.

No.

First, the bond market has to contract….vastly. That’s wealth destruction on a colossal scale, and it will by synonymous with the largest monetary deflation in history. I have no doubt that after the deflationary wave is past, “experts” will decide that the economy is suffering from a SHORTAGE of money, and I do not doubt that they’ll try to print enough banknotes to reflate the economy.

That’s a process that absolutely should lead to hyperinflation, the end of the dollar, the end of any pretense that this is a republic and very possibly the break up of the USA into smaller pieces, with warfare, military coups and all sorts of havoc along the way.

Just my 2 cents.

PS: The scary part of this is that for a time during the deflation, as wealth is contracting mightily, CONgress will still be relatively flush with money and this will perversely make our dysfunctional central government even more powerful.

When elephants dance, it’s the grass that suffers.

Westcoaster
Westcoaster
June 26, 2015 10:40 pm

@D.C.: Medicare is the most popular and successful of all the gov programs. I agree they fuck everything up, but Medicare would be just fine were it not for Billy Tauzin (R) and the non-negotiable drug prices.
All the other developed countries have gone to single payer and while the U.S. is paying 18% of GDP for healthcare, these other countries are paying 8%. That 10% is a helluva lot of loot and it’s also why your position is incorrect. All the politicos are in on the loot including what you call the “hard left”.
Single-payer is the only answer to the problem at this point.
Add the Oklahoma surgery center to the “medical tourism” list. They actually post their prices.

Zarathustra
Zarathustra
June 26, 2015 10:48 pm

Westcoaster says:

@D.C.: Medicare is the most popular and successful of all the gov programs. I agree they fuck everything up, but Medicare would be just fine were it not for Billy Tauzin (R) and the non-negotiable drug prices.
All the other developed countries have gone to single payer and while the U.S. is paying 18% of GDP for healthcare, these other countries are paying 8%. That 10% is a helluva lot of loot and it’s also why your position is incorrect. All the politicos are in on the loot including what you call the “hard left”.
Single-payer is the only answer to the problem at this point.
Add the Oklahoma surgery center to the “medical tourism” list. They actually post their prices.
_________________________________________

If single payer costs 8% of GDP in other countries it would cost three times that in the US. This is a government that cannot run passenger trains, nor mail without incurring huge deficits. Just imagine what it would do with hospitals…

Persnickety
Persnickety
June 26, 2015 11:27 pm

I think Karl Denninger (etc.) has it right on this one – the fundamental problem is concealed and dishonest pricing, which the government allows. So much of the system is basically fraud, even if treated as being lawful. We need a simple, firm law requiring 100% transparent up-front pricing, creating no right to a dime of payment for anything that isn’t transparent, and providing Draconian punishments for any continuation of the fraud regime. If we actually did that, I think our system would be fixed within a few months.

Persnickety
Persnickety
June 26, 2015 11:33 pm

@Zarathustra, I am very familiar with the med mal regime from multiple angles. For most doctors, it is not much of an issue besides being a cost of doing business. There are a handful of counties within the nation where corrupt and stupid juries will hand silly large awards to any injured person, regardless of whether the standard of care was met or anything else that should matter legally. These counties include Cook and Madison counties, Illinois, Miami and Dade County (and to a lesser extent most of Florida), and Philadelphia. Outside of that small handful of bad venues, the system isn’t so bad, regardless of what doctors like to think. In most instances where there’s a large award, outside of those few jurisdictions, it’s because someone made a big and unforgiveable mistake, which caused some patient to die, or worse yet, have a long-term crippling condition. The cases with a crippled patient requiring long-term care are the worst financially, because the cost of that care will be based on current high medical costs and realistic medical inflation which is running at high single digits or even low double digits. That formula over a decade or three can easily produce an eight figure award, purely for forecast expenses of medical care.

taxSlave
taxSlave
June 27, 2015 7:41 am

Thinking about malpractice insurance and the associated litigation.

Can I sue the feral government for fucking up our monetary system, firing policy, privacy, medical insurance, train system, etc…?

Why not?

Oh right, we have (s)elections where the ruling elite provide two acceptable (to them) choices for us to fight about.

What a fucked up system.

I want freedom from government.

taxSlave
taxSlave
June 27, 2015 7:44 am

I hate tao-spell check – firing should have been FOREIGN

taxSlave
taxSlave
June 27, 2015 7:44 am

I give up

ragman
ragman
June 27, 2015 8:19 am

Fraud in medicare is rampant. Billions of dollars are stolen from the systems by “doctors” and “health care facilities”. Here in SO FL almost every name involved with this fraud is spanish. Worthless fuckers come up from some third world shithole and then steal everything they can from the American taxpayer. Out own thieves in CONgress have stolen about 2 trillion dollars from the SS system , spent it and replaced it with worthless IOUs. Just wait ’til Hillary gets in there.

robert h siddell jr
robert h siddell jr
June 27, 2015 9:37 am

DC Sunsets: I know you know finance & economics better than me. But I don’t think you are giving enough weight to global issues and future events. I believe the NYC banksters, stupid liberals and Obama have given the BRICS Casus belli & we will be OBE from natural (an angry God), liberal stupidities, & BRICS planned retaliations. True, when Bonds crash (esp globally) and the Fed has to finally throw in the towel on massive dollar printing, rates will increase and the Depression will cause deflation. But, I am convinced that when NYC banksters ripped the world off and wrecked global finance as seen in 2008, and then Putz Obama quadrupled the Federal debt and stepped on every other countries schmeckel; and business and citizens doubled down on debt, we gave the BRICS the Will for Revenge and an Achilles Heel point to attack & recover some losses but mostly to stomp the US Beast’s nuts to pulp. They now have their own internet, international investment bank, markets, growing militaries and pacts, public sentiments, etc, and when they think some provocation or situation is sufficient, they will sell trillions of US Bonds & spend trillions of reserves (out bidding us on food, oil, etc), turn their export supply lines off, flex their military muscles, etc, and Presto, 1973 inflation deja vu. Then who ya gonna call? Who’s our friend then?

Anonymous
Anonymous
June 27, 2015 10:11 am

Westcoaster, you need to look at the true condition of medical care in those countries that you seem to think are superior.

With the internet and internet translating programs there is no excuse to be ignorant.

Bad and deteriorating to substandard levels that would not be tolerated in the U.S. for the most part for anyone but the rich and powerful who have their own little private system others can’t get into).

That’s why so many of their rich come her to be treated and so few of ours go there for that reason.

taxSlave
taxSlave
June 27, 2015 10:24 am

“The economics of Obamacare are very bad. The law is inflicting broad damage on job creation and new business formation. It ruins job incentives by making it pay more not to work, thereby intensifying a labor shortage that is holding back growth and in turn lowering incomes and spending.

And across-the-board Obamacare tax increases are inflicting heavy punishment on investment — right when the U.S. economy desperately needs more capital as a way of solving a steep productivity decline.

Because of Obamacare, there’s an additional 0.9 percent Medicare tax on salaries and self-employment income, a 3.8 percent tax increase on capital gains and dividends, a cap on health care flexible spending accounts, a higher threshold for itemized medical expense deductions, and a stiff penalty on employer reimbursements for individual employee health policy premiums.

Each of these tax hikes is anti-growth and anti-job.

There is so much talk about “secular stagnation,” inequality and stagnant wages these days. But there’s little talk about the negative economic impact of Obamacare. It’s a much bigger story than SCOTUS jurisprudence.

A couple of examples.

First, there’s the problem of the 49ers and the 29ers. The business mandates and penalties imposed by Obamacare when small firms hire a 50th employee or ask for a 30-hour workweek are so high that firms are opting to hold employment to 49 and hours worked to 29. Lower employment and fewer hours worked are a double death knell for growth.

The Bureau of Labor Statistics sheds light on this. Although part-time work has fallen during the recovery, from about 9 million to 7 million, it hovered around 4 million during the prior recovery. And part-time employment, which as a share of total employment peaked at about 20 percent in 2010 and has slipped to about 19 percent, hovered around 17 percent during most of the prior expansion. Obamacare?

Everybody is complaining about the low labor force participation rate and the equally stubborn reduction in the employment-to-population rate. But why are we surprised? Obamacare is effectively paying people not to work.

University of Chicago economist Casey Mulligan argues that Obamacare disincentives will reduce full-time equivalent workers by about 4 million, principally because it phases out health insurance subsidies as worker income increases. In other words, Obamacare is a tax on full-time work. After taxes, people working part time yield more disposable income than they would working full time.

Mulligan calculates that both explicit and implicit marginal tax rates within Obamacare may rise to nearly 50 percent, as the law discourages those who attempt to climb the ladder of success. National prosperity and economic growth are again the victims.

And if all that weren’t bad enough, Obamacare enrollment is coming up short, and the program is unable to sustain an adequate risk pool. Expert health insurance analyst Robert Laszewski and the consulting firm Avalere find that exchanges are succeeding in enrolling low-income individuals but are struggling to attract middle- and higher-income enrollees.

Meanwhile, it appears that the healthy millennials are not buying enough Obamacare to finance the older and less healthy — especially those with pre-existing conditions.

So if the sign-ups are lower and the risk pool is shorter and the hoped-for redistribution from young to old isn’t happening, insurance companies are forced to jack up premium rates. Again, not surprising. But the crisis is coming earlier than expected.

Laszewski reports that Blue Cross Blue Shield of Texas wants a 20 percent rate hike; in Maryland, it’s 34 percent; Oregon’s biggest insurer, Moda Health, wants a 26 percent hike; and Blue Cross Blue Shield of Tennessee wants a 36 percent hike.

Not every state is experiencing this. But bad news has a way of spreading. Plus, insurance companies are increasingly worried that the government won’t back them through risk corridors or claim reinsurance or risk adjustments. So the dirty secret here is that a major taxpayer bailout is in the cards.

Look, government-run health insurance — or government-run anything — won’t work. Only free market competition with free consumer choice will adequately set prices, premiums and other costs. Obamacare mandates reduce freedom and raise costs.

Meanwhile, hospitals, doctors and patients will suffer from lower reimbursements. Doctors are leaving in droves. The worst health care, Medicaid, which is completely government-run, is exploding.

All this is why the system must be scrapped. And it won’t be missed. In the latest NBC News/Wall Street Journal poll, 65 percent of Americans think Obamacare needs either modifications or a major overhaul. Just 8 percent say it is working well, and 25 percent say it should be eliminated.

The Supreme Court decision is a minor part of the story. The big-picture question is: Can the U.S. not become Greece?

Larry Kudlow is CNBC’s Senior Contributor and author of American Abundance: The New Economic & Moral Prosperity.

Stucky
Stucky
June 27, 2015 10:40 am

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gator
gator
June 27, 2015 10:50 am

the analogy i prefer for medical pricing is car repairs. When I call around to see how much to fix the air conditioning on my tahoe, as I had to do recently, I was able to say what I needed done, and see how much it will cost in about 2 minutes. Try explaining over the phone that you need to have something simple done, like a broken leg needs to be set, xrays done, and a cast put on. Ask them to tell you how much that will cost. the person you are talking to will have no idea, neither will the doctor, neither will the nurse.

On the other hand, if you go into an urgent care, as I have done, it has a simple list of how much everything costs if you pay cash. As a person who has had numerous shoulder dislocations(i put it back in the socket by myself now, its a blast…) I saw it only costs a couple hundred dollars to have everything done. When i got the same thing done in the ER the first time I did it, the bill my insurance got was several thousand dollars.

gator
gator
June 27, 2015 10:50 am

@ stucky, still trying to figure out if that sign is also a gay joke…..

NickelthroweR
NickelthroweR
June 27, 2015 11:42 am

Greetings,

This is always a tough one as I have lived under a single-payer system and I found it to be superior to the one we have here. Of course, this was Germany and those guys are, well, famous for their organizational skills. I never had to wait to see my primary care physician but anything requiring surgery is scheduled out several months into the future which is why the rich do come here for such things as cash can buy you instant access in our corrupt for profit system.

I’ve told this story here before but I’ll repeat it again to highlight the difference between our systems.

I lived with a German family. Grandma lived on the first floor. She was in her mid 90’s. One day she fell down the stairs. Here is what the Germans did.

Within 45 minutes, a doctor with a little black bag arrived at her home (sent by the state). He checked grandma out, found nothing to be broken and gave her a good dose of morphine. He told the family, “she is old, things like this will happen. Take her to see her doctor Monday morning.” This made sense as taking grandma off to a hospital would have frightened her. She was comfortable in her surroundings and could recover better at home rather than freaking out in some strange bed somewhere.

What did this cost the German government? A few hundred dollars at most.

What would we have done here in this country?

A call to the authorities would have brought a convoy of government vehicles with their sirens screaming. Grandma would have been carted off to a hospital where, fearful of lawsuits, every test known to man would have been undertaken. Because of her age and health, she would have spent the weekend in an ICU which would have cost more than all of the taxes paid into the system over a lifetime. In the end, the doctors would have said, “she is old, things like this will happen.”

The Germans could provide quality health care for all at lower cost because they use common sense while we flail about like a bunch of stupid retards.

Anonymous
Anonymous
June 27, 2015 11:52 am

NickelthroweR,

From watching German language movies (English subtitled, I don’t speak German), I derive an understanding that Germany essentially has a three tiered health care system.

One for the wealthy that provides excellent state of the art care, one for the working German citizen that provides basic care immediately and elective care (non life threatening situations) eventually, and one for the lower class and “immigrants” that provides what amounts to basic and rationed care only with non life threatening elective care being virtually unavailable.

Rationing seems to be all pervasive on some level in every government run “single payer” system, sometimes accomplished by simply putting off care till the patient dies first (as is openly done in England where it is an official policy for older patients to be put aside and almost never receive certain procedures that are common and immediate for older people here).

Capn Mike
Capn Mike
June 27, 2015 1:10 pm

@NickelthroweR
That’s a great story, and I don’t don’t you. But the money line is: “anything requiring surgery is scheduled out several months into the future which is why the rich do come here for such things as cash can buy you instant access in our corrupt for profit system.”
Well, that’s the dirty little secret of single payer systems. Day to day medical costs are easily managed. It’s the big stuff that kills the plan. So anybody in Canada, say, who needs major surgery just crosses over to the States, where there’s a TON of surgery centers right up on the border (coincidence? don’t make me laugh) to take care of them. Visa, Mastercard, no prob.
So, once the U.S. goes single payer, where ya gonna go???
Me, I’m goin to Panama!!!

Capn Mike
Capn Mike
June 27, 2015 1:11 pm

oops that second “don’t” was “doubt”

SRV
SRV
June 27, 2015 2:06 pm

Hate to break the news to those RW patriots…

But Obamacare is not to blame for the irresponsible cost of health care in America!

As in virtually every example of runaway cost of a vital service, corporate greed and a complete absence of empathy for any human being (not in the 0.1% club) is and always has been the root cause (of course the GOP lawmakers are at the head of the corruption line to vacuum up the graft).

Of course it’s just too easy for the right to count on their good little followers to swallow the lies about the first black president being responsible for the ills of the insane, patchwork US healthcare system.

The rest of the developed world has proven that, while flawed, the single payer model gives equal or better care (with some exceptions for those to whom cost is not an issue) at HALF the cost!

There is no debate… only the dogma of entrenched positions, fueled by liberal greasing of the legislative skids, in defense of corporate profit.

starfcker
starfcker
June 27, 2015 3:20 pm

SRV, obamacare passed without a single repug vote in the house or senate. signed by a blackish dimocrat. Are you oblivious to fact?

Rise Up
Rise Up
June 27, 2015 3:23 pm

SRV says: Of course it’s just too easy for the right to count on their good little followers to swallow the lies about the first black president being responsible for the ills of the insane, patchwork US healthcare system.
—————-
Of course it’s just too easy for the left to DIScount the blatant LIES told by Obama about his healthcare program:

“If you like your doctor, you can keep your doctor”
“If you like your health care provider, you can keep your health care provider”
“You will save $2500 per year”

Heard of Jonathan Gruber?

Anonymous
Anonymous
June 27, 2015 3:45 pm

SRV,

Ever notice you never see anyone comparing the amount -number and type- of medical procedures single payer services provide on a patient for patient basis with the US?

There’s a reason for that.

Single payer systems may do it at half the cost, but the amount of procedures they provide each patient is less than half of what we get.

Consume more, spend more: It’s that simple.

And we consume much more on an unrestricted basis while they ration to avoid doing so.

Homer
Homer
June 27, 2015 4:39 pm

I’M SICK OF IT!!! SICK, SICK, SICK Every where i turn, it’s GOVERNMENT, GOVERNMENT, GOVERNMENT. I can’t read the papers or look at the TV without, GOVERNMENT, GOVERNMENT, GOVERNMENT. My life is consumed with, GOVERNMENT, GOVERNMENT, GOVERNMENT. It’s insane, I tell you. Is GOD the center of my life? NO, it’s GOVERNMENT, GOVERNMENT, GOVERNMENT. I’M SICK, SICK, SICK OF IT ALL, I TELL YOU.

I have a life to live, given to me by GOD not the GOVERNMENT.

As Samuel said to the Israelites, “God has not desired that you have a king (government), but if you want a king, you will have the kind of king, you as a people deserve” “If you are a good people you will have a good king (government), but if you are a bad people, you will have a bad king (government). The Israelites had some of the best and some of the worst kings.

You wanted government? Well, God’s giving you the government you deserve ‘good and hard’.

It is ironic that the ‘end times’ predicted in the Bible involve government. It was a depiction of the end result of government extrapolated to it’s final outcome. What do you expect of a government filled with selfish and self centered people? Mother Teresa? And YOU are goina vote for them again.
Go figure! Live up to your calling. Go out and give milk and Mooooo.

Homer
Homer
June 27, 2015 4:49 pm

Damn, it Homer. Get a grip! I’m goina have to up your meds.

Homer
Homer
June 27, 2015 5:12 pm

Look People! Competition works. I increases quality and provides choices. Corporations hate this.
Especially, corporations the are marginal. They seek governmental help in limiting competition by passing laws that inhibit a foothold by newer, leaner and better rivals.

Corporations don’t really want to limit competition, they want to eliminate it. They want to be the only source to fill your needs, less choice for you and shabbier products at higher costs. That is what Obama Care is, less choice for you and shabbier products at higher costs.

Ya! Thanks, Barry, Nancy and Harry for thinking of us and not those nasty corporation that give you so much money. Barry, I hope you don’t think I’m ungrateful. Every-time I see you on TV giving one of your great speeches, I reach for the Vaseline, but I have ta tell you. I’m really sore.

Homer
Homer
June 27, 2015 7:05 pm

dc.sunsets–“When elephants dance, it’s the grass that suffers.” I like that. I could imagine Hemingway saying that.

Let me say this, Hyperinflation just isn’t Inflation on steroids. One is psychological and one is monetary.

Inflation is the expansion of the money supply (credit) and deflation is the contraction of the money supply. Hyperinflation is the loss of confidence in the money and a desire not to hold it, but to trade it for real things. Like all psychological emotions it has life of its own and not easily controlled or reigned in.

As was seen in Zimbabwe, Argentina, and Venezuela, the governments have little control over Hyperinflation. It stops when the currency is completely repudiated or the currency is back by something real. Brazil was not yet in Hyperinflation when action was taken to prevent Inflation from advancing. Confidence was not destroyed and actions were taken to bolster confidence. It worked.

People erroneously believe that when interest rates rise and existing bonds are depreciated against the higher interest paid with the newer bonds that money was lost. Just like in 2008 with the stock market collapse trillions of dollars went to money heaven. Was the money lost? No. It was never there to begin with. It just was the sudden realization that the stocks were worth less if sold ‘at market’. There was never a profit except in the minds of the stockholders. The profit never existed until sold or used as collateral for money. The monetary value of something is what someone is willing to give you for it, and that’s psychological. It’s still a bid and ask world.

As I have said, the amount of credit must balance with real ‘goods’. There is too much credit created today and I don’t foresee an increase in the production of goods. Therefore, credit must contract. The nominal value of credit (debt). How to do this? The time honored way is default (repudiation), crashing the markets sending the credit to ‘money heaven’, and Hyperinflation sending the credit to ‘money heaven’ the hard way. Hyperinflation affect everyone even the Innocents. The new and fourth way is through money rationing. Bank holidays, confiscation of accounts and inability to spend the money that you currently have. In other words, limits on your ability to spend money.

Are we going to see ‘price deflation’? Yes, as inventories are sold down and businesses are selling everything to get money to pay down their debt. Fewer people in the market place buying because they’re broke. No buyers mean lower prices. Then a strange thing happens. inventories are depleted, production is marginal and people begin to realize that the money is overvalued and want to get what existing ‘goods’ they can for their money. Prices begin to rise as there are fewer goods and more money. The government does a ‘Nixon’ with price controls and they pour more money into the market which acerbates the problem of people unable to meet their needs. Black Markets spring up with the ensuing loss of respect for law: Rioting and Bloodshed. The Watts riots on steroids.

Money (credit) becomes Hyperinflated as the Fed has no choice but to print and print and print.

Exhausted the economy settles into a stupor. A once great nation brought to its knees by ‘fiat money’.
A third world nation finally having to live with reality.

Yup! Hyperinflation will come as sure as night follows day.

Homer
Homer
June 27, 2015 8:10 pm

PBS just ran a show on ‘Animal Brains-bird intelligence”. Interesting! It was showing the problem solving ability of birds. They had a puzzle that the birds had to solve in order to get a reward of food.

The birds had an uncanny ability to solve the puzzle. These birds were thinking. One example was a tube half filled with water and food resting on top of the water, but the water in the tube was too low for the birds beak to reach the food. The bird looked at the problem and then started to pick up pebbles and dropping them in the tube to raise the water level to the point that the bird could reach the food.

That’s smart thinking.

Then they tried to see if dogs would be as smart in solving the puzzles. The dogs were unable to solve the problems even tho they had a larger brain. The moderator questioned why this was so.

I knew immediately why. I saw the same answer in the Indian populations and the Negro populations and other welfare dependent individuals. The dogs were fed and taken care of and the birds were scavengers and struggling to survive. The birds were learning how to solve problems in a ‘bird eat bird’ world. the saying, “Necessity is the mother of invention” should be “privation is the mother of invention”.

The Indians were taken care of as is the welfare individual today. They have deteriorated and become slothful. That’s what happens when your not forced into the cold, cruel world. Aside from stealing, the sin of socialism is the destruction of those you are supposedly helping.

Where do you think we stand as a Nation, today???

Persnickety
Persnickety
June 27, 2015 9:26 pm

@5-cent: I was reading this bit “Within 45 minutes, a doctor with a little black bag arrived at her home (sent by the state). He checked grandma out, found nothing to be broken and gave her a good dose of morphine. He told the family, “she is old, things like this will happen. Take her to see her doctor Monday morning.””

And no joke, I was assuming that the morphine was going to be an “oopsie” lethal dose, and 95yo Grandma wasn’t going to need any further care. Obviously not the case with the rest of your story. I guess I’ve been reading too many stories about Belgium and the Netherlands.

Persnickety
Persnickety
June 27, 2015 9:32 pm

As for “rationing care”, this is a buzzword to get people upset but it means nothing. All valuable goods and services are in limited supply and there is some form of rationing. It may be market based, governmental, or some of each, but all things are rationed. Filet mignon? Rationed. Police services? Rationed. Milk? Rationed. Organic vegetables? Rationed. Really capable teachers? Rationed. Gasoline? Rationed. etc. etc. etc.

Even if we were to drive down the cost of medical care – and I think it could be knocked down by 90% or more – it would still be rationed. That’s just simple reality, and it’s OK – we accept it everywhere else in life. I drive an SUV that gets 19mpg because I can afford to and want to. I don’t fly a private jet that burns 1000 gal/hour because I can’t afford it, even though I wish I could. Rationing.

All that said, I think the worst kind of rationing is a purely governmental mechanism, because you KNOW the system set up will be unfair and corrupt. Market systems aren’t always fair, but are often not corrupt (or at least not entirely corrupt).

Llpoh
Llpoh
June 27, 2015 9:45 pm

Australia has a dual system – universal healthcare backed up by private.

Emergency situations are dealt with immediately via the universal system, but if you need “elective” surgery – ie for a bum knee, well then, you have to wait. Years in some cases. Unless of course you have private health insurance, in which case you can get treated straight away.

But the kicker is this – yes, Oz spends less on healthcare than the US. But it is absolutely crapping its pants re the rapidly growing use of the universal health system as the population ages (in combination with the rapidly growing “pension” system which is the equivalent of SS).

Universal healthcare systems are going to offer sub-standard treatments as populations age. No country can offer first rate, immediate, all-encompassing healthcare with a rapidly ageing population – it is far too costly.

Oz can kick that can down the road a lot further than the US can, as 1) it can massively increase its population by %, and 2) it has enormous reserves of natural resources vis a vis its population, which will serve as a base underpinning of its economy going forward.

It is perhaps 20 or 30 years behind the US in its progress towards collapse.

Social welfare states are fucked. Demographics, if nothing else, will see to it.

starfcker
starfcker
June 27, 2015 10:20 pm

I employed a finish carpenter last year, a man I had used before, some 15 years ago. He had grown heavy in that time, and his personal situation was different. He was divorced and living with his aging mother. He was doing cabinetry in my office, and I had frequent chats with him about his situation. At age 48, he had type 2 diabetes and high blood pressure. His overarching concern in life was keeping his health insurance.

starfcker
starfcker
June 27, 2015 10:31 pm

His mother probably has munchhausen syndrome, he was carting her to the emergency room every couple of weeks, for various aches and pains. I have had no contact with people like this, who use healthcare in a frivolous way. He seemed angry when I suggested there were better ways to take care of these things, and ended up quitting before the job was done. It just seemed like such a waste to me.

Homer
Homer
June 27, 2015 11:50 pm

Persnickety–You’re getting it. All scarce resources are rationed. That is what the Free Market does, is ration scarce goods and services. How, you ask? By setting a price. It’s a bid and ask world. Does that seem cruel to you, folks? Either the Free Market or the government’s central planners and bureaucrats will ration. Make no mistake, it will be rationed. It all a matter of who does it the rationing.

I trust the Free Market where needs are met. The Free Market creates anew the things that are needed. The Socialist central planners and bureaucrats just allocate what’s there. They are just re-arranging the deck chairs on the Titanic, where Free Marketism creates new lifeboats.

Soon, the central planners run out of money and their evil draconian methods to pull every last gold tooth from the hapless surfs fails. They throw up their hands and say, “We had the best of intentions.” Sometimes, I hope there is a special place in Hell for them as they have ruined so many lives.

taxSlave
taxSlave
June 28, 2015 12:29 am

Homer – I like the way you think.

flash
flash
June 28, 2015 8:33 am
Anonymous
Anonymous
June 28, 2015 2:57 pm

Im in the camp where politicians gov have taken advantage(through corruption,lawlessness,greed) of the good nature of the citizens of the U S .No accident politicians are all wealthy,citizens are getting their pockets picked.Im not clear these minions of Satan understand when people have nothing left to lose,thats when the real show starts