Thread: Do you support Obama Care ?

Don’t fall for Obamacare’s Medicaid bait
Quin Hillyer - April 20, 2014

Louisiana’s editorial boards and other opinion leaders all seem to agree that Gov. Bobby Jindal is wrong to reject the Medicaid expansion offered by Obamacare. But Jindal is right. Obamacare’s Medicaid offerings glitter like fool’s gold.

Before doing the math, let’s study some history. It’s not just that President Barack Obama has broken almost every promise he made about Obamacare, from driving premiums down to keeping your doctor if you so desire — although the overall Obamacare debacle certainly should raise red flags about its Medicaid component. It’s also that Louisiana, in particular, has reason to distrust the feds, whichever party is in charge, when it comes to programs where state and federal governments share the costs.

Jindal had direct experience with this proclivity. When he became Louisiana’s Secretary of Health and Hospitals in 1996, the state faced a catastrophic budget gap because the federal government changed the rules for a Medicaid/Medicare payment system called “Disproportionate Share.” Sure, Louisiana had gamed the system — but it did so under the rules set by the feds. When the rules changed, the state was left high and dry. Jindal himself devised the plan Louisiana used to avoid disaster, and sold it to the federal Centers for Medicare and Medicaid Services with the help of the state’s then-powerful congressional delegation.

Salvaging anything from that near-disaster was, as they say, “a close-run thing.”

The details aren’t crucial now; what’s important is that Jindal knows full well that Congress and national agencies can’t be trusted to set the same rules tomorrow that they promise today. This has a huge bearing on Obamacare’s promises to cover 90 percent of the costs of Medicaid expansion. Simple arithmetic combined with painful experience says those promises are budgetarily unsustainable.

Even at 90 percent federal coverage, Louisiana can’t afford the other 10 percent. The Jindal administration estimates the expansion would cost Louisiana $1.7 billion in the first ten years. The estimate is well in line with those of similarly sized states, such as Alabama. It may even be a low-ball figure. The Pelican Institute in New Orleans notes that other states’ earlier experiments along similar lines proved hideously expensive. For instance, “Arizona’s Medicaid expansion from 2000 to 2008 cost 400 percent more than expected.”

Meanwhile, perish the thought that the other 90 percent, even if actually delivered, is somehow “free money.” The vast majority of those who would enter the expanded Medicaid system aren’t the uninsured, but those who would merely be switching over from existing, private insurance. (Jindal’s team pegs this number of likely switchers at 171,000. That’s a big number, but not unreasonable. Previous expansions in Maine, Oregon, Delaware and, again, Arizona, saw this same phenomenon.) Smaller risk pools in the private insurance market are likely to result in higher premiums for everybody not on a government plan, while the momentum towards government-financed health care will put greater burdens on taxpayers.


















For most Louisiana workers, that would be a nasty double-whammy.

The results for those newly on Medicaid wouldn’t be pretty, either. Numerous studies show that Medicaid provides substandard care – and it actually narrows choices, as more and more doctors refuse to accept Medicaid patients.

Jindal makes another argument, politically potent and somewhat relevant, even if it relies on some inferential logic. Writing in the publication Politico, he notes that Obamacare offers to cover a greater portion of Medicaid expansion than the federal government covers for existing Medicaid payments to the states. Thus, the existing Medicaid populations, such as the disabled, effectively would be getting a lesser deal.

Many of these patients lack current access to “community-based services.” Jindal reasons that if the federal government does have the wherewithal to spend more on Medicaid, the extra money should go to the disabled rather than to the able-bodied workers covered by the Obamacare expansion.

If this isn’t exactly taking existing money away from the most vulnerable, it still is valid to say Obamacare’s Medicaid scheme would misallocate potential funds away from needy populations.

Louisiana is better to remain unencumbered by the many strings attached to Obamacare, and instead concentrate on its own, ongoing reforms that promise better care at lower cost. But those successful reforms are a story for another day.

New Orleans native Quin Hillyer is a contributing editor for National Review.

http://theadvocate.com/home/8934206-...-dont-fall-for

Networks Ignore Damning Report on ObamaCare Enrollment Problems
By Curtis Houck | July 2, 2014

On Tuesday evening and Wednesday morning, all three broadcast news networks and the two largest Spanish language evening network newscasts refused to cover disturbing news regarding ObamaCare. Two audits from the Health and Human Services Department’s Inspector General found Tuesday that 2.6 million unresolved problems in the applications of those seeking health care on the federal marketplace (used in 36 states).

While the news media are conducting a blackout on this troubling news about Obamacare, the networks gave plenty of coverage to President Obama’s so-called ‘victory-lap’ in April when the number of those ostensibly enrolled hit eight million people and weeks earlier when the deadline to receive initial coverage passed.

According to an editorial in Wednesday’s Investor’s Business Daily, these audits cast into doubt the true number of enrollees as the government neglected to check the validity of applicants Social Security numbers, U.S. citizenship or legal status or if any information was entered in error. The inability of governments at the federal level and in two states left taxpayers prone to fraud, abuse, and overpayments. The editorial concluded that: http://news.investors.com/ibd-editor...-failures-.htm

If ObamaCare were a private comapny, you can bet its executives would be facing criminal charges. Instead, Obama and the press are cheering ObamaCare as a great success.

ABC’s World News with Diane Sawyer, CBS Evening News with Scott Pelley, and NBC Nightly News With Brian Williams all refused to cover the news, but had air time to show a video of Mick Jagger joking about other famous Brits his age, corruption in China, and a viral video of two brothers singing about their native Canada respectively. In addition, the evening newscasts on the two largest Spanish language networks, Univision’s Noticiero Univision and Telemundo’s Noticiero Telemundo, completely ignored the story as well. Noticiero Telemundo was able to report though on the growing significance of cell phones in people’s lives.

On Wednesday morning, it was the same, sad story with no coverage. ABC’s Good Morning America and NBC’s Today did find time at the conclusion of their news briefs to show video of a black bear that had to be rescued after its face stuck inside a jar.

To the credit of The New York Times and The Washington Post, both newspapers published lengthy articles on the audits. However, both papers buried the stories on pages A17 and A11, respectively.

As the Media Research Center’s Rich Noyes reported, back in April the networks gave plenty of coverage to President Obama's so called "victory-lap" when the number of those ostensibly enrolled hit eight million people and weeks earlier when the deadline to receive initial coverage passed. http://newsbusters.org/blogs/rich-no...tone-obamacare

David Muir of ABC News hailed it as a “major milestone” while CBS’s Scott Pelley called it a “recent success.” The networks went so far out of their way to support the president that ABC’s Good Morning America reported misleading facts on the state of health care sign-ups.

According to Newsbusters contributor Tom Blumer, the website Politico ran a gushing headline the day on a pro-Obamacare piece entitled “Obama Spikes the Football.” ABC News brought on Republican consultant Matthew Dowd during a special report on April 1 on Obamacare to inform Republicans that they “would be really smart” to allow President Obama to declare victory on the issue and abandon efforts to repeal the law and to “admit reality and move on.”

One of the new audits, which examined both the federal and state-run marketplaces, stated that the Center for Medicare and Medicaid Services (CMS) was only able to confirm the citizenship and residency statuses of less than one percent of applicants. http://freebeacon.com/issues/cms-una...are-enrollees/ The New York Times reported one of the audits finding that infants and young children were labeled, in some situations, as incarcerated. http://www.nytimes.com/2014/07/02/us...inds.html?_r=0

The issues were due to a “not fully operational” system to automatically screen applicant’s availability. The Washington Times reported that the audits found problems on the federal marketplace confirming applicant’s Social Security numbers, citizenship verification on the California marketplace, and determining which applicants sought information over the phone on Connecticut’s exchange. http://www.washingtontimes.com/news/...-and-verifica/ These issues, one of the audits said, “may have limited the marketplaces’ ability to prevent the use of inaccurate or fraudulent information.”


http://newsbusters.org/blogs/curtis-...#ixzz36dNHU5ys

One doctor's horror story of practicing in the age of ObamaCare
Dan Calabrese on Friday September 12th, 2014

"The practice of medicine in the current environment is unsustainable."

Dr. Mark Sklar is an endocrinologist in solo practice in Washington D.C., in addition to serving as an assistant professor of medicine at Georgetown University Medical Center. So the man knows his stuff, and what he's experienced in recent years - as the federal government has increasingly inserted its clutches into both the delivery and the finance mechanisms of health care - has been nothing good.

Writing in this morning's Wall Street Journal, Dr. Sklar tells us that he now has to spend so much time on data entry and other menial work required to satisfy federal regulations, he is forced to choose between giving up all his personal time or severely curtailing the time he can spend really caring for patients. And ObamaCare is taking things to an absurd new level:

To prevent physicians from prescribing more costly medications and tests on patients, insurers are increasingly requiring physicians to obtain pre-authorizations. This involves calling a telephone number, often being rerouted several times and then waiting on hold for a representative. The process is demeaning and can take 30-45 minutes. Rather than having physicians pre-authorize expensive medications, the outrageous costs of many non-generic medications must be addressed. I understand that pharmaceutical companies need to make profits to cover investments in drug development. However, they should have some compassion for their customers.

To avoid Medicare penalties, I also must participate in the Physician Quality Reporting System program. Initially, this involved choosing three codes during the patient visit to reflect quality of care, such as blood pressure or blood-sugar control, and reporting them to Medicare. In 2015, the requirement will increase to nine codes.

Coming down the pike, but thankfully postponed from the October 2014 deadline, is something called ICD-10. This is a newer system that will contain about 70,000 medical diagnostic codes used for billing insurance. The present ICD-9 system has about 15,000 codes. The Physician Quality Reporting System and ICD-10 requirements are intended to benefit population research, but the effect is to turn physicians into adjuncts of the Census Bureau who spend time searching for codes—and to further decrease the amount of direct contact with patients.

The practice of medicine in the current environment is unsustainable. The multiple bureaucratic distractions in my day consume so much time that I have to give up what little personal time I have in the morning, evening and on weekends if I want to continue to provide excellent care during office hours.

Dr. Sklar also touches on a theme I've voiced often - that as much as possible without subjecting patients to unmanagable risks, we need get third-party payers out of health care. It's entirely doable, too. If most people who now have employer-provided health care realized how much of their paychecks was diverted into health insurance premiums, they would quicly realize they could divert most of it into health savings accounts from which they could simply pay for most of their basic care out of pocket - without having to involve insurance company bureaucracies, let alone the government kind.

The delivery of most basic health care would become dramatically less expensive if doctors and patients could simply make decisions without having to submit bills for approval from some other party (which of course has to get paid). There should still be insurance against catastrophic risk, but that should have little or nothing to do with basic day-to-day care.

As the experience of Dr. Sklar and so many others shows, however, we're going in exactly the opposite direction under ObamaCare. The governmetn is making the delivery of health care and the process of paying for it more complicated, more costly and more burdensome for everyone involved - all in the name of making it "affordable."

I realize some will offer nothing but crocodile tears for well-compensated physicians who complain about having to work late and do data entry, but those who see it that way should understand something. Doctors are human beings. They did not go to medical school to spend all their time doing make-work nonsense like this. And if this is the type of experience politicians and bureaucrats are determined to impose on doctors, guess what: We're going to have a lot fewer doctors. Why go into a profession if meddling outsiders are going to ruin the experience for you? Some will anyway, but if it keeps going in this direction, we will lose enough physicians that we will likely face a supply crisis in medical care.

Oh, by the way, you know what happens to prices when a service is in limited supply? There is nothing affordable about that scenario.

http://www.caintv.com/one-doctors-horror-story-of-pr

28 Democratic Senators Who Voted For Obamacare Are No Longer in Office

Posted by Jim Hoft on Wednesday, November 5, 2014, 9:12 PM



Today 28 of those senators are gone.

And, Mary Landrieu is expected to lose her runoff election in December.

The Examiner reported: http://www.washingtonexaminer.com/26...stom_click=rss

On Dec. 24, 2009, the Democratic-controlled Senate passed President Obama’s healthcare law with a filibuster-proof 60-vote majority, triggering a massive backlash that propelled Republicans to control of the House the following year. On the Senate side, going into Tuesday’s elections, 24 senators who voted for Obamacare were already out or not going be part of the new Senate being sworn in on January.

To be sure, it isn’t fair to attribute all of the turnover in the chamber to Obamacare. Many senators voted for Obamacare and lost re-election battles in which they were hit hard for their support for the law, and other Democrats were forced to retire because they had no hope of getting re-elected given their support for the law. But in some cases — such as John Kerry leaving his seat to become secretary of state, or Robert Byrd passing away — Obamacare clearly had nothing to do with it.

Additionally, some outgoing pro-Obamacare votes were replaced by new Democratic senators.

That having been said, as of this writing, 16 Senators who voted for Obamacare either failed to win reelection or declined to run for reelection and had their seats turned over to Republicans. That number is likely to grow once the results are in from the Senate runoff in Louisiana, which Mary Landrieu is expected to lose.

http://www.thegatewaypundit.com/2014...ger-in-office/