Patterico's Pontifications


The Premature Gloating of ObamaCare’s Fans

Filed under: General,Health Care,Obama — JVW @ 4:15 pm

[guest post by JVW]

This past spring and summer saw progressives giddy with triumph concerning the alleged success of ObamaCare in enrolling new customers. From academics to the usual interest groups to the President himself, we were deluged with stories about all the wonderful things that the Health Care Act had done for the country. With Chief Justice Roberts’ majority opinion in the King vs. Burwell case seeming to settle the issue of the bill’s legality, those who remained skeptical of the ability of the government to efficiently manage health policy in a nation of 330 million people were told to “get over it,” even by some on our own side.

But, as the saying goes, that was then. Yesterday’s Washington Post contained an interesting piece informing us that roughly a quarter of the people who chose a health plan this year through ObamaCare have since stopped paying for it. Of 12.7 million people who took out a plan in 2015, only 9.9 million were continuing to make payments by the end of June. This drop-off is significant numerically, and does not bode well for the big push coming next year as explained by the author:

For next year, congressional budget analysts are estimating that 21 million Americans will have health insurance through the exchanges — more than double the enrollment now.

Many health policy experts think that, in the two years since the marketplaces opened, they already have attracted the people who are easiest to enroll. Elizabeth Carpenter, a vice president of the consulting firm Avalere Health, said that the Congressional Budget Office has been assuming that sign-ups for 2016 will surge, because financial penalties will increase under a part of the law that requires most Americans to carry health insurance.

“The question is,” Carpenter said, “given where we are today, should we expect a slower ramp-up?”

Couple that with the expected rise in premiums forecast for next year which is once again likely to outpace the rise in family income, and 2016 could be a very important year for the future of government-managed health care, even apart from the matter of which party does well in the fall elections.

Addendum: Hat tip to Powerline for the link to the WaPo story.



Oh, But This is Rich!

Filed under: Education,General,Health Care,Public Policy — JVW @ 2:45 pm

[guest post by JVW]

A bunch of PhDs who apparently don’t understand the concept of irony:

Health Care Fixes Backed by Harvard’s Experts Now Roil Its Faculty (New York Times).



Obamacare turns two

Filed under: 2012 Election,Health Care — Karl @ 8:12 am

[Posted by Karl]

Obamacare turns two this week.  After the March 2012 Obamacare cost estimate was released, it became apparent that some — and not all lefty pundits — are upset with those noting that the gross cost is exploding as it is phased in.  Apparently, it’s just plain mean to remind everyone how Democrats used the phase-in to get the initial cost estimate under $1 trillion for political cover.  And most of the same people are also upset with those talking about the exploding gross cost because the CBO is also projecting more deficit reduction from increased mandate penalties.  As Conn Carroll notes:

To recap, the CBO now predicts that Obamacare: 1) will force millions more Americans out of their current employer coverage than originally advertised; 2) will force millions more Americans onto Medicaid than originally advertised; 3) will force millions more Americans to pay fines for not obtaining health care; 4) will force businesses to pay billions more in mandate fines; and 5) will leave millions more Americans without insurance than originally advertised.

But to Obamacare’s defenders in the leftosphere, increased fines are a feature, not a bug.  They also overlook all of the dubious assumptions on which the claim of deficit reduction is based.

In contrast, Pres. Obama has no plans to mark the two-year anniversary of his signature piece of domestic legislation.  His White House dodges its prior claims Obamacare would spur the economy.  HHS Secretary Kathleen Sebelius is unable to defend Obamacare’s impact on the debt, insurace costs, employer coverage, or the myriad waivers handed out to the politically-favored.  Unlike the dead-enders still defending Obamacare, Obama himself stands for reelection and can read the polls.  The “Terrible Twos” can be a painful thing for a Dad.



Visual ObamaCare

Filed under: Health Care — DRJ @ 12:01 pm

[Guest post by DRJ]

America’s Bewildering New Health Care System

Visual ObamaCare:

“In addition to capturing the massive expansion of government and the overwhelming complexity of new regulations and taxes, the chart portrays:

* $569 billion in higher taxes;

* $529 billion in cuts to Medicare;

* swelling of the ranks of Medicaid by 16 million;

* 17 major insurance mandates; and

* the creation of two new bureaucracies with powers to impose future rationing: the Patient-Centered Outcomes Research Institute and the Independent Payments Advisory Board.

[Texas Rep. Kevin] Brady admits committee analysts could not fit the entire health care bill on one chart. “This portrays only about one-third of the complexity of the final bill. It’s actually worse than this.”

A larger version and a .pdf version of the chart can be found at the GOP Joint Economic Committee website.



Texas Physicians are Opting Out of Medicaid

Filed under: Health Care — DRJ @ 1:25 pm

[Guest post by DRJ]

The Dallas Morning News reports Texas physicians are opting out of Medicaid:

“Just 32 percent of primary-care doctors are accepting Medicaid, according to a survey by the Texas Medical Association. And fee cuts threaten existing doctor-patient relationships, especially in North Texas.”

The head of Texas Health and Human Services Commission explains why more Medicaid cuts are inevitable:

“[Tom] Suehs, head of the Health and Human Services Commission, has said he’s sensitive to doctors’ gripes about low Medicaid payments, even as state GOP leaders order him to scrub programs for savings.

“No one ever wants to cut Medicaid,” said commission spokeswoman Stephanie Goodman. “It’s 75 percent of [the commission’s] budget. So when you start to identify places to reduce our budget, it gets very hard to skip Medicaid.”

But things will only get worse when ObamaCare makes deeper cuts and adds more patients. Texas physicians see government health care in their future and are opting out. As Mike K explains, even physicians who opt-out won’t be able to escape the government regulations and oversight that will compromise their professional independence and the integrity of the medical profession.



Obama’s Recess Appointment (Updated)

Filed under: Health Care,Obama — DRJ @ 12:23 pm

[Guest post by DRJ]

President Obama used a recess appointment to install Dr. Donald Berwick as the head of the agency running Medicare. However, President Obama circumvented the normal advise-and-consent process — Berwick’s nomination was never set for a hearing and thus was not considered by the Senate subcommittee charged with vetting his qualifications — even though the President’s political party is in charge of the vetting.

A memo from GOP Senator Chuck Grassley’s office suggests why Berwick’s nomination is a Democratic hot potato:

“The memo from a staffer for Sen. Charles Grassley (R-Iowa) suggests that by using a recess appointment to place Donald Berwick at the head of the agency running Medicare, the administration may be avoiding questions about whether Berwick’s healthcare institute received undisclosed funding from industry groups. The memo also raises questions with Berwick’s stance on euthanasia.
“I want to make sure it is absolutely clear up front that we were prepared for a nomination hearing to occur,” the staffer writes in the memo. “Furthermore, Senator Grassley had in fact requested that the hearing take place the week of June 21 (before the hearing on the Kagan nomination in Judiciary). So these items were not a precondition for holding the nomination hearing. Republicans were in no way holding up this process. We wanted the hearing.”

I think it’s pretty clear the Obama Administration didn’t want the hearing.


UPDATE 7/10/2010
— Republican Senator claims the Obama Administration planned this from the beginning:

“Senator John Barrasso, a leading spokesman for congressional Republicans on health care issues, today accused President Barack Obama of “intentionally misleading” the country and Congress by appointing Donald Berwick to run the Centers for Medicaid and Medicare Services. The White House yesterday announced that Berwick would receive a “recess appointment,” which allows the president to put a nominee in place without Senate confirmation.

“This appointment shows incredible arrogance on the part of the president and it makes a mockery of his promise to run a transparent administration,” said Barrasso, an orthopedic surgeon from Casper, Wyoming.

Barrasso repeatedly urged Obama to appoint someone to head CMS during the year-long health care debate that ended this past spring. In an interview this afternoon, Barrasso said that Congress did not yet even have all of the paperwork to conduct a hearing on the nomination. The Obama administration, he argues, planned to recess-appoint Berwick from the beginning in order to avoid a public debate over Berwick’s radical views. Barrasso says of Obama: “I think this was his intention all along.”

Barrasso and other Republicans have criticized Berwick since he was first mentioned for the CMS job. They point to his writings in favor of health care rationing and in praise of Britain’s state-run National Health Service (NHS). “I think the NHS is one of the great human health care endeavors on earth,” he said in a 2005 speech. “It can be an example for the whole world — an example, I must say — that the United States needs now more than most other countries do.”

Over the course of the health care debate, Democrats dismissed and even mocked those who described White House proposals as socialized medicine or a step toward a single-payer system.”


Democrats Kick the Medicare Can Down the Road While Decrying Can-Kicking

Filed under: Health Care,Obama — DRJ @ 5:23 pm

[Guest post by DRJ]

ObamaCare promised to expand health care without busting the budget. To do that, health care legislation omitted the so-called Doc Fix that prevents doctors from being hit with scheduled Medicare cuts. Just three months later, Doc Fix is back.

I guess this means the ObamaCare budget is officially busted.



Practicing Three-Star Medicine

Filed under: Health Care — DRJ @ 2:51 pm

[Guest post by DRJ]

Although she practices medicine in Texas, Dr. Stella Fitzgibbons published an Op-Ed in the LA Times today in which she chronicles the hardships she faces each day as her patients demand top-notch care when something less would suffice:

“Consider the case of a man I’ll call Mr. A. At the age of 80, he is admitted to intensive care after a huge stroke. He also has pneumonia and kidney failure. He is too sick to tell us his views on aggressive care at the end of life, but his family is happy to fill the void. They insist we use every tool at our disposal to prolong his life, despite brain scans making it clear that he will never again be able to walk, talk or feed himself. The total bill for the last month of life? Many tens of thousands of dollars.”

Fitzgibbons provides other examples. She refers to this as patients wanting “four-star” medical care when “three-star” care would do. Her message? It sounds like Fitzgibbons want us to know that unless the government dramatically increases funding of ObamaCare, we should get used to a different quality of care.

I think most Americans already see that coming, although some of us have already experienced it with doctors who have plenty of money but a deficit of time and patience.



A Health Care Defeat

Filed under: Health Care,Obama,Politics — DRJ @ 1:08 pm

[Guest post by DRJ]

As Steven Den Beste shows in his review of last year’s news, President Obama was revered a mere 365 days ago. Time and polls have changed that, even among his own Party:

“Not three months after lawmakers passed his $1 trillion insurance overhaul, Obama is facing a rare defeat on health care at the hands of his own divided Democrats. Moderates have rebelled against adding billions more to the deficit in a treacherous election year.”

It’s no wonder President Obama has returned to berating Republicans for opposing the most recent version of the Medicare Doc Fix. When times get tough, it always works to blame Republicans.



Oklahoma Legislature Passes Abortion Questionnaire Law

Filed under: Government,Health Care — DRJ @ 8:24 pm

[Guest post by DRJ]

The Oklahoma Legislature has passed an abortion questionnaire law over the veto of its Democratic Governor:

“The Oklahoma Legislature overrode Gov. Brad Henry’s veto of an abortion bill that will require women seeking abortions to complete lengthy questionnaires beforehand about their finances, education and relationships.

The Senate voted 33-15 on Tuesday to override the Democratic governor’s veto. The House easily voted to override the veto on Monday.

Of the eight abortion-related bills the Republican-controlled Legislature has passed this session, Henry vetoed two others. One, which would require women to undergo an ultrasound and listen to a detailed description of the fetus before receiving an abortion, is on hold because of a legal challenge.

“It’s disappointing because every veto override just triggers more lawsuits and legal bills for taxpayers,” said Henry spokesman Paul Sund. “Similar abortion laws passed by the Legislature were challenged and thrown out by the courts last year, and the latest versions are probably headed for the same fate.”

The litigation issue doesn’t concern me since few laws emerge without some legal challenge, but I’m still concerned about this law. Supporters claim it will generate information that makes it easier to understand why women seek abortions:

“The most recent bill mandates women complete a 38-question form, which includes multiple subsections, answering questions about their race, education, income, relationships and reasons for seeking an abortion.

Doctors will be required to fill out an 11-question form about any complications that arise during the procedure. Those who fail to comply could face fines or the loss of their licenses.

The information from the questionnaires will be compiled by the Oklahoma State Department of Health and posted on the agency’s website, but must not include the woman’s name, address, hometown or other identifying information.

Supporters say the information will help lawmakers understand why women get abortions and craft policies to prevent more of them from occurring.

“This is to stop future abortions from happening,” said Sen. Clark Jolley, R-Edmond, who sponsored the bill in the Senate. “This is about gathering data to prevent the need for women to make this choice.”

However, concerns expressed by one GOP Senator make sense to me:

“But Republican Sen. Jim Reynolds of Oklahoma City, who opposes abortion, voted against the bill and said he found it “appalling” that information from a personal questionnaire regarding a medical procedure would be provided to a government entity.”

I don’t want the government prying into my health decisions, and I agree that laws like this open the door to more and more official data-gathering.


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