Today, it was announced that a panel of the Appeals Court in Cincinnati had voted that the requirement that all American citizens maintain minimum health insurance or be fined was reasonable by a 2-1 margin. This is the first major victory for Obama Care in the Appeals Court arena. However, this is not the end of the fight. Supporters of repeal can request a full hearing by the Circuit or they could appeal it directly to the Supreme Court. Those decisions have not been made.
What does this mean for you and I. At the present moment, not very much, however, if this trend of muddle headed judges (is that too strong) continues, we could well see our country saddled with Obama Care forever. It will not be good when 1/6 of the economy is controlled by the government. They cannot run the post office profitably or run the trains on time so to expect them to run the health care system, a significantly more complex business, successfully will guarantee you a trip to the funny farm.
Government never has been run any business with any sort of acumen. Why? Profit motive! A business has to make money but the government does not. Where a business person might not add personnel until they are needed, the government bureaucrat will add them without regard to how well the program is doing. He does so because the more people he has working for him, the higher is his salary. The motivation is not success but to get more people under him/her.
If the company is not profitable, the business person closes up their shop. Not so for the government program. It soldiers on, changing direction and asking for more support from the taxpayers so that those using the service will not be left without. Amtrak is a great example. The railroad business at the beginning of the 20th century was a massive business generating millions of dollars in business.
With the advent of the airplane, the passenger train business declined to such numbers that it could no longer be viable. So government in its great wisdom decides that "we needed" to maintain this business, so Amtrak was started.
Amtrak has never been profitable and probably never will for a couple reasons. First of all, air fares are low making flying cheaper and forcing the passenger rail business to compete with even lower fares. Secondly, planes are much faster. You can fly across the country in a matter of hours verses days on the train. Trains are great is you are in no hurry to get where you want to go, but in today's world where everything is rush rush, the market for slow is very limited.
So why do we keep supporting this dinosaur? Politics, nostalgia and inertia are the only reasons that make any sense. I am sure some Representatives and Senators have supporters who want rail traffic to continue. Maybe they have a business that builds locomotives (for example, General Electric) or rail cars that are made in their district and losing Amtrak would result in a loss of jobs. Additionally, we still love to watch trains and remember when they were THE way to travel. However, we have always had trains so why should we stop now is probably the real reason for Amtrak. Does it make sense, no.
Now we are looking to the same bureaucrats who run the Post Office and Amtrak to run our health system when never in the history of the world has one operated at a break-even no less a profit nor has the benefits been delivered in as cost-effective manner as the planners and promoters of the system have predicted. Most times benefits are "rationed" by various screens to provide services to those who will benefit most from the operation or product. If you are too old or too ill, you will be passed over for someone else. In Canada, anyone over 65 cannot get a heart bypass regardless of their health. Sorry pal, those dollars are for younger people. So, they come to the United States and pay for it themselves.
I am not looking forward to seeing the United States' great health system (it has problems that could be rectified) descend to disgrace because we did not speak out and encourage change. Obama Care, especially in these economic times, will be the absolutely wrong medicine for the medical business. Let's work to make sure it gets repealed.
The following article relates more of the details of today's court action. Let us know what you think, write a comment.
CINCINNATI (AP) — In the first ruling by a federal appeals court on President Barack Obama's health care overhaul, a panel in Cincinnati affirmed Wednesday that Congress can require Americans to have minimum insurance coverage.
A conservative law center had challenged the measure, arguing on behalf of plaintiffs who said potentially being required to buy insurance or face penalties was subjecting them to financial hardship. They warned that the law was too broad and could lead to more federal mandates.
The Thomas More Law Center, based in Ann Arbor, Mich., argued before the panel that the law was unconstitutional and that Congress overstepped its powers.
The government countered that the measure was needed for the overall goal of reducing health care costs and reforms such as protecting people with pre-existing conditions. It said the coverage mandate will help keep the costs of changes from being shifted to households and providers.
The three-judge 6th U.S. Circuit Court of Appeals panel delivered a long opinion with disagreement on some issues.
A George W. Bush appointee concurred; a Ronald Reagan appointee who is a U.S. district judge in Columbus sitting on the panel disagreed. Judges are selected for panels through random draw.
An attorney for Thomas More said the center expects to appeal. It could ask for the full circuit court to review the case or go on to the U.S. Supreme Court.
More than 30 legal challenges have been filed over the health care overhaul, some focusing on different issues.n to you and I?
What does this mean for you and I. At the present moment, not very much, however, if this trend of muddle headed judges (is that too strong) continues, we could well see our country saddled with Obama Care forever. It will not be good when 1/6 of the economy is controlled by the government. They cannot run the post office profitably or run the trains on time so to expect them to run the health care system, a significantly more complex business, successfully will guarantee you a trip to the funny farm.
Government never has been run any business with any sort of acumen. Why? Profit motive! A business has to make money but the government does not. Where a business person might not add personnel until they are needed, the government bureaucrat will add them without regard to how well the program is doing. He does so because the more people he has working for him, the higher is his salary. The motivation is not success but to get more people under him/her.
If the company is not profitable, the business person closes up their shop. Not so for the government program. It soldiers on, changing direction and asking for more support from the taxpayers so that those using the service will not be left without. Amtrak is a great example. The railroad business at the beginning of the 20th century was a massive business generating millions of dollars in business.
With the advent of the airplane, the passenger train business declined to such numbers that it could no longer be viable. So government in its great wisdom decides that "we needed" to maintain this business, so Amtrak was started.
Amtrak has never been profitable and probably never will for a couple reasons. First of all, air fares are low making flying cheaper and forcing the passenger rail business to compete with even lower fares. Secondly, planes are much faster. You can fly across the country in a matter of hours verses days on the train. Trains are great is you are in no hurry to get where you want to go, but in today's world where everything is rush rush, the market for slow is very limited.
So why do we keep supporting this dinosaur? Politics, nostalgia and inertia are the only reasons that make any sense. I am sure some Representatives and Senators have supporters who want rail traffic to continue. Maybe they have a business that builds locomotives (for example, General Electric) or rail cars that are made in their district and losing Amtrak would result in a loss of jobs. Additionally, we still love to watch trains and remember when they were THE way to travel. However, we have always had trains so why should we stop now is probably the real reason for Amtrak. Does it make sense, no.
Now we are looking to the same bureaucrats who run the Post Office and Amtrak to run our health system when never in the history of the world has one operated at a break-even no less a profit nor has the benefits been delivered in as cost-effective manner as the planners and promoters of the system have predicted. Most times benefits are "rationed" by various screens to provide services to those who will benefit most from the operation or product. If you are too old or too ill, you will be passed over for someone else. In Canada, anyone over 65 cannot get a heart bypass regardless of their health. Sorry pal, those dollars are for younger people. So, they come to the United States and pay for it themselves.
I am not looking forward to seeing the United States' great health system (it has problems that could be rectified) descend to disgrace because we did not speak out and encourage change. Obama Care, especially in these economic times, will be the absolutely wrong medicine for the medical business. Let's work to make sure it gets repealed.
The following article relates more of the details of today's court action. Let us know what you think, write a comment.
US appeals court upholds Obama health care law
CINCINNATI (AP) — In the first ruling by a federal appeals court on President Barack Obama's health care overhaul, a panel in Cincinnati affirmed Wednesday that Congress can require Americans to have minimum insurance coverage.A conservative law center had challenged the measure, arguing on behalf of plaintiffs who said potentially being required to buy insurance or face penalties was subjecting them to financial hardship. They warned that the law was too broad and could lead to more federal mandates.
The Thomas More Law Center, based in Ann Arbor, Mich., argued before the panel that the law was unconstitutional and that Congress overstepped its powers.
The government countered that the measure was needed for the overall goal of reducing health care costs and reforms such as protecting people with pre-existing conditions. It said the coverage mandate will help keep the costs of changes from being shifted to households and providers.
The three-judge 6th U.S. Circuit Court of Appeals panel delivered a long opinion with disagreement on some issues.
A George W. Bush appointee concurred; a Ronald Reagan appointee who is a U.S. district judge in Columbus sitting on the panel disagreed. Judges are selected for panels through random draw.
An attorney for Thomas More said the center expects to appeal. It could ask for the full circuit court to review the case or go on to the U.S. Supreme Court.
More than 30 legal challenges have been filed over the health care overhaul, some focusing on different issues.n to you and I?
The Congressional Budget Office, the Medicare trustees report, and other independent economists have analyzed the ACA and concluded that it will achieve substantial cost savings compared to status quo.
ReplyDeleteI also showed you awhile back that the European and Canadian systems provide nearly universal health care with better health outcomes by most statistical indicators at about half the cost per capita compared to our privatized system.
This shows that a for-profit corporation is very good at creating profits, while not so good at cost control for consumers. Of course, this only applies to those who actually have health insurance. We now have a record 50+ million people who have no health insurance at all. They get care mostly at hospital emergency rooms, which is the most costly and least cost-effective way to deliver health care. You and I subsidize their health care, because the doctors and hospitals pass along those costs to us through higher prices for services. This may not be Amtrak, but it is a horrible way to run a railroad -- or health care system!
Speaking of Amtrak, I don't think that is an appropriate analogy, because the health care system under the ACA remains privatized. (Unfortunately, the "public option" was defeated in the Senate.)
However, there is a "public option" that we can use for comparative purposes. The VA runs the largest integrated health-care system in the country. They consistently beat the private system in quality of care, cost control, and customer satisfaction…
http://www.vacareers.va.gov/career-life/cutting-edge/quality-care.asp
Now, if you can complain about Amtrak, then allow me to complain about my own health insurance company -- United Healthcare. Their customer satisfaction scores are horrible -- one of the worst in the industry, which I can understand from years of personal experience.
National Committee for Quality Assurance is an excellent source of objective comparative data. They rank United Healthcare in 60th place among other private health insurance providers. Have you seen the United Healthcare public relations advertising on TV (featuring the girl on the surf board with her mother talking about their wonderful customer service?). I see AARP dropped them, probably due to complaints. UHC provides a lot of Medicare supplemental. In fact, their TV ad claims they have 70 MILLION customers! Unfortunately, my wife and I are locked into them unless our pension provider changes insurers.
--David
David, Point one, please get a copy of the law or a summary and you will find that anyone who says this plan will save money is smoking funny cigarettes. You will notice there are a multitude of appropriations that are worded "$x in FY 2010 and WHATEVER is necessary in FY 2011-2015." How can you say with a straight face that you know what the spending will be in those out years?
ReplyDeletePoint 2--most of the uninsured are 22-40 year olds who feel they are invincible and do not need insurance. I face parents each day with that concern.
Point 3 - Obama Care in 2014 will result in 50% of the companies dropping their coverage instead of continuing to pay. Companies have done the math, continiue to pay premiums of 5, 10, or 20,000 per year or pay a $2000 fine. Doesn't take a Rhodes Scholar to figure those numbers. Talk about a crisis when that happens! Immediately, the call will be for the public option due to the great number of uninsureds!
Point 4--I sell United Health and have had very good results with their claims paying verses Blue Cross of Michigan from which I just keep having terrible results. My problem is that if someone is sick, their only choice is Blue Cross as they have to take everyone.
Point 5--Anyone with a pension should be elated as they hardly exist in the private sector. Each month when I pay $1700 per month for my health insurance, it grinds me when public employees complain about their "massive" $50 monthly premium for their family.
Lastly point 6--recent studies destroy the Obama assumptions that the plan would be less than current. We will not have the savings as promised.
Keith, from one cowpoke to another, I looked at your site and think we should link up as we have similar thoughts and interests.
ReplyDeleteWelcome to the fight to make the United States rationale again.
Tom
You wrote,"How can you say with a straight face that you know what the spending will be in those out years?"
ReplyDeleteI believe that the Congressional Budget Office and the Medicare trustees report do not base the projections on exact estimates of costs and savings from each component of ACA. They look at the overall structure of the changes. You can look at the health care systems in places like Switzerland and Albania to see that they institute a lot of the same kinds of cost controls into their healthcare system that the ACA envisions. You only have to compare the growth rate of private insurance in the U.S. to growth rates other countries (or even our own Veterans hospitals or Medicare) to see that this is the general direction we need to go in order to get our per capita costs closer to that of the rest of the industrialized world. Anybody who looks seriously at the international data and can't see that must, in my opinion, be smoking something.
Here is an excerpt from the Medicare Trustees report…
"The financial outlook for the Medicare program is substantially improved as a result of the changes in the Affordable Care Act. In the long range, however, much of this improvement depends on the feasibility of the ACA’s downward adjustments to future increases in Medicare prices for most categories of health care providers. The development and implementation of new models for delivering and paying for health care have the potential to reduce cost growth rates to the level established by the statutory price updates, but specific outcomes cannot be assessed at this time….Although the magnitude of the shortfalls is reduced substantially by various Affordable Care Act provisions, the HI trust fund still does not meet the short-range test of financial adequacy. In the long range, projected HI expenditures and scheduled tax income are much closer to balancing because of the legislation, if the slower price updates can be continued indefinitely. If not, and prices are increased, then HI income and expenditures will remain substantially out of balance. Under either scenario, the trust fund does not meet the test of long-range close actuarial balance…The Affordable Care Act introduced important changes to the Medicare program that are designed to reduce costs, increase revenues, expand the scope of benefits, and encourage the development of new systems of health care delivery that will improve health outcomes and cost efficiency."
--David
Continued….
ReplyDeleteYou wrote, "Point 2--most of the uninsured are 22-40 year olds who feel they are invincible and do not need insurance. "
So? My point is that they are not invincible, and their trips to the ER are costing the rest of us a lot of money. That is a major reason why our per capita costs are so much higher than other rich countries and our outcomes so much worse. Having 50+ MILLION uninsured is a huge drag on our economy and the health of our country.
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Point 3 - Obama Care in 2014 will result in 50% of the companies dropping their coverage instead of continuing to pay. Companies have done the math, continiue to pay premiums of 5, 10, or 20,000 per year or pay a $2000 fine.
This is nonsense. Ask yourself, why don't companies today just drop health care for all their employees and save themselves the money? The ACA puts regulatory constraints on their escalation of premium fees. Today, they can -- and have -- increased premiums by 30% annually -- while core inflation is only 3%. They are exercising their oligopolistic pricing power.
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Point 4--I sell United Health and have had very good results with their claims paying verses Blue Cross of Michigan…
Okay, so they aren't as bad as Blue Cross. We have a battle with UHC every year just with our claims for annual checkups.
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Point 5--it grinds me when public employees complain about their "massive" $50 monthly premium for their family.
You are proving my point about the high cost of private insurance. We pay UHC $530 per month and they jack up our rates every year (this year it went up 18%). Under the ACA, they are required to cost-justify anything over 10%.
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Lastly point 6--recent studies destroy the Obama assumptions that the plan would be less than current. We will not have the savings as promised.
Were the "recent studies" financed by private insurance companies or some conservative "think-tank"? No thanks. I will rely on CBO, Medicare Trustees, etc. analysis.
--David
David, we will have to disagree on this. When Obama Care completely becomes law, the unintended results of the bill "that we have to sign so we can find out what is in it" per Nancy Piiosi will come to reality and you will be shocked.
ReplyDeleteMedicare loses $500 million under Obama Care, wait to see those increases.
Obama Care unconstitutionally requires me to purchase a product--that is NOT freedom. If you argue, car insurance, that is not a comparison due to the fact that you do not need to own a car.
Don't you understand why the rates are going up now? The companies have to meet an annual calculation of premiums verses paid claims. In small groups that percentage is 80% and for larger groups 85%. If the percentage is under 80, they have to refund premiums and if claims are over 80, the company eats the loss and has no opportunity to make it up. This has two unintended results. First companies are raising premiums now to stock pile money to prepare for unreimbursed losses which inevitably will occur. Secondly, in those years where the percentage is nearing 80 in the latter months of the year, ALL claims will be denied regardless of validity to avoid a loss. I am sure that is going to make you very happy when your claim for your heart bypass is rejected and you are forced to pay for it or be sued by the doctor and hospital.
Also doctors are going to leave the practice by the thousands when Obama Care comes into full force. So we are going to have millions of new patients and not enough doctors, that is going to be a wonderful thing! Wrong!
Additionally, please tell me how 6 years of expenses can equal 10 years of income and be a zero sum gain. Obama care comes to be in 2014 and the income started in 2010. By 2020, we are supposed to be equal. Sounds like funny math to me.
Obama Care is a very poor program, intended to descimate the public health system we have. Bad idea
David, I thought that you are a libertarian, a person who thinks for himself, who wants to be left alone? ObamaCare is just the opposite. It forces you to buy something that you might not want. It takes away your rights as a free man to make and suffer from your decisions. I am confused. Please explain.
ReplyDelete"A health policy analyst with the National Association of Insurance Commissioners told us that "as a general trend across all carriers in a state … there’s about a 1 to 2 to 3 percent increase" in premiums in the individual market due to the health care law. If the legislation hadn’t been enacted, the bulk of the reported premium increases still would have occurred. "The real driver of the premiums is the costs, and you have to get the costs under control," the NAIC analyst said.
ReplyDeleteThese premium increases are mainly in the individual market, where about 14 million people buy their own insurance. That’s only about 6 percent of those with health coverage (non-elderly) in the U.S.
Stephanie Marquis of the Washington State Office of the Insurance Commissioner told us that rate changes requested because of the health care law are expected to be less than 5 percent, while increases in premiums due to rising medical costs average 13.12 percent for individual plans and 15.54 percent for small-group plans."
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According to the above experts, the premiums have increased mostly because of the costs not associated with the implementation of the ACA. The ACA requirements regarding the medical loss ratio will hopefully get their administrative costs reduced without them simply raising the premiums through the roof to make up the difference. The requirement that they must cost-justify any annual premium increase over 10% will achieve that, assuming it is enforced. So we get more money spent on patient care and less on themselves.
Check this article also….
http://www.nytimes.com/2011/03/05/health/policy/05cost.html
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To answer your other question: As a Libertarian, I do not like that we have to pay for all those ER visits by those "invincible" young people. By gambling that they won't get sick, they are gambling with your money and my money. A Libertarian says you have to live with the consequences of your own decisions, not force others to pay when you gamble and lose. If you read the federal court decision carefully, I think what they are saying is that the function of the ACA under the commerce clause is to regulate health care costs for the nation, and the individual mandate is a tool in that process. Why should we pay while others who could pay free-load on our dime?
What's worse, it makes the entire health care system extremely costly and inefficient when we have 50+ million people uninsured. It is just a really stupid way to organize a health care system, which is why we are the only rich country in the world that does it this way. You are right, though, we aren't going to agree on this.
--David