We wrote about the problems with ObamaCare over the past years and there have been detractors who felt that we were just against it because Obama wanted to have the plan. The supporters suggested we were foolish to think there would be problems. We were told that this was a wonderful plan and would save money. (Hey, they had a Congressional Budget Office (CBO) office report that said so.) Sarah Palin was ridiculed by suggesting there might be "death panels."
Now that we have had some time to digest the plan, see "review panels" aka death panels, we realize that we were on the right path and the deniers were uninformed. The CBO has revisited the plan and has determined that the cost has doubled and the number of people who will lose their employer paid insurance is seven times the number in the original document! We believe both of those numbers are significantly low and expect that costs will quintuple or worse and that most employees will lose their employer provided coverage by 2017.
Anyone who has taken the time to review the plan in detail will notice a recurring phrase. It is an open door, an unrestrained limit on spending. That phrase is "and whatever is needed in years x through y." In other words, should HHS determine that an initial funding of, for example, $25 million is not enough for a plan provision in subsequent years, they are authorized to spend $250 million or more. There is no cap on the spending on this bill! A great example is under the "Trauma Care Centers and Service Availability " section of the law. The law appropriates $100 million for Fiscal Year (FY) 2009 and "such sum as may be necessary for FY 2010 through FY 2015." Please tell us how the CBO could "score" this and make any reasonable assumptions?
Another example is the "Community Transformation Grants" which is essentially Michelle Obama's school children healthy foods and exercise program. The Law authorizes "appropriated sums as may be necessary to carry out this section for each of FY 2010-2014." Score that for me CBO? Is that $1 million for $780 million? No one knows.
These are a couple examples of the malfeasance in this law. When you start reading it, even the summary, one wonders who will ever get their hands around the entire mess. That's probably the reason for hiring all the attorneys and IRS agents. We got to keep these pesky citizens in line.
In the following post, Larry Elder, covers some other unintended results of ObamaCare. Don't read it on an empty stomach.
Conservative Tom
ObamaCare Still a Disaster -- No Matter How the Supreme Court Decides
"I am a refugee," my anesthesiologist told me after I had awakened from my third surgery in 12 years -- one to repair a muscle tear in my left shoulder and two for the same disc in my lower back. "I am part of the British 'brain drain' of the late '60s. Doctors could not make any money. So I left." Britain's loss, my gain. The same surgery 12 years ago required a two-day stay in a hospital. Last week, after a two-hour surgery, I left the same day as an outpatient.
But under ObamaCare, we can expect a loss of talent and a decline in quality of care. Thousands of us, the doctor explained, abandoned England to practice medicine in America. "So, how's this?" my doctor said. "I left the U.K. to get away from the government telling me how to practice, what to charge -- and now we are getting the same thing. ObamaCare stinks, and the people will regret it. What happened to the docs there will happen here."
Great Britain began practicing socialized medicine through the taxpayer-funded National Health Services in 1948. And indeed, one of the first U.K. studies on the emigration of their native-born physicians, "British Doctors at Home and Abroad," published in 1964, noted that, beginning in the 1950s, their docs were leaving for "high-income" countries at an alarming rate: "Many of them stressed the wider field of work they could undertake in general practice abroad and criticized the limited role of the general practitioner in England." And nearly half a century later, Britain's "brain drain" continues.
Medical advances require research and development. And as much as government spends on health care and medical research, the private sector spends much more. But ObamaCare places a tax on medical equipment manufacturers, to raise $20 billion for the federal coffers when it goes into full effect in 2013. As a result, some medical device manufacturers are already closing up shop or downsizing to reflect lower profits under ObamaCare. Some canceled plans for new U.S. plants, looking to other parts of the world. Many manufacturers have already announced significant layoffs, and most also look to other alternatives, including cutting research and development, and passing along the tax's costs to the patients.
In addition to the excise tax on medical device manufacturers, ObamaCare imposes many more taxes, including the following: an individual mandate excise tax for adults who don't purchase "qualifying" health insurance; an employer mandate tax for those companies who don't offer health coverage; and a surtax on investment income -- making the rate as high as 43.4 percent on gross income from interest, annuities, royalties, net rents and passive income for families making more than $250,000. Given this, will we see the same private-sector investments in the health care field, as ObamaCare imposes ever more regulations designed at increasing "accessibility" and "controlling costs"?
What about costs?
Obama promised that ObamaCare would "bend the cost curve" down. The Congressional Budget Office just released new figures on the 10-year cost of ObamaCare. Starting in 2010, government began taxing for ObamaCare to build up revenues. So for the first four years, ObamaCare takes in tax money but does not start spending in any significant amount until 2014. This was a tactic designed to make ObamaCare seem more "affordable."
But even with this gimmick, the CBO just doubled its original projections for the cost of ObamaCare. Now, the CBO pegs the cost to taxpayers at $1.76 trillion over the next decade. And, critics point out, this price tag is only for the cost of insurance subsidies, Medicaid and CHIP (Children's Health Insurance Program). It doesn't include implementation or other costs, which will likely send the taxpayers' bill soaring past $2 trillion.
Obama said his plan would save American families $2,500 a year on their insurance premiums. The new CBO report says premiums will rise 10 to 13 percent, and that up to 20 million people could lose their employer-provided health insurance every year from 2019 to 2022, a sharp revisal of its previous estimate of up to 3 million.
Oh, it all seems so lovely on paper, doesn't it?
Sen. Obama said that if he were "starting from scratch," he'd have a single-payer system. This is what they have in Canada. But when a high-ranking member of the Canadian government -- and proponent of the Canadian health care system -- needed surgery, he did not stay home. After having his 2010 heart surgery performed in Miami, Canadian Premier Danny Williams told reporters: "This was my heart, my choice, and my health. I did not sign away my right to get the best possible health care for myself when I entered politics."
Consider what the then-incoming president of the Canadian Medical Association said about their single-payer health care system: "(Our) system is imploding." Consider what the outgoing president said: "Competition should be welcomed, not feared."
My doctor remains cheerful. "I retire in a few years," he said. "Then it's your problem."
Fact-checking...
ReplyDelete"Q: The president claimed the Affordable Care Act would cost $900 billion. But the Congressional Budget Office scored the next 10 years of the program and came to a number of $2.4 trillion. Why the discrepancy?
A: There are a lot of people who are misreading this latest cost estimate by the Congressional Budget Office. What it actually found is that the law will cost about $50 billion less than it estimated last year.
Now why are people saying it will cost twice as much? Because they're looking at gross spending, not net spending. And why is gross spending so much bigger? Because the Congressional Budget Office estimates in 10 year increments. And when it first estimated how much it would cost, it includes years in which most of the law wasn't in effect. So now that these 10 year estimates include more years when the law is in force, and the federal government will be paying for more people on Medicaid and more people getting subsidies to help them buy insurance, it will obviously cost more. But the federal government will also be collecting more money to help offset that cost, through a variety of new taxes and fees.
Thus, the overall cost is about $1.1 trillion. But it's all paid for. Now you might still disagree about whether it's a good idea to expand government and expand taxes and fees to pay for it. But this latest CBO estimate in no way says the cost has doubled since the law was passed."
http://www.npr.org/blogs/health/2012/03/22/149164172/answers-to-your-questions-about-the-health-care-overhaul-law
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Tom, I come back to the international data. Other countries with universal health care have statistically better health outcomes at half the per capita costs as the U.S. The sooner and closer we can get there (and away from leaving ourselves at the tender mercies of for-profit health insurance companies and their practices) the better it will be for the health of the nation as a whole as well as the costs of health care.
By the way, it is unrealistic to expect the CBO to come up with a precise cost estimate for every single item, but the items you are complaining about are not a large proportion of overall costs in any case. So, even if those estimates are too low, it would not have a substantial impact on overall costs. The main cost savings will come from other parts of the program, especially getting more preventive care and finally containing fees and the premium increases of the insurance companies.
--David