Tag Archives: Doctor

By any measure, Obamacare has been a disastrous failure

Well, the law was supposed to take until now to come into full effect. Now that we are getting the full Obamacare, what are we seeing?

The Wall Street Journal says not enough of the young Democrats who voted for Obamacare are signing up for it:

This month the Health and Human Services Department dramatically discounted its internal estimate of how many people will join the state insurance exchanges in 2016. There are about 9.1 million enrollees today, and the consensus estimate—by the Congressional Budget Office, the Medicare actuary and independent analysts like Rand Corp.—was that participation would surge to some 20 million. But HHS now expects enrollment to grow to between merely 9.4 million and 11.4 million.

Recruitment for 2015 is roughly 70% of the original projection, but ObamaCare will be running at less than half its goal in 2016. HHS believes some 19 million Americans earn too much for Medicaid but qualify for ObamaCare subsidies and haven’t signed up. Some 8.5 million of that 19 million purchase off-exchange private coverage with their own money, while the other 10.5 million are still uninsured. In other words, for every person who’s allowed to join and has, two people haven’t.

Among this population of the uninsured, HHS reports that half are between the ages of 18 and 34 and nearly two-thirds are in excellent or very good health. The exchanges won’t survive actuarially unless they attract this prime demographic: ObamaCare’s individual mandate penalty and social-justice redistribution are supposed to force these low-cost consumers to buy overpriced policies to cross-subsidize everybody else. No wonder HHS Secretary Sylvia Mathews Burwell said meeting even the downgraded target is “probably pretty challenging.”

The program doesn’t work unless young, poor, healthy people are forced to pay for the health care of rich, older, sickly people.

The radically leftist New York Times reports that out of the 22 health insurance co-ops Obamacare created, nine of them have already closed – leaving customers without coverage.


The grim announcements keep coming, picking up pace in recent weeks.

About a third, or eight, alternative health insurers created under President Obama’shealth care law to spur competition that might have made coverage less expensive for consumers are shutting down. The three largest are among that number. Only 14 of the so-called cooperatives are still standing, some precariously.

The toll of failed co-op insurers, which were intended to challenge dominant companies that wield considerable power to dictate prices, has left about 500,000 customers scrambling to find health insurance for next year. A ninth co-op, which served Iowa and Nebraska, closed in February.

At a time when the industry is experiencing a wave of consolidation, with giants like Anthem and Aetna planning to buy their smaller rivals, the vanishing co-ops will leave some consumers with fewer choices — and potentially higher prices.

The failures include co-ops in New York, Colorado, Kentucky and South Carolina.

The shuttering of these start-ups amounts to what could be a loss of nearly $1 billion in federal loans provided to help them get started. And the cascading series of failures has also led to skepticism about the Obama administration’s commitment to this venture.

UPDATE: A day after this was posted, another IRS co-op has just closed, this time in Utah. Now we are up to 10 out of 22.

Cato Institute health care expert Michael Tanner talks about the increases in health care premiums caused by Obamacare at CNS News:

For example, insurance companies have begun submitting their requests for rate increases for 2016, and those requests suggest that premiums could skyrocket next year. Already we’ve seen requests for increases for individual plans as high as 64.8 percent in Texas, 61 percent in Pennsylvania, 51.6 percent in New Mexico, 36.3 percent in Tennessee, 30.4 percent in Maryland, 25 percent in Oregon, and 19.9 percent in Washington. Those increases would come on top of premium increases last year that were 24.4 percent above what they would have been without Obamacare, according to a study from the National Bureau of Economic Research. At the same time, deductibles for the cheapest Obamacare plans now average about $5,180 for individuals and $10,500 for families.

Recall that on this blog, pretty much all of 2009 and 2010 was spent carefully explaining the moral hazards and other problems created by Obamacare. This was stuff that Republicans knew would happen. But on the other side of the aisle, there was too much naive, youthful exuberance from the secular left. Evidence was ignored, and feelings won the day. Obamacare was passed on the memes and tweets, while the studies reported by people like me went entirely unread.

Investors Business Daily just posted a list of 12 problems with Obamcare for the middle class:

Remember how many times I blogged about this one:

6. Shorter Workweeks

Because ObamaCare’s employer mandate fines don’t apply for workers who average fewer than 30 hours per week, the law gives companies an incentive to put a cap on workhours — particularly for low-wage workers who are less likely to be offered coverage.

The impact isn’t big enough to show up in economywide data, but there’s little doubt that the employer mandate has hurt a lot of people. IBD found 450 employers that capped workhours, and Current Population Survey data show a dive in the share of workers clocking just above 30 hours per week.

And what about the penalty for not buying what the government tells you to:

7. Impact On Wages

In 2016, a company with 50 full-time-equivalent workers could face a penalty of $2,160 per employee (with 30 workers exempted). When the after-tax fine is converted to tax-deductible wages, it equates to $1.71 an hour for a full-time worker.

Who will pay the penalty? For the most part, it won’t be employers — at least not directly. The CBO expects that “the penalty will be borne primarily by workers in the form of reduced wages or other compensation.”

Again, I want to emphasize that it is the evidence-hating secular left that is surprised by these “unexpected” problems with their childish policy. Those of us on the religious right predicted them, because we read the studies that were done before the 2012 election.

The Wall Street Journal reports that the economy’s not doing so well, either:

Changes in quarterly earnings and revenue for S&P 500 companies
Changes in quarterly earnings and revenue for S&P 500 companies

In 2006, we handed both the House and Senate to Democrats. The national debt was $8.5 trillion. In 2008, we handed the Presidency to the Democrats. The national debt was $10 trillion. After 10 years of Democrats, we now have a national debt of $18.5 trillion. It has been a long, low-interest, no-growth Keynesian binge. The kind of economics you expect from a socialist community organizer.

Obama said Obamacare would not add to the deficit, CBO says it adds $1.35 trillion

In the video above, Obama promised the American people that his health care plan would not add one dime to the deficit. And the low-information voters who voted for him believed him. Just like they believed that they could keep their doctor, that they could keep their health care plan, that Obamacare would lower the costs of health care, that Benghazi was caused by a YouTube video, and so on.

So how much did Obamacare add to the deficit?

The UK Daily Mail has the latest numbers from the Congressional Budget Office.


It will cost the federal government – taxpayers, that is – $50,000 for every person who gets health insurance under the Obamacare law, the Congressional Budget Office revealed on Monday.

The number comes from figures buried in a 15-page section of the nonpartisan organization’s new ten-year budget outlook.

The best-case scenario described by the CBO would result in ‘between 24 million and 27 million’ fewer Americans being uninsured in 2025, compared to the year before the Affordable Care Act took effect.

Pulling that off will cost Uncle Sam about $1.35 trillion – or $50,000 per head.

The numbers are daunting: It will take $1.993 trillion, a number that looks like $1,993,000,000,000, to provide insurance subsidies to poor and middle-class Americans, and to pay for a massive expansion of Medicaid and CHIP (Children’s Health Insurance Program) costs.

Offsetting that massive outlay will be $643 billion in new taxes, penalties and fees related to the Obamacare law.

That revenue includes quickly escalating penalties – or ‘taxes,’ as the U.S. Supreme Court described them – on people who resist Washington’s command to buy medical insurance.

It also includes income from a controversial medical device tax, which some Republicans predict will be eliminated in the next two years.

If they’re right, Obamacare’s per-person cost would be even higher.

Did Obama know that he was lying when he said that his health care plan would not add one dime to the deficit?

Well, his buddy Gruber, the architect of Obamacare, certainly did:

But we should not be surprised, either by the low intelligence levels of Democrat voters or by the lies of Democrat politicians. After all, they want single payer health care – look what Harry Reid says:

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.”

And they know – from looking up North to Canada – that single-payer health care will necessarily involve massive increases in taxes.

CTV News describes a recent study on the costs of single-payer health care in Canada:

A typical Canadian family with two parents and two kids will pay up to $11,786 for public health care insurance this year, according to a new study from the conservative think tank Fraser Institute.

Using data from Statistics Canada and the Canadian Institute for Health Information, the Fraser Institute study estimated the amount of taxes Canadian families will pay for public health insurance this year.

What do you get for $11,786?

You get to be on a waiting list for a primary care physician, and you get to wait months for treatment. You can pay taxes your whole life, and then wait behind people who want sex changes – people who have never paid a dime into the system. And sometimes, you die while waiting for treatment. That’s “fairness” and “equality”. And that’s where the Democrats want to take us.

Remember when Obama said that we could keep our health care plans and our doctors?:

Democrats voters looked at this man, and they just knew – without any studies or any evidence – that he was telling the truth.

But the Congressional Budget Office says that TEN MILLION people will lose their employer health plans under Obama by 2021.


The Congressional Budget Office now says ObamaCare will push 10 million off employer-based coverage, a tenfold increase from its initial projection. The “keep your plan” lie just gets bigger and bigger.

The latest CBO report is supposed to be a big win for the Obama administration because the projected costs are 20% below what the CBO first projected in 2010.

But the CBO report also shows that ObamaCare will be far more disruptive to the employer-based insurance market, while being far less effective at cutting the ranks of the uninsured, than promised.

Thanks to ObamaCare, the CBO now expects that 10 million workers will lose their employer-based coverage by 2021.

This is in addition to the FOUR MILLION who already lost their health care plans in 2013.

NHS appeals decision allowing midwives to conscientiously object to performing abortions

What happens when you let a secular government take over health care provisioning?

Here is a story from the BBC about the state-run health care system in the UK.


The UK’s highest court will hear legal arguments on whether midwives have a right to refuse to take any part in abortion procedures on moral grounds.

NHS Greater Glasgow and Clyde appealed to the Supreme Court after judges in Scotland said Roman Catholic midwives had a right to conscientious objection.

[…]Five judges in London will hear the case. A ruling is expected next year.

Ms Doogan, from Garrowhill in Glasgow, and Mrs Wood, from Clarkston in East Renfrewshire, were employed as labour ward co-ordinators at the Southern General Hospital in Glasgow.

[…]This landmark case tests the balance between those whose religious beliefs do not allow them to play any part whatsoever in abortion, and the health authorities’ duty under the law to enable women to have an abortion. Many Christian groups back the midwives’ position.

The midwives’ counsel, Gerry Moynihan QC, told the court in the women’s earlier successful appeal that the law was clear that the right to conscientious objection contained in the Abortion Act was intended to apply to the whole team whose involvement was necessary to achieve the procedure.

If the Supreme Court upholds the midwives’ earlier successful appeal, it could set a legal precedent, allowing other midwives who object to abortion to take the same stance.

The Royal College of Midwives and the women’s charity British Pregnancy Advisory Service have both warned that any such ruling could have severe implications for the care of women choosing to terminate their pregnancy.

The BPAS is the largest abortion provider in the UK. I blogged before about their leader, Ann Furedi, who supports sex-selection abortions. I thought then that sex-selection abortions was the worst thing about abortion, but now I see that she would actually force her moral views on other people, compelling them by the power of government to act against their beliefs. There is something deep inside me that just recoils from making a person do something that they think is morally wrong. But I guess pro-abortion people don’t share my concern.

When I blogged before about these two midwives when they won their appeal case, I wrote this:

If the health care system were private, then it would be easy for midwives to find another company to work for that did not violate their consciences. But when the government runs the whole health care system, where are you supposed to go? They are a monopoly and they make the rules. Yet another reasons for Christians to vote for smaller government. In a free market, if you don’t want to buy something from one store, you can go to another store. There is competition. But where are these nurses supposed to go? They are midwives, and the government and the courts make the rules in a government-run health care system.

This is why we need to keep the government OUT of health care. When you work for a government monopoly, and they want you to do something that you don’t want to do, you have two choices – do what they want or leave the country. If the only health care system is government-run, then if you want to practice health care, you have to leave. That seems unfair to me.

White House review of VA finds “corrosive culture” to blame for poor patient care

The Wall Street Journal reports.


A White House review of the VA health system points to a culture that has degraded the timely delivery of care and requires a restructuring to improve transparency and accountability.

Acting Secretary of Veterans Affairs Sloan Gibson and Rob Nabors, White House deputy chief of staff, told President Barack Obama on Friday that significant further action was needed to address systemic problems.

Six weeks after the president dispatched Mr. Nabors to assess problems within the VA, the president’s aide outlined a long list of issues affecting access to timely care at VA medical facilities.

Mr. Nabors’s work is the latest in a series of reviews and reports issued in the past two months, including those from the VA’s independent inspector general, the Office of the Special Counsel and the VA itself. The new report found what Mr. Nabors described as a “corrosive culture” that affects employee performance and patient care. He added that the Veterans Health Administration structure has “impeded appropriate management, supervision and oversight.”

The review also found that the VA’s goal for scheduling many medical appointments within 14 days is “arbitrary, ill-defined and misunderstood.” That goal had been set in 2011. The VA recently eliminated that 14-day target.

Mr. Gibson praised the report. “We know that unacceptable, systemic problems and cultural issues within our health system prevent veterans from receiving timely care,” he said in a statement.

The White House has scrambled to respond to evidence of widespread mismanagement within the VA and to fill a growing number of vacancies in top posts. An internal assessment also revealed improper appointment-scheduling procedures and efforts to hide long wait times across the VA health system.

Another interim report from the VA inspector general confirms that:

The VA’s independent inspector general office has said it would likely issue in August its full report on its sweeping review of the department. An interim report, issued just days before Mr. Shinseki’s resignation, showed problems throughout the VA. They included employees tinkering with official patient appointment wait times to make them seem much shorter than the actual times veterans were having to wait.

In case you were wondering why this is all happening in the VA health care system and not in the private health care system, it’s because the VA is 100% pure government-run health care, as health care expert Avik Roy explains in Forbes magazine. The VA is not scandal is not some sort of aberration from government-run health care. Long wait times and patient deaths are essential to government run health care, in practice.

How do doctors feel about the federal government’s regulation of their profession?

In the Wall Street Journal, a doctor speaks out about government control of health care.


In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

[…]The Centers for Medicare and Medicaid Services dictates that we must use an electronic health record (EHR) or be penalized with lower reimbursements in the future. There are “meaningful use” criteria whereby the Centers for Medicare and Medicaid Services tells us as physicians what we need to include in the electronic health record or we will not be subsidized the cost of converting to the electronic system and we will be penalized by lower reimbursements. Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist?

This is not a unique complaint. A study commissioned by the American Medical Association last year and conducted by the RAND Corp. found that “Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction.”

In addition to the burden of mandated electronic-record entry, doctors also face board recertification in the various medical specialties that has become time-consuming, expensive, imposing and a convenient method for our specialty societies and boards to make money.

Meanwhile, our Medicare and Medicaid reimbursements have significantly declined, let alone kept up with inflation. In orthopedic surgery, for example, Medicare reimbursement for a total knee replacement decreased by about 68% between 1992 and 2010, based on the value of 1992 dollars. How can this be? Don’t doctors have control over what they charge for their services? For the most part, no. Our medical documentation is pored over and insurers and government then determine the appropriate level of reimbursement.

I don’t know about other physicians but I am tired—tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way I practice medicine. No other profession would put up with this kind of scrutiny and coercion from outside forces. The legal profession would not. The labor unions would not. We as physicians continue to plod along and take care of our patients while those on the outside continue to intrude and interfere with the practice of medicine.

We could change the paradigm. We could as a group elect not to take any insurance, not to accept Medicare—many doctors are already taking these steps—and not to roll over time and time again. We have let nearly everyone trespass on the practice of medicine. Are we better for it? Has it improved quality? Do we have more of a voice at the table or less? Are we as physicians happier or more disgruntled then two years ago? Five years ago? Ten years ago?

Doctors certainly provide a lot more value to me than unions, lawyers and government workers of all sorts. I wish we had more doctors, and fewer unions, lawyers and government workers. Anything that doctors can do to push back against their tormentors would be welcome in my opinion.