Tag Archives: Single-Payer

Trump signs executive order giving Americans relief from Obamacare fees and taxes

Health insurance costs rose dramatically under Obama
Health insurance costs rose dramatically under Obama (click for larger image)

The Washington Free Beacon reports.

Excerpt:

On his first day in office, President Trump signed an executive order that would relieve the economic burden that Obamacare has caused, fulfilling a promise he made on the campaign trail.

[…]Trump promised Americans that on day one of taking office, he would ask Congress to immediately deliver a full repeal of the Affordable Care Act.

“Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare,” Trump said. “As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next president and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry.”

“It is not enough to simply repeal this terrible legislation,” Trump said. “We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country.”

Since Trump’s economic policy draws on the experts at the conservative Heritage Foundation, we can expect that the alternative to Obamacare will be one based on a system that is proven to be successful. Switzerland has a health care system that has universal coverage, yet is fully privatized. It costs little, and delivers a lot of health care. Their system works, unlike socialist health care systems in the UK and Canada – which Obama was trying to emulate.

House Republicans say:

“Our goal is a truly patient-centered system, which means more options to choose from, lower costs, and greater control over your coverage,” said Speaker of the House Paul Ryan (R., Wis.). “And as we work to get there, we will make sure there is a stable transition period so that people don’t have the rug pulled out from under them.”

The nominee to lead the Department of Health and Human Services Rep. Tom Price (R., Ga.) echoed that sentiment, saying at his confirmation hearing that it is imperative that individuals have health coverage and have greater choices and opportunities to get the coverage they need.

“I think there’s been a lot of talk about individuals losing health care coverage—that is not our goal, nor is it our desire, nor is it our plan,” Price said.

The Daily Signal has more details on the relief provided to poor Americans in his executive order. It directs Trump’s subordinates to:

[…]exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.

The Daily Signal also comments:

As to the substance, the new president’s clear directive is for his appointees to focus on minimizing the damaging effects of the law. That constitutes a sharp change in direction from the one taken by the Obama administration.

The implementation approach taken by the Obama administration was essentially to try to increase subsidized enrollment heedless of any resulting costs or disruptions to either the public or private sectors. This executive order signals that the Trump administration’s first order of business for Obamacare will instead be to minimize those costs and disruptions.

Some numbers from CNBC:

For many Obamacare customers this year, they’ll be paying more for less.

A new report on Obamacare plans details how plan premiums, deductibles and other out-of-pocket insurance costs have grown sharply even as the size of networks of health providers covered by those plans are shrinking in 2017.

The report from the Avalere consultancy also details how the number of insurers selling Obamacare plans have also shrunk, decreasing competition in the individual health plan market.

Last year, just 4 percent of all regions of the United States had only one participating insurer on Obamacare exchange, according to Avalere’s analysis. This year, 36 percent of all regions in the U.S. will have only one participating health insurer on an Obamacare exchanges.

Avalere’s report also found that in 2017, just 31 percent of all exchange-sold plans are “preferred provider organizations” or “point of service” plans, down from 52 percent of all plans in 2014, the first year of Obamacare coverage

PPOs generally have a wider networks of doctors and hospitals covered by the plan, and cover more out-of-network services than do other types of plans, including health maintenance organizations.

I have a friend who is a Democrat. For every month of the last 6 years, I have been presenting him with the numbers on Obamacare showing the negative impact on small businesses and poor Americans. He makes 6 figures as a software engineer, and knows literally nothing about economics. I have even told him stories about some of my friends who are poorer who struggled with the financial burdens caused by the law. His response was stunning: “what does this matter to you, you have health care through your employer”. That’s how Democrats think. As long as they are OK, who cares about the poor. The important thing for them is that government run everything and make all the decisions, because ordinary people cannot be trusted with freedom.

You can read more about the disaster of Obamacare here in a report by the Heritage Foundation.

Is health care a right or a commodity?

I have a key that will unlock a puzzling mystery
I have a key that will unlock a puzzling mystery

Here is a splendid post about the economics of health care from Ben Shapiro, writing for National Review.

He responds to a view held by those on the radical left: people need health care, therefore health care is a right.

Excerpt:

The idea here seems to be that unless you declare medical care a right rather than a commodity, you are soulless — that as Marx might put it, necessity, rather than autonomy, creates rights.

This is foolhardy, both morally and practically.

Morally, you have no right to demand medical care of me. I may recognize your necessity and offer charity; my friends and I may choose to band together and fund your medical care. But your necessity does not change the basic math: Medical care is a service and a good provided by a third party. No matter how much I need bread, I do not have a right to steal your wallet or hold up the local bakery to obtain it. Theft may end up being my least immoral choice under the circumstances, but that does not make it a moral choice, or suggest that I have not violated your rights in pursuing my own needs.

But the left believes that declaring necessities rights somehow overcomes the individual rights of others. If you are sick, you now have the right to demand that my wife, who is a doctor, care for you. Is there any limit to this right? Do you have the right to demand that the medical system provide life-saving care forever, to the tune of millions of dollars of other people’s taxpayer dollars or services? How, exactly, can there be such a right without the government’s rationing care, using compulsion to force individuals to provide it, and confiscating mass sums of wealth to pay for it?

The answer: There can’t be. Rights that derive from individual need inevitably violate individual autonomy.

But there are ways to make a commodity less expensive, and of higher quality. It happens all the times in free markets, where innovators are rewarded with profits – just think of the people who sell smartphones.

More:

To make a commodity cheaper and better, two elements are necessary: profit incentive and freedom of labor. The government destroys both of these elements in the health-care industry. It decides medical reimbursement rates for millions of Americans, particularly poor Americans; this, in turn, creates an incentive for doctors not to take government-sponsored health insurance. It regulates how doctors deal with patients, the sorts of training doctors must undergo, and the sorts of insurance they must maintain; all of this convinces fewer Americans to become doctors. Undersupply of doctors generally and of doctors who will accept insurance specifically, along with overdemand stimulated by government-driven health-insurance coverage, leads to mass shortages. The result is an overreliance on emergency care, costs for which are distributed among government, hospitals, and insurance payers.

So, what’s the solution for poor people? Not to declare medical care a “right,” and certainly not to dismiss reliance on the market as perverse cruelty. Markets are the solution in medical care, just as they are in virtually every other area.

Treating medical care as a commodity means temporary shortages, and it means that some people will not get everything we would wish them to have. But that’s also true of government-sponsored medical care, as the most honest advocates will admit. And whereas government-sponsored medical care requires a top-down approach that violates individual liberties, generates overdemand, and quashes supply, markets prize individual liberties, reduce demand (you generally demand less of what you must pay for), and heighten supply through profit incentive.

It’s always a good idea to look at how health care is working in countries that do have single payer health care systems. Canada has a single-payer system. How is that working out?

The Fraser Institute issued a recent report on health care in Canada:

Waiting for treatment has become a defining characteristic of Canadian health care. In order to document the lengthy queues for visits to specialists and for diagnostic and surgical procedures in the country, the Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.

This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have in-creased since last year. Specialist physicians surveyed report a median waiting time of 20.0 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 18.3 weeks reported in 2015. This year’s wait time—the longest ever recorded in this survey’s history—is 115% longer than in 1993, when it was just 9.3 weeks.

[…]It is estimated that, across the 10 provinces, the total number of procedures for which people are waiting in 2016 is 973,505. This means that, assuming that each person waits for only one procedure, 2.7% of Canadians are waiting for treatment in 2016.

[…]Patients also experience significant waiting times for various diagnostic technologies across the provinces. This year, Canadians could expect to wait 3.7 weeks for a computed tomography (CT) scan, 11.1 weeks for a magnetic resonance imaging (MRI) scan, and 4.0 weeks for an ultrasound.

Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.

The typical cost of the single-payer health care system to a Canadian family is nearly $12,000.

Socialist Canada has been doing a lot of taxing and spending to try to fix this problem, but the problem is getting worse. And no wonder: when the government controls health care, it becomes a tool for buying votes. Abortions and sex changes are “health care” in Canada. Breast enlargements and IVF are “health care” in the UK. Of course, good luck getting treatment when you are in your old age and will not be voting much in the future : both Canada and the UK have euthanasia programs to get rid of elderly people who are no longer as useful to politicians as young people who still have lots of voting ahead of them.

Is Obamacare a spectacular failure because of incompetence, or by design?

Private insurer participation in Obamacare exchanges, 2015-2016
Private insurer participation in Obamacare exchanges, 2015-2016

First, let’s establish that Obamacare really is a failed policy.

One of my favorite health policy experts Sally C. Pipes reports for CNBC (H/T Bree) on how private insurers are reversing their decision to sell customers Obamacare policies.

Excerpt:

Aetna the nation’s fourth-largest health insurer, just decided to stop offering plans on Obamacare’s exchanges in all but four states in 2017. The firm says that it was losing roughly $300 million per year on these policies. And it projected that its losses would only increase, since the share of covered individuals “in need of high-cost care” was growing, according to CEO Mark Bertolini.

Aetna isn’t the only insurer giving up on Obamacare. UnitedHealth, America’s biggest insurer, will sell plans in just three states next year, down from 34 this year. Humana will offer coverage in just 156 counties in 2017, 88 percent fewer than this year.

In other words, the insurance “death spiral” has arrived. Obamacare’s critics have long predicted that exchange plans’ high premiums and deductibles would keep all but the sickest Americans from enrolling. These people would need so much medical care that insurers would lose money no matter how much they raised premiums. Eventually, insurers would have no choice but to pull out.

[…]Insurers that haven’t pulled out of Obamacare are requesting premium hikes averaging 24 percent next year. And some states have it far worse. Many Georgians could see a hike of 65 percent. The 600,000 Texans enrolled in Blue Cross Blue Shield may face a 59 percent premium increase.

I must have blogged about 50 posts on Obamacare, and why it would fail, before the 2012 election. I even had podcasts and articles by Sally C. Pipes! She predicted all of this long ago. The 2012 election was our last chance to stop it, and we failed.

Obamacare premium growth, 2015-2016
Obamacare premium growth, 2015-2016

I always like to think about the future so I can prepare for it. Investors Business Daily thinks that if Hillary is elected, she will use this crisis to push for single payer health care. Single payer basically means that you pay into the government based on what you earn, and the sickest / least responsible people get a deal because they get “free” care. It’s a terrible deal for healthy, fit single men who never use health care. We have to pay about $10,000 a year in taxes, and never use it.

Investors Business Daily explains:

So what’s Hillary Clinton’s answer to the failing private exchanges? Get more people on government insurance through what she calls the “public option.” This would be a government-run health care plan offered in ObamaCare exchanges across the country.

“The public option, Clinton says, “will strengthen competition and reduce costs.”

But wait a minute. The “public option” was pushed by liberal Democrats in 2009 when ObamaCare was being built, and it was rejected by centrists in the party because it looked too much like a steppingstone to single payer.

As a matter of fact, that was the idea behind the “public option” in the first place.

As Mark Schmitt explained in the liberal American Prospect, “The public option was part of a carefully thought out and deliberately funded effort (to convince the single-payer crowd) they could live with the public option as a kind of stealth single-payer.” The idea was that the public option would be able to undercut private plans, driving them all out of the exchanges.

But all those centrists Democrats who opposed the public option are gone from the Senate, and if Hillary Clinton gets elected with a more liberal Senate majority, the public option will likely be top of her agenda.

With the vast Medicaid expansion, and the public option (as well as Clinton’s proposal to expand Medicare), it’s not far-fetched to say that soon the only people covered by private insurance will be the diminishing number who get it through work. (ObamaCare was also designed to shrink employer-based health.)

I guess my solution to this is to hang on to my employer-subsidized plan for as long as I can, and then if single-payer becomes the law, then I’ll just ease back my working. Maybe work part-time in a less demanding job. I don’t want to get up and go to work to pay for strangers, especially if their “health care” is just abortions, in vitro fertilization, drug addiction therapy, breast enlargements and sex changes – which is what happens in countries where the government does run health care. They just use it as a way to buy votes.

Canadian Liberal Party introduces bill to legalize euthanasia

Jody Wilson-Raybould, Minister of Justice and Attorney General of Canada
Jody Wilson-Raybould, Minister of Justice and Attorney General of Canada (right)

Life Site News has a story about Canada’s new assisted suicide bill:

The Liberal government’s euthanasia bill introduced Thursday will not protect vulnerable Canadians or the conscience rights of physicians, say anti-euthanasia activists.

While Justice Minister Jody Wilson-Raybould’s Bill C-14 is more restrictive than the legislative framework the special joint parliamentary committee recommended in its February 2016 report, it essentially provides “a perfect cover for acts of murder, absolutely,” says Alex Schadenberg, executive director of the Euthanasia Prevention Coalition.

The draft legislation restricts eligibility for euthanasia and assisted suicide to competent patients 18 years of age and older who have “an incurable serious and incurable illness, disease or disability” which “causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions,” who are in “an advanced state of decline in capability” and whose “natural death is reasonably foreseeable.”

The legislation mandates that a patient request assisted suicide or voluntary euthanasia in writing, and that this request be approved by two independent medical practitioners, or nurse practitioners.

It mandates a 15-day waiting period after the request is approved, but that period can be waived if the two medical practitioners deem the patient’s condition will deteriorate before that time is up.

[…]Schadenberg says the bill “does not provide effective oversight in the law,” because while it calls for two independent physicians or nurse practitioners to approve a request for euthanasia,  “this is the system where the doctor or nurse practitioner who does the act also does the reporting.”

The legislation also provides “legal immunity for anyone, anyone who does anything at a person’s request, under Sections 241.3, 241.5,” he said.

[…][W]hile the bill acknowledges conscience rights in its preamble, it “provides no protection for conscientious objectors,” according to Albertos Polizogopoulos, a constitutional lawyer for Canadian Physicians for Life.

Canadian doctors are already forced to perform abortions against their conscience, so this last point is no great surprise.

In a country that has single payer health care, all medical care is paid for by the federal government. You pay into the system your whole life (at an average of 42% of your income, in Canada) and then at the end, you get in line and hope that the government will treat you. It is extremely convenient for the government to kill off patients who are elderly. Elderly patients won’t be able to vote in many more elections, but they will want to draw away funds that could be used to buy the votes of young people who want “free” breast enlargements, plastic surgery, sex changes and IVF treatment. So the government has every incentive to cut loose the old people and then buy the votes of young people with the taxpayer money they save. Single payer health care is a scam to help politicians stay in power.

Similar laws in places like Belgium and Netherlands have been used to cut down on the medical bills that the government must pay.

A Parliamentary committee brief that I found on the Canadian government web site says this:

A study published in the NEJM entitled: Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium (March 19, 2015) found that 4.6% of all deaths in the first six months of 2013, in the Flanders region of Belgium, were by assisted death and 1.7% of all deaths were assisted deaths without explicit request representing more than 1000 assisted deaths without explicit request in 2013.

The supplemental appendix in the study informs us how the researchers classified the data.

It states: “If in the latter case the drugs had been administered at the patient’s explicit request, the act was classified as euthanasia or assisted suicide depending on whether the patient self-administered the drugs. If drugs were used with the same explicit intention to hasten death but without the patient’s explicit request, the act was classified as hastening death without explicit patient request. This can include cases where a patient request was not judged as explicit by the physician, where the request came from the family or where the physician acted out of compassion.”

This research study confirms that many intentional hastened deaths are occurring without the explicit request of the patient which contravenes the Belgian assisted death law and medical ethics.

Previously, I blogged about how the UK government provides bonuses to hospitals who put elderly patients on an end-of-life pathway.

Ethicist Wesley J. Smith comments on the Canadian law in National Review.

Excerpt:

The Canadian government has tabled its new euthanasia bill–and as expected, it will be the most radical in the world.

Since the death doctor need not be present at the demise, the bill creates an unprecedented license for family members, friends–heck, a guy down the street–to make people dead.

[…]In short, this provision is the perfect defense for the murder of sick and disabled people who requested lethal drugs.

The George Delury case is an example of what I mean: Delury said he assisted wife, Myrna Lebov’s suicide out of “compassion” and at her request due to MS.

But his real hope was not only to be free from care giving, but become famous writing a book about her death. (He did, What If She Wants to Die?)

It almost worked. But because assisted suicide was a criminal offense, authorities conducted an investigation and discovered his diary.  It showed that contrary to the compassionate face Delury was conjuring, in reality, he emotionally pressured Myrna into wanting to commit suicide, telling her, for example, that she was a burden and ruining his life.

He also withheld full dosage of antidepressants so he could use those drugs to kill her. And, he but put a plastic bag over her head to make sure she died.

If euthanasia Canada’s bill had been the law of New York when Delury killed Myrnov, he might have been able to coerce her into asking for lethal drugs. At that point, he could have killed her any time he wanted and there wouldn’t have been a criminal investigation to find his diary.

Canada has just paved the way for a person, hungry for an inheritance or ideologically predisposed, to get away with the perfect murder.

In the last election, the Liberal Party promised the Canadian voters the moon, in terms of new spending. They said it would only add 10 billion to the deficit this year. But now (after the election) the number has exploded to 30 billion this year and over 100 billion over the next five years. Could this euthanasia plan be the first step in balancing the books, so they can win re-election?

What happens when Christians vote to put secular government in charge of health care?

Canada Election 2015: Socialists in red, Communists in Orange, Conservatives in blue
Canada Election 2015: Socialists in red, Communists in Orange, Conservatives in blue

No need to wonder, just look north to Canada. Wesley J. Smith explains in First Things.

Excerpt:

Last year, the Canadian Supreme Court created a right to euthanasia and assisted suicide. To qualify for death, the court ruled unanimously, one must be a competent adult with a medically diagnosed condition causing “irremediable suffering”—a circumstance wholly determined by the patient and including “psychological suffering.”

The decision went well beyond mere legalization. Indeed, the court manufactured an enforceable legal right for qualified patients to receive what Canadian policymakers are euphemistically calling “medical aid in dying” (MAID).

But what about doctors opposed to euthanasia? The court left with Parliament and the medical colleges (associations) the decision of whether and how to accommodate doctors with conscience objections, granting a one-year (now extended) period within which to enact laws to govern the practice. Since then, civil liberties groups, provincial medical colleges, and official government commissions have urged Parliament … to pass laws that would coerce doctors who are religiously or philosophically opposed to euthanasia to cooperate actively in mercy killings by forcing them to procure death doctors for their patients.

But isn’t there a “Constitution” in Canada? Yes, but it’s interpreted by unelected judges:

All of this would seem to fly in the face of Canada’s 1982 Charter of Rights and Freedoms,which states, “Everyone has the fundamental freedom of conscience and religion.” Illustrating the utter lack of regard that secularized Canada now has for religious liberty, the Canadian Civil Liberties Association—that country’s counterpart to the ACLU—applauded the parliamentary committee’s call to stomp upon religious conscience as a “promising step forward.”

Doctors aren’t the only ones threatened with religious persecution under Canada’s looming euthanasia regime. Provincial and federal commissions have both recommended that nurses, physician’s assistants, and other such licensed medical practitioners be allowed to do the actual euthanizing under the direction of a doctor.

Voting for a single-payer health care system, such as the one praised by Donald Trump, makes the situation much worse:

Even Catholic and other religious nursing homes and hospices may soon be required by law to permit euthanasia on their premises, for the federal commission recommended that federal and provincial governments “ensure that all publicly funded health care institutions provide medical assistance in dying.” That is a very broad category. Canada has a single-payer, socialized healthcare financing system that permits little private-pay medical care outside of nursing homes. Not only that, but as Alex Schadenberg, director of the Canada-based Euthanasia Prevention Coalition told me, “religiously-affiliated institutions [in Canada] have become the primary care facilities for elderly persons, those requiring psychiatric care, and dying persons. They are now being told that as a condition of providing those services they will be required to permit doctors to kill these very patients by lethal injection. If they refuse, they will find themselves in a showdown with the government.”

The more people who opt to kill themselves, the less the government has to pay in health care. Naturally, the secular government looks at euthanasia as a great way to cut the costs of taxpayers who have paid into the single-payer system their whole lives, and now want to make withdrawals. If the government kills them now, they get to keep all the money, and not give any of it back.

The rights to religious liberty and conscience protections are put at risk everywhere that the secular government takes over the private sector. Christians need to be careful what they vote for at election time. Small government is best for religious liberty and conscience protections.