Americans are Already Under a Medicare-For-All System

Democrats are always up to the challenge of extending centralized power over our lives, no matter the cost. Their latest scheme is to abolish private health insurance in lieu of a universal healthcare system under the auspice of Medicare. The projected price tag is $33 trillion over a decade.


We shouldn’t be surprised. These Marxist have been trying to fix our healthcare system for over 50 years with disastrous results. I would say that we’ve already in a Medicare-for-all system. Because of bad policy decisions, a third-party payer system has been instituted which has distorted the market. The patient/customer no longer participates in the cost/benefit analysis resulting in the high cost of healthcare.

So, since prices are no longer determined by the free market, who or what determines the cost? Why it’s Medicare, of course. Here is an excerpt from the Mercatus Center:

Payments for Medicare benefits substantially influence the prices paid by private-sector insurers. Many private insurers simply adopt Medicare’s levels of reimbursement to providers, and those that do not still are affected when Medicare changes its rates. Although analysts disagree about whether the link leads to lower or higher private payments, Medicare’s administrative pricing system clearly cannot replicate a well-functioning competitive market. What can be done to move Medicare closer to the optimal prices corresponding to those produced by a competitive market?

A new study published by the Mercatus Center at George Mason University assesses the numerous problems with Medicare’s price calculations and looks at how they affect prices in commercial insurance policies. The study proposes an arrangement of competitive bidding on bundles of services as a promising alternative to Medicare’s price-fixing regime.

Need I remind everyone that this is the same government that brought us $1000 toilet seats in the 1980’s. You would’ve thought they learned their lesson, but think again. Just recently, the Air Force paid $10,000 for a toilet seat cover. And everyone expects fiscal discipline from Washington D.C.?

Source:

https://www.advisory.com/daily-briefing/2018/07/31/medicare-for-all

https://www.mercatus.org/publication/medicare-role-determining-prices-throughout-health-care-system

https://www.washingtonpost.com/business/capitalbusiness/the-air-forces-10000-toilet-cover/2018/07/14/c33d325a-85df-11e8-8f6c-46cb43e3f306_story.html?utm_term=.4db990a92fa1

Medicare for All! Why not?

As a card-carrying curmudgeon, nothing gives me more pleasure than reading an op-ed written by a Progressive and then tearing it to pieces. The Charlotte Observer is a prime source of absurdity, stupidity and outright propaganda for everything government. They put the I in libtard, and we can’t thank them enough for it.


When I read some of these articles. I can’t help but think these people are grasping onto a few strands of reality. Maybe that’s because in a liberal’s utopian worldview, they’re incapable of introspection. Failure is not part of their vocabulary. Why else would they double-down on centralized healthcare when the Affordable Care Act has been anything but. So hey, it’s Medicare for all! Why not!

Here is an excerpt from an op-ed written by a Mr. Bohmfalk advocating for just that:


Medicare is an extremely successful and popular government program, a very good thing for 15 percent of our citizens. As private, for-profit health insurance continues to squeeze enrollees into narrower provider networks and unaffordable cost-sharing, many Americans under 65 are desperate for relief. Most business leaders do not realize that around one-third of every healthcare dollar goes to administration, rather than healthcare. We pay around twice per person what every other country pays for healthcare, the largest share of GDP. Despite being the biggest market, we pay the world’s highest prescription drug prices. Our health outcomes, including life expectancy, rank near the bottom.


Now why is there a narrower field? Could it possibly be that Obamacare forced other insurers and providers out of business thereby squeezing enrollees into narrower networks that are unaffordable? Oh yeah, Americans need relief, alright. They need relief from an obtrusive and authoritarian federal government.


Now let’s address administrative cost. Did Obamacare reduce this bugaboo? NO! They exasperated it. Do a search on the internet and you’ll see pages of articles lamenting this government created monstrosity. But once again, this assertion of lower administrative cost is deceptive. Here is an excerpt from an article pre-Obamacare:


A more accurate measure of overhead would therefore be the administrative costs per patient, rather than per dollar of medical expenses. And by that measure, even with all the administrative advantages Medicare has over private coverage, the program's administrative costs are actually significantly higher than those of private insurers. In 2005, for example, Robert Book has shown that private insurers spent $453 per beneficiary on administrative costs, compared to $509 for Medicare. (Indeed, Robert has written the definitive paper on this subject, from which the above figure is taken.)


Remember these points the next time someone tries to tell you that Medicare is “more efficient” than private insurance.

Yes, remember this, because Mr. Bohmfalk is going to double-down. 

And as for paying twice per person in other countries, all I have to say is what do you expect? Do you expect third-world prices in a first-world country? Of course, we’re going to pay more than the rest of the world, simply because our standard of living is higher. This is basic economics.


However, if liberals insist on everything “free,” we could be like Venezuela, where healthcare is nonexistent thanks to socialism. See what free gets you?

Still , healthcare would be cheaper in the United States had we an actual free market system where the patient/consumer actually participated in a cost/benefit analysis rather than being dependent on a third-party payer system. Competition reduces cost whereas monopolies reduce access and inflate the prices of goods and services. Make no mistake about it, Obamacare monopolized our healthcare system.


Mr. Bohmfalk continues:


Except in the Medicare population. Once people have access to healthcare, their health dramatically improves. Medicare has a secret for the rest of the country: We can expand Medicare to cover everyone, improve it to cover prescription drugs and eliminate deductibles and co-payments, and save money in the process. The secret lies in Medicare’s 2-3 percent administrative overhead, a fraction of private insurance companies’. Politicians commonly campaign on eliminating waste, but their promises rarely materialize. With Improved Medicare for All, we can convert hundreds of billions in administrative waste to actual, life-saving healthcare.


Improving Medicare can be a fairly straightforward process, as described in the House bill HR 676. The taxes to fund it would be less than current healthcare spending for 95 percent of households — a clear win-win for the vast majority of us. Employers would no longer be burdened with providing health insurance and could better compete globally. Everyone truly could choose and keep their doctors, if not their current expensive and restrictive insurance plans.


Mind you, Mr. Bohmfalk stated earlier that 15% of the population is currently on Medicare. According to the trustees of Medicare, this program is scheduled for insolvency in the year 2026 - three years earlier than forecasted. And liberals want to expand it? Their vision of utopia is in reality, a dystopia.  Oh yeah, don't forget, if you like your doctor, you can keep your doctor.  LOL!!!


Source:


https://www.charlotteobserver.com/opinion/op-ed/article215566870.html


https://www.forbes.com/sites/theapothecary/2017/02/01/the-aca-increased-rather-than-decreased-administrative-costs-of-health-insurance/#29bc4ef09e77


https://www.investors.com/politics/policy-analysis/spending-and-overhead-costs-explode-under-obamacare/


https://www.forbes.com/sites/theapothecary/2011/06/30/the-myth-of-medicares-low-administrative-costs/#3b9e7901140d


http://www.latimes.com/nation/nationnow/la-na-pol-medicare-finances-20180605-story.html

The Federal Government's Dr. Feel Good Opioid Policy

Should we be shocked that with the advent of Obamacare, Americans all of a sudden have an opioid epidemic? Libtards create government funded problems then have the audacity to act surprised when it backfires. Worse, they don’t have the intellectual curiosity to understand what went wrong. For instance, did you know there is an American Pain Society? I sure didn’t, but here is an article describing the government’s Dr. Feel Good policies: 

For one thing, the Veterans Health Administration was one of the earliest adoptersof a pain management strategy called “Pain as the Fifth Vital Sign,” originally advocated by the American Pain Society.

The intention was good — to ensure that patients don’t suffer unnecessarily. But there’s now widespread agreement that pain should never have been treated as a vital sign and that, sadly, this assessment and treatment protocol contributed to the over-prescription of opioid painkillers.

Doctors outside of the VHA system faced pressure from the government as well: The Center for Medicaid and Medicare Services included questions about pain management in patient satisfaction surveys that were linked to payment, encouraging a standard of patient-pleasing over good medicine. This — along with the example set by VHA policy — fostered a culture that encouraged health-care providers to offer pain-relieving prescriptions, popular with patients, without adequate regard for the potential long-term consequences. Fortunately, these survey questions have been removed



It wasn’t just pain management surveys in Medicare and Medicaid; the Joint Commission (JC) that pushed more providers to over-prescribe also played a role. The JC has a unique statutory mandate to accredit hospitals to treat (and be reimbursed for) Medicare patients. Most states also rely on JC accreditation as a prerequisite for Medicaid reimbursement as well. These are by far the biggest payers in American health care. If the JC says jump, hospitals ask, “How high?”



I remember President Pen and Phone telling a woman at a town hall meeting that instead of treating her elderly mother, it would be cost effective if the government gave her a pill to ease the pain. Now look at what we got.


Source:

https://www.realclearhealth.com/articles/2018/05/03/the_governments_role_in_the_opioid_epidemic_110783.html

Medicare is Responsible for High Health Care Cost

I cannot believe some of the op-eds that are published in the Charlotte Observer.  Do they have a fact checker?  Shouldn’t the editorial board question the assertions of some of these writers?

The latest absurdity that was published in the Disturber was written by J. Edward Bell from the Charleston School of Law.  His solution for affordable healthcare is to dump catastrophic illnesses onto Medicare.  Here is an excerpt:

This idea can be the ultimate fix that makes health care affordable for most Americans.

Almost half of health care premiums are for catastrophic illnesses – the most expensive illnesses people experience. Two systems have developed to deal with these illnesses – the Medicare system for people 65 and older, and the system for everybody else.

People under 65 often are charged more than actual health costs because medical providers often take advantage of enhanced billing to recoup some of the costs they incur for treating people without insurance. These “cost-shifts” are variable costs that are hard to control, which leads insurers to charge a lot for premiums of people under 65.

But if you are covered by Medicare, the program pays actual costs to a medical provider. Because Medicare only pays actual costs, the overall cost of treatment for the Medicare patient is much less than for the patient under 65.

The difference in costs is amazing, according to research by the Charleston School of Law. Consider a patient under 65 who has an average catastrophic medical bill of $1.6 million. The cost for a Medicare patient with the same illness: about $320,000, or 80 percent less. That’s a savings of more than $1 million.

First of all, you can’t buy catastrophic insurance unless you are granted an exemption from the federal government, and once that is obtained you are limited to the exchanges and god forbid you don’t qualify for a subsidy.

Second, Medicare is the main driver for all healthcare cost.  They set the standard.  The Washington Post let the cat out of the bag back  in December 2013.  Here is an excerpt:

Economists believe that the Medicare prices are even more important than that massive scale suggests, because in the absence of a traditional market for medical services, the Medicare prices form the foundation for private insurers, as well.

That is partly because Medicare is such a huge player in the market, accounting for more than a fifth of the money spent on personal health care. But there is a second, possibly more important impetus: Because of the complexity of modern medicine, setting prices is an arduous, time-consuming task. Insurers save money by letting Medicare do the work.

To measure the impact of Medicare prices, Gottlieb and Jeffrey Clemens at the University of California at San Diego analyzed millions of claims to see how changes in Medicare prices were followed by changes in the prices that private insurers paid. The results were stark.

 “Our results indicate that the private sector will copy Medicare’s pricing errors,” Gottlieb said. “On the flip side, they would gain when Medicare payments better reflect the value of what is being delivered.”

 While that paper largely studied physician fees and outpatient services, other research published in May found that Medicare pricing for hospitals is similarly influential. The paper, by health care researcher Chapin White and published in Health Affairs, found that a 10 percent reduction in Medicare pricing yielded a 3 or 8 percent reduction in private prices, depending on the statistical method used

I published a blogpost back in 2012 about how Medicare and the third party payer system had distorted the healthcare market.  Since the consumer/patient is factored out of the cost/benefit analysis, market pricing no longer exist.  No one knows the cost of a procedure or for that fact an aspirin.  Hence, we have hyperinflation in an industry whose pricing is determined by a government entity.  And everyone wonders why no one can afford healthcare.

Source:

http://costonscomplaint.blogspot.com/2012/09/is-medicare-distorting-health-care.html

http://www.charlotteobserver.com/opinion/op-ed/article170495982.html

https://www.healthinsurance.org/faqs/what-is-the-acas-catastrophic-plan-and-who-is-eligible/

https://www.washingtonpost.com/business/economy/medicare-pricing-drives-high-health-care-costs/2013/12/31/24befa46-7248-11e3-8b3f-b1666705ca3b_story.html?utm_term=.33e504fbc6f3

Democrats Plot to Expropriate Healthcare System

Senator Dick Durbin and his fellow Marxist are on the long march to expropriate our entire healthcare system.  This man has the same mentality as Hugo Chavez and the Castro brothers.  Why doesn’t he praise those utopian models?  Instead, he uses Medicare to push his hostile takeover of the best medical system in world.

Obamacare Targets Non-Profit Charitable Organizations

Let’s make no bones about it; the main goal of progressives is to force people into a single-payer healthcare system.  Their intention is to make life miserable for anyone seeking a modicum of care and God help the chronically afflicted.

Private insurance has become too expensive to the point where middle to upper income families are seeking federal subsidies.  No one can afford this crap.

One of the many victims of Obamacare is non-profit organizations that help the poor and the chronically afflicted.  What’s amazing is the people who run these organizations blame the insurers instead of the yahoos who are intentionally undermining their good works.  Here is an excerpt from an article written by Dana A. Kuhn founder of Patient Services Inc.

 Fortunately, charitable programs exist precisely to alleviate the onerous financial pressures for those living with chronic disease, as well as help them navigate the emotional – and even legal – challenges that often arise. Today, non-profit patient assistance programs provide as many as three-quarters of a million Americans with a temporary bridge to life-saving and life-sustaining treatments.

And these programs don’t just save lives – they do so without using a dime of taxpayer dollars.

I founded Patient Services Inc. (PSI), the first non-profit patient assistance program, from my kitchen table in 1989. As a former hospital counselor and as someone living with both hemophilia and HIV, I understand firsthand the financial pressures that families face in treating chronic medical conditions.

But now, this life-saving assistance is in jeopardy for hundreds of thousands of Americans. A faulty policy issued by the Centers for Medicare and Medicaid Services (CMS) is preventing charities from providing premium assistance to many of the nation’s sickest, most vulnerable patient populations.

Currently, health insurers in 38 states are citing this policy to deny coverage to those who benefit from charitable premium assistance, unnecessarily putting countless American lives at risk.

So insurers are at fault because of a policy mandated by the Centers for Medicare and Medicaid Services?  Shouldn’t Dana Kuhn’s grievances be with the government agency that’s denying patients charitable premium assistance?

What these people don’t seem to realize is that Progressives want all of us on Medicaid.  Charitable organizations have no place in their single-payer paradise.  The central planners will take care of all of us.  They have no need for the Dana Kuhns of this world.   

Source:

http://www.huffingtonpost.com/entry/57dbf96fe4b053b1ccf29836

Democrats Pushing Medicaid Expansion Despite Higher Costs

How can anyone declare a federal government agency is unbiased in the Age of Obama?  Anyone with common sense knows these bureaucracies are peopled with progressives whose sole purpose in life is to expand the federal government and protect those who adhere to their totalitarian ideology.  Can anyone say Hillary Clinton?  If it weren’t for Obama’s Justice Department she would be sitting behind bars by now.  Unbiased my ass.

So, I'm rather amused by an Associated Press article on an unbiased report from “nonpartisan experts” at the Center of Medicare and Medicaid Services. 

The nonpartisan experts at the CMS Office of the Actuary wrote in their report that they were expecting costs to decrease in 2015. They had reasoned that uninsured people who were putting off care would sign up for Medicaid in 2014, the first year of expansion. The experts expected that pent-up demand would ease in 2015, and per-person costs would drop. But the opposite happened: Costs went up.

An Obama administration spokesman says estimating the cost of a new health program is not an exact science.

"It is natural for estimates to change as new data become available, but the bottom line is that a growing body of evidence shows that Medicaid expansion improves the health of states' citizens, while reducing the burden of uncompensated care," CMS spokesman Aaron Albright said in a statement.

Albright said that the overall cost of the Affordable Care Act's coverage expansion is still lower than estimated when the law passed in 2010. However, other variables besides per-person costs enter into that overall figure. They include the total number of people enrolled, which has been lower because many states have not expanded Medicaid.

Really?  Probably because these scoundrels tried to dump those cost off onto the States.  Sure, these D.C. creatures would help fray the cost for the first three years, but after that who knows.  Democrats are still trying to con States into enrolling in this monstrosity.

In a recent report to Congress, the Centers for Medicare and Medicaid Services said the cost of expansion was $6,366 per person for 2015, about 49 percent higher than previously estimated.

"We were told all along that the expansion population would be less costly," said health economist Brian Blase with the Mercatus Center at George Mason University in Virginia. "They are turning out to be far more expensive." Blase previously served as a GOP congressional aide.

The new estimates could be a warning light for Democrat Hillary Clinton, who has promised that if elected president she would work to expand Medicaid in the remaining 19 states that have not done so. Higher costs would make it harder for a President Clinton to sell Obama's full-financing plan to Congress.

If the costs are higher than expected, then why would anyone want to expand it?  Maybe there is something wrong with the law.  Has anyone thought about that?  Are these people really this stupid?

Source:

http://www.wafb.com/story/32743604/medicaid-estimate-renews-cost-concerns-over-obamacare

https://www.cms.gov/index.html

Obama Admin. Plunders Medicaid and Medicare

The Democratic Party is the federal mafia.  Barack Obama has installed progressive capos at the head of federal bureaucracies and is plundering the U.S. treasury.  The latest shakedown happened at the Department of Human and Health Services and Centers for Medicaid and Medicare.  Secretary Sylvia Burwell diverted billions of taxpayer monies from programs designed to help the poor and elderly to insurance companies that conspired with the Obama administration to force citizens to buy their product.

At issue for lawmakers on the House Energy and Commerce Committee is whether the Centers for Medicare and Medicaid Services violated the Affordable Care Act by diverting $3.5 billion intended for the U.S. Treasury to insurance companies.

“[Earlier this month], the administration announced that they would be using billions of taxpayer dollars to make payments to insurance companies under the Obamacare reinsurance program,” Rep. Joe Pitts, R-Penn., said Wednesday during a hearing with Department of Health and Human Services Secretary Sylvia Mathews Burwell.

“The announcement that the administration made represents an illegal wealth transfer from hardworking taxpayers to insurers,” he continued, “and this law is very clear—$5 billion of reinsurance fees must be returned to the taxpayers.

Experts have pointed out that with the absence of payments to the U.S. Treasury in 2014 and 2015, the Centers for Medicare and Medicaid Services owes the U.S. Treasury $3.5 billion in payments from the transitional reinsurance program—$2 billion for 2014, and $1.5 billion for 2015.

Laws?  Progressives don’t need stinking laws.

Source:

http://dailysignal.com/2016/02/24/lawmakers-obama-administration-illegally-diverted-billions-intended-for-u-s-treasury-to-insurers/

Taxpayers' Entitlement Hill

H/T:
MuskegonPundit

North Carolina's Obamacare Dystopia

The Obamacare chickens are coming home to roost.  North Carolina lawmakers held a forum outlining the consequences of this disastrous program that was destined to fail.  Carolina Journal reported the following:

RALEIGH — State lawmakers were presented Tuesday with a litany of potential horror stories related to the federal Affordable Care Act. At its worst, Obamacare would sock North Carolina with thousands of job losses, double-digit insurance premium increases, deep Medicare cuts to help pay for the health reform, and insolvent hospitals and medical facilities

Chris Conover, a professor at Duke University’s Center for Health Policy and Inequalities Research, offered this grim assessment to the General Assembly’s Joint Study Committee on the Affordable Care Act and Implementation Issues.

And Conover was not alone. Mona Moon, executive administrator of the State Health Plan for Teachers and State Employees, said the retirement system would incur $116 million in Obamacare compliance costs by 2017. The ever-evolving law could tag taxpayers with additional costs on state agencies, school systems, community colleges, and universities, Moon said.

Mark Fleming, vice president of government affairs for Blue Cross Blue Shield of North Carolina, said the insurance giant already sees “troubling trends,” including a mix of patients that has been sicker than expected and a program infrastructure that remains a work in progress long after its launch.

Fleming warned of the potential for higher insurance premiums for all North Carolinians as a result.

Yet, even with the facts looking them straight in the eye, Democrats still are in denial:

The cascade of negative testimony caused some Democratic committee members to roll their eyes. Some walked out early on Conover’s harsh evaluation, and Sen. Floyd McKissick, D-Durham, issued an almost plaintive request.

“Is it intended that we will have someone speak and provide us information who actually believes the Affordable Care Act is a good idea?” he said. “Or are we only going to hear from those who are in opposition to the Affordable Care Act?”

State Rep. Verla Insko, D-Orange, expressed surprise at Conover’s contention that the state’s economy would shrink by 90,000 full-time equivalent jobs, and 300,000 full-time equivalent positions would shift to part-time, as employers try to avoid the employer mandate to pay for insurance for full-time workers and other Obamacare-related costs.

“I don’t know that there’s any reason why the Affordable Care Act would cause a reduction in the number of employees unless we had robots doing some of the work,” Insko said. 

She also insisted that higher taxes could be an economic stimulus because of multiplier effects of government spending, and that some of the nation’s most robust economies are in high-tax states

Amazing!  Absolutely amazing, that after all that has happened and all that is yet to come, these people are completely blinded by their ideology.  And as usual this so-called representative believes government spending is the answer to our economic woes.  Without a doubt, Rep. Verla Insko believes the New Deal pulled us out of the Great Depression.

If you think the above employment assessment is bleak, wait until you read the following prospects for our utopian health care system:

“Relatively minor improvements” in benefits under Obamacare “are more than offset by the sizable cuts in Medicare … to bankroll 40 percent of the ACA’s costs,” Conover said. Continued Medicare cuts in doctor payments “will be devastating” to seniors’ access to health care, according to Medicare’s actuaries, he said.

“Very deep cuts” in Medicaid Disproportionate Share payments to hospitals are planned atop a 75 percent cut in Medicare DSH payments, Conover said. Those payments cover the cost for the uncompensated care of uninsured people. 

Medicaid is prohibited by statute from paying more than Medicare for hospital services, so Medicare cuts will drive payment rates for both Medicaid and Medicare to well below the levels that are paid by private insurers, Conover said. 

The Medicare actuary predicts that 15 percent of health facilities will be operating in the red by 2020 as a result. 

“As these facilities are shuttered or start shedding money-losing services such as emergency rooms, this obviously is going to have adverse effects on access to care for the community at large, not just for seniors,” Conover said.

A quarter of North Carolina doctors do not accept Medicaid patients now due to low reimbursement rates. 

“The ACA has put Medicare on a path to soon be paying less than Medicaid does for doctor services,” Conover said. “We can only imagine what’s going to happen to access to care to seniors when Medicare’s payment rates are less than half of the Medicaid levels.”

We are in the throes of the Democratic Party’s dystopia. If we continue on this path, can anyone say:  Look out Venezuela, here we come!

Source:  http://www.carolinajournal.com/exclusives/display_exclusive.html?id=10915

http://capitalismisfreedom.com/joys-socialism-venezuela/

Senator Kay Hagan Voted to Cut Medicare

Senator Kay Hagan doesn’t have a high regard for voters in North Carolina.  She is blaming the Centers for Medicaid and Medicare for following the laws that she and her fellow democrats voted for in Obamacare.  National Review reported the following:

In 2009, Senator Kay Hagan (D-NC) promised North Carolinians who depend on Medicare that she was going to “protect Medicare” and that they would “not see a drop in their Medicare coverage.”

But in 2010 Kay Hagan voted to slash Medicare Advantage to pay for ObamaCare. (H.R. 4872, CQ Vote #72: Motion agreed to 56-42: R 0-40; D 54-2; I 2-0, 3/24/10, Hagan Voted Yea)


In North Carolina 463,159 seniors depend on Medicare Advantage plans (28% of all Medicare enrollees).

According to America’s Health Insurance Plans, in North Carolina, seniors on Medicare Advantage plans experienced cost increases and benefit cuts of an estimated $50-60 per month as a result of this year’s 6 percent cut to the program due to ObamaCare.

Now, as North Carolina seniors are being crushed under the weight of ObamaCare and as her own poll numbers plummet, Kay Hagan admits in a letter to Centers for Medicare & Medicaid that she cut Medicare for seniors after promising North Carolinians that they wouldn’t “see a drop in their Medicare coverage” 




Hagan’s letter reads: “We write to raise serious concerns about the Medicare Advantage (MA) 2015 rate notice and the impact further cuts may have on the millions of individuals enrolled in the program,” the senators write. “We are strongly committed to preserving the high quality health plan choices and benefits that our constituents receive through the MA program. Given the impact that payment policies could have on our constituents, we ask that you prioritize beneficiaries’ experience and minimize disruption in maintaining payment levels for 2015.”

Senator Hagan can run from her record, but she can’t hide.  And I don’t believe North Carolinians have to be reminded of this disaster known as Obamacare.  What we need is someone in the Senate who will actually read the bills before passing them.  There is no excuse for what this woman has done.

Source:  http://www.nationalreview.com/campaign-spot/371539/senate-democrats-why-didnt-someone-tell-us-obamacare-would-cut-medicare-jim

Obamacares Death Panel

Source:  http://directorblue.blogspot.com/2013/12/death-panel-comix-shocking-obamacare.html

Dead Patients and Illegal Aliens Scam Medicare

We already know how inefficient and wasteful the federal government is.  Here is another stat to emphasize the amount of known fraud that persists through Medicare:

Medicare paid $23 million for dead patients in 2011 and $29 million for drug benefits for illegal immigrants from 2009 to 2011, according to a report Thursday from the Health and Human Services inspector general.

The investigators said Medicare has safeguards to try to stop payments to dead patients, but it still ended up sending out the $23 million anyway.

The Centers for Medicare and Medicaid Services (CMS) — the same agency that is struggling to fix the broken Obamacare website — acknowledged the problems and said it will try to take steps to fix them.

And these central planners want to take over the whole health care system?  God forbid.

Source: http://www.washingtontimes.com/news/2013/oct/31/medicare-paid-millions-dead-patients-illegals/#ixzz2jRhaiEsu

North Carolina's Big Hospitals Predatory Practices

Liberal politicians never fail to scream about the “record profits” of oil companies, but you’ll never hear them complain about big hospitals.  The profit margin for the integrated oil and gas industry is 7.9%.  Nationally in 2010, big hospital recorded a 9.3% profit margin.  In North Carolina, Duke Hospital pulled in a 20.1% profit margin.  Now, that’s an eye opener.  Here are a few reasons why:    

In North Carolina’s cities, these hospitals are piling up profits, along with billions of dollars in reserves. An investigation by The News & Observer and The Charlotte Observer found that:

• UNC Hospitals and Duke University Health System recently booked record profits. Duke’s total profit, which includes investment income, rose to a half-billion dollars in 2011, a margin of 20.1 percent.

• They’ve made their money largely from employer-sponsored health insurance, often inflating prices on drugs and procedures – sometimes to three, four or 10 times over costs. North Carolina hospital costs are more than 10 percent higher than the national average for Aetna, said Jarvis Leigh, a network vice president.

• They’ve hiked their fees each year, leaving many patients with crippling debt. Some hospitals have sued thousands of patients, while others have turned to collection agencies to pursue debtors.

• They’ve plowed their profits into expensive buildings and machines and have rewarded executives with generous salaries. Twenty-five executives of public and nonprofit hospitals in North Carolina had total compensation of more than $1 million in 2010 or 2011, the most recent data available.

• They’ve solidified their market power by stashing billions of dollars for future purchases. Duke, for example, has reserves of $1.5 billion. In Charlotte, Carolinas HealthCare System has banked more than $2 billion

Another factor in soaring health care cost is a third-party payer system.  Hospitals make up the losses for Medicaid and Medicare patients by overinflating their prices onto the insured.  Also, patients are removed from the decision making process.  That ultimately leads to unnecessary testing and questionable billing practices.

What is amazing is that these same hospitals are demanding that North Carolina legislators approve the expansion of Medicaid.  Why is that?  Could it be to drive independent practitioners out of business and into their all-encompassing rubric?

Many independent physicians can’t keep their doors open because of the low reimbursement rates of Medicaid and Medicare, while at the same time compete with the predatory practices of big hospitals.  Independents are retiring, or joining the behemoths.

Consolidation almost always leads to higher prices.  And Obamacare certainly will contribute to the cost.  Here is an excerpt from the News and Observer stating just that:

With the 2010 passage of the Affordable Care Act, the Obama administration aims to control health care costs.

Some experts, however, fear the law – under review at the U.S. Supreme Court – could wind up doing the opposite. The law calls for the creation of networks of hospitals, doctors and other medical providers. But that sort of consolidation, studies have shown, almost always leads to higher prices.

With mergers and acquisitions, some hospital systems have become so large and dominant that they can easily raise their prices.

Increasingly, the Triangle is dominated by three expanding hospital systems: Duke, UNC and WakeMed.

And isn’t that what Obamacare is about? Consolidating services and resources into one giant monstrosity?  And as we’ve seen with the politicians and bureaucrats in Washington D.C. cost is of no concern to the totalitarians, particularly when they want to control it.

Source: http://www.newsobserver.com/2012/04/22/2016905/north-carolinas-urban-hospitals.html#storylink=cpy

http://www.csmonitor.com/Business/Consumer-Energy-Report/2012/0427/Are-the-oil-companies-gouging-gas-prices

http://www.newsobserver.com/2012/12/15/2547121/doctors-join-hospitals-and-prices.html

CBO Director: Fix Entitlements or Raise Taxes on All Americans

And lets not forget all that "free" Medicaid money the federal government is doling out.

H/T:  Weasel Zippers

Is Medicare Distorting the Health Care Market?

Health care cost doubled the rate of inflation in 2010, and in some areas it's five times or greater. If you look at the previous decade, health care rose an astonishing 48%, while the overall economy rated at 26% of inflation. Politicians are quick to point a finger at the insurance companies, but neglect the other three pointing back at them. Since the implementation of Medicare – and subsequent price controls – healthcare cost has skyrocketed, and with it a distortion of the market.

One of the biggest factors for this rising cost of health care is a lack of consumer participation. Since Medicare patients are removed from the process of a cost benefit analysis, they’ll often be given superfluous care. Here is report by Avik Roy of The Heartland Institute published in National Affairs:

In theory, Medicare does include some cost-sharing provisions, especially for physician payments under Part B. But over time, private insurance companies began to realize that Medicare's design allowed them to provide seniors with supplemental coverage to pay for the deductible and co-insurance requirements of the program — a good deal for insurers (for whom costs are finite and low), as well as for the seniors who purchase such plans (and are thereby freed from any direct cost for health care). Today, almost 90% of seniors have supplemental coverage plans, which means in effect that they have unlimited health coverage for a low and fixed cost, and thereby every incentive to seek generous, and even unneeded, care.

Combined with the fact that Medicare generally pays health-care providers on a per-service basis rather than on a per-patient or per-outcome basis, this means that Medicare creates an enormous incentive for everyone involved to provide more services to seniors. Volume, more than the cost of individual services, has been Medicare's fiscal downfall. And, as discussed below, reformers trying to fix the program's finances — from the 1970s through the health-care bill enacted last year — have sought to do so through price controls that reduce the amount the program pays for each service provided, which actually creates an even greater incentive for physicians and hospitals to provide a greater number of services to make up the lost revenue.

Proponents for Obamacare believe the federal government is more efficient than insurance companies when it comes to administration cost. That is laughable. Here are some of the outlays:

First, other government agencies help administer the Medicare program. The Internal Revenue Service collects the taxes that fund the program; the Social Security Administration helps collect some of the premiums paid by beneficiaries (which are deducted from Social Security checks); the Department of Health and Human Services helps to manage accounting, auditing, and fraud issues and pays for marketing costs, building costs, and more. Private insurers obviously don't have this kind of outside or off-budget help. Medicare's administration is also tax-exempt, whereas insurers must pay state excise taxes on the premiums they charge; the tax is counted as an administrative cost. In addition, Medicare's massive size leads to economies of scale that private insurers could also achieve, if not exceed, were they equally large.

Speaking of fraud, the federal government is so efficient that an estimated $60 to $100 billion of Medicare spending goes to fraud. Can you imagine what Obamacare is going to be like?

What’s ironic about this whole Medicare debate is the Bill Clinton factor. The savior of the Democratic Party denigrated Rep. Paul Ryan’s market based plan at the DNC. What Bubba failed to mention is that his own commission gave a similar recommendation. Had he been able to keep his pecker in his pants, we might have solved this problem a long time ago.

In 1997, as a result of the Balanced Budget Act, Congress organized the National Bipartisan Commission on the Future of Medicare, under the leadership of Democratic senator John Breaux and Republican representative Bill Thomas. The commission's final recommendation, supported by members of both parties, was that Medicare should be converted to a "market-based Premium Support model" similar to the one used in the Federal Employees Health Benefits Program.

Under the commission's proposed system, retirees would have been able to choose between private health plans and a traditional government-run fee-for-service plan (a consolidation of Medicare Parts A, B, and C). Thus traditional Medicare would have become one option among many, competing for business. Regardless of what option they chose, beneficiaries would have been expected to pay a premium equal to 12% of per capita health costs, but would have paid no premium at all if they bought a plan that was at least 15% cheaper than the average one. In addition, the commission recommended increasing the Medicare eligibility age from 65 to 67, in harmony with Social Security.

After the commission made its proposal, President Clinton made a counter-proposal, shaped in large part by his Treasury secretary, Lawrence Summers. He proposed "managed competition" for Medicare, in which private insurers would have engaged in competitive bidding for health coverage of the elderly. Retirees who chose plans that cost less than the average bid would have retained three-fourths of the savings. Clinton also proposed new subsidies to encourage employers to retain private-sector health coverage for their retirees, taking some of the burden off of Medicare.

These two sets of proposals were, in many ways, quite compatible. Indeed, according to historian Steven Gillon, President Clinton and House Speaker Newt Gingrich, along with several prominent Senate Democrats, were close in 1997 to a historic agreement for reforming Medicare along these lines. But after the Monica Lewinsky scandal erupted in early 1998, Clinton was focused on defending himself from impeachment, and this required currying the favor of ideological Democrats over pragmatic ones. Thus no serious effort was made to bridge the various reform proposals, and Medicare's problems went unresolved.

Will we ever be able to fix Medicare and our health care system as a whole? We could if the politicians would stay the hell out of it. I highly recommend reading Avik Roy’s piece in full, just click the link below. It’s rather long, but well worth it.

Source: http://www.bizjournals.com/cincinnati/blog/2012/05/health-care-costs-double-the-rate-of.html

http://www.nationalaffairs.com/publications/detail/saving-medicare-from-itself

North Carolina Still Uncommitted to Obamacare

While most Southern states have determined their participation in Obamacare, North Carolina is still weighing the options.

"I think that North Carolina is more in a wait-and-see mode," said Rep. Nelson Dollar, R-Wake, one of the state House's chief budget-writers.

Democratic Gov. Beverly Perdue is still evaluating "what's in the best interest of North Carolina families and North Carolina taxpayers," spokeswoman Chris Mackey said. But since she leaves office in January, Perdue's successor will likely set the tone on any expansion, which could cost the state hundreds of millions of dollars to carry out.

Not only is the implementation of this intrusive federal government program costly, so is the concomitant fraud that invariably follows. Senator Tom Coburn proclaimed that 20 cents of every Medicare dollar goes to fraud. Of course, nobody knows the exact figures. It’s fraud! It’s incalculable.

With that in mind, North Carolina has just recently referred over two hundred cases of Medicaid fraud to the Attorney General’s office:

Raleigh, N.C. — One day after the WRAL Investigates team reported on potential fraud in North Carolina's Medicaid system, the state Department of Health and Human Services announced that it is investigating 206 providers across the state with unusual Medicaid billing.

Most of the potential fraud cases are local, with 103 in the Triangle, 43 in the Charlotte area and 24 in Greenville and surrounding counties, state officials said. Ten of those cases have been turned over the state Attorney General's Office for review.

The WRAL Investigates team reported Monday that 23,000 billing hours were linked to a licensed therapist in Wake County last year, even though there are only 8,760 hours in a year.

Billing records show psychologist Eunice Ngumba-Gatabaki worked, on average, 60 hours per day, which cost the state $1.79 million last year.

"People should be outraged," said Gov. Bev Perdue. "Those are dollars that aren't there to treat older sick people or children."

Gatabaki's daily average increased last June as records show she worked more than 100 hours per day for 17 days. She says "there may have been some bills inadvertently billed under my provider number that may be attributable to other licensed providers."

I personally have had an experience with Medicaid grifters. In my youth, I worked on the house of Sheldon Weinberg. I remember the night, I looked up from a book I was reading, and there on the television was Ronnie Weinberg on Unsolved Mysteries. Here is the video clip (please excuse the bad audio):

These people had it all: a beautiful house in Florida, a condo in Trump Towers, a Rolls Royce, a Zimmer, and a private plane; and all at the expense of the U.S. Taxpayer.

North Carolina should weigh all options when it comes to Obamacare, particularly when it comes to waste and fraud.

Source: http://www.newsobserver.com/2012/08/14/2268630/nc-isnt-set-on-medicaid-changes.html#storylink=cpy

http://www.politifact.com/truth-o-meter/statements/2009/aug/27/tom-coburn/coburn-says-20-percent-every-medicare-dollar-goes-/

http://www.wral.com/news/local/wral_investigates/story/11129883/

http://www.nytimes.com/1989/01/09/nyregion/family-rises-using-fraud-on-medicaid.html?pagewanted=all&src=pm