Sally Pipes, of the Pacific Research Institute, and noted conservative, has suggestions on how to end Obamacare. Her Forbes (online, Dec. 29) article suggests the reformation of Medicaid; as well as Implementing a “system of block grants” that “would bring Medicaid costs under control and allow states the freedom to experiment with various mechanisms for delivering benefits.” . . . “Such experimentation could lead to better care for Medicaid recipients at a lower cost to taxpayers.”
Pipes also suggests the elimination of both the ACA Individual and Employer Mandates, as well as reformation of the Tax Code.
Laura Tyson, is a one-time chair of the U.S. President’s Council of Economic Advisers, and also is a professor at the Haas School of Business at the University of California, Berkeley. Lenny Mendonca is a former director of McKinsey & Co. Both have recently and jointly posted (online, Dec. 30, for Market Watch) an article which asks if there is any chance for, “the start of a new era of public-private collaboration to develop innovative solutions to complex social problems, and, thus, to restore trust in government itself.” The Market Watch writers claim the ACA is establishing broad incentives in the area of “healthcare efficiency.”
● Use of electronic health records.
● Establishment of “Affordable Healthcare Organizations.”
● Reduction of hospital visits by “Super Users” (New Jersey).
● “Pay For Success” A 1.9 billion monetary amount to that state, from the federal government, if the state restructures its Medicaid services.
Doctors who treat patients on Medicaid are facing an arduous beginning to their 2015 practice years.
According to a new post on Vox by Sarah Kliff (online, Dec. 29) doctors in the category are now looking at a 42 percent reduction – in terms of Medicaid physician reimbursements. The final decline(s) in Medicare reimbursements to doctors will ultimately differ from state to state. This is due (according to Kliff’s Vox report) to each state determining and establishing its own rate of payment for primary care doctors.
California has a pattern of paying Medicaid doctors very low rates; the Affordable Care Act has increased their fees by as much as 50 percent. On the other hand, in North Carolina, as state in which two program fees were approaching identical, the rate increase was less.
According to a Dec. 30 post on the Daily Caller website, Jonathan Gruber, at one time, Barack Obama’s “healthcare adviser” took the position that the Affordable Care Act was anything but, this as he was authoring the legislation in conjunction with the Obama White House.
The Daily Caller also claims Gruber continues to not produce requested documents – while awaiting another invitation for additional congressional testimony before Rep. Darrell Issa’s (R-Calif.), House Oversight and Government Reform Committee. Will that appearance occur in 2015?
The Daily Caller report also says, now coming to the forefront, is information which details misstatements going into the composition of Obamacare. The Daily Caller report, by Patrick Howley, says that Gruber claimed “Obamacare had no cost controls in it and would not be affordable” – – (October 2009 policy brief). Yet, Gruber had told the U.S. public that their respective premiums would decrease in cost appreciably.
Also according to The Daily Caller, Gruber is quoted as saying (on October 2, 2009) “[Y]ou can’t mandate insurance that’s not affordable.”
What is described as Universal Healthcare, as it turns out, comes with a price tag. According to some, it’s a high one. A new article in The Investors Business Daily (IBD, online, Dec. 29) – says that in 2010, President Obama promised the Affordable Care Act would “lower costs for families and for businesses.” It turns out, according to IBD that neither is the case. For example, service businesses, inclusive of garbage collectors, are passing their added healthcare expenditures on to their consumers. This translates to higher bills. One trash collection company in Charlotte, N.C., according to IBD, sent a letter to its customer base, “Unfortunately, we are unable to internalize this cost and are sorry we have to pass this cost on to you.”
Currently, businesses (employers) with 100 or more full-time staff are looking at significant increases in health insurance expenditures. This will literally be a result of first time compliance with the Affordable Care Act’s – “Employer Mandate.”
As a potential or verifiable candidate for public office; or even one later enjoying frontrunner status, will severing perceived inappropriate private sector ties make you more likeable in the eyes of voters? That question perhaps, first and best, should be put to Mitt Romney. The former Massachusetts Governor cut the majority of his connections with Bain Capital approximately 10 years prior to running for president. It did not make him any more endearing to the electorate. A new report in Mother Jones (online, Dec. 26) alludes to former Florida Governor Jeb Bush likely carrying the same type of baggage , at least in this regard, as Romney. Soon after Bush’s term as Florida’s Chief Executive ended, he became an adviser to Leman Brothers, then to Barclay’s.
It’s Bush’s affiliation with Tenet Healthcare that is probably most problematic – at this point — should he decide to make a 2016 presidential bid.
As writer Kevin Drum, elaborates in the mother jones posting, “According to various media reports, Tenet backed President Barack Obama’s health reform act and has seen its revenues rise from it. Bush’s involvement with Tenet could give ammunition to conservatives in the GOP who view him as too moderate – – particularly those who despise the Affordable Care Act.” Drum also says, “I can’t help but get a chuckle out of this. In normal times, Bush would have left Tenet because it’s a big, soulless corporation that’s paid fines for Medicare fraud and been criticized for dodgy tax practices at the same time it was beefing up executive pay. A man of the people who aspires to the Oval Office can’t afford to be associated with this kind of dirty money.”
A recent article by Scott Wong in The Hill (online, Dec. 21) discusses a federal budget “tool” which may permit Republicans (and anyone else in Congress opposed to the ACA) to essentially bulldoze Obamacare. It is known as “budget reconciliation” and uses stalling techniques such as filibustering, closing debate, etc. While potentially employable – it remains as a divisive point for Republicans. According to the Hill some are calling for it to be used to restructure the Internal Revenue Code, or pass major energy initiatives.
Senate Republicans see real power in reconciliation, because it would grant leeway to enact laws with “a 51-vote simple majority rather than the usual 60, greatly increasing the chances of moving legislation to President Obama’s desk,” according to Wong’s Hill report.
Concurrently, there is support on both sides of the political aisle to scrap smaller components of Obamacare. Things like restoration of the 40 hour work week, and repeal of the dreaded Medical Device Tax. According to The Hill account, “those provisions wouldn’t require the filibuster-proof budget tool.”
More and more, Republicans see budget reconciliation as another political strategy; a way to send a message, one seen as demonstrating “a contrast with Democrats on Obamacare ahead of 2016.”
Wong’s Hill report also says the last year reconciliation was deployed was in 2010. At the time, Democrats (absent a huge majority) needed it to alter Obamacare.
In a new report in Human Events (ojnline, Dec. 18) blogger John Hayward describes Vermont as ”a little socialist paradise – the landlocked Cuba of the Northeast.” Thus, adds Hayward, it “seemed to make it an ideal laboratory for the great experiment in single-payer, but the small size of the laboratory proved to be its undoing. Socialism is a lie; it relies on deception and trickery to conceal its costs, fooling voters into surrendering their freedom in exchange for discounted goods that suddenly become far more expensive, once the need for deception ends.”
Now comes news (according to the Human Events report) that Vermont Governor Peter Shumlin has lowered the boom on single payer healthcare in his state. In making his announcement, the governor said, “These are simply not tax rates that I can responsibly support or urge the Legislature to pass,” adding, “In my judgment, the potential economic disruption and risks would be too great to small businesses, working families and the state’s economy.”
Is Shumlin’s action confirmation of the argument that Obamacare / single-payer healthcare can’t can’t work in the Green Mountain State – – and every other state? Hayward additionally argues, “Obamacare will collapse as planned by its designers, and we’ll be told total, direct government control over the medical industry is our only option. Every American should consider the fate of Vermont’s single-payer scheme as a teachable moment, and a warning, but it’s not going to get a whole lot of national media coverage. It will be spun the same way every leftist failure from Soviet communism on down has been spun: the wrong people tried it, at the wrong time.” The right inclined Human Events cites the more left-leaning Politico, which recently reported that Shumlin voiced other insecurities about government sponsored healthcare in his state, “This is not the right time.” The governor also expressed his own concerns over an increase in taxation needed to fund it.
Hayward perhaps best sums his anti-ACA positions on the issue by writing, “A big left-wing scheme died because the governor had to admit it would cause “economic disruption and risks” that would be too much for small businesses and individual citizens to handle.”
“Should we be worried that an architect of Obamacare seems to be an advocate of what sounds an awful lot like Eugenics?” – Healthcare consultant David Catron asks this question in The American Spectator (online, Dec. 15). The Merriam Webster Dictionary (online) defines “Eugenics” as, “a science that tries to improve the human race by controlling which people become parents.” In light of Jonathan Gruber’s recent anti-voter comments regarding their level of intelligence (or lack of it) new questions have arisen. Is the scientifically-based concept of “positive selection” reflective of at least a portion of the Affordable Care Act, its “cost control strategy?” Questions as these (and others) are raised by Mr. Catron’s Obamacare analysis.
In the recent hullabaloo over the now notorious remarks by Obamacare “architect” Jonathan Gruber’s – – as offered during his recent testimony at a hearing of the House Oversight Committee, the one chaired by California Congressman Darrell Issa, R-Calif. – – the possibly overlooked phrase, “positive selection” was uttered. The term was brought under the political spotlight; as Catorn writes, as it was “read aloud by Republican Rep. Thomas Massie, from a 1997 paper the professor [Gruber] co-authored concerning abortion.” Catron tellingly adds, “Rep. Massie asked the professor what was meant by “positive selection.” This question was evidently not anticipated in Gruber’s pre-testimony coaching, so he became evasive.”
In the past, Gruber has referred to “mass abortions” of “unborn babies,” which also concurrently categorizes as “marginal children,” Gruber was present at high level White House meetings during the development and inception phases of Obamacare, or the Affordable Care Act, as it is also known. The American Spectator articles also discloses, “When Massie continued to press him about whether he supported the rationing of end-of-life care, Gruber finally claimed, “I do not advocate that government should ration end of life care.” This was almost certainly a lie. Gruber on record saying that, where medical decisions are concerned, “seniors do a terrible job.”
What will drive people to sign up for Obamacare during the latest round of open enrollment? Will it be the positives? The perceived benefits of doing so? Or, will it be fear and worry over the looming ACA tax (or fine) for having failed to do so? In a new report for the Hill (online, December 17) Elise Viebeck asks these questions, then explains, “Consumers face a Feb. 15, 2015, deadline to buy insurance, after which those without coverage could be hit with fines of $325 per adult or 2 percent of family income, whichever is higher.” Viebeck’s Hill piece also points out, “People without insurance are running out of time to avoid the hefty Obamacare penalties that the IRS will be handing down in 2016.”
Meanwhile, those in the without health insurance category are seeking an escape hatch to avoid the tax penalty now more closely look at the healthcare exchanges (or marketplaces) – prior to their closing. Both tax preparers and insurance companies see the impending tax as chances at more business. For example, chain tax-preparer Jackson Hewitt is prodding customers consumers to visit their locations, pledging their associates “work harder to keep up with the latest tax law changes to protect you from possible penalties – – not everyone else does.”
Meanwhile if prodding doesn’t work, there is always the previously alluded to fear: CareFirst BlueCross BlueShield (of Washington, D.C. ) warns consumers in that metropolitan region that going without health insurance coverage would come with a steep cost.”CareFirst Blue Cross Blue Shield has also sent D.C. residents a mailer, which in part says, “When you don’t have health insurance . . . you put your financial security at risk.”
The Hill report additionally explains, “The penalties for going without health insurance were also more modest, with uninsured people due to pay $95 per adult or 1 percent of family income this tax season. Under the second-year enrollment rules, families that forgo insurance could end up owing $1,000 or more.”