Empty promises on health care will haunt Obama

Empty promises on health care will haunt Obama

Byron York
Washington Examiner
Nov. 22, 2010

Barack Obama is only halfway through his term, but it's not too early to ask: What is the biggest whopper he has told as president? So far, the hands-down winner is:

"No matter how we reform health care, we will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."

Obama made that particular pledge in a speech to the American Medical Association in June 2009, but he said the same thing, with slight variations, dozens of times during the health care debate. And now, exactly eight months after he signed the Patient Protection and Affordable Care Act into law, we're seeing just how empty the president's promise was.

The New York Times reports there is a "growing frenzy of mergers" in the health care field in which hospitals and other care providers, pressured by the new law's provisions, are joining forces to save money. "Consumer advocates fear that the health care law could worsen some of the very problems it was meant to solve," the paper reports, "by reducing competition, driving up costs and creating incentives for doctors and hospitals to stint on care, in order to retain their cost-saving bonuses."

The Obama administration's answer to the problem will undoubtedly be more regulation. But the wave of mergers is just one of many signs of trouble with the new law.

For example, we know that the government's Center for Medicare and Medicaid Services has found that the new law will increase health care costs, rather than reduce them, in the coming decade. We know that cuts in Medicare, with the money saved going to pay for expanding coverage to the poor, will jeopardize seniors' access to care. We know the law will make it impossibly expensive for companies that currently offer bare-bones health coverage to low-income employees to keep doing so. We know several corporations are taking giant write-downs because the bill will increase the cost of providing prescription drug coverage to retired employees. And perhaps most important, we know the law offers an enormous incentive for employers who currently provide coverage to workers to stop doing so, sending those workers to buy coverage in government-subsidized health care exchanges.

In sum, what the law means for millions of Americans is: No matter what the president said, if you like the coverage you have now, you can't keep it.

And a lot of people do like their coverage. A new Gallup Poll found that when Americans are asked to assess the quality of their own health care, the results "are among the most positive Gallup has found over the past decade." A total of 82 percent of respondents rate their health care as excellent or good, while just 16 percent rate it as fair or poor."

The key question of health care reform has always been how to make things better for the 16 percent while not messing things up for the 82 percent. Obama decided to blow up the system for everyone.

In doing so, he has created not just well-founded anxiety in those who are skeptical of the new law but also unrealistic expectations in those who support it. "We just told millions of people that they can go to the exchanges in 2014 and buy insurance," writes Aaron Carroll, an Indiana University School of Medicine professor who blogs on health care issues at a site called the Incidental Economist. "There won't be any lifetime or annual limits. There won't be denials for pre-existing conditions. There won't be any surcharges for having such conditions. And it's going to be 'reasonably' priced."

Carroll talked to lots of insurance executives, and concluded it's just not going to happen. "I feel like many people think they will have choice of doctor, choice of hospital, and the ability to dictate care," he writes. "I'm not seeing how insurance companies will be able to offer such products at prices people can afford."

Is any of this a surprise? The fact is, the president knew or should have known that his health care scheme would have these effects. He paid a political price for his actions on Nov. 2. There might be more to pay on Nov. 6, 2012.

I have been saying this since the first drafts of this legislation! Anyone who had actually read the bill could have told you this, as I did!

This is, imho, all a part of Obama's plan and he has said that he wanted to have single-payer health care by the end of his first term in office! Of course he didn't tell the American people this - rather he BLATANTLY LIED to them as noted above. But he wasn't so dishonest when speaking before an entitlement-oriented UNION audience telling them about his desire to create a single-payer system.

I wonder what those who voted for Obama here have to say about this?

dblboggie wrote:I wonder what those who voted for Obama here have to say about this?

The way I see it is that Obama supporters don't care. As long as they get the entitlement, it's all good.

I know that's crass but that's the way I feel about it.

TexasBlue wrote:

dblboggie wrote:I wonder what those who voted for Obama here have to say about this?

The way I see it is that Obama supporters don't care. As long as they get the entitlement, it's all good.

I know that's crass but that's the way I feel about it.

Well we shall see how much they like that "entitlement" when it takes a month to get an appointment with their primary care physician, 2-3 months to get an MRI or PET scan and they get turned down for that knee or hip replacement because they are too old - or are denied that cancer fighting drug they need because it's too expensive. And wait till they see what that "entitlement" is going to cost them, their children and grandchildren in taxes.

dblboggie wrote:

TexasBlue wrote:

dblboggie wrote:I wonder what those who voted for Obama here have to say about this?

The way I see it is that Obama supporters don't care. As long as they get the entitlement, it's all good.

I know that's crass but that's the way I feel about it.

Well we shall see how much they like that "entitlement" when it takes a month to get an appointment with their primary care physician, 2-3 months to get an MRI or PET scan and they get turned down for that knee or hip replacement because they are too old - or are denied that cancer fighting drug they need because it's too expensive. And wait till they see what that "entitlement" is going to cost them, their children and grandchildren in taxes.

People have said the VA can do it, so why not ObamaCare? I have an answer for that. Many of those who say that aren't veterans. Many of those people don't know that if you have to reschedule a VA appointment, it gets pushed back a few weeks instead of just a few days. I know because I've been there.

TexasBlue wrote:

dblboggie wrote:

TexasBlue wrote:

dblboggie wrote:I wonder what those who voted for Obama here have to say about this?

The way I see it is that Obama supporters don't care. As long as they get the entitlement, it's all good.

I know that's crass but that's the way I feel about it.

Well we shall see how much they like that "entitlement" when it takes a month to get an appointment with their primary care physician, 2-3 months to get an MRI or PET scan and they get turned down for that knee or hip replacement because they are too old - or are denied that cancer fighting drug they need because it's too expensive. And wait till they see what that "entitlement" is going to cost them, their children and grandchildren in taxes.

People have said the VA can do it, so why not ObamaCare? I have an answer for that. Many of those who say that aren't veterans. Many of those people don't know that if you have to reschedule a VA appointment, it gets pushed back a few weeks instead of just a few days. I know because I've been there.

A few weeks if you're lucky! As much as 2 months if your particular VA is short of doctors (as is mine). I had to see a oncologist for a diagnosis on a blood test and it took a month and a half wait to see him... an ONCOLOGIST! Imagine waiting that long to see if you had cancer!!! The VA system IS what Obamacare will look like if it is not repealed. And people are NOT going to like it one bit, because they are WAY more civilians than there are veterans, which means their waits are going to be much worse than ours are in the not so distant future as more and more doctors opt out or retire and fewer people pursue a medical profession as it becomes less and less remunerative.

More civilians and not enough doctors or nurses.

TexasBlue wrote:More civilians and not enough doctors or nurses.

Yep! And the illusion that health care will now be cheap for those using the government option will cause an increase in those people utilizing the system - it is basic economics - and demand (for health care services) will very quickly outstrip supply (doctors, specialists, nurses and empty beds) and then the shit will hit the fan in a big way. Just wait and see, if this thing isn't repealed we are in for a world of hurt.

I'm sure the next step is for Obama to make people go to medical school to fill the gap.

TexasBlue wrote:I'm sure the next step is for Obama to make people go to medical school to fill the gap.

Not as far-fetched as one might think given what he is trying to do with cap-and-trade and card-check.

dblboggie wrote:

TexasBlue wrote:More civilians and not enough doctors or nurses.

Yep! And the illusion that health care will now be cheap for those using the government option will cause an increase in those people utilizing the system - it is basic economics - and demand (for health care services) will very quickly outstrip supply (doctors, specialists, nurses and empty beds) and then the shit will hit the fan in a big way. Just wait and see, if this thing isn't repealed we are in for a world of hurt.

Basic economics also tells you that where there's a demand, there will be a supply.

BubbleBliss wrote:

dblboggie wrote:

TexasBlue wrote:More civilians and not enough doctors or nurses.

Yep! And the illusion that health care will now be cheap for those using the government option will cause an increase in those people utilizing the system - it is basic economics - and demand (for health care services) will very quickly outstrip supply (doctors, specialists, nurses and empty beds) and then the shit will hit the fan in a big way. Just wait and see, if this thing isn't repealed we are in for a world of hurt.

Basic economics also tells you that where there's a demand, there will be a supply.

In a free market, that would be true because there would be a financial incentive to meet that demand. BUT, we are not talking about a free market anymore. This legislation, along with extant laws and regulations on health care providers, have made being a doctor, specialist, nurse, or other health care worker more trouble than it is worth. And with the federal government telling providers what they will get paid for their services (the poor compensation for Medicare and Medicaid services has already forced a huge number of doctors to stop accepting Medicare and Medicaid patients), you are going to see fewer and fewer people pursuing a medical career (this has been the trend already, and it will only get much worse as Obamacare rolls out).

So, like I said, because of government interference in the market, the supply of health care providers will continue to shrink even as the demand for them increases. This will result in the rationing of health care. THAT is just basic economics.

(the poor compensation for Medicare and Medicaid services has already forced a huge number of doctors to stop accepting Medicare and Medicaid patients)

What will force doctors to accept ObamaCare? Another law? We already have laws on emergency room care but I'm speaking of an office visit for a cold.

TexasBlue wrote:

(the poor compensation for Medicare and Medicaid services has already forced a huge number of doctors to stop accepting Medicare and Medicaid patients)

What will force doctors to accept ObamaCare? Another law? We already have laws on emergency room care but I'm speaking of an office visit for a cold.

A law FORCING doctors to accept government insurance would cause an even greater flight of doctors from the business and ensure that even fewer people would spend the 12 years of very expensive schooling that is required to become a doctor. Of course, such a law would be completely unconstitutional, but hey, we now have a law dictating how private-sector insurers spend their earnings, so I guess a law forcing doctors to accept government insured patients isn't all that far-fetched is it?

BubbleBliss wrote:Basic economics also tells you that where there's a demand, there will be a supply.

I'm assuming that my reply to your response above proved sufficient to put this issue to rest in your mind Bubbles?

dblboggie wrote:

BubbleBliss wrote:

dblboggie wrote:

TexasBlue wrote:More civilians and not enough doctors or nurses.

Yep! And the illusion that health care will now be cheap for those using the government option will cause an increase in those people utilizing the system - it is basic economics - and demand (for health care services) will very quickly outstrip supply (doctors, specialists, nurses and empty beds) and then the shit will hit the fan in a big way. Just wait and see, if this thing isn't repealed we are in for a world of hurt.

Basic economics also tells you that where there's a demand, there will be a supply.

In a free market, that would be true because there would be a financial incentive to meet that demand. BUT, we are not talking about a free market anymore. This legislation, along with extant laws and regulations on health care providers, have made being a doctor, specialist, nurse, or other health care worker more trouble than it is worth. And with the federal government telling providers what they will get paid for their services (the poor compensation for Medicare and Medicaid services has already forced a huge number of doctors to stop accepting Medicare and Medicaid patients), you are going to see fewer and fewer people pursuing a medical career (this has been the trend already, and it will only get much worse as Obamacare rolls out).

So, like I said, because of government interference in the market, the supply of health care providers will continue to shrink even as the demand for them increases. This will result in the rationing of health care. THAT is just basic economics.

The market is still free enough to form a supply to such a great demand. The balance will automatically establish itself between pay and service, as it always does, even with government regulations.

Not to mention, the medical field is not a field one should go into only for the pay, but also to help other people and to take on the daily challenges that a medical profession poses.

BubbleBliss wrote:

dblboggie wrote:

BubbleBliss wrote:

dblboggie wrote:

TexasBlue wrote:More civilians and not enough doctors or nurses.

Yep! And the illusion that health care will now be cheap for those using the government option will cause an increase in those people utilizing the system - it is basic economics - and demand (for health care services) will very quickly outstrip supply (doctors, specialists, nurses and empty beds) and then the shit will hit the fan in a big way. Just wait and see, if this thing isn't repealed we are in for a world of hurt.

Basic economics also tells you that where there's a demand, there will be a supply.

In a free market, that would be true because there would be a financial incentive to meet that demand. BUT, we are not talking about a free market anymore. This legislation, along with extant laws and regulations on health care providers, have made being a doctor, specialist, nurse, or other health care worker more trouble than it is worth. And with the federal government telling providers what they will get paid for their services (the poor compensation for Medicare and Medicaid services has already forced a huge number of doctors to stop accepting Medicare and Medicaid patients), you are going to see fewer and fewer people pursuing a medical career (this has been the trend already, and it will only get much worse as Obamacare rolls out).

So, like I said, because of government interference in the market, the supply of health care providers will continue to shrink even as the demand for them increases. This will result in the rationing of health care. THAT is just basic economics.

The market is still free enough to form a supply to such a great demand. The balance will automatically establish itself between pay and service, as it always does, even with government regulations.

You don't understand how capitalism works, do you Bubbles? Who is going to spend a quarter of a million dollars on a 12 year education, spend possibly more than that on malpractice insurance, all for the opportunity to earn peanuts because the federal government will only pay a tiny fraction of what their services are actually worth in the real world? Who do you see rushing in to meet this increasing demand given this brave new government government controlled health care world, pray tell?

We ALREADY have medical professionals abandoning the field, and an even greater number who refuse to take patients who pay with Medicare, Medicaid, or any other government controlled insurance scheme!

The writing is on the wall for any to see.

The "balance," as you say, will NOT establish itself between pay and service because IT IS NOT A FREE MARKET!!!! Balance can only be achieved if both sides are FREE to make choices; choices by providers about what to offer, what to charge for it, and choices by consumers on who to buy it from, and what one is willing to pay!!!

The federal government is stepping in a DICTATING what will be offered, and what it will cost, WITHOUT REGARD to supply OR demand.

BubbleBliss wrote:Not to mention, the medical field is not a field one should go into only for the pay, but also to help other people and to take on the daily challenges that a medical profession poses.

Wow! Seriously? So one should be willing to spend a small fortune for a grueling 12 years of schooling and ridiculously exorbitant malpractice insurance premiums (cause those poor people these magnanimous doctors are serving just love to sue at the drop of a hat), to "help other people," is that right?

A person's career should not be about self-interest, but about serving the greater good? Am I reading this straight here? We should make sacrifices of our individual liberties and the limited resources of our life's labor for the good of the collective?

I'm sorry buddy, but it doesn't work like that here... or anywhere for that matter.

I do very well understand capitalism. And to answer your question as to who will pay for that: The same people who pay $80,000 for a major in education and end up earning not even $40,000 a year. The same goes for degrees in Social Work and other such things.
No, the balance will always be met, even with interference. If it results in raising prices or alternative practices opening up, somebody will see an opportunity and go for it. That's always been the case with government interference.

The medical profession is not a career to go into just to make tons of money, it is also to help people. Of course there should be a good reward for this in terms of income, but it should not be the ridiculous amount some doctors earn right now. Teachers can barely live a decent life yet that profession is still being filled by plenty of people because they enjoy working with kids and helping people.

BubbleBliss wrote:
I do very well understand capitalism. And to answer your question as to who will pay for that: The same people who pay $80,000 for a major in education and end up earning not even $40,000 a year. The same goes for degrees in Social Work and other such things.
No, the balance will always be met, even with interference. If it results in raising prices or alternative practices opening up, somebody will see an opportunity and go for it. That's always been the case with government interference.

The medical profession is not a career to go into just to make tons of money, it is also to help people. Of course there should be a good reward for this in terms of income, but it should not be the ridiculous amount some doctors earn right now. Teachers can barely live a decent life yet that profession is still being filled by plenty of people because they enjoy working with kids and helping people.

While it is true that there will still be some who are willing pay an exorbitant amount of money for an education in a profession that doesn't pay well, that doesn't mean that what we are doing today will create enough of a supply of medical professionals to meet the demand that will be created by the "health care reform" bill when it adds another 40 million persons to government insurance rolls. That government insurance will be cheap, will compensate medical professionals at well below true market value, decreasing the number of medical professionals who will accept that insurance, making medical help for those insured even scarcer than it is now - and that is going to force rationing. And those doctors that still accept government insurance plans will likely be forced to increase their costs to regular patients, which means those patients private insurers will be required to raise their premiums to offset that increase in medical costs. And then we get to the mammoth increase in regulations and the costs of compliance going through the roof, making care and private insurance even more expensive for everyone.

And all of this because our imperial federal government refuses to shed any of their precious power over people's lives in order to make care more affordable for all. There are numerous private sector fixes for what ails our health care system - I've gone over them many times before. All of these fixes would reduce the federal government's footprint in the health care and health insurance industries. These fixes would return personal choices back to providers and consumers, like what kinds of insurance plans providers can offer and what kinds of plans consumers can buy, like HSA's that give consumers direct control over their health care decision making. Tort reform, reduced regulatory burdens, the injection of more competition by allowing insurers to sell plans across state lines. All of these things and many more could greatly reduce health care and health insurance costs. But these kinds of things don't make the government more powerful or give them more control over markets and people - and that will never do for government.

If a significant shortage of medical professionals does in fact come up, there are incentives the government can take to increase the amount of medical jobs in the US. That has happened with plenty of industries and it has worked in the past.

BubbleBliss wrote:
If a significant shortage of medical professionals does in fact come up, there are incentives the government can take to increase the amount of medical jobs in the US. That has happened with plenty of industries and it has worked in the past.

And that is even more government expenditure of our tax dollars, more government regulation over educational institutions, more government demands on students availing themselves of such subsidies or incentives, and it still doesn't address the other problems that the Obamacare legislation ignores, like tort reform, inability to foster greater competition amongst private sector insurers by allowing sales across state lines, etc, etc, etc.

And just so you know, there already is a significant shortage of medical professionals and even the mainstream media have been unable to ignore how Obamacare is going to exacerbate this shortage, which the Association of American Medical Colleges says will double the existing estimates of the shortage of physicians going forward through 2015.

You are trying to solve this problem by adding ever more layers of government interference and control. I am saying that this is not going to work, it is only going to make things worse. We need to get the government OUT of the health care delivery and insurance business and let market forces work their magic. And before anyone launches into it, I do not mean that government does not have a valid oversight role in these matters. But as things stand now, government is choking the life out of these markets.

Yes, the government needs to pull out of the insurance sector in some areas, but it still needs to maintain a strong presence in it for the reasons I've stated before.
What needs to stop is the lawsuits against doctors and hospitals. Sure, if you get seriously injured because of careless acts or just because the hospital/doctor wants to save money on health standards, then you should be entitled to compensation.

BubbleBliss wrote:
Yes, the government needs to pull out of the insurance sector in some areas, but it still needs to maintain a strong presence in it for the reasons I've stated before.
What needs to stop is the lawsuits against doctors and hospitals. Sure, if you get seriously injured because of careless acts or just because the hospital/doctor wants to save money on health standards, then you should be entitled to compensation.

Excellent. Now we're talking. I have no objection to valid government oversight of the insurance industry, but what we have today is not oversight but rather a series of regulatory dictates that hamper the industry's ability to offer products that consumers want, products that would be cheaper to purchase as they would not be mandated to cover all manner of things that many consumers don't need or want. We also have state laws that severely limit competition by prohibiting insurers from selling their policies across state lines. This gives big companies in states near monopoly status, and that is never good for the consumer.

I completely agree with you on the law suits! Some specialties have been especially hard hit by frivolous law suits, such as OBGYN specialists. There are some states where it got so bad that there were barely any doctors left that would deliver children. We need tort reform in a serious way as these suits have been driving up malpractice insurance premiums to insanely high levels and have forced doctors to practice "defensive medicine" (a new term that frivolous lawsuits gave birth to), meaning that they order every test under the sun for every patient, just to be safe. These things are part of the reason for our skyrocketing health care and health insurance costs.

At the very least, we need "loser pays" made the law of the land - and setting reasonable caps on settlement amounts.

Tort reform is opposed by the Dems. They didn't include one spigot of it in the HC bill.

Now... let's talk HSA's; Health Savings Account's. Dbl, explain to everyone what those are. Again, this was opposed by the Dems when they were legislating the HC bill.

TexasBlue wrote:Tort reform is opposed by the Dems. They didn't include one spigot of it in the HC bill.

Now... let's talk HSA's; Health Savings Account's. Dbl, explain to everyone what those are. Again, this was opposed by the Dems when they were legislating the HC bill.

Ah yes... HSA's. HSA's are brilliant because they give the individual consumer direct control over health care decisions - not insurers or the government.

Here is how they work. Under an HSA, a person is allowed to make monetary deposits into an account (just like at a bank) up to a set amount each year - this is typically about $5,000/year for a family about half that for single persons (under current law, that amount increases a small about each year). That money is not taxed, which creates another incentive to make regular contributions to the account for future health care expenses. Another important point is that this account is owned directly by the individual - not a business or government agency - it's their money. Some employers already offer HSA plans combined with high-deductible health plan (HDHP), and make contributions to employee HSA accounts (sometimes matching, sometimes not). The funds in HSA accounts roll over year to year, so one can amass quite a tidy sum of money in such an account. Additionally, these funds can be invested by the individual (similar to IRA’s in that respect) and the interest earned on those investments is also sheltered from taxation until the money is withdrawn (although if the withdrawal is for a qualified medical expense, then it is not taxed).

One does not need anyone’s permission to make withdrawals from the HSA accounts, and if these are for qualified medical expenses, they remain tax free. You can hit your HSA for any reason (it is your money), but if it is not a qualified medical expense, you then have to pay taxes on that amount and there is typically a 10% penalty (unless you are over 65 years old or disabled – then you just pay the tax).

The great thing about HSA's is that they make people much more responsible consumers of health care services. They tend to shop for the best price, and as they are cutting out a middle man (most of these accounts come with something like a debit card which can be used exactly like a debit card and also checks), you can bargain for better prices as it’s exactly like paying cash on the spot for services rendered. This cuts down on the enormous amount of paperwork a health care provider has to do when dealing with an insurer (whether that be private or public).

Just imagine young people, newly entering the job market, setting up HSA's and contributing to them for 20 or 30 years and investing a portion of those funds – imagine how much cash money (not imaginary government insurance money) they would have to cover their health care needs.

While there are disadvantages for HSA’s for older and lower income persons, this does not always have to be the case. If we started educating young people right now, (while keeping Medicare and Medicaid for the poor and elderly) and encouraged this current generation of young people to participate in HSA’s, in a generation we could turn the way we think about obtaining health care completely around and dramatically lower not only health care costs, but also health insurance costs. Of course, we’d see even more dramatic changes if we could get the federal government to scale back regulation, encourage competition, and reform tort laws.

That’s about it. Let me know if I left anything out.