5. Four million people will lose their employer-based plans.
The new health care law will impose a list of benefits each health care plan will have to offer if they are to remain in business. The Congressional Budget Office also estimates that about 4 million people would lose their employer-based plan and be forced to buy plans on the new government exchanges.
6. Medicare will cut services along with costs.
The bill makes $528 billion in cuts to Medicare, including a $136 billion reduction for Medicare Advantage. The Medicare Advantage cuts will force 4.8 million seniors off the popular plan by 2019. An additional $23 billion in cuts to Medicare will come from a panel charged with slashing Medicare spending.
7. The bill will not pay for itself.
The CBO found that the bill would reduce the deficit by $138 billion over 10 years, but the savings was achieved by leaving out a $208 billion provision lawmakers will have to enact later to ensure doctors are adequately paid for treating Medicare patients. When the “doc fix” is included in the bill, it runs $59 billion in the red over the next decade. And former CBO Director Douglas Holtz-Eakin said that “if you strip out all the gimmicks and budgetary games” the 10-year deficit would exceed $560 billion.
Strike up the band, the ship is sinking! Look at all the folks laughing and joyful about this sad end to a once great Republic. I’m not sure what we will be once the economy collapses, but one thing for sure, the politicians that did this to us won’t be in power anymore. I think they have set up conditions for a far-right political blowback.
Gird up your loins…
If you thought the world was a cold hard place before…you ain’t seen nothin’ yet.
another look: San Francisco Chronicle article give some year by year implimentations…that is of course if the doom’s day button isn’t pushed by my friend above…..
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/03/23/MN531CJKCG.DTL&tsp=1
I am mad as hell that we have put this on our children, grand children and great grand children…..
#2
It wasn’t me that pushed the “doom’s day button”, I just understand the numbers when I look at them.
Enjoy your dance.
http://www.usdebtclock.org/
Kendall, I’m disappointed you’ve chosen to highlight this article, which is highly partisan and filled with half-truths and speculation. “Obamacare?” Are we in second grade?
S&T, we’ll let you know when it’s safe to come out of your bomb shelter.
Politics aside, I have the sinking feeling that I would have if I just signed a binding contract for a house or car that was way, way beyond what I could afford. This is that sobering. Then too all our choices have moved from the marketplace to the lever pullers within the Washington beltway. Who has confidence that they understand what we truly need?
#5
Please point out the specific partisan statements, half-truths, and speculations in the article that you find disappointing.
Why are you concerned with calling the bill “Obamacare”? Wasn’t it President Obama that touted it from the bully pulpit, twisted arms, and offered an Executive Order to push it through? He owns this, for good or ill. It is “Obamacare”. You think it will be for the good. I disagree. You offered an opinion. I offered a link to the debt clock. Who is in 2nd grade?
Executive order? What Executive order? Has anyone seen that yet? Bueller? Bueller?
Yeah! He flashed a piece of paper that he put is his signature on but who actually read it? LOL! The sad truth is he knew that when he put that “Executive Order” out thee it was not worth the paper and ink that it was written on and with and neither was his signature…he knows it was a rouse…and the dodo heads that fell for it deserve the loss of their offices in Nov.
Actually, he’s supposed to sign the executive order (language is here) sometime today, but we should be reminded that an executive order CANNOT trump Congressional legislation, so it’s essentially meaningless except as a cover for “pro-life” Dems that has fooled no one.
Chicago style politicos wield Chicago style politics……who knew?
The Executive order tripe is merely covering for caving antiabortion votes to get the rancid butter passed. Watch what happens. Oops, no executive order!
Obamacare is a good example of “a spoonful of sugar makes the medicine go down.”
All of the “pluses” go into effect immediately. It’s wonderful your kids will now get family healthcare until they are 26; that there will be no disqualification for pre-existing conditions and no lifetime cap on care (I actually agree with 2 out of three of these goals, although we could have done it in a manner far short of enacting socialized medicine).
However, the problems and costs will crop up later: that private insurers will now be forced to raise premiums to cover the new government mandated benefits (which will lead to a nother round of, “see, look what the evil insurers are doing to you!”); and things like being forced to buy insurance or be fined or jailed, the fact that private insurance eventually will be forced out of business, that businesses will be fined if their employees go out and try to get private insurance on their own, that your care will be limited by government regulators, that doctors will not be able to be reimbursed for their costs, are all way down the road. By that time it will be too late to do anything.
And when you are faced with a 30% increase in the costs of your healthcare, and you say, what happened to that $2,800 savings I was supposed to get, the Obama administration will play the same game it played with the “stimulus” bill and say, “Oh no, we only promised you would save $2,800 over what your increase in medical costs would otherwise be!” Since that statement is impossible to disprove, just like it is impossible to disprove they “saved” jobs that would otherwise have been lost, they will be In Like Flint for our lifetimes and our children’s. Welcome to Socialist America.
[blockquote]Please point out the specific partisan statements, half-truths, and speculations in the article that you find disappointing.[/blockquote] I started to in this response, but quickly ran out of space. But it is full of opinion and speculation, focuses on the sensational, and ignores all the benefits of the bill. It’s fear-mongering. For example, in their “Truth” #1, they quote a single opinon that the plan will cost more for middle-income families. In some cases, that may be true, but for the vast majority of families, they will either be getting a subsidy, or their premiums will be capped at a specific amount about in line where premiums are now. Given that insurance premiums have been rising 8-15% or more every year for the last decade, this is a net gain for families.
The rest of the items in the list rely on speculation (such and such “may” happen) to play up fears, but don’t mention some of the benefits:
— for many more people, insurance becomes more affordable, not less;
— children can stay on their parent’s policy until age 26;
— no one can be denied for pre-existing conditions or dropped for poor health;
— maximum benefit amounts are eliminated;
— medicaid is expanded to cover more people
just to scratch the surface. I don’t see any of that mentioned in the article.
Instead of linking to the debt clock, how bout linking to this page, which shows you exactly how the bill will affect you based on your income, family size and current source of coverage: http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/ Most people will either get better coverage (because they are under-insured now) or will pay less for the coverage they already have.
Obamacare will bankrupt Insurance Companies! Not only will they go bankrupt but before they do …BHO will come out and do a media campaign that rails against the Insurance Companies calling them greedy as if it is all their fault instead of him and his policy that he has signed today that will make it impossible for the insurance companies to be able to keep up with “FREE” preventive health care costs with no one paying for preventative procedures except the government who bill the Insurance Companies and then you and I the tax payer will wind up paying for it all and if we can no longer do so and the money is not there….the Insurance companies will be closed down and all we will be left with is the GOVERNMENT!
Decisions & Votes have consequences!
Scott K I went to your site and did the little calculation and since there is only two of us in our 50’s+ and paying child support with one income here is what we are looking at and by the way we have not had insurance for 5 years!
[blockquote]Beginning in 2014, you will receive tax credits to help afford insurance premiums in the new exchanges as well as assistance with deductibles and co-payments. According to your income and family size, the tax credits will ensure you do not spend more than $4750 on premiums. Your maximum out-of-pocket costs for deductibles and co-payments would be capped at 30% of the total cost.
You are required to have health insurance. If you don’t, you will pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5 percent of household income.[/blockquote]
So this means that I will have to find a second job and my husband a second job in order to meet this demand…how in the hell is this helping me?
By the way it is [b]UnConstitutional[/b] to force me to buy health care insurance!
Another thing that should be mentioned is that at the last moment the Democrats slipped in provisions to nationalize the student loan industry, now requiring that all student loans be obtained through the government.
Why did they do this? Because hidden in the new government-mandated student loan program is a tax that will be imposed upon the loans (a 4% per annum tax on the principal of the loan, buried in the interest rate) to help pay for Obamacare and other new socialist programs. See press release by Sen. Lamar Alexander here:
http://alexander.senate.gov/public/index.cfm?p=PressReleases&ContentRecord_id=a8114fee-b14b-4afb-b528-5ec2fcae3819
Scott K
So I guess I can judge the success of this plan on where my insurance premiums are in what 2 years – 4 years? if they are at or where they are now the bill is a success?
I don’t think insurance companies will go bankrupt – I think they will start offering a bill processing option where people get the insurance company rates for minor care. This will NOT be insurance since the individual will be responsible for all the charges. Most people will use this and pay the fine.
Then people will use this service and be able to sign up for care quickly if they actually need anything significant. The cost of insurance will balloon beyond belief
Note that the penalty only applies to income hence children and or nonworking spouses won’t be subject to very much. Can children even be penalized at all?
All of the benefits of this program have to be paid for by someone. Money does not actually grow on trees. The taxes on drugs and medical devices, the “free” annual physicals, the subsidies, etc., etc., — these are all going to cost money. Costs are going to go up and benefits are going to have to be cut. There aren’t enough “rich” people to pay for all of this, and there will be fewer of those because of the business disincentives in the bill. If folks think otherwise, I suppose they may also be expecting the actual Easter Bunny to deliver candy in a couple of weeks.
It’s way worse than most of you write. We can not pay for this bill. Plus the huge debt we ( USA ) already has. There is no way to pay for it. They can not raise taxes enough to pay for it. Hyper-inflation would help, but the o’s policies are deflationary—so there goes that.
It is really that bad. You don’t see it yet. But you will. And, yes, God’s had could intervene, but with a president who does not go to church, I am not too keen on than. Look at Niniva.
bl
First, the CBO is not generally known for accurately forecasting future expenditures of programs, they tend to underestimate the expenditures that are experienced.
Second, the Executive Order offer is, very literally, [b][i]worthless[/i]![/b] Federal appeals courts have repeatedly and consistently held that in order for [i]comprehensive health care statutes[/i] to exclude federal funding for abortion, the statute itself, as amended, must [i]explicitly[/i] forbid such expenditures. That is the reason that the ([b]only[/b]) solution in the past was the Hyde amendment. It amended the statute to include Congress’ [i]explicit[/i] prohibition on such expenditures. If you think otherwise, you are sadly mistaken. This has been addressed during the past week or two by a number of law professors, including this letter to Rep. Bart Stupak from a professor of law at Catholic University.
Pax et bonum,
Keith Töpfer
#16 — If it’s unconstitutional to force you to buy health insurance then it is constitutional to turn you away at the Emergency Room Door; or to refuse you coverage in middle and old-age.
You simply can’t have it both ways.
No one who is mortal (and last I checked the mortality rate is still 100%) can go through their life without healthcare; and, practically speaking, no one can pay for the health care they will eventually need. This is a huge commons problem Pretending it doesn’t exist is irresponsible.
On the whole, I have really appreciated T19’s coverage of the healthcare debate. This one falls short — it’s pretty much just more partisan distortion (with an occasional fair-minded criticism). For what it’s worth, the complacent and self-congratulatory piece from the Washington Post posted earlier this morning isn’t much better, so at least Kendall is even handed in posting partisan rants!
[b]13. Scott K[/b],
You wrote [emphasis mine]: [blockquote]how bout linking to this page, which [b]shows you exactly how the bill will affect you[/b] based on your income, family size and current source of coverage:[/blockquote]
How about reading the disclaimer on that page a little bit more carefully before making [i]pie in the sky[/i] assertions. The description of the calculator reads as follows [emphasis mine]: [blockquote]A number of factors – including income, age, location and family size – will determine how it specifically impacts your life. [i]This tool looks at what it [b]could[/b] mean for your health coverage and taxes[/i] based on your income, family size and current insurance status.[/blockquote] Furthermore, the reason I refer to your assertions as [i]pie in the sky[/i] is that, as of the current date of this comment, it is almost a certainty that [i]NO ONE [b]knows[/b][/i] what the costs and benefits are, for the following reasons:
• If my suspicions are correct, the precise list of covered benefits isn’t available in a published form.
• The bill that follows, which at the moment is only promised, is not available for public analysis and even if it were, has not been adopted. There is a finite non-zero probability that once that bill has been approved, if it is, the whole package may have to go back to the House for ratification.
• Neither you, nor I knows what is in the bill, so your confident assertions are “whistling in the dark.”
• To the extent the so-called “health care reforem” is patterned after Medicare, the odds are that the reimbursement rates will be insufficient to provide enough physicians, particularly specialists, to deliver the requisite quantity of service to the beneficiaries needing same.
Please believe me that when I refer to Medicare I have some knowledge of the subject. I am retired from service in the U.S. Navy, and as such, am covered along with my spouse by a Federal “health insurance” program called Tricare. Tricare reimburses physicians at rates that are, by law, identical to those used by Medicare. The military retiree community has already been seeing substantial difficulties in obtaining care under Tricare for more than a decade, particularly in areas of the U.S. away from major populations centers. Doctors simply can’t afford to take too many Tricare (or Medicare) patients and still earn a living, whether you like it or not.
Secondarily, every year Medicare (and therefore Tricare) reimbursement rates are, by law, required to be reduced. The justification for this was in the original law and it was based on the great savings that were to be realized with Medicare. Every year for quite some number of years now, Congress has been required to hold the reductions in abeyance. The cumulative reduction that is currently being held in abeyance is 21%. Realize that this is not a reduction of 21% from what the medical provider (any medical provider) bills, it is 21% from the current level of Medicare reimbursement. The current rates of reimbursement are, on average, in the vicinity of 20 or 25 [i]per cent[/i] of the billed amount.
The message behind this history, is that no one (let me be perfectly clear about that, [b]NO ONE[/b]) is going to see their “medical costs” reduced by this program. At least not on balance. The U.S. taxpayer cannot now afford to pay the taxes necessary to keep Medicare afloat, and Medicare and Tricare together amount to a relatively small fraction of the U.S. population. Extend the same sort of program to everyone and what you have is a clear recipe for bankruptcy in a fairly small number of years.
Medicare doesn’t work because of the rate of increase in medical expenses, which is in turn driven, to some significant degree, by the fact that Medicare and Medicaid reimbursement rates don’t begin to cover enough of the actual costs of medical care. Granted that some levels of compensation in the medical and medical administration fields are probably out of line. But that is massively overshadowed by the fact that government dictates price, it doesn’t compute it.
So, please climb down off your high horse until you show some grasp of the reality of how the world actually works. We will all be much calmer and more collected if you were to do so.
Pax et bonum,
Keith Töpfer LCDR, USN [ret.]
RE: ““Obamacare?â€
Heh — oh yeh, that’ll be the long-term name for this giant hog in a poke — it’s good for the bill to be hung around his neck right from the start. He owns it, and he’ll take responsibility for it too.
Obamacare is the *perfect* name for this corrupt amagalm of horrors.
Sarah, for the moment it’s “Reidcare,” since what is law today is that abominable Senate bill. Soon “Pelosicare” will be added to it, supposedly making it better, but really adding another layer of taxes and costs and corrupt deals. We should just call it “DemCare” as a reminder of what the Democratic Party will do when it gets Congressional super-power and the Presidency. Never again, if we’re wise.
Keith – I agree with you that no one knows every detail yet. Which is why I am amused by the panic in some of these posts. If you don’t think I’m calm and collected you are misreading my posts.
#15 TLDillon: If you currently don’t have any insurance, then of course you will be paying more than you pay now which is nothing. You will receive subsidies so that you can be covered for a lot less than it would probably cost you now, and the insurance company won’t be able to deny you coverage if you are not in perfect health. And the $$ quoted for you is the *maximum* you would pay, not necessarily the final amount. Isn’t that better than going bankrupt if you or your spouse gets sick?
Surprise!!! Not!
#22,
[blockquote]#16—If it’s unconstitutional to force you to buy health insurance then it is constitutional to turn you away at the Emergency Room Door; or to refuse you coverage in middle and old-age.[/blockquote]
Minor problem with your strawman here. I believe it is unconstitutional for the government to force everyone to purchase any product in the marketplace, however we must never equate healthcare with health insurance. One may not have health insurance, but you would receive health care, the payment for the treatment is between you and the hospital then. I have no problem helping the indigent, but for those who are not, choices have results. Refusing coverage would be allowable if the market dictated, no company should be forced to sell its product at a loss.
Furthermore, why do you, or anyone else, have a right to any of my life as represented by time, money, expertise, etc.? I may choose to give it to you, but you have no right to demand it of me.
And do not try the auto insurance argument. No one is forcing you to drive, you have the choice and if you do you have to play by the rules. However, I no longer have the freedom to make a bad choice with my life as by the virtue of existing I must participate in the national healthcare system.
Just sayin’…
if the tea [partiers] had had their way back when social security and medicare were being discussed we wouldn’t have either program now so i don’t understand the griping about cutting bene’s in this article. seems to me they would be more than happy to cut everyones’ benefits to nothing on anything provided by our government. want health care but can’t afford it? go without, die quickly or go begging.
[Comment edited by Elf as have subsequent posts – please be careful of inflamatory language]
#28 — I’m assuming you have insurance. I do. Therefore we’re already pooling the risk. Right now, I’m paying for care for somebody else with “my” money; later somebody else will pay for me with “their” money.
Otherwise, “payment for treatment is between you and the hospital” — yep, and I go bankrupt. Result, the overall cost of care is driven up.
FWIW, I am appalled by the Democrats willingness to demonize the health insurance companies to get the thing passed. But then I am also appalled by the utterly short-sighted and irresponsible political calculation made by the Republicans. What in the world are we going to do when it comes time to tackle Social Security?
#29
“…if the tea [partiers] had had their way back when social security and medicare were being discussed we wouldn’t have either program now so i don’t understand the griping about cutting bene’s in this article…”
Current Unfunded Social Security Liability: $14,233,000,000,000
Current Unfunded Medicare Liability: $74,887,000,000,000
Current Unfunded Perscription Drug Liability: $18,831,000,000,000
Current Liability per citizen: $349,441
Current Debt per citizen: $180,589
Current Debt per family: $690,933
Current Median family income: $61,000
Now add the cost of Obamacare…
So, how are we going to pay?
J. Champlin, and that’s why how the Democrats pushed this through is actually more important in some ways than the bill itself. It sets a precedent for ramming through important legislation – from Megan McArdle at the Atlantic:
I don’t think Obamacare is respectful or helpful; I meant to take it out of the title and have now done so. So thanks #5. I post lots of articles from different perspectives and what is important is to interact with the substance of the article(s) if you agree or disagree.
Can we also call a halt to [deleted] (see #29, magnolia) as demeaning and sexually offensive?
[Thanks – we agree – Elf]
Dr. Harmon, I am willing to call it something else, but what? So many news sources have been calling it “Obamacare” for so long, liberal sources included, and the President has called it “my bill” so many times that I don’t think it’s demeaning. The President and the Congressional leadership are proud of this legislation, claim credit for it, and think it’s the right thing for the country.
I second Branford’s request on the elimination of the “[deleted]” term, which is not a term used by or accepted by those opposed to this health care bill.
#30–Yes, I have insurance, and [b]I[/b] pay for it with the money I earn, it is not a gift. So, I am fine with the pool, and spreading the risks around. However, [b] I [/b] have chosen to participate. No one is forcing me to do so. That is the point.
By your logic, that the overall cost goes up, everyone ought to be forced to only buy certain food products, homes, housewares, cars, you name it, at subsidized prices. Then they could live within their means without any unfortunate events occuring to them to put them in debt, you know ’cause they might go bankrupt and the overall cost of said goods would go up. There is an element of utopianism to all of this, and utopianism does not work as “stuff” has a tendency to happen. We can try to mitigate it, but life is messy.
If this bill is about insuring those currently without insurance, there were easier and more popular options.
I do believe that there should be a balance between personal responsibilty and true charity. I really am not a cold-hearted person, I just don’t believe that the nanny state is really interested in what is best for me. Maybe, if the Church acted like the Church and became the seat of charity again, with it’s own hospitals and clinics and kitchens and shelters, and…., we wouldn’t need the State to do it all for us.
That is the true difference between the political philosopies, who can do a better job of caring for the least of these, centralized bureaucratic governments, or local consortiums of dedicated people?
If we can’t legislate morality, how can we legislate charity?
Don’t forget that the States and the Federal Government5 are different sovereigns and operate under different rules. The Federal Government is a government of limited powers which are spelled out in the Constitution. In theory at least. (Although I think that the Commerce Clause has been stretched past the breaking point so as to make the concept of limited powers a farce.)
States on the other hand have what is called “the police power” which is a term of art meaning they have all the powers of a nation state unless limited by their own constitution or the Federal Constitution. A state is not a government of limited power in the way that the Federal Government is supposed to be. The fact that a state may require a driver to have insurance is permissible unless limited in some way and it totally different from the Federal Government requiring health insurance for which it must point to a specific grant of power in the Constitution.
I have 2 children between 21 and 26. If they are now covered by my employer, which is a self insured company, then all of my coworkers will receive a pay cut thanks to this bill. Why does everyone keep saying that the ability to keep adult children on their parents insurance is an immediate plus? It will be for some, possibly for me. Others will pay for my benefit. Similarly, I read of someone complaining that it is not fair that reproductive health issues , such as in vitro fertilization, are not covered. As though there is a pot of gold somewhere to pay for any added benefits. I am not even saying what should or should not be covered, or that the bill just passed is good or bad. It would just be nice if there was honesty in stating where the money is coming from when arguing for these things.
Well, I’m one of those “elderly” who will be rationed, just as I am now, or perhaps more so. So there’s nothing for me to say, altho I still pay income tax, and am managing OK now, I do not look forward to the day when the “Government” decides I cost too maintain (and without some sort of intervention that will happen)..
As my doctor said, “you are in reasonably good health for your age”.
I dread the day when that changes. Think of your parents/grandparents, are you prepared to sacrifice them on the altar of “health care for (almost) all ” ?
And of course no one seems to think the killing of unborn babies will make any difference. So, young and old will be flung away.
Grandmother in SC
Good Luck with that folks, may God forgive you.
Scott K….We stopped paying for insurance so we could afford to live. It was either the house payment or insurance…I choose to have a roof over my head. So now IA m being forced to buy insurance that quite frankly is going to do nothing more for me except make we wait for treatment and pay for it and yet again cut into my income that we earn not the government and they are telling me that I HAVE TO PURCHASE. Mind you this is just medical insurance…what about dental…vision? That will be next….and oh yeah what kind of house I have to live in and what kind of car I drive…because you see you all have opened up a pandora’s box and the door is open….How is that Hope & Change (Chains) working for ya?
Thank you Eastern Anglican
My husband and I pay out of our own pocket for our health needs which is nothing…a common cold maybe once a year if that . We are in relatively good health. I have never been refused health care and I write the check every time I have had to go to the doctor and once to the emergency room a few years ago with pneumonia and again I wrote the check. Believe it or not it was far cheaper than the health insurance we were paying for every month/year.
#31 Sick & Tired of Nuance
Great post just one thing left out …the illegal immigrant….that cost is incalculable
I agree with Branford…I take offense at the term [deleted]. Having attended a few Tea Parties I am still a human being with feelings and I matter…I am no [i]”[deleted]”[/i] tea or other wise.
My husband is 78, I am 73; we take no drugs…prescription or OTC.
We are both in good health, see our Primary care Physician(who is subsidised by the Cripple Creek government(read casinos) every three years so that he has a base line should we have some medical emergency. We are on Medicare, which is a good deal for Medicare.
We have a good Supplemental Insurance with a low co-pay per visit, also a good deal for the SI. When Medicare lowers its payout, our Chiropractor will have to close his office (just as our former PC Physician had to do a couple of years ago)…we have discussed that with him. If we can find a Chiropractor who will treat us for his full fee, we will pay it, no questions asked.
I mostly worry about the new health care program because of my grandchildren who are only minimally employed: 36 hrs per week so that the employer does not have to pay any benefits. These kids can barely meet food and rent and transportation requirements now; what will it be like for them and countless others when they are forced to purchase health insurance?
Frances Scott
[b][i]THE PROBLEMS OF POLITICS BY DEMAGOGUERY[/i][/b]
I do notice that no one on this site, or the others I frequent, has noticed that all “rights” inherently imply “responsibilities.” If I have a right to health care, someone else has a responsibility to make it availble. By “make it available” I do not intend that it must simply be given to me, but rather that there must be someone who is qualified to provide it for a fee. Thus, the universal right to health care, a right assured in law, necessarily implies that government has a corresponding “responsibility” to ensure that there are sufficient doctors available to provide that to which I have the “right.”
This leads directly to the conclusion that, if there are insufficient people available in a particular medical specialty, the government has the responsibility to assign sufficient students to medical school to study in that specialty. If government has a specific responsibility, then they implicitly have the authority to take the necessary action.
That, in turn, leads directly to the solution of conscription of students into medical school to take up assigned specialties. This conclusion is inescapable, unless one allows for the possibility that those people suffering from diseases specific to the specialty that is suffering a personnel shortage are to be declared “excess to requirements” and “eliminated.” Welcome to the [i]brave new world[/i] of medical conscription. Medicine will no longer be a calling, it will become something one is drafted into by a government agency.
The alternative to having these specialists scattered about the countryside is that they will be located only in the larger urban centers. Thus, if you need to see such a specialist, you will need to travel, presumably fairly substantial distances, just to be seen and evaluated, let alone treated. Yet another “hidden cost” of the idea of universal health care. One wonders if employers like McDonald’s will have sufficient resources that whole families of “Ronald McDonald”-type housing will be available for those who can’t afford a motel room, yet must travel hundreds of mile just and need at least one night’s sleep to make it possible to be seen or treated.
Pax et bonum,
Keith Töpfer
___________________
“[i]Everyone has to believe in something. I believe I will now go home and have a whisky[/i].”—[i][Anonymous][/i]
Geesh MA Keith Topfer…..You are right no one not even me gave that little diddy a thought but there it is and you are right….what is the point to force people to buy Health Insurance for medical problems if and when they arise but there are not enough doctors or even doctors available for certain health issues….I have been hearing how many doctors are going to retire because they cannot afford to handle this new Government Health Care…we may have a shortage sooner rather than later.
By the way, even though earlier today the White House said Pres. Obama would sign the Executive Order that Rep Stupak negotiated, it looks like, once again, every Obama promise has an expiration date. Check it out here:
Whoops – I meant to say “the White House said Pres. Obama would sign the Executive Order today that Rep Stupak negotiated” – now he’ll just sign it “soon.” Any bets on the definition of “soon”?
You know if the Commerce Clause is broad enough to require people to buy health insurance, it should be broad enough to conscript doctors as 45 suggests. And to require them to practice in those areas the Government believes would best promote commerce.
Would “Conscription” be just like what they do in Communist Countries? Tell you what you will do for a living?
RE: “I second Branford’s request on the elimination of the “[deleted]†term, which is not a term used by or accepted by those opposed to this health care bill.”
I, on the other hand, don’t give a hoot in the holler if the Collectivists on this thread or any other call me or anyone else a “[deleted]” — I enjoy smiling at their rage and pettiness and lack of imagination. Just think what will happen when they actually *lose*. ; > )
Keep in mind — this is them when they *win*.
I don’t mind “[deleted]” — and obviously on other websites I’ll enjoy calling the “health” [sic] “care” [sic] “reform” [sic] by the name that has so accurately been given it.
A cursory examination of the article would show that the author’s financial understanding is… selective.
She begins by basically quoting only the AEI. That’s fine, but it doesn’t offer much confidence that she’s critically examining things. Why not compare the AEI to the CBPP and the EPI and make a case comparatively?
Her first point is selective. What is the number of “middle class” individuals making $88,000 are not on their employer’s health insurance plan? Second – although her point is correct, the plans offered may offer much more than the current plans. Her complaint that a family of $100,000 would end up spending a quarter of their net income is admirable, but that’s already the case.
“2. Health insurance premiums will go up for nearly half of Americans.”
Yes. They’ll go up without the bill. In fact, they’ll probably go up even more without the bill.
“3. Health reform is unlikely to create new jobs.”
She then goes on a he-said/ she said analysis without any depth. Yes, insurance company jobs would be lost. Hospital jobs would increase. More nurses, fewer insurance bureaucrats.
4. Federal funding may cover abortion.
Well – “may” is a slippery word. she essentially takes the conservative talking point at face value. Chances are, a universal health care removes one incentive mothers abort: lack of health care for them and their kids.
5. Four million people will lose their employer-based plans.
Possible. but we don’t know what the quality of those plans are. The government plan would be the same one the members of congress have.
6. Medicare will cut services along with costs.
Really? It will offer to more people a simplified, good government system. The incentives that work so that doctors encourage testing rather than quality care would change. Costs SHOULD be cut.
7. The bill will not pay for itself.
No it won’t. She’s right, to some extent. Of course, perhaps Obama could learn from Bush’s tricks to pay for war.
8. Higher Medicaid costs will gradually shift to the states.
I’m not sure if this is a problem or not.
9. Doctor shortages could lead to rationing.
“Could.” That’s pretty slippery. I’m sure some doctors are scared, but plenty will retire anyway. I believe the current bill contains a raise for doctors. It’s quite a speculative idea, at the very least.
10. The bill raises taxes for many individuals and businesses.
I love the use of the word “many.” Yep. Many people are members of unions and make more than $200,000 a year. Many MORE aren’t either.
It taxes people with health care plans that are inefficient and encourage waste in the system (the cadillac plans), and it requires those with lots of money to pay a small percentage more. The taxes on drug makers, etc, may also be covered by the insurance companies – not only the consumers.
Regarding Obama – if he had in fact been authoritarian, this bill would never have passed. He had, actually, the implicit support of hospitals, doctors, big pharm, the AARP and even insurance companies. He didn’t write the bill (unlike most other presidents who wanted national health care), it came from congress. He incorporated ideas from the Republicans. It’s a bill more conservative than Nixon’s or Truman’s.
Whereas all other politicians failed, Obama succeeded. Might be worth examining why.
[Would commenters please be careful of language used and leaving heated comments – thanks – Elf]
[blockquote]Whereas all other politicians failed, Obama succeeded. Might be worth examining why.[/blockquote]
Well let us see….he canceled his overseas trip (Yet another one in less than 2 years in office) to meet privately (no transparency there0 with his fellow Dems to bully them using Chicago style politics into voting yes…. telling them that is will hurt his presidency (like he is not doing a fine job of that himself alone). Made back door deal with Louisiana, Idaho, Florida, California, and no telling who else, and scammed Stupak into thinking that he could and would actually sign an executive order on abortion. That is just for starters!
[b]49. Br. Michael[/b],
I don’t believe that the Commerce Clause is even necessary, although it does provide an additional argument, for the institution of conscription of citizens to be directed into medical education and employment. “Rights” always imply some corresponding responsibility—the responsibility on the part of others is a part of the definition of a right for the one. If I have a right to engage in free speech, subject to certain specific limitations, then all of you have a responsibility not to interfere unreasonably with my reasonable exercise of that right.
[b]50. TLDillon[/b],
“Conscription” is what was used during the 20th century until 1 July 1971 by the U.S. Government to impose military service on young Americans. That specific implementation of conscription was managed by the Selective Service System (SSS) and was popularly referred to as the “military draft.” People were required by law to register with the SSS and to carry a “draft card.” As more recruits were needed by the military, lottery drawings were held to randomly select individual male citizens over the age of 18 who were then legally obliged to report for a physical examination and, if they passed the exam, to report for active duty in the U.S. military services. In the case of a hypothetical system for medical conscription, there would probably be academic criteria that would disqualify some, and might rank those above some threshold on the basis of academic ability.
Just think “draft.”
Pax et bonum,
Keith Töpfer
“lottery drawings were held to randomly select individual male citizens over the age of 18 who were then legally obliged to report for a physical examination and, if they passed the exam, to report for active duty in the U.S. military services. In the case of a hypothetical system for medical conscription”.
The difference being of course that the alternative to achieving the age of 18 is dying young, while the alternative to graduating medical school is going into business or law or engineering etc. Once they start conscripting docs for poverty wages work in one horse towns, medical schools will close. They may then, try conscripting folks who are already in the pipeline (graduating residency or, heck in their 30s, 40s and 50s). Again there is a slight difference in conscripting a teenager to make it through boot camp under the bullying eye of a 40 year old drill master, and conscripting a 35 year old physician to perform neurosurgery under the bullying eye of a bean counter. “Oh I strained my back, (limp…limp…limp)”. “My migraines are making me dizzy (barf…puke…eye rolling…barf).
“Huh? You want me to take care of BABIES? Oooh but I’ve never had to deal with babies! HEY BAYBEE! TIME FOR A SHOT IN THE REAR! Now why did his mom get so mad and say she didn’t want me for a doc anymore? I just don’t unnerstand these folks, Sarge! Honest, I’m trying my best. I told you I was a dermatologist! I dunno why they sent me here.”
There was a reason why they drafted 18 year olds who weren’t even allowed to vote at the time. It was because the 21 year olds would have made significantly worse cannon fodder.
No. Health care reform will provide most people with basic care. That is why primary care physicians and general surgeons and ER physicians get a raise. It is DESIGNED to kill specialty care (whose rates are being cut from the less than breakeven rates present previously). Because specialty care is why people now live to be 88 instead of dying at 72. Specialty care is why preemies survive in America, and are not even counted as having been born in Europe. But specialty care is not cost effective. Having folks die at 72 instead of 88 will save social security. Similarly having preemies die instead of growing up to be kids with mild cerebral palsy, will reduce costs for medicaid and disability. Specialty care is not “cost effective” if the purpose of medicine is to generate healthy tax paying citizens, and minimize non-tax paying citizens. Specialty care is only “cost effective” if life itself is considered valuble, even the lives of those who no longer contribute monitarily to Society. The purpose of Health care reform is to reform health care such that “useless eaters” don’t survive. I suspect it will suceed in this goal.
Catholic Mom your pediatric endocrinologist will become a pediatrician and a few years later, will then become a “primary care physician”. The best pediatric endocrinologist I know works night shift in a small town ER in Missouri. He couldn’t pay his overhead in private practice, so he stopped doing endocrinology. Pediatric subspecialists are a dying breed. This is because seriously sick kids all have medicaid which does not even begin to pay for overhead, let alone physican salary. All specialists currently see medicaid as a ministry. Pediatric specialists have more medicaid than anybody else, and this reform is designed to make them extinct. I should know, I was voted best pediatric neurologist South of Kansas City, North of Little Rock, East of St. Louis and west of Tulsa. I loved pediatric neurology. However I could not pay my staff and continue seeing kids. Now I’m an adult neurologist. If adult specialty care goes the way of pediatric specialty care, then I will become a primary care physician. I already practice primary care for our local free clinic. It will not tax me to see mostly easy patients instead of mostly complex patients. I’m sure I will enjoy being a primary care provider. However, I plan to continue to be a neurologist as long as I can, and as long as my conscience is not forced to participate in euthanasia (which I think will be coming within 10 years).
All specialists began as generalists, and most of us can revert. Health care reform encourages reversion from higher order skills to more primary ones. That’s not a bad thing if you are generally healthy and need a little tune up. That is most people, after all. Most folk just need a primary care doc, and access to an ER and a general surgeon for acute emergencies. It’s a very bad thing if you are sick and old, or sick and very young or simply sick and unlucky. It is a very bad thing if you need a neurosurgeon for your head trauma, or a cardiologist for your stent in your blocked coronary artery. In the hospital I work at, our only neurosurgeon works as a neurologist now (despite having had an outstanding reputation previously). He doesn’t do surgeries any more, and since he’s been out of surgery for more than a year, he couldn’t do surgery even if he changed his mind and wished to do so. Some skills, once lost, are not easily regained. Neurosurgery is NOT like riding a bicycle. You need to keep in practice to operate safely. The best cardiologist I know retires this year. He could keep going, but he’s educated his kids and would rather “work for love” as he puts it. My sister is having her cataract fixed next month by her extremely well qualified Indian born opthalmologist because he plans to go home to India in another year. Most of the foreign born specialists will go home over the next several years. My sister could wait another five years before having her eye fixed, however she is not sure that the expertise will be available then. If opthalmologists can’t make a living, they will become optometrists and sell glasses instead of taking care of glaucoma, retinal detachments, cataracts or performing other sight-saving interventions. We figure that it makes sense to get elective surgery done now. Particularly if it is something a bit complex.
Medicine is a very complex system. Pushed past the tipping point, complex systems can collapse very rapidly.
I feel privileged to have been a physician during these her best of years, and I am grateful for all the opportunities I have had to serve my patients while practicing a trade that I love.
My children will not be doctors.
The worst problem that this whole tragedy shows is the arrogance of our so called leaders. The Democrats have shown that they will stretch existing law, assume authority that they do not have, and do to anyone that does not vote with them any damage they want. This sounds like an organization called TEC. But, with the government it is far worse. They have proven in passing this law that they really do not care what you or I need or want. They are the intellectual elite that they feel knows best. That is scary. Obama said he would fundamentally change this country and enough people didn’t know or care what he meant and voted for him. Now we have started down a very slippery slope to a socialist or perhaps fascist state.
Anyone using the car insurance example is either very poorly informed or prefers to twist truth to make it sound like what it isn’t. Auto insurance is regulated by the states and the only part mandated is liability. That is to protect those that are involved in an accident from the other person. My liability will not cover me, it covers you. If I want collision and property damage, that is my choice but the state does not mandate it.
I am tired of Washington not listening. Remember, the Congress is supposed to work FOR us. Remember the phrase “of the people, by the people, for the people”? I was amazed that this was used in the signing pep rally yesterday. The House and Senate have both shown by their actions that they think a politbureau is what is best for us. Anyone want to take them up on that?
Thank-you, Dr. Clueless, for your comments in#56. I wonder is it either/or- universal coverage/specialty medicine? I assume that had Congress set about first trying to control costs, we may have been able to reach something close to universal coverage while at the same time keeping specialty medicine. Afterall, where will the privileged Canadians go for treatment? In your opinion would tort reform make a substantial dent in costs?
I think tort reform would make a significant dent in costs but would not permit both universal coverage and specialty medicine. The problem is that we are mortal. Eventually everybody is going to die. Twenty percent of us (at best) will die suddenly in an accident or sudden heart attack, the rest of us will die more slowly with another medical condition added every 2 years after the age of about 65 or so. First the hypertension and cholesterol (easily controlled) then the MI (controlled with stents) then the spinal stenosis and the need for a hip replacement with mild renal insufficiency etc. etc.. By the time we reach 80 most folks have about 7-8 medical conditions, that need to be managed. When I was an intern a quarter century ago there was perhaps only 1-2% 80 year olds in the hospital. Now they make up the majority of the folk in the ICU. Since everybody dies eventually, each added year increases costs. That is what is unsustainable. It has also given us the healthiest and most active octogenarians in the world.
There is no substitute for cost containment other than rationing. (Tort reform will help some, but not enough). Canada rations by access. This is the rationing that Congress has chosen. Turn the specialists into primary care providers, and access goes down. If access goes down, costs go down. (So does the life expectancy of the old).
England rations by a combination of permitting the wealthy to buy care, while explicitely denying certain procedures in their NHS (no dialysis after age 50, no elective surgeries after certain ages etc)
Unfortunately funds are not unlimited. We must ration. For our children’s sake we should have the courage to ration rationally. Unfortunately, most folks are not willing to make difficult decisions, which is why HCR has a panel to do that for us.
Clueless – thank you for taking the time to write your comment. We must not get upset or mad or violent but quietly get in line next fall and vote. Everyone knows we can not afford this on so many angles, but once you pass out something for free, I am not sure you can take it back without angering a bunch of folks. My father said several times in his life that if you don’t pay for it you won’t appreciate it. One can only imagine what the doctors offices and hospitals will look like.
Thanks, Clueless.