Tag Archives: health care

MEDICARE AND OUR OUTRAGEOUS MEDICAL CARE PRICING PROGRAM

This is a true story.  A family member had an accident in the home.  She took a nasty backward fall and her head slammed against a piece of sharp edged furniture.  The result was a bloody mess and a call to 911 for assistance.  Ambulance, police and fire department vehicles were promptly on the scene.  The patient was transported to the hospital about 4 miles distant.

Three stitches were required to close the wound.  Some tests were made to be sure there were no hidden injuries.  Twelve hours later the patient was released and walked out of the hospital.  It was as simple as that; there were no extenuating circumstances.  The medical care was good; the healing was complete.  That’s not the story.

When the bill came, it was $27,607.92.  That’s the story.  One item was $13,541.54.  It was called Trauma Response Level II.  That’s the price for the house call.  The other items were all various hospital charges.  One does not expect good medical care to be cheap but having to pay these prices is bizarre!  But wait.

There were two more items on the bill.  One item was Insurance Paid $1,610.51.  The other was Insurance Adjustment $25,947.41.  Translation – A) the prices were highly inflated, and B) nobody paid the artificially inflated prices.  Nobody was ever expected to.  The injured was a Medicare patient.  Medicare only pays a certain percentage of the “price” for each service, so the price is set high because the percentage paid is low.  There is something seriously wrong with a system that requires healthcare providers to bill at horrendous rates in order to receive modest remuneration for their services.  That’s the story.

Oh yes, there was one more item.  There was a box at the top of the bill that read Your Portion $50.00.  And so in round numbers, the patient paid $50, the healthcare providers got $1,600 but they had to bill for $27,000 to get it.

What about the uninsured, perhaps a mid-life family provider currently out of work, a foreign tourist or a member of the perpetually unemployed?  Is there a separate billing rate for them?  In some cases there is not.  Full rate billings happen every day.  In these cases it is up to the patient to negotiate a better rate.  It’s similar in the doctor’s office.  There is a list price, the price an insurance company pays and there is the price Medicare pays, all different prices for exactly the same service.  What you pay if you are uninsured may be different from all the other three and it will be the highest.  Health care in America is superb.  The financial administration of it stinks.

OBAMACARE IS WORKING AS PLANNED

In Connecticut, Aetna Insurance petitioned the State regulators to allow a 24.7% rate increase to cover the increased cost of providing coverage under Obamacare. They were granted a 14.2% increase for large group plans and an 18% increase for small group plans. Similar rate hikes are being granted in other states. Facing this magnitude of cost increase several companies have announced they will no longer be providing health coverage for their workers. These employees will end up on the government plan by default. This is Obamacare working as planned.

The squeeze is on. Insurers need to raise prices for survival, employers need to control costs to remain internationally competitive. The pragmatic solution for business is to default to single payer government coverage. For insurance companies the path to survival is to diversify away from providing health care coverage. In time, at the end of the struggle the government plan will be the only man left standing. Pelosi, et al, knew this consequence was built into the bill. Whatever else was there didn’t much matter.

INALIENABLE RIGHTS

The Declaration of Independence declares the rights to life, liberty and the pursuit of happiness to be inalienable rights, rights that can be denied to no man. Franklin Roosevelt added food, clothing, housing and adequate health care in what he termed “The Second Bill of Rights”.

The Declaration of Independence. It is just one page, not 2,000

The difference should be apparent. Life, liberty and the pursuit of happiness do not require the taking of a right from one person to fulfill the right of another. However, implementation of the FDR’s Second Bill of Rights does just that. It demands the taking of personal property from those who have it in order to pay the cost of goods and services for those who do not provide for themselves, no matter the reason. A right cannot be denied. The inalienable right to life cannot be denied. The inalienable right to require someone else to pay your medical bills does not exist.

This is not to say that society has no obligation to support the needy. Dennis Miller, in his inimitable style, said it well when he said “We just want to see some bona fides, that’s all.”

STUDENT LOANS OUTLAWED BY OBAMACARE

LIBERTY LOST, ONE BILL AT A TIME

The Patient Protection and Affordable Care Act, commonly referred to as Obamacare, includes a provision that eliminates private sector student-loan programs. Preposterous? Nothing is preposterous in Washington.

In a letter to supporters, Larry Arnn, president of Hillsdale College, writes:

[Hillsdale’s resolution to remain independent of government funding] comes at a time when the federal government is increasing its unconstitutional grip on higher education. In the most recent example, sweeping legislation was passed that takes the student-loan business away from private lenders and hands it over to the Department of Education. This measure was tacked onto the health-care bill at the zero hour, and with false and laughable claims of saving billions of taxpayer dollars.

He who controls the purse strings controls absolutely. We are losing our liberty one increment at a time. We are losing it in subtle, almost clandestine ways. Did you know this provision was in the health-care bill? I would venture to say that many, perhaps even most of our representatives who voted for the bill were unaware of it.

Bob B

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MEDICARE MESSAGE FROM KATHLEEN SEBELIUS

Medicare and the New Health Law is the title of a glossy full color bulletin written by Kathleen Sebelius, Secretary of Health & Human Services. The leaflet is currently in the mail to a broad list of recipients across the nation. It is an expensive mailing, no doubt. It is little more than a propaganda piece that reads like an Obama speech with all of the same talking points.

Within the bulletin’s four pages Sebelius manages to cast aspersions on the insurance industry 5 times. For instance, in the opening paragraph we read:

It will also ensure accountability throughout the health care system so that you, your family, and your doctor – not insurance companies – have greater control over your care.  (emphasis is in the original).

The same arguments we heard from Obama when he was campaigning for passage of the bill are repeated in the bulletin: reduction of fraud, better quality care for more people at less cost, and new services to assure people “will no longer be forced into poverty”.

There is need for a letter to explain the provisions of the new law but this is not it.

Bob B

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OBAMA’S DOT COM STORE

Did you know Obama has a dot com store? He calls it Organizing for America. For $25 you can promote three things in one shot –  Barack Obama, government health care, and the use of the word f*****g.

At his store Barack is selling T shirts, ladies and mens, your choice of white or blue, emblazoned with “Health Reform is a  BFD“, the acronym for the celebrated, and now glorified remark our Vice President made to our President, Barack Obama. (They won, now they push our nose in it.) Shipping is free.

What hath Democracy wrought upon us that we should be led by street thugs?

Bob B

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EASTER REVIEW

You did well if you took a vacation from the political scene over the Easter weekend. But now it is Monday and the laundry must be done. Here is a collection of events that you may have missed.

Obama claims he has saved the nation from bankruptcy
AP reports: Obama says he did a full court press for a health care system remake because “this country was going to go bankrupt” [without it].
http://finance.yahoo.com/news/Obama-US-would-go-bankrupt-apf-633531268.html?x=0&sec=topStories&pos=main&asset=&ccode

Florida doctor puts sign on door
Backlash from the medical community has begun. If you want Obamacare please find another doctor, was the essence of the announcement this doctor posted on his door.
http://www.orlandosentinel.com/news/local/breakingnews/os-mount-dora-doctor-tells-patients-go-aw20100401,0,6040296,full.story

British MP calls an end to special relationship with America
It appears the Brits have had enough of Obama’s insults, or maybe it was our position on the Falklands. Member of Parliament Mike Gapes, speaking as chairman of the Foreign Affairs Select Committee said the time has come for Britain to drop the idea that there exists a special relationship with the United States. Can you blame them, after our President has already expressed the same sentiment.

Obama has caused America to lose a good friend. Perhaps he will find some new ones for us.

Bob B

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OBAMACARE AND THE SUPREME COURT

As of March 29th thirteen states have joined in a legal challenge to the law known as Obamacare. According to the New York Times their case rests on two arguments, (A) the Constitution does not permit the Federal government to mandate the purchase of goods or services from the private sector, and (B) the provisions of Obamacare overstep states rights as provided in the Constitution. The Times predicts failure because “the law was carefully drafted to withstand just this kind of challenge.”

For the government to asses a penalty for a citizen’s failure to make a specified purchase in the private sector would undoubtedly be deemed unconstitutional by the Supreme Court. Therefore the new law calls it a tax. In a court of law names do not prevail, attributes do. You cannot avoid licensing your dog by calling it a cat. This argument is weak.

The second argument is very interesting indeed. States rights have been Fabianized away over many years. A favorable ruling on this issue could stop the slide and maybe even reverse the trend. A hearing on this issue could have impact well beyond Obamacare.

I fear the stir among the states is but a scream in reaction to sudden pain that will subside with time, and along with it, the determination to pursue the SOTUS course. If the November elections offer hope of legislative appeal it would further lessen the incentive to go with the Supreme Court option. That would be unfortunate for we would miss an opportunity to watch a landmark case.
Bob B

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UNINTENDED CONSEQUENCES

Benefits and even jobs will be lost in the wake of ObamaCare. Yahoo business page reports:

Remember the part in the ObamaCare pitch when they said if you like your current health care, it won’t change? Turns out it might.

Companies are already announcing that their health care premium costs are going through the roof. Some are responding by firing people. Some are cutting benefits. And some are presumably eating it.

One thing Washington never gets is the economic rule of rational expectations. That rule says people will react to changes in the law.  The reaction of employers may not be intended but it is predictable.

It is not correct that “some are eating it”. It is the consumer that will pay it because all expenses are eventually reflected in the price. The alternative ends in bankruptcy.

Bob B

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OBAMACARE PROVISIONS

As I write, the house has passed the health care bill but it has not yet been presented to Obama for signature. Subject to changes in Senate Reconciliation this is what we face.

If you wish to remain self insured, as many youth do, you will pay a $750 annual fine to the government.

You may be a young, healthy, drug free non smoker but will still be charged a rate that enables the program to pay for services for obese drug addicts who smoke two packs a day because it will be unlawful for insurance companies or Medicare to differentiate.

You will no longer be able to choose less expensive policies with higher deductibles because they will be outlawed.

If you are a small business owner your cost to provide insurance to employees will increase. You will need to provide insurance that covers employees children up to age 26.

Everyone will have to buy insurance that covers maternity, newborn care and pediatric services. How this got by the gay lobby I do not know.

Everyone, including drug free alcohol abstainers will be required to buy insurance that covers substance abuse, mental health, chronic disease management, oral and eye care.

Insurance companies will be in competition with the government insurance program but insurance companies will not be allowed to adjust their premiums to compete without permission of the government.

If you are a physician with an equity interest in a hospital the hospital is not allowed to expand unless the county in which it is located has experienced a population expansion exceeding 150% in the last 5 years. So if your hospital provides superior performance Obamacare limits your ability to expand to meet the increased demand.

If you are a physician in private practice the government will begin to monitor your claims, not just for fraud, but to compare how you have used your resources in comparison to your peers. If you have performed more of a certain service than your peers, the government will be armed with the data to restrict those services they deem to be excessive.

Financial penalties are extracted from pharmaceutical companies that develop new medicines and sell them as branded drugs. The greater your success the greater the penalty under a formula that compares your sales to overall sales. The expected total penalty is forecast to be $2.3 billion annually.

Medical device makers face a similar schedule of penalties, called fees, forecast to total $2 billion annually.

The deferred compensation of insurance company executives is capped at 500,000. Compensation for executives in the entertainment industry remain unlimited for the time being.

The extraction from the insurance industry is forecast to be $6.7 billion annually. The formula is complex but it is based on a ratio of premium income to administrative costs. The higher the ratio the higher the penalty. It is a penalty for efficiency.

If you have investment income or income from trusts or estates it will be subject to a new 3.8% tax. The same will apply to earnings over 200,000 or 250,000 if you file jointly.

You may ask why insurance and pharmaceutical stocks continue to do well. The answer has two parts, first there will be more volume, second the penalties will be passed on to the consumer. To paraphrase Reagan, corporations do not pay fees to the government, they just collect them from the consumer and pass them on to the government.

Bob B

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A plea
Random Thots is but a small voice. Others speak the same message, broader, louder and with greater eloquence. You know who the good ones are. The Quick Links sidebar is a good start. Point your fellow Americans to these grass roots sources of truth not obtainable from other sources. If you also see fit to include this little blogger I will be gratified.