Doctor’s View

Michael Ramirez Cartoon

 

You shouldn’t judge the Affordable Care Act based on headlines or by listening to politicians or talking heads. I tried for a while, but only heard wildly conflicting stories that seemed to have little basis in reality.

Instead, you should ask someone who actually deals with the law on a daily basis — a doctor, for instance.

The Physicians Foundation did exactly that in its “2014 Survey of American Physicians,” which was released last month. The survey, which reached over 80% of doctors in the U.S. and elicited responses from some 20,000, is doctors’ collective report card on the Affordable Care Act’s first four years.

The grades aren’t good. Only 25% of doctors give it an “A” or a “B” grade. Nearly half ( 46%) give it a “D” or an “F”.

I can help explain why so many of us are fed up with the law: In many cases, it shifts our focus from patients to paperwork, from finding cures to filing documents.

The survey indicates that physicians now spend 20% of their time on non-clinical paperwork. I now spend many hours at a desk or a computer rather than at the bedside assisting patients. This isn’t why I became a doctor.

Unsurprisingly, this shift negatively influences patients’ access to health care — doctors simply don’t have the time to see the same number of patients.

The survey indicates that 44% of doctors “plan to take one or more steps that would reduce patient access to their services.” This includes “cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking a non-clinical job.”

I would add another important effect based on my own observations: Spending less time with patients.

The ACA’s regulatory burden directly bears on these decisions. There are already at least 11,000 pages of government regulations related to the law. Some of it applies to insurers, some of it applies to doctors and some applies to the relationship between the two.

No matter who it applies to, it adds bureaucratic hassles to the health care process that may impact your doctors’ ability to attend to your medical needs.

It should come as no surprise, then, that 69% of physicians “believe their clinical autonomy is sometimes or often limited,” meaning they have a diminished ability to make medical decisions in consultation with patients.

And “limited” may be an understatement. The ACA’s implementation has also coincided with a dramatic decline in private practice — the small, personal doctors’ offices that have been in local communities for generations.

The number of private-practice doctors has dropped by nearly half in a mere six years, with the most dramatic drops occurring in the four years since the Affordable Care Act was signed into law.

According to the survey, 35% of physicians are now independent practice owners. In 2012, half were independent. In 2008 — two years before the ACA was passed — 62% were independent. In the last two years alone, the number of solo practitioners has dropped from 25% to 17%.

No wonder: Private and solo practitioners often lack the staff and the financial resources required to implement and keep up with the ACA’s dramatic changes to medicine.

The Physicians Foundation survey indicates that our country’s health care is still going in the wrong direction. Of course, it’s important to note that the Affordable Care Act is only one of many issues affecting doctors’ decisions and outlook.

But it is not a good sign that in the law’s first few years, physicians are seeing fewer patients, private practices are disappearing and nearly twice as many doctors believe the law is harming, not helping, American health care.

• Fodeman is an internal medicine doctor practicing in Tucson, Ariz. (IBD)

The Lie of The Year 2013 Crowned

“Doh” is now defined as “Expressing frustration at the realization that things have turned out badly or not as planned, or that one has just said or done something foolish,”

Nearly 40 times over 4 years, mind you…

Lie of the Year: ‘If you like your health care plan, you can keep it’

(Politifact)

…the American Medical Association in 2009: “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.”

Pants on Fire!

“What we said was, you can keep (your plan) if it hasn’t changed since the law passed.” –Barack Obama, Monday, November 4th, 2013.

False

“FACT: Nothing in #Obamacare forces people out of their health plans.” Valerie Jarrett, Monday, October 28th, 2013.

It was a catchy political pitch and a chance to calm nerves about his dramatic and complicated plan to bring historic change to America’s health insurance system.

“If you like your health care plan, you can keep it,” President Barack Obama said — many times — of his landmark new law.

But the promise was impossible to keep.

So this fall, as cancellation letters were going out to approximately 4 million Americans, the public realized Obama’s breezy assurances were wrong.

Boiling down the complicated health care law to a soundbite proved treacherous, even for its promoter-in-chief.  Obama and his team made matters worse, suggesting they had been misunderstood all along. The stunning political uproar led to this: a rare presidential apology.

For all of these reasons, PolitiFact has named “If you like your health care plan, you can keep it,” the Lie of the Year for 2013.

37 Times in 4 years. It was a lie!

“We weren’t as clear as we needed to be in terms of the changes that were taking place, and I want to do everything we can to make sure that people are finding themselves in a good position, a better position than they were before this law happened. And I am sorry that they are finding themselves in this situation based on assurances they got from me,” he said.” —Obama November 2013

Says the pathological liar!

House minority leader Nancy Pelosi defended Obama’s statement as accurate and blamed insurance companies. “Did I ever tell my constituents that, if they like their plan, they could keep it? I would have, if I’d ever met anybody who liked his or her plan, but that was not my experience,” she said.

Says the crazy woman who looks like she’s had more plastic surgery than Joan Rivers! (I know that below the belt….ah, so what, like she cares what anyone thinks).

So why would you ever trust them again?

Not that I ever did to begin with,mind you…

This the fourth time in five years the “Lie of the Year” has been about this one health care law. So it must a superior piece from superior beings, right?
🙂

Otherwise, the winners break down like this:

  • In 2009, Sarah Palin won, for her insistence that Obamacare would include “death panels.”
  • In 2010, it was Republican consultant Frank Luntz’s assertion that Obamacare would lead to a “government take over of health care.”
  • In 2011, various Democrats were given the title for saying that Republicans had voted to end Medicare.

Only there hatred of Mitt Romney overwhelmed them in 2012.

But there is plenty of evidence that Sarah Palin was correct. And, of course Frank Luntz’s assertion is the same one I’ve been saying for the past 5 years.

So, remember kiddies, Obamacare is a good and just thing. The liberal media & Democrats say so…and anyone who says otherwise is a dirty rotten liar! 🙂

And you can Trust them to tell you the truth 🙂

It’s not like they granted themselves waivers, or their political allies and friends. Or pushed back pieces of it, like the employer mandate, so as to not damage themselves further in 2014.

Naw, nothing like that at all… 🙂

Prove The Mayans Wrong

The Devil’s Choice

Experts say the move by insurers to limit consumers’ choices and steer them away from hospitals that are considered too expensive, or even “inefficient”, reflects the new competitive landscape in the insurance industry since the passage of the Affordable Care Act, Barack Obama’s 2010 healthcare law.

It could become another source of political controversy for the Obama administration next year, when the plans take effect. Frustrated consumers could then begin to realise what is not always evident when buying a product as complicated as healthcare insurance: that their new plans do not cover many facilities or doctors “in network”. In other words, the facilities and doctors are not among the list of approved providers in a certain plan.

Under some US health insurance plans, consumers can elect to visit medical facilities that are “out of network”, but they would probably incur high out of pocket costs and may need referrals to prove that such care is medically necessary.

The development is worrying some hospital administrators who see the change as an unintended consequence of the ACA.

“We’re very concerned. [Insurers] know patients that are sick come to places like ours. What this is trying to do is redirect those patients elsewhere, but there is a reason why they come here. These patients need what it is that we are capable of providing,” says Thomas Priselac, president and chief executive officer of Cedars-Sinai Health System in California.

One of the biggest goals of “Obamacare” was to make subsidised healthcare plans that are being sold on the new exchanges as affordable as possible, while also mandating that certain benefits, like maternity care, were covered and that people with pre-existing medical conditions could not be denied access.

Amid these new regulatory restrictions, says Tim Jost, a health policy expert, insurance companies have had to come up with new ways to cut the cost of their products. In this new era, limiting the availability of certain facilities that are seen as too expensive – in part because they may attract the sickest patients or offer the most cutting edge medical care – is seen as the best way to control costs.

As has been pointed out numerous times, we are heading for a two tiered health care system where the rich – and friends of Barack like unions – will have access to the very best doctors and facilities while the rest of us get whatever is left over.

Winners and losers folks. And guess which one the majority of us are? (AT via FT)

“President Obama famously promised, if you like your doctor, you can keep your doctor. Doesn’t that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan?”

Emanuel tried heading toward after-the-fact nuances, but Wallace wouldn’t let go: “It’s a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?”

“Yes,” Emanuel finally admitted before quickly turning another corner. “But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice.”

Which Wallace jumped on, soon forcing Emanuel to admit that Americans under Obamacare “are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network.”

And that led to the key admission in the following segment of the interview:

“Which will mean your premiums will probably go up,” Wallace noted.

“They get that choice,” Emanuel said. “That’s a choice they always made.”

“Which means your premium may go up over what you were paying so that, in other words — ”

“No one guaranteed you that your premium wouldn’t increase,” Emanuel added. “Premiums have been going up.”

“The president guaranteed me I could keep my doctor,” said Wallace.

And if you want to, you can pay for it,” said Emanuel. (Blaze)

And if you can’t, oh well, you get the leftovers. Government Charity. Be happy. 🙂

But always remember, it wasn’t the Government’s fault! 🙂  Vote For me the other guy’s an asshole!

“Everyone was rich, and no one was poor. At Least no one worth talking about”-Douglas Adams.

Political Cartoons by Glenn Foden

Political Cartoons by Eric Allie

Political Cartoons by Glenn McCoy

141014 600 Obamacare Site Fixed cartoons

 

 

The Hippocrite’s Oath

Going on Vacation today.

So this blog may be offline for a bit.

Political Cartoons by Eric Allie

‘Substandard” and “cut-rate” is what President Obama calls the health plans that millions of Americans have lost, even though they wanted to keep them.

Backpedaling on his promise that “if you like your plan, you can keep your plan,” Obama is now telling Americans another whopper: The insurance they can get on ObamaCare exchanges is a better deal.

Don’t believe him.

On the exchanges, you may no longer be able to use the doctors and hospitals you prefer. Many exchange plans exclude the top-drawer academic hospitals like Cedars Sinai in Los Angeles, the Mayo Clinic in Minnesota and New York Presbyterian in New York City.

Instead, the law says exchange plans must cover care at “essential community providers … that serve predominantly low-income, medically underserved individuals.”  (Sec. 1311c(1)C)  That means clinics, public hospitals and hospitals largely serving the Medicaid community.

The law’s authors reasoned that exchange plan customers should be able to shift back and forth between their plans and Medicaid, as their earnings fluctuate, without changing doctors and hospitals.

That’s reasonable, but it’s bad news for consumers who had access to esteemed hospitals and doctors under their old plans and then got pushed into the exchanges.

Medicaid-level care is, sadly, “substandard,” to use the President’s word. A review of the experiences of nearly 900,000 patients undergoing eight different surgical procedures found that Medicaid patients were 50% more likely to die in the hospital after surgery than patients with private coverage.

This review, by researchers at the University of Virginia, is one of several studies proving that Medicaid patients get worse care than patients with private insurance.

But many of the plans being offered on the exchanges are Medicaid with a private label slapped on them. The McKinsey Center for U.S. Health System Reform reports that Medicaid insurers are playing a large role in the exchanges.

Just as many doctors refuse to accept Medicaid, they are also refusing to accept exchange insurance. In California, a Blue Cross plan on the exchange covers 47% fewer doctors than Blue Cross subscribers in California currently get. In New York, only a quarter of physicians have decided to take exchange insurance, because the payments are so low.

Why so low? Because insurers know the low-cost plan will be king in nearly every exchange. All the plans offer the “essential benefit package.” Customers currently have no other way to compare than on price.

That’s despite the law’s promise that exchanges would list each plan’s quality rating and disclose which hospitals and doctors are covered. (Sec. 1311d(4)D) and (Sec. 1311c(1)B).  Why isn’t this information provided, as the law requires?  We can only guess that it’s because ObamaCare administrators don’t want us to see the truth.

Cancer patients whose plans are canceled are getting whacked hardest. They are losing access to the specialized cancer hospitals and oncologists treating them. And they will get meager help, if any, paying for innovative cancer drugs that cost thousands of dollars.

The most troubling provision in ObamaCare’s Section 1311 gives the secretary of health and human services blanket authority to control how doctors and hospitals treat patients. All in the name of improving “quality.” That could mean everything in medicine, such as when your OB/GYN should do a Caesarean.

What that means for you is that if you enroll in an exchange plan, with or without getting a subsidy, your care will be standardized by the federal government with an eye to reducing what you consume and how much it costs.

Your doctor may have to choose between doing what’s right for you and avoiding a penalty. Exchange plans can pay only those doctors who obey whatever regulations the Secretary imposes.

Yet the President claims that people losing their health plans and having to sign up on the exchanges will be getting a better deal. Losing your doctor, shopping blind for a health plan, settling for Medicaid-level care and government controls, all for a premium 41% higher than before and with a deductible that’s doubled? Sounds substandard to me.

Right now, most people getting cancellations bought plans in the individual market. Wait until the other shoe drops in 2014, and millions of people who had on-the-job coverage lose it. The truth about ObamaCare will become so painfully obvious that even the White House lie machine can’t cover it up. (BETSY MCCAUGHEY)
But don’t worry, The Ministry of Truth is here to save you from this so don’t worry, be happy!

Michael Ramirez Cartoon

Choice, Liberal Style

Just in case you had any doubts:

Reid said he thinks the country has to “work our way past” insurance-based health care during a Friday night appearance on Vegas PBS’ program “Nevada Week in Review.”

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.” (LV Sun)

Major health insurance companies–Blue Cross, Aetna, United, Humana–have decided not to participate in various states in the Obamacare health-insurance exchanges that will be the only place Americans will be able to buy a health insurance plan using the federal subsidies authorized under the Obamacare law.
In Connecticut you had 6 choices. Now you’ll have 3.
That’s your “expanded” choice, Liberal Style.
 
Mind you, when I started this blog nearly years ago I came to the conclusion that this all ultimately led to driving the Insurance Companies out of business so you only had Mama Government to depend on anyhow.
That’s the Liberal definition of Choice. You choose what they want you to choose.
Nothing else. They know best.

If You Like Your Doctor,’ Hope Your Insurer Is Participating in the Exchange

“No matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor, period,” Obama said on June 15, 2009.

“If you like your health care plan, you will be able to keep your health care plan. Period,” he said.  “No one will take it away. No matter what.”

That promise, however, has been revised by the Department of Health and Human Services (HHS), which now says, “you may be able to keep your current doctor” in the health insurance marketplace.

“Most health insurance plans offered in the Marketplace have networks of hospitals, doctors, specialists, pharmacies, and other health care providers,”HHS said on its website for the health reform law.  “Networks include health care providers that the plan contracts with to take care of the plan’s members.”

“Depending on the type of policy you buy, care may be covered only when you get it from a network provider,” they said. (CNS)

DON’T MAKE TOO MUCH NOW, YA HEAR…

Millions of families could be facing a bizarre situation: If they earn one extra dollar a year, their insurance costs will climb by thousands. It’s just one of the many perverse outcomes ObamaCare will create.

Whenever the topic of ObamaCare costs comes up — something that is occurring with increasing frequency as insurance companies start to announce sky-high ObamaCare rates for next year — backers boast about subsidies.

Who cares if premiums are high, they say, since many will get subsidies through an ObamaCare exchange. (TAXPAYER FUNDED OF COURSE!) But what ObamaCare groupies fail to consider is that these subsidies phase out, and do so in a way that will be extraordinarily punishing for many families.

As Terence Jeffrey explained on CNSNews.com, a middle-class family earning just one more dollar could, because of the way the subsidies are structured, end up paying thousands of dollars more for health insurance.

Jeffrey discovered this when he plugged sample income data into the Kaiser Family Foundation’s “Subsidy Calculator.”

http://kff.org/interactive/subsidy-calculator/

A 56-year-old couple with two kids and $110,280 income would be right at the limit for ObamaCare subsidies, according to that calculator. (Subsidies phase out on incomes over 400% of poverty.) Even so, if they bought a $19,832 “Silver” plan through an ObamaCare exchange, they’d get $9,355 in premium subsidies.

But if their income were to climb to $110,281, their subsidy would drop to zero.

It’s even worse than that. ObamaCare also subsidizes out-of-pocket costs for lower-income families who buy Silver plans. And these, too, go away as income climbs.

A Commonwealth Fund report shows what this will mean to a family at the edge of the ObamaCare cliff. Once it goes over the income limit, its out-of-pocket maximum jumps from $8,066 to $12,100.

In other words, a family that has big medical bills and gets a tiny raise could suddenly face more than $13,000 in additional premiums and out-of-pocket expenses.

There are mini-cliffs along the way, too, as the premium and out-of-pocket subsidies step down at various incomes.

Let’s say a family making $55,125 buys a $9,000 plan in an ObamaCare exchange. If its income climbs to $55,126, the premiums shoot up $1,800 and the out-of-pocket maximum jumps $2,000, according to a separate analysis by the American Cancer Society.

As a result, ObamaCare will create a huge incentive for millions of families either to hide income, earn it underground, or turn down a raise in order to avoid getting hit with these huge leaps in insurance costs.

But at least they won’t be “rich” assholes.

Oh, and many of them won’t have to worry about the cliffs of doom because they’ll be working part-time because their boss can afford them otherwise.

Utopia.

And this is only the first step to a much better Complete Government Control.

Rejoice.

This is on top of the many other unfortunate economic incentives ObamaCare will create.

Employers who want to avoid or minimize the massive cost of the employer mandate, for example, will do well to cut part-time hours to below 30 a week, since ObamaCare considers 30 hours full-time work. Many are already taking this step.

Companies also have an incentive to keep their full-time workforce below 50 people, since going over that exposes them to the employer mandate and potentially hundreds of thousands of dollars in new costs.

And as the Ethics and Public Policy Center’s James Capretta explains, ObamaCare will encourage employers to avoid hiring low-income families. Why? Companies pay a penalty only if a worker gets subsidized coverage in an ObamaCare exchange. Since wealthier families don’t get subsidies, the company won’t face any fines.

As a result, ObamaCare will end up hurting the very middle class families it was supposed to help.

Surprise! Surprise! Surprise!  A Liberal “feel good” policies goes bad. Never saw that coming. I know they don’t. And I also know, they don’t care.

Anyone who thinks this all can be fixed with more tinkering to the law is missing the point. Whenever the government gets involved in a marketplace, it creates distortions that ripple across the economy. And these distortions almost always end up making the country less productive, less efficient and less prosperous.

The only way to avoid the perverse incentives that ObamaCare will create is to get rid of the law entirely.

But it’s the Holy Grail of The Left. Imagine the power of life and death at your command….

The Doctor: Davros, if you had created a virus in your laboratory, something contagious and infectious that killed on contact, a virus that would destroy all other forms of life, would you allow its use?
Davros: It is an interesting conjecture.
The Doctor : Would you do it?
Davros: The only living thing, a microscopic organism reigning supreme… A fascinating idea.
The Doctor : But would you do it?
Davros: Yes… Yes…
[raises hand as if holding the metaphorical capsule between thumb and forefingers]
Davros: To hold in my hand a capsule that contains such power, to know that life and death on such a scale was my choice… To know that the tiny pressure of my thumb, enough to break the glass, would end everything… Yes, I would do it! That power would set me up above the gods! AND THROUGH THE DALEKS, I SHALL HAVE THAT POWER!

Now just substitute Harry Reid for Davros and ObamaCare for Daleks….

Enjoy. 🙂

 
 
 

Certainty

Why should anyone believe what the president says about ObamaCare? Last week he touted nonexistent rate cuts and rebate checks. And the White House now admits his promise about keeping your doctor was false.

On Thursday, the president tried to shore up the ever-weakening support for ObamaCare by boasting about $100 rebate checks millions of Americans were supposedly getting in the mail thanks to the law’s restrictions on overhead spending by insurance companies.

“Millions of Americans opened letters from their insurance companies,” Obama said, and “were pleasantly surprised with a check.”

Not exactly. An AP fact check of Obama’s talk found almost all those checks went to employers who provide health benefits to their employees, and who didn’t have to pass them on to workers.

No one in government knows how many individuals — beyond the handful Obama pointed to during his talk — actually got checks in the mail, or for how much. AP called Obama’s claim “misleading advertising.”

Obama then claimed ObamaCare will push premiums down, saying these savings are already evident in states like “California, Oregon and Washington.”

But California used a bogus apples-to-oranges comparison to make its claim that premiums will be lower. In reality, they’re going up. Independent analyses found premiums in Oregon and Washington in the individual market will be 66% and 80% higher under the new law.

As for New York, where the ObamaCare premiums allegedly will be 50% below current rates, that state’s individual market had been all but destroyed by the same “guaranteed issue” and “community rating” market reforms ObamaCare plans to impose nationwide.

Then there’s the oft-repeated promise that, under ObamaCare, if you like your doctor you can keep your doctor, and if you like your plan you can keep your plan. Obama even stamped a “guarantee” on this.

It was, of course, bogus. The Congressional Budget Office says 7 million workers will lose their employer-provided health plans, no matter how much they like them.

Many in the individual market are starting to get cancellation notices from insurers because no matter how much they like their current policies, they don’t comply with ObamaCare’s long list of mandated benefits.

Unions, too, are screaming that many of their members will lose the coverage they like once ObamaCare goes into effect.

And guess what? Many of these folks won’t be able to keep the doctor they like, either, when they go looking to get insurance coverage through an ObamaCare exchange. The administration has finally admitted as much, something the Weekly Standard discovered when looking through the HealthCare.gov site.

“Depending on the plan you choose in the Marketplace, you may be able to keep your current doctor,” the website says. Got that? May be able to keep. That’s a far cry from Obama’s “guarantee.”

Keep this in mind the next time anyone starts singing ObamaCare’s praises.

And another certainty…

Detroit, however, is dead, and unions and government killed it. Michigan recently became a right-to-work state, but it was too late to save a city that had become beholden to unions. As the United Auto Workers helped destroy the auto industry in and around Detroit, it’s no accident that Mercedes-Benz decided to build its flagship SUV in a shiny new facility in Vance, Ala.

Labor overhead was an albatross around Detroit’s neck. Until recently, total pay and benefits for a full-time worker at the Big Three averaged $140,000 a year vs. $80,000 for their foreign competitors. Add an estimated $2,000-plus per car for retiree health care and pensions for the Big Three, and you wonder not why Detroit failed, but why it didn’t fail sooner.

Detroit’s response to a declining business climate was more taxes, fewer city services and bloated pensions for workers in the only growth area — government.

Sound familiar. It should! It’s the Obama Jobs and Taxes model.

The city’s $11 billion in unsecured debt includes $6 billion in health and other retirement benefits and $3 billion in retiree pensions for its 20,000 city pensioners, members of the public sector unions that helped bring Detroit to its knees.

In the face of government incompetence, it was the people of Detroit who went on strike. Detroit lost a quarter-million residents between 2000 and 2010. A population that in the 1950s teemed with 1.8 million is struggling to stay above 700,000. Much of the middle-class and scores of businesses also have fled, taking their tax dollars with them.

1967 riots didn’t help their cause either.

Detroit is the rotten fruit of uncontested progressive socialism. In 1960, Detroit had the highest per capita income in the U.S.; today, it’s the poorest of our large cities. An estimated 78,000 of the city’s homes are unoccupied, and in 2011 half the occupiers of its 305,000 properties did not pay any tax. Some 40% of the street lights do not work.

Detroit has 264,209 households, and 91,204 — or 34.5% — get food stamps. Only 54.3% of Detroit residents participate in the labor force. This is how America is beginning to look. If we continue down President Obama’s path, America will become Detroit, only with a press to print money.

Indeed, the scary part is that Detroit is what Obama wants to fundamentally transform America into: a place where wealth is redistributed, not created, and where government picks winners and losers in an economy in which we all ultimately lose.

Speaking at Ohio State University in May, he told graduates not to listen to “voices that incessantly warn of government as nothing more than some separate, sinister entity that’s at the root of all our problems.” (IBD)

Detroit didn’t. We should.

And ObamaCare is the icing on the Progressive Liberal Cake.
And if you don’t like it, well the Ministry of Truth, NSA, IRS, FDA, HHS and the rest of the alphabet soup is here to help.
Doesn’t that make you feel better? 🙂
“Government isn’t the solution to our problems, Government IS the problem” — Ronald Reagan

134863 600 Detroit Bankruptcy cartoons

134649 600 Zimmerman Lynched cartoons

 

The Pork Sleighs Me

Political Cartoons by Jerry Holbert

Some Christmas Pork over the Crony Barrel:

WASHINGTON — President Obama’s $60.4 billion request for Hurricane Sandy relief has morphed into a huge Christmas stocking of goodies for federal agencies and even the state of Alaska, The Post has learned.

The pork-barrel feast includes more than $8 million to buy cars and equipment for the Homeland Security and Justice departments. It also includes a whopping $150 million for the National Oceanic and Atmospheric Administration to dole out to fisheries in Alaska and $2 million for the Smithsonian Institution to repair museum roofs in DC.

An eye-popping $13 billion would go to “mitigation” projects to prepare for future storms.

Other big-ticket items in the bill include $207 million for the VA Manhattan Medical Center; $41 million to fix up eight military bases along the storm’s path, including Guantanamo Bay, Cuba; $4 million for repairs at Kennedy Space Center in Florida; $3.3 million for the Plum Island Animal Disease Center and $1.1 million to repair national cemeteries.

Budget watchdogs have dubbed the 94-page emergency-spending bill “Sandy Scam.”

Matt Mayer of the conservative Heritage Foundation slammed the request as an “enormous Christmas gift worth of stuff.”

“The funding here should be focused on helping the community and the people, not replacing federal assets or federal items,” he said.

Never Let a Crisis Go to Waste! 🙂

Mark Steyn:

A few years ago, my small local hospital asked a Senate staffer if she could assist them in obtaining federal money for a new building. So she did, expediting the process by which that particular corner of northern New Hampshire was deemed to be “under-served” and thus eligible for the fed gravy. At the ribbon-cutting, she was an honored guest, and they were abundant in their praise. Alas, in the fullness of time, the political pendulum swung, her senator departed the scene, and she was obliged to take a job out of state.

Last summer, she returned to the old neighborhood and thought she’d look for a doctor. The sweet old guy with the tweed jacket in the neatly painted cape on Main Street had taken down his shingle and retired. Most towns in the North Country now have fewer doctors than they did in the 19th century, and the smaller towns have none. The Yellow Pages lists more health insurers than physicians, which would not seem to be an obvious business model. So she wound up going to the health center she’d endowed so lavishly with your tax dollars just a few years earlier.

They gave her the usual form to fill in, full of perceptive inquiries on her medical condition: Do you wear a seat belt? Do you own a gun? How many bisexual men are you now having sex with? These would be interesting questions if one were signing up for eHarmony.com and looking to date gun-owning bisexuals who don’t wear seat belts, but they were not immediately relevant to her medical needs. Nevertheless, she complied with the diktats of the Bureau of Compliance, and had her medical records transferred, and waited . . . and waited. That was August. She has now been informed that she has an appointment with a nurse-practitioner at the end of January. My friend pays $15,000 a year for health insurance. In northern New Hampshire, that and meeting the minimum-entry requirement of bisexual sex partners will get you an appointment with a nurse-practitioner in six months’ time.

Why is it taking so long? Well, because everything in America now takes long, and longer still. But beyond that malign trend are more specific innovations, such as the “Office of the National Coordinator for Health Information Technology,” which slipped through all but unnoticed in Subtitle A Part One Section 3001 of the 2009 Obama stimulus bill. Under the Supreme National Coordinator, the United States government is setting up a national database for everybody’s medical records, so that if a Texan hiker falls off Mount Katahdin after walking the Appalachian Trail, Maine’s first responders will be able to know exactly how many bisexual gun-owners she’s slept with, and afford her the necessary care.

This great medical advance is supposed to be fully implemented by 2014, so the federal government is providing incentives for doctors to comply. Under the EHR Incentive Program, if a physician makes “meaningful use” of electronic health records, he’s eligible for “bonuses” from the feds — a mere $44,000 from Medicare, for example, but up to $63,750 from Medicaid. If you have a practice at 27 Elm Street and you’re treating the elderly widow from 22 Elm Street, she’s unlikely to meet the federally mandated bi-guy requirement, but you can still qualify for bonuses by filing her smoking status with Washington. For medical facilities in upscale suburbs, EHR is costly and time-consuming, and, along with a multitude of other Obamacare regulatory burdens, helping drive doctors to opt out entirely: My comrade Michelle Malkin noted the other day that her own general practitioner has now switched over to “concierge care,” under which all third parties (whether private insurers or government) are dumped and a patient contracts with his doctor solely through his checkbook. Some concierge docs will even make house calls: Everything old is new again! (For as long as the new federal commissars permit it.)

But in the broken-down rural hinterlands, EHR and other novelties make it more lucrative for surviving medical centers to prioritize federal paperwork over patient care. For example, there’s a lot of prescription-drug abuse in this country, and so the feds award “meaningful use” bonuses for providing records that will assist them in determining whether a guy with a prescription for painkillers in New Hampshire also has a prescription for painkillers with another doctor over the Connecticut River in Vermont. So in practice every new patient in this part of the world now undergoes a background check before getting anywhere near a doctor. It doesn’t do much for your health, but it does wonders for an ever more sclerotic bureaucracy.

Hence the decay of so many “medical” appointments into robot-voiced box-checking. At the doctor’s a couple of months back, the nurse was out to lunch, and so the receptionist-practitioner rattled through the form. In the waiting room. “Are you sexually active?” she asked. “You first,” I replied. I hope I didn’t cost her the federal bonus.

But don’t worry, it’s totally secure. Carl Smith Jr. was the first physician in Harlan County, Kentucky to introduce EHR. “Because of this technology,” Dr. Smith says, “we can send the patient’s prescription electronically by secure e-mail to pharmacies.” Wow! “Secure e-mail”: What a concept! It’s a good thing the e-mail is secure at American pharmacies because nothing else is. Last Christmas, while guest-hosting at Fox News in New York, I had a spot of ill health and went to pick up a prescription at Duane Reade on Sixth Avenue. The woman ahead of me was having some difficulties. She was a stylish lady d’un certain age, and she caught my wandering eye. After prolonged consultation with the computer, the “pharmacist” informed her (and the rest of us within earshot) that her insurer had approved her Ortho but denied her Valtrex. I was thinking of asking her for cocktails at the Plaza, when I noticed the other women in line tittering. It seems that Ortho is a birth-control pill, and Valtrex is a herpes medication.

So good luck retaining any meaningful doctor-patient confidentiality in a system in which more people — insurers, employers, government commissars, TSA Obergropinführers, federal incentive-program auditors — will be able to access your medical records than in any other nation on earth.

No foreigner can even understand the American “health care” debate, which seems to any tourist casually surfing the news channels to involve everything but health care. Since the Second World War, government medical systems have taken hold in almost every developed nation, but only in America does the introduction of governmentalized health care impact small-business hiring practices and religious liberty, and require 16,500 new IRS agents and federal bonuses for contributing to a national database of seat-belt wearers. Thus, Big Government American-style: Byzantine, legalistic, whimsical, coercive, heavy on the paperwork, and lacking the one consolation of statism — the great clarifying simplicity of universal mediocrity.

As I wrote a couple weeks ago, Obamacare governmentalizes one-sixth of the U.S. economy — or the equivalent of the entire French economy. No one has ever attempted that before, not even the French. In parts of rural America it will quickly achieve a Platonic perfection: There will be untold legions of regulators, administrators, and IRS collection agents, but not a doctor or nurse in sight.

Michelle Malkin: Department of Health and Human Services Inspector General acknowledged that the incentive system is “vulnerable to paying incentives to professionals and hospitals that do not fully meet” the program’s quality assurance requirements. The federal health bureaucracy “has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments postpayment is also limited,” the IG concluded.

Translation: No one is actually verifying whether the transition from paper to electronic is improving patient outcomes and health services. No one is actually guarding against GIGO (garbage in, garbage out). No one is checking whether recipients of the EMR incentives are receiving money redundantly (e.g., raking in payments when they’ve already converted to electronic records). No one is actually protecting private data from fraud, abuse or exploitation.

But not doing it, or doing it more rationally of course, is, you guessed it “racist” “sexist” “bigotry” and “trying to kill grandma.”

America in the 21st Century, what a Kingdom of Bureaucracy. The Bureaucrat is King and you’re just a smelly, nasty, demanding little serf who just wants to annoy them.

Congrats. It’s what you voted for Amerika. 🙂