Cut!

Raise the cost of something, and inevitably demand for that thing goes down. It’s a venerable principle in economics.

So five years ago when ObamaCare was being enacted, we and many others warned that its coverage mandates for employers would result in hours being cut back and workers being laid off. We were criticized at the time as Chicken Littles. Now comes a survey of 743 personnel executives by the Society of Human Resource Management, as reported by Robert King of the Washington Examiner, that shows businesses are doing just that. Nearly 14% of firms have cut part-time hours for workers, King wrote, and another 6% plan to do so.

Still worse, 5% of companies have already either cut or plan to cut the total number of workers they have, thanks to ObamaCare.

ObamaCare’s employer mandate requires businesses with 100 or more employees to provide health insurance to 70% of their workers who put in 30 or more hours a week. That goes up to 95% next year.

Meanwhile, small businesses with 50 to 99 workers will start feeling the pinch in 2016, when the mandate hits them, too.

So it’s only logical: Businesses are cutting hours to avoid having to pay for the mandate — a predictable response in the real world, but apparently not in the world of the economists, politicians and planners who concocted ObamaCare’s destructive rules.

As for “bending the cost-curve down,” as President Obama promised repeatedly, forget about it. The survey found that 77% of companies had higher health-care costs this year than last year, and just 6% saw their costs decrease. For those who had costs rise, 24% saw costs go up 16% or more.

If you want to know why this job recovery has been the worst since the Great Depression, you need look no further than these depressing statistics.

In September 2009, President Obama addressed Congress, vowing that his healthcare plan would “slow the growth of healthcare costs for our families, our businesses, and our government.” But costs for all three have actually grown.

During the campaign in 2008, Obama repeatedly said that his health reform plan would save the average family $2,500 a year in premiums. But this year, almost half of those surveyed by CBS and the New York Times characterized “the affordability of basic medical care as a hardship.” That’s a quarter more people than said so last year.

The Kaiser Family Foundation, the New York Times, and Avalere Health crunched government numbers and concluded that even premiums for coverage offered on the exchanges would rise between 2 and 5% during 2015.

Meanwhile, a study from the National Bureau of Economic Research determined that premiums in the non-group market in 2014 increased by 24.4% over what they would have cost without Obamacare.

Costs for small businesses have also grown. Last year, the average cost of employer-sponsored health insurance for an individual exceeded $5,700. That’s 23% more than in 2009, the year before Obamacare was signed into law.

One in 10 businesses has laid off workers to cope with growing healthcare costs. And “one-third of small firms say they are purposefully not growing as a result of the Affordable Care Act,” according to a National Small Business Association Survey.

Meanwhile, one in five companies has reduced employee hours to avoid falling afoul of Obamacare’s employer mandate, which requires companies with 100 or more employees who work more than 30 hours a week to provide health insurance this year. Next year, companies with 50 or more workers will be subject to the mandate.

Companies who fail to comply must pay fines of the lesser of $3,000 per employee who receives subsidies in Obamacare’s insurance exchanges or $2,000 for every worker after the first 30.

The cost of Obamacare has also grown dramatically for the government — and thus for taxpayers. In 2009, President Obama claimed that his plan would cost a little more than $900 billion over the next decade. But according to a recent report from the Congressional Budget Office, the law’s net price tag has ballooned to nearly $1.2 trillion.

The law’s ballooning cost is largely the result of its failure to slow overall health spending. Nationwide, health spending grew 5% in 2014, compared to a 3.6% increase the year prior, according to a new report from Altarum Institute. The Centers for Medicare and Medicaid Services forecast spending to grow by 6% a year from 2015 through 2023 — “largely as a result of the continued implementation of the ACA coverage expansions.”

To make matters worse, the health law has also failed to deliver “the best care, not just the most expensive care,” as the President promised in 2009. Under Obamacare, Americans now have fewer healthcare options than before.

The number of insurers selling to individual consumers in the exchanges has dropped by more than 20% compared to the year before Obamacare took effect, according to the Heritage Foundation. Consumers who buy coverage on the exchanges often find that their preferred hospitals are out of network, McKinsey & Co. reports.

Meanwhile, Deloitte surveyed 20,000 doctors and discovered that many are cutting their work hours or leaving the practice of medicine altogether. USA TODAY recently reported that many doctors are limiting their intake of patients who bought coverage on the exchanges; the reimbursement rates offered by their policies are just too low.

“Physicians who are in solo practices have to be careful not to take too many patients reimbursed at lower rates or they’re not going to be in business too long,” said the President of the Medical Society of the State of New York.

For patients, this exodus of doctors translates into less access, longer waits before appointments, and less one-on-one time with the few doctors who will see them. Last year, patients had to wait an average of 18 days for appointments with specialty doctors. This waiting game is “going to get worse and not better,” according to a study from consultancy Merritt Hawkins.

But since it “felt good” and they “had the best of intentions” and it’s all the fault of evil insurance companies the Liberal won’t hold themselves responsible for making things much worse than if they hadn’t meddled in the first place.

Trust Me

Whoops!  Guacpocalypse Alarm...

Chipotle stirred up the media and guacamole lovers with news that it could “suspend” guacamole from its menu due to global warming.

But a restaurant spokesman tells the Los Angeles Times: “This is way overblown.” 

The annual report (sent to the investors not the general public)  from the restaurant chain warned:

“Increasing weather volatility or other long-term changes in global weather patterns, including any changes associated with global climate change, could have a significant impact on the price or availability of some of our ingredients. …

“In the event of cost increases with respect to one or more of our raw ingredients, we may choose to temporarily suspend serving menu items, such as guacamole or one or more of our salsas, rather than paying the increased cost for the ingredients.”

Hilarious! I love it when the Chicken Little Global Warming Apocalypse crowd lets there hysterical nerves get the best of them.:)

Now back to yesterday’s Obamacare guru, the brother of Rahm “dead fish” Emmanuel (who is the mayor of the second lowest bond rated city in America-Detroit being #1).

Under the Affordable Care Act, the Health and Human Services Department is spending billions of dollars to expand community health clinics, which are mainly staffed by nurse practitioners and physician assistants.

“It’s going to be one part of a complex part of the health care system,” Dr. Ezekiel Emanuel, one of the architects of Obamacare, told Fox News’s Bill O’Reilly Tuesday night. “So if your kid has a sore throat and you want to find out if it’s strep throat, or your kid has what appears to be an ear infection and you want to find out if it’s otitis media — you really don’t need to go to the pediatrician. You can go to these clinics.”

Doctors, you don’t need no stinking Doctors!!….:)

“But there aren’t any doctors,” O’Reilly said.

“Well, you don’t need a doctor for every part of your health care,” Emanuel responded.

“You don’t need a doctor,” O’Reilly echoed. “If I want a strep throat diagnosis, I don’t want Lenny who just came out of the community college…”

“Excuse me, but those are nurse practitioners — it’s not Lenny out of a community college,” Emanuel said. “And it is just putting a swab back there and getting a strep throat assessment.”

It sure it doesn’t say “you only saw a nurse, here’s a lower rate” on my bill. 🙂

Emanuel said electronic health records make it possible for the clinic to send the diagnosis to a patient’s primary physician.

And if you don’t have one, genius? Oh that’s right, the government will probably get around to assigning you one for your own protection, just like the “share repsonisbility payment”. 🙂

“Are you worried?” O’Reilly asked. “Say you had VD, STD — I’m sure you don’t.”

“Please, don’t insult me,” Emanuel replied.

O’Reilly said he’s worried about the privacy of electronic medical records.

“We have laws to protect the privacy,” Emanuel said. Several times, he accused O’Reilly of “sowing fear with no grounds.”

TARGET ANYONE??? Yeah, no hacker would want your medical records… 🙂 And Privacy laws, ooooh ahhh! Yeah that says no one can get them.

HELLO NSA! 🙂

“You know me, I’m afraid of everything,” O’Reilly said. “Say TMZ offers somebody like $5,000 to get a famous person’s medical records. Is that unheard of? Is that unheard of? Come on, is that unheard of? You know it goes on all the time.”

“They will not, they have high security and everyone is well aware of this, and they are taking it seriously. And if they — if they didn’t, they would have already offered that for electronic health records and we would have seen the breach.”

Ah, the arrogance of a Liberal!

They don’t need $5,000. They just need a 17 year old geek from Russia!

Emanuel said 80 percent of doctors now use electronic health records — “and there has not been that kind of breach… And there is not a single case, Mr. O’Reilly, of those medical records being breached for things like STDs or a very famous Hollywood star’s medical records.” (CNS)

Yeah, and because it hasn’t happened yet, means it will never happen…. 🙂

The same guy Dec 2013 with Chris Wallace (listen the arrogance):

WALLACE: It’s a simple yes or no question. Didn’t he say if you like your doctor, you can keep your doctor?

EMANUEL: Yes. 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. We know in all sorts of places you pay more for certain — for a wider range of choices or wider range of benefits. The issue isn’t the selective networks. People keep saying, ‘Oh, the problem is you’re going to have a selective network.’

WALLACE: Well, if you lose your doctor or lose your hospital —

EMANUEL: Let me just say something. People 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.

WALLACE: Which means your premiums will probably go up.

EMANUEL: They get that choice. That’s a choice you’ve always made.

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

EMANUEL: No one guaranteed you that your premium wouldn’t increase. Premiums have been going up.

WALLACE: The president guaranteed me I could keep my doctor.

EMANUEL: And if you want to, you can pay for it. Under President Bush, premiums went up 80% after inflation. We have actually seen a leveling off of health care costs and premiums in the last few years because of changes that have been made.

As a matter of fact, choice is something — we all understand that for more choice, more benefits, you have to pay more.

So YOU chose to pay more to keep your Doctor, not the Government. YOU chose to be dropped by your health care provider, not ObamaCare Regulations…

Since you always had the choice, and we chose not to have ObamaCare, why did we get it anyways?

Oh, right- THE AGENDA IS THE AGENDA!!!!

TRUST ME! 🙂

We are from the Government and we are here to help you!

P.s. (March 4th): “We are preparing tonight for another major delay in the implementation of the President’s health care law.” Correspondent Jim Angle chipped in that Obama “prepares to offer yet another delay in ObamaCare, one to postpone the political pain of cancelling millions of plans in the individual market just like last fall.”

Wouldn’t want any rash/hysterical mad “choices” against Democrats in November now would we!!!! 🙂

Political Cartoons by Lisa Benson

Political Cartoons by Glenn McCoy

Political Cartoons by Steve Breen
 Political Cartoons by Bob Gorrell

Actions Have Consequences

Political Cartoons by Eric Allie

President Obama’s proposal to raise the minimum wage to $10.10 an hour would increase earnings for 16.5 million low-wage Americans but cost the nation about 500,000 jobs, congressional budget analysts said Tuesday. (WP)

Then they can pay for ObamaCare! They just might not have a Job…:)

A bipartisan group of lawmakers is asking the Obama administration to scale back draft regulations under ObamaCare that would force restaurants to post nutritional information on their menus.

“Specifically, the proposed rule limits the ability of businesses to determine for themselves how best to provide nutritional information to customers,” (The Government knows best always, right?) the lawmakers wrote in a letter to FDA Commissioner Margaret Hamburg. “As a result, the proposal harms both those non-restaurants that were not intended to be captured by the menu labeling law as well as those restaurants that have flexibility and variability in the foods they offer.” 



Pizza places and grocery stores in particular have complained about the draft standards, saying they would be all but impossible to maintain. For instance, there are 34 million different combinations of pizza toppings, according to an industry trade group. It’s impractical to require that they list calorie counts for all of the options, they say.



“Yet, to date there is little evidence to suggest that the FDA has considered these alternatives,” the lawmakers wrote to Hamburg. “Instead, it appears that the FDA has withdrawn from interacting with affected industries and instead proceeded on a path that will unnecessarily burden many small businesses across the country.” (The Hill)
THE AGENDA IS THE AGENDA!  And no grubby Congressperson or Pizza joint is going to stop us from our holy mission to force you to do the right thing and make you less fat!

We’ll just remove the source… 🙂

And, of course regulations like this and a $3 raise in the minimum wage won’t have any effect on a businesses bottom line or cause them to go out of business.

And if it does, who needs them.

The equivalent of about 2.5 million Americans will quit their jobs, cut their hours or stop looking for work during the next decade because of new benefits available under the health-care law, according to recent Congressional Budget Office estimates that have renewed debate over the program’s effect on the economy.

The White House and its allies argue that the government has a role in addressing a failure of the health-insurance market: the high prices and coverage restrictions that have kept health coverage out of reach for so many people. Like Social Security, which provides a safety net so people can retire, the health law may have the effect of leading some Americans to stop working, they say.

We are from the Government and we are here to help you…:)

But they called the impact positive, arguing that people have for too long been stuck in jobs that are a poor fit or that they dislike, simply for the benefits. While some people may make the calculation to just work less to keep more generous benefits, many will use their time to do something more productive, such as start their own business or take care of family members, advocates of the new law say.

Government assistance is so much more satisfying, after all…Sponge off other people, after all, they’ll be making more money to pay for it. 🙂

All you have to do is lower your expectations and swallow your pride and the government trough is open slop for you!

Here little piggy!…

Extending the maximum length of benefits beyond 26 weeks made highly educated unemployed people “more ‘relaxed’ and more patient in selecting jobs,” wrote Lei Fang and Jun Nie in a new working paper, “Human Capital Dynamics and the U.S. Labor Market.” Had unemployment benefits not been extended, they estimated, “the unemployment rate during the 2010-2012 period would have been 0.5 percentage point lower than the actual level.”

Their findings follow earlier research by Makoto Nakajima, a senior economist at the Federal Reserve Bank of Philadelphia. Mr. Nakajima estimated extended jobless benefits accounted for 1.2 percentage points of the jump in the unemployment rate from the end of 2007 to the fall of 2009. (WSJ)

And now for the Orwellian doublespeak of the week: “You can’t say the Affordable Care Act has killed job growth,” <WH advisor> Schiliro told an audience at a Kaiser Family Foundation presentation Wednesday. “In the 46 months since it passed, over 8 million jobs have been created… No one would say the Affordable Care Act created those jobs, but you can’t say the ACA has killed job growth.”

You can’t say it created those jobs, but I just did! You can’t say it killed jobs, because that is not the Agenda Message so stop saying that!

The Bureau of Labor Statistics estimates that the financial crash and resulting recession lost the U.S. economy 8.8 million jobs.

The Congressional Budget Office issued a report concluding that the equivalent of 2.3 million jobs would be lost because Obamacare’s structure incentivizes less work with more taxpayer subsidies.

Business leaders such as the National Federation of Independent Business (NFIB) estimate that the Health Insurance Tax will reduce employment by up to 262,000 jobs by 2022. (DC)

The Labor Participation is the lowers it’s been in 35 years! Yet, we have 14 million new Americans since Obama came into office.

And after all, that’s why the employer mandate has been put off several times, because it’s just so good for everyone! 🙂

The employer mandate will only begin in 2015 for businesses with 100 or more full-time employees, the Treasury Department announced. Companies with between 50 and 99 employees will be exempted from the law for another year — unless a company fires workers to make it beneath the threshold for the delay.

The IRS regulations on the delay make it very clear that only companies that shrink from 100-plus full-time workers just before the delay for “bona fide business reasons” will be exempted from the mandate to have coverage.

The government that is going to force you to go out of business or fire people must approve of the reasons or else you won’t be allowed the benefit of their benevolence!

Nice. 🙂

It’s good to be the King! or the King’s Minions! 🙂

Oh, and that choice thing…

California’s health care exchange promised potential customers they would have enough physicians to choose from. But some new enrollees, including an Alameda County woman, are discovering that their doctor choices are extremely limited.

Julia Turner is surprised that she even has to search for a doctor. When she signed up for a policy through Covered California late last year, her long-time physician was listed as participating in her Blue Shield plan. It turned out; however, that he is not accepting patients with her Blue Shield policy, purchased on the Covered California exchange.

When Turner called around to find someone else to treat her, she got more frustration. “The only doctors accepting new patients are urgent care clinics,” Turner told KPIX 5 ConsumerWatch.

None of the doctors are located in the city in which she lives. Instead, Turner said, “They are in areas of East Oakland that have a lot of violence.”

Which I’m sure is some rich person’s fault, or “income inequality”.Don’t worry, Obama will demand they get paid more and everything will be alright!

Promise! Trust Him, he’s got your back! 🙂

When KPIX 5 contacted all of the 41 doctors on the list Blue Shield provided to Julia, it found only four of the doctors were actually accepting new adult patients, and only one of them was board certified.

The California Department of Managed Health Care said there is no law that requires the insurer’s provider list to be accurate. However, state law does require insurers to have an “adequate” network of doctors. That means there must be at least one doctor for every 1,200 enrollees within 15 miles of their home.

But many enrollees, in both Blue Cross and Blue Shield plans purchased on the exchange said they are struggling to find even one doctor willing to take new patients due to what are now being call “narrow networks.”

The narrowest networks – those with the fewest doctors – are in some of the Northern California counties with the lowest median household income and the highest number of Medi-Cal recipients. Alameda County falls into that category.

Pat Johnston of the California Association of Health Plans, the industry group representing the insurers, admits there some issues with doctor availability. Johnston calls it a “tradeoff.”

 

“Remember one of the factors here is trying to make it affordable,” he explained. He admits that depending on the insurer, there are fewer provider options for enrollees who purchase the subsidized policies on the exchange.

 

Those you trade Freedom (of Choice) for “security” deserve neither, and you’ll likely get it too! But be happy, it’s not the Government’s fault!! They are here to save you! 🙂

After all the pressure the insurer rolled over and made nice for her. but…“This is not what we were promised. I see those (Covered California) commercials now and I want to scream,” Turner said.

And Obama wants to mess with you even more, rejoice! 🙂

Political Cartoons by Steve Kelley

Political Cartoons by Steve Breen

Political Cartoons by Lisa Benson
 Political Cartoons by Michael Ramirez

 

Let’s Review

Health Care: The administration has amended or delayed ObamaCare 19 times. Unions are screaming about the harm it will cause. The exchanges are in disarray. Yet it’s Republicans who are out of touch for wanting to stop it?

After all, the solution to many Democrats is Single Payer, even MORE government intervention.

Recently, Rep. Chris Van Hollen, D-Md., accused the GOP of having “a fetish about trying to kill ObamaCare.” Guess he has a point. After all, just look at some of the terrible things Republicans have been saying about it in recent weeks:

• It will “destroy the foundation of the 40-hour workweek that is the backbone of the American middle class.”

• It will “end up forcing millions out of multi-employer plans.”

• It “creates unstoppable incentives for employers to reduce weekly hours for workers.”

• Its “perverse incentives are already creating nightmare scenarios.”

• “In its rush to achieve its passage, many of the act’s provisions were not fully conceived.”

• And, repealing ObamaCare would “protect our employers, our industry and our most important asset: our members and their families.”

Oh, wait! It wasn’t Republicans saying those things. Every one of those complaints was lodged by top union officials who, despite backing the law, now see its dark side.

Democrats such as Van Hollen also conveniently overlook the fact that Obama has already signed 14 bills into law that changed or killed parts of ObamaCare and delayed another five key pieces that proved unworkable, according to a new Congressional Research Service report.

The CRS also found that the administration missed half of the deadlines set in the law. And an inspector general report found it well behind schedule ensuring the ObamaCare data hub is secure.

Then there’s the fact that, just weeks before the exchanges are supposed to open, “not a single state appears to be completely ready.” That’s what Leavitt Partners’ W. Brett Graham told a congressional panel this week, adding that many states have “only recently begun to test their systems” to verify eligibility and subsidy requests.

So, let’s review.

We have a law that unions say will seriously harm middle-class families, that’s already required multiple fixes and delays, that relies on exchanges that won’t be ready, and that poses serious privacy risks.

Seems to us the real question that needs asking isn’t why the GOP is so obsessed with stopping ObamaCare, but why Democrats are so determined to let this disaster roll down the tracks.

THE AGENDA IS THE AGENDA!!! They aren’t going to be denied now!

If you think the Obama health law is only for the uninsured and you won’t be affected, you’re in for a surprise next time you go to the doctor. Be prepared for questions unrelated to why you are seeking medical help — questions that you don’t want to answer.

Whether you’re at the dermatologist or the cardiologist, you’ll likely be asked: “Are you sexually active? If so, with one partner, multiple partners or same-sex partners?”

Doctors are being turned into government agents, pressured financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.

Going to the doctor can be embarrassing. But for your own good, you confide things to a doctor you wouldn’t tell anyone else. What is happening here is different.

“This is nasty business,” says Dr. Adam Budzikowski, a New York cardiologist, who called the sex question “insensitive, stupid, and very intrusive.” He could not think of an occasion when a cardiologist would need such information.

Doctors and hospitals that don’t comply with the federal government’s electronic health records requirements forgo incentive payments now and face financial penalties from Medicare and Medicaid starting in 2015. The Department of Health and Human Services has already paid out over $12.7 billion in incentives to doctors and hospitals.

Dr. Richard Amerling, a nephrologist and Albert Einstein Medical College associate professor of medicine, explains that medical record should be “a story created by you and your doctor solely for your treatment and benefit.” But the administration’s electronic record requirements are turning it “into an interrogation, and the data will not be confidential.”

Lack of confidentiality is what concerned the New York Civil Liberties Union in a 2012 report. Electronic medical records have enormous benefits, but with one click of a mouse every piece of information in a patient’s record, including social history, is transmitted, disclosing too much.

The social history questions also include whether you’ve ever used drugs, including intravenous drugs. As the NYCLU cautioned, revealing a patient’s past drug problem, even if it was a decade ago, risks stigma.

On the other end of the political spectrum is the Goldwater Institute, a free-market think tank. It argues that by requiring everyone to have health insurance and then imposing penalties on insurers, doctors, hospitals who don’t use the one-click electronic system, you are violating Americans’ medical privacy.

Protests from these privacy advocates are largely ignored. On Jan. 17, HHS announced that if patients want to keep something out of their electronic record, they should pay cash. That’s impractical for most people.

In 2010, when Congress was drafting ObamaCare, the National Rifle Association demanded a protection that became Section 2716 of the final law. It bars the federal government from compelling doctors and hospitals to ask you if you own a firearm. That’s the only question they can’t be told to ask you.

Where are the women’s rights groups that went to the barricades in the 1980s and 1990s to prevent the federal government from accessing a woman’s health records? Hypocritically, they are silent now.

Patients need to defend their privacy by refusing to answer the intrusive “social history” questions. If you need to confide something relating to your treatment, ask your doctor about keeping two sets of books so that your secrets stay in the office. Doctors take their oath seriously and won’t be offended.

Are such precautions paranoid? Hardly. We’re only starting to see the data collection ambitions of the executive branch.

On Sept. 6, the New York Times reported that Edward Snowden’s revelations show that the National Security Agency has “broadly compromised the guarantees that Internet companies have given consumers to reassure them that their communications, on line bank and medical records, would be undecipherable to criminals or governments.”

Be cautious about sharing your medical secrets with Uncle Sam. (IBD)

He wants to know everything about you…and so do the hackers.

And drink more water, Mama Government, Michelle Obama Said so…

“I really care about your health like I care about my kids’ health,” she told the crowd. “That’s why I’ve devoted so much of my energy into making sure that your generation is as healthy as you can be.  We’ve been talking about how you got to move and keep active and eat right.

“But as we were thinking about this, we were thinking, what is the one thing that we can have you guys do that ensures good health? And it’s really pretty simple. It’s drink more water. Just drink up. Because truly — as I’ve said before — water is the first and best energy drink.” (IBD)

Dead lines

Political Cartoons by Gary Varvel

“I was really shocked that 64 percent [of uninsured adults] said they haven’t decided if they will purchase insurance by the Jan. 1 deadline,” Adams said. “I was definitely surprised by the high number of people who really have no clue what they’re going to do next year.” 

“We don’t want these consumers to miss this key deadline,” she said, adding that new heath-care exchanges under Obamacare will begin accepting applications for insurance in less than four months. “They’re going to potentially go without health care for the entire year.

Supporters of President Obama’s overhaul of American medicine are touting the early evidence from California’s Obamacare exchange (still under construction) as good news for their side.  But as the Los Angeles Times notes, the Golden State’s version of Obamacare will mean higher insurance premiums and a lower quality of care, as those who use its exchanges to buy federally mandated insurance will encounter not only higher prices but also diminished access to hospitals and doctors. 

 

The Times observes that “one downside for many consumers will be far fewer doctors and hospitals to choose from.”  The Times writes:

“People who want UCLA Medical Center and its doctors in their health plan network next year, for instance, may have only one choice in California’s exchange: Anthem Blue Cross. Another major insurer in the state-run market, Blue Shield of California, said its exchange customers will be restricted to 36% of its regular physician network statewide.

 “And Cedars-Sinai Medical Center, one of Southern California’s most prestigious and expensive hospitals, said it’s not included in any exchange plans at the moment.”

Insurers are also raising their prices in anticipation of additional costs that will come with the arrival of Obamacare, which was supposed to have been the corrective for this sort of thing. The price of health care coverage will surely continue to rise as companies are compelled to accept anyone regardless of risk. It is, after all, the measure of risk that determines the real price of insurance. Not, unfortunately, the intuition of regulators or the wishes of legislators.

As I have said repeatedly for years, mess with Adverse Selection and Health Care is doomed to go up even faster.

Under ObamaCare, the 30-hour workweek may take a cue from the clumsy Dodo bird and disappear — due to clumsy regulation.

If that sounds extreme, just consider: For a worker making $16 an hour for 29 hours per week, the 30th hour of work each week could cost an employer $112.15.

In other words, ObamaCare could cost an employer as much as $96.15 extra an hour — or six times the going hourly wage in this example.

Here’s how: Employers who offer health coverage that is deemed either too pricey or too skimpy will owe $3,000 for each full-time, 30-hour-per-week, worker who taps ObamaCare subsidies.

Because the $3,000 fine is nondeductible, it’s equal to $5,000 in deductible wages for a profit-making firm facing a 40% combined federal and state tax rate.

Simply dividing that $5,000 by 52 weeks yields an ObamaCare cost of $96.15 per hour.

The 31-hour, 32-hour, 33-hour and 34-hour workweeks also may become relatively rare.

For example, ObamaCare could tack on as much as $48 per hour for a worker clocking 31 hours, or two hours beyond ObamaCare’s care-free threshold of 29 hours per week.

Yet, even for those clocking 40 hours, the incremental cost of ObamaCare of $8.74 per hour beyond the 29th hour of work could effectively add 55% to a $16/hour wage.

When it comes to modest-skilled, modest-wage workers in highly competitive industries with low profit margins, employers will be hard-pressed to ignore such cost increases.

Not surprisingly, there’s evidence that employers are already taking steps to dodge ObamaCare’s penalties. Retailers have been cutting hours for nonsupervisory workers at the sharpest rate in more than three decades, Labor Department data show.

Still, there is much uncertainty about just how dramatic the shift to sub-30 hours per week will be. Employers will likely perceive a cost to worker productivity and satisfaction if they depend too heavily on part-timers. However, the pressure to keep prices low or risk losing business may limit flexibility.

A big unknown is the extent to which workers who are eligible for ObamaCare subsidies will opt to sign up. Doing so will require those earning 200% to 300% of the poverty level to fork over 4% to 7% of income for a bronze plan.

Some employers are betting young, low-income workers won’t. As an enticement to keep ObamaCare participation low, some firms are preparing to offer their workers “skinny” coverage for basic expenses like doctors visits and generic drugs as an alternative to paying a tax penalty.

Still, it will be harder for employers to escape ObamaCare costs for older workers, who would take on bigger risks by going without insurance. The result may be that older workers will be the most likely to see their hours reduced below 30.

The lowest earners also will be extremely likely to see their hours cut. For example, a worker earning $8 per hour would have to pay just $79 a year to get ObamaCare’s subsidized bronze-level plan, according to Kaiser Family Foundation’s health subsidy calculator. That’s less than the potential tax penalty.

Even spreading the cost of ObamaCare’s wage-equivalent penalty of $5,000 over a 40-hour workweek would effectively raise the minimum full-time wage by $2.40 an hour.

Yet this is among the worst approaches for raising a low-earner’s take-home pay because it is one that employers can avoid — but only if they punish the worker by limiting hours of work. (Andrew Malcolm)

So you’ll have expensive health insurance, but you’ll have a smaller paycheck!

Such a Deal!!

Political Cartoons by Steve Kelley

 Political Cartoons by Nate Beeler

The Future Pathway of ObamaCare

ObamaCare of the Future Update: The British National Health Services “Pathway” Or the Liverpool Care Pathway: A “kinder” way to kill you quickly…

The new investigation will examine how hospitals have received tens of millions of pounds to implement the controversial system for care of the dying.

Kevin Fitzpatrick, spokesman for the campaign group Not Dead Yet, said: “It is very worrying that in any situation less than 100 per cent of families are being consulted before patients are being put on the Liverpool Care Pathway. It is a shock for families to find that out.

“In some situations doctors are prepared to do it without consulting families because they think they know what is best and questions arise as to why they think it is OK to do that. Families have the right to know why a loved one is being put on the LCP.”

Ministers yesterday ordered an independent inquiry into why hospitals have been paid to hit targets for numbers of patients dying on the Liverpool Care Pathway.

Hospitals incentive to kill you early…Hmmm…Sounds familiar somehow…. 😦

In England, it’s called the Liverpool Care Pathway (LCP). Here it is better known as the “death panel,” but the end result is the same. When you become so sick that the cost of your care is deemed burdensome to the state, you are consigned to the proverbial ice floe and set adrift.

And with Obamacare already at 3x the cost and it just really began this week and doesn’t kick into high gear for another year what does this foretell in a Nation that is already $16 Trillion in debt???

Shocking new figures released on Tuesday reveals that the situation in Britain is more grave (no pun intended) than anyone thought. The MailOnline reports that as many as 60,000 patients are placed on the LCP each year, a virtual death sentence, without giving their consent. A third of families, moreover, are kept in the dark when doctors withdraw lifesaving treatment from loved ones.

And it gets worse than that: Some patients are denied nutrition and fluids, both measures designed to hasten their deaths, which typically occur within 29 hours.

Elspeth Chowdharay-Best of Alert, an anti-euthanasia group, is quoted as saying, “The Pathway is designed to finish people off double quick. It is a lethal pathway.”

Yet, not everyone shares that grim assessment. National Health Service Secretary Jeremy Hunt has claimed that the LCP is a “fantastic step forward,” adding that “we need to be unabashed about that because it’s basically designed to bring hospice-style care to terminally-ill people in hospitals.”

Secretary Sebelius  and IPAB anyone… 🙂

Sarah Wootton, chief executive of the campaign group Dignity in Dying, said: “The NHS is clearly moving in the right direction. However, the report highlights there is a need for further training and education on end-of-life communication. As a society we need to appreciate that dying is not a failure of medical care and treatment, but dying badly is.”

But Secretary Hunt told LBC Radio that a few wrongful deaths shouldn’t be construed as an indictment on the system:

I would be very sad if as a result of something that is a big step forward going wrong in one or two cases we discredited the concept that we need to do a lot better to give people dignity in their final hours because it’s something we haven’t done well.

Lots of people don’t want to die with lots of tubes going in and out of their body — they actually want to die in a dignified way.

Hunt didn’t elaborate on how much dignity patients experience when their suffering goes untreated or they are denied food and water.

Tens of thousands of patients with terminal illnesses are being placed on a “death pathway”, almost double the number just two years ago, the Royal College of Physicians has found.

It aims to give patients a ‘good death’ by avoiding unnecessary and burdensome medical intervention but there have been accusations it hastens death because it can involve the removal of artifical hydration and nutrition.

A report into palliative care in the NHS found that in one, unnamed hospital trust, half of families were not told that their loved one had been placed on the LCP and in a quarter of trusts, one in three families were not informed.

The Liverpool Care Pathway was intended for use in hospices but was given approval by the Department of Health in 2006 leading to widespread use in hospitals. Concerns about the pathway were raised first in The Daily Telegraph in 2009 when experts warned that in some cases patients have been put on the pathway only to recover when their families intervened, leading to questions over how people are judged to be in their “last hours and days”.

Daily Mail: Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial ‘death pathways’. Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.

But the Mail can reveal the practice of withdrawing food and fluid by tube
is being used on young patients as well as severely disabled newborn
babies.

The decision to order an independent investigation follows deepening concern over the LCP, which is thought to be used in the deaths of 130,000 hospital patients each year.

Now project that onto a country 5 times larger and that gets to be be 2/3 of a million people.

On ‘bribe’ payments, first revealed by the Daily Mail, which have seen at least £30million given to hospitals that hit targets for numbers of patients who die on the pathway, Mr Lamb said: ‘We are doing an analysis to focus on the circumstances under which these payments have been made.

How the mail led the way

Welcome to the Future! 🙂

Political Cartoons by Chuck Asay

Political Cartoons by Glenn Foden

Political Cartoons by Chip Bok

Political Cartoons by Gary Varvel

 Political Cartoons by Bob Gorrell

 

The Coming of ObamaCare Ethics

Just when you thought Obamacare and  Contraceptives were fun…

All student health care plans covering female college students in the United States must include coverage for free voluntary sterilization surgery, the Department of Health and Human Services announced late Friday afternoon.

Women of college age who do not attend school will also get free sterilization coverage whether they are insured through an employer, their parents, or some form of government-subsidized plan.

“In a study of the cost-effectiveness of specific contraceptive methods, all contraceptive methods were found to be more cost-effective than no method, and the most cost-effective methods were long-acting contraceptives that do not rely on user compliance,” said the Institute of Medicine report on its mandate recommendations.(CNS)

Say Just say “yes” to Sterilization, and No to “Just say no” abstinence!

“The reduction in the number of pregnancies compensates for the cost of contraception,” HHS Secretary Sebelius has said in the past.

The prestigious Journal of Medical Ethics has just given us a sneak-peek into what ObamaCare will surely be mandating in the not-too-distant future.

The Journal published an article this month seeking to mainstream the view that infanticide is a health-improving measure.  Calling it “after-birth abortion,” two philosophers argue that killing a newborn should be a purely elective decision of parents who believe the baby would be a burden or would negatively impact their family’s well being. (life News)

So, they way to cover cost of Obamacare is to have less people in the system!!

For the past several years, the medical profession has been undergoing a disturbing transformation. The process was begun by the Centers for Medicare and Medicaid Services (CMS) in an effort to control exploding Medicare costs, and was accelerated by the passage of the Patient Protection and Affordable Care Act of 2010. As a surgeon in practice for over 30 years, I have witnessed this transformation firsthand. I fear that my profession will soon abandon its traditional code of ethics and adopt one more suited to veterinarians.

For centuries, my predecessors and I have been inculcated with what has come to be called the “Hippocratic Ethic.” This tradition holds that I am ethically required to use the best of my knowledge to recommend to my patient what I consider to be in my patient’s best interests—without regard to the interests of the third-party payer, or the government, or anyone else.

But gradually the medical profession has been forced to give up this approach for what I like to call a “veterinary ethic,” one that places the interests of the payer (or owner) ahead of the patient. For example, when a pet owner is told by a veterinarian that the pet has a very serious medical condition requiring extremely costly surgery or other therapy, the veterinarian presents the pet’s owner with one or more options—from attempt at cure, to palliation, to euthanasia—with the associated costs, and then follows the wishes of the owner.

In a few years, almost all doctors will be employees of hospitals and will be ordered to practice medicine according to federally prescribed guidelines—guidelines that put the best interests of the state ahead of the interests of individual patients.

Several factors in combination are bringing this ethical approach to my profession.

Since the mid-1980s, Medicare has imposed price controls on health care providers. Over the years, in order to accommodate increasing Medicare utilization, physician payments have steadily dropped.

Meanwhile, the regulatory burden on physicians has increased. In the last few years, CMS required all providers to adopt electronic health records or face economic sanctions from Medicare. It is the ultimate goal that every health care provider, including pharmacies, will have electronic databases that will be accessible to the U.S. Department of Health and Human Services (HHS).

In 2009, as part of the so-called stimulus bill, the Federal Commission for the Coordination of Comparative Effectiveness Research (FCCCER) was created. Its mission is to collect the data culled from all electronic health records and make recommendations regarding the comparative effectiveness of drugs, procedures, and therapies. In rendering advice, the FCCCER will essentially answer the following question: What is the most cost-effective way of allocating a fixed amount of resources among a population of roughly 310 million people?

With this same question in mind, the U.S. Preventive Services Task Force, a committee that reports to HHS, concluded in 2009 that mammogram screenings should not be recommended to women under age 50. This caused an uproar among both private health care providers and breast cancer advocacy groups, and the task force soon backed down. Similarly, in the fall of 2011, the task force recommended the abandonment of certain routine prostate cancer screenings. Once again, health care providers and cancer advocacy groups protested, and the task force rescinded its recommendation.

In 2010 the Patient Protection and Affordable Care Act established an Independent Payment Advisory Board (IPAB). Beginning in 2014, the 15 presidential appointees on this board will determine what therapies, procedures, tests, and medications will be covered by Medicare, using advice provided by the FCCCER. Such determinations will then be used to design the coverage packages for the non-Medicare insurance offered through the government–run exchanges. The decisions of the IPAB are not subject to Congressional oversight or judicial review.

Meanwhile, in an effort to control costs now, CMS has developed practice guidelines and protocols for physicians to follow. Committees of health care academics and statisticians developed these guidelines, using data from large population samples.

These protocols govern the therapeutic decisions made by the health care practitioner—right down to the pre-operative antibiotics a surgeon may order. Despite the fact that several recent peer-reviewed studies concluded that the protocols have had no positive effect—in fact, one study showed post-op skin infections increased since the protocols were instituted—CMS imposes financial penalties on hospitals that fail to get protocol compliance from their medical staff.

Medical students and residents are now being trained to follow federally-derived protocols and guidelines as a normal part of medical practice. As a result, this new generation of doctors will be less inclined to challenge the recommendations of federal task forces and agencies. Some academics also worry that “teaching to the protocol” might discourage independent thinking and the use of intuitive knowledge, two traits essential to the practice of good medicine.

In addition, decreased reimbursements and increased regulatory demands on physicians have led many to sell their practices to hospitals. The New England Journal of Medicine* estimates that 50 percent of the nation’s doctors are now hospital employees. As private medical practice becomes more economically untenable, look for the overwhelming majority of doctors to become salaried hospital employees—many working in shifts—in the next few years. Virtually every doctor now graduating a residency program is taking a position as a salaried hospital employee.

Ten thousand people will turn 65 every day for the next 19 years, placing an even greater fiscal burden on the Medicare program.

One way CMS is trying to deal with this is by penalizing hospitals and doctors who treat patients with resistant problems. Effective this year, any patient readmitted to a hospital within 30 days of discharge for the same or a related problem will be treated by the hospital without compensation. The plan is to implement the same policy with respect to the original treating physician in the near future.

To help deal with this more definitively, an old concept with a new name is being promoted and encouraged by the Affordable Care Act: the Accountable Care Organization (ACO). The ACO harkens back to the infamous HMO capitation system of the early 1990s over which the population rebelled.

In a nutshell, hospitals, clinics, and health care providers have been given incentives to organize into teams that will get assigned groups of 5,000 or more Medicare patients. They will be expected to follow practice guidelines and protocols approved by Medicare. If they achieve certain goals established by Medicare with respect to cost, length of hospital stay, re-admissions, or other “core measures,” they will get to share a portion of Medicare’s savings. If the reverse happens, they will face economic penalties.

Private insurance companies are currently setting up the non-Medicare version of the ACO. These will be sold in the federally subsidized exchanges mandated by the Affordable Care Act. In this model, there are no fee-for-service payments to providers. Instead, an ACO is given a lump sum, or “bundled” payment for the entire care for a large group of insurance beneficiaries. The ACOs are expected to follow the same Medicare-approved practice protocols, but all of the financial risks are assumed by the ACOs. If the ACOs keep costs down, the team of providers and hospitals reap the financial reward: a surplus from the lump sum payment. If they lose money, the providers and hospitals eat the loss.

In both the Medicare and non-Medicare varieties of the ACO, cost control and compliance with centrally-planned practice guidelines are the primary goal. The hospital and provider networks will live or die by these objectives.

When almost all health care providers are salaried employees of hospitals, hospitals might then be able to get ACOs to work better than their ancestor HMOs. The hospital administrators will have more control over their medical staff. If doctors don’t follow the protocols and guidelines, and desired outcomes are not reached, hospitals can replace the “problem” doctors.

So where does all this place the medical profession with respect to its ethical credo? In a few years, almost all doctors will be employees of hospitals and will be ordered to practice medicine according to federally prescribed guidelines—guidelines that put the best interests of the state ahead of the interests of individual patients.

When the physician’s primary obligation is to satisfy the wishes of the payer—ultimately the wishes of the state—how can patients be truly confident in their doctors’ decisions?

I submit that it all boils down to a question of professional ethics.

The medical profession must decide—and soon—which ethical doctrine to follow: Are doctors to be agents of their patients or agents of the state? All of us should dread the latter choice—because we will all be patients some day.

Jeffrey Singer practices general surgery in Phoenix, Arizona, writes for Arizona Medicine, the journal of the Arizona Medical Association (Goldwater Institute)

Obama Memo on the Obamacare Case at the Supreme Court:

WHERE’S MY RECOVERY?

Today, over 4 years since the recession started, there are still almost 24 million Americans unemployed or underemployed. That includes 5.6 million who are long-term unemployed for 27 weeks, or more than 6 months, the highest since the Great Depression. The number of Americans employed part-time for economic reasons was still 8.1 million. The Bureau of Labor Statistics (BLS) says, “These individuals were working part time because their hours had been cut back or because they were unable to find a full-time job.”

Another 2.6 million persons were marginally attached to the labor force, essentially unchanged from a year earlier. The BLS says, “These individuals were not in the labor force, wanted and were available for work, and had looked for a job sometime in the prior 12 months. They were not counted as unemployed because they had not searched for work in the 4 weeks preceding the survey.”

African Americans have been suffering an outright depression under Obama, with unemployment today, 51 months after the recession started, still over 14%. Black unemployment has been over 14% for Obama’s entire term in office. Black teenage unemployment today is still nearly 35%, where it has persisted for Obama’s entire term as well.

Hispanics have also been suffering a depression under Obama, with unemployment today still in double digits at nearly 11%, where it has also persisted for Obama’s entire term. Over one fourth of Hispanic youths remain unemployed today, which also has persisted for years.

The Census Bureau reported last September that more Americans are in poverty today than at any time in the entire 51 year history of Census tracking poverty. Americans dependent on food stamps are at an all time high as well. White House spokesman Jay Carney recently tried to blame the Republicans for that, saying that it was their policies of deregulation that caused the recession. But actually it was liberal policies of overregulation forcing the looting of the banks for subprime loans under threat of discrimination suits that caused the recession. See, e.g. Paul Sperry, The Great American Bank Robbery.

Moreover, it was Obama’s responsibility to foster a timely, robust recovery restoring traditional American prosperity. Where is that? The absence of that is because Obama doesn’t believe in traditional American anything. (American Spectator)

The New Jersey Office of Homeland Security and Preparedness has released a new document entitled “Terrorism Awareness and Prevention”. The paper is aimed at raising awareness on how New Jersey residents can help combat terrorism, including tips on how to spot signs of suspicious activities and behaviors.

So what are these suspicious behaviors? “Look for signs of nervousness in the people you come in contact with.” This includes “exaggerated yawning when in a conversation,” “repetitive touching of face,” “increased breathing rate,””unusual perspiration,” “excessive fidgeting,””trembling” and “goose bumps.” Though some might say these are all completely natural body reactions, the document says otherwise.

While pacing around and being jumpy is also listed as a potential indicator of malicious intent, standing still in a rigid posture also fits the bill of terrorist intent. So what should you do to avoid getting flagged as a potential enemy of the state? Stand still, or gesture profusely? In reality, there’s probably not much you can do.

You’re just toast.

Hot dogs. Bison Wellington. Baby back ribs.

President Barack Obama is roaming all over the culinary map this week.

The president made a lunchtime detour to a barbeque and ribs joint Thursday on his way back to the White House after a speech about energy policy.

The president came away from Texas Ribs & BBQ with a takeout bag containing 2 slabs of baby back ribs and a brisket sandwich with fries.

Earlier in the week, Obama downed a hotdog at an NCAA basketball game in Ohio. And on Wednesday, he dined on bison at a fancy state dinner.

So “Let’s Move”!! 🙂

ANOTHER TSA UPDATE

Passengers at airports can now avoid TSA pat downs, long lines and can carry liquids on board by paying $100.

However, the TSA’s new fast track ‘Precheck’ screening is likely to rile the family of a wheel-chair bound toddler who was recently subjected to invasive security checks.

Unlike the background check passengers in the scheme, who will be able to skip screening, the three-year-old was stopped at O’Hare Airport in Chicago.

‘We can reduce the size of the haystack when we are looking for that one-in-a-billion terrorist,’ TSA Administrator John Pistole told the Journal.

And a Three year old in a wheelchair is definitely a candidate for that 1 in a Billion!
So you just have to bribe them a $100 bucks! Gee…
FAST & FURIOUS

Breitbart.com has uncovered video from 1995 of then-U.S. Attorney Eric Holder announcing a public campaign to “really brainwash people into thinking about guns in a vastly different way.”

Holder was addressing the Woman’s National Democratic Club. In his remarks, broadcast by CSPAN 2, he explained that he intended to use anti-smoking campaigns as his model to “change the hearts and minds of people in Washington, DC” about guns.

“What we need to do is change the way in which people think about guns, especially young people, and make it something that’s not cool, that it’s not acceptable, it’s not hip to carry a gun anymore, in the way in which we changed our attitudes about cigarettes.”

Liberal leopards don’t change their spots.
Now don’t you feel better about Obamacare, The TSA, Security and The Economy! 🙂
Political Cartoons by Gary Varvel

 Political Cartoons by Glenn Foden