The Best is Yet to Come


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WP:Nancy Pelosi told us there would be days like this. The only way to find out what was in Obamacare was to pass it and see what happens. Congress passed it, the messiah signed it, and we’re beginning to see what happens.

Barack Obama and the gang that can’t shoot straight aren’t having much fun, but if they think they aren’t having fun now, just wait. The “best” is yet to come.

The best the Democrats can say about Obamacare is that it’s an approaching train wreck, in the memorable description of Sen. Max Baucus of Montana. Mr. Baucus was one of the authors of the legislation and now he’s hurrying home to Montana for good, anxious to avert his eyes from all the hair, teeth and eyeballs soon to be scattered along the railroad right-of-way.

Pundits and professors are rifling through the thesaurus, looking for the right word to describe what the Wall Street Journal calls “a fiasco for the ages.” The Journal editorialists reminded everyone that they “fought the Affordable Care Act from start to passage, and we’d like to apologize to our readers. It turns out we weren’t nearly critical enough.”

The editors of The New York Times, Mr. Obama’s most reliable sycophants, are deep in mourning, but working furiously to apply more rouge to the corpse before it turns the parlor too fragrant for a wake. It’s summer, and they’re running out of ice.

The “downside” to the delay in implementing the employer mandate is that it gives Republican critics the facts and figures, the “ammunition to portray the health care reforms as a failure,” The Times says. But not to worry, the year’s delay decreed by the president will allow the Internal Revenue Service time to figure out “how this mandate will work … it is more important to do this right than to do it quickly.”

It’s ever so reassuring to know the IRS is on the case. 🙂

Mr. Obama and his gang obviously don’t know what to do next. Handwringing and delay is never a strategy for D-Day; when the beach slides under the bottom of the Higgins boats it’s too late to consider whether the invasion was a good idea.

The White House announced the one-year delay in enforcing the employer insurance mandate for Obamacare, which might not even be legal, just as everyone was hurrying out of Dodge for the Fourth of July holiday. Minions were hastily assigned to explain the delay.

Mark Mazur, the deputy assistant (or is it the assistant deputy?) of the Treasury assigned to dream up new taxes, complained that the delay was caused by the “complexity of the requirements.” Life, in addition to being unfair, turns out to be complicated, too.

Valerie Jarrett, the president’s most trusted (if not necessarily most competent) adviser, promised that the determined president is “staying the course.” This is not reassuring, either, since it’s “the course” that’s the source of the disaster. The flood has washed out the bridge across the river, but never mind, the road to where the bridge used to be is still there.

Obamacare probably can’t be fixed short of dumping it and starting over, but this would require an admission by the president and his men (and women) that they’re as incompetent and maladroit as events reveal them to be. The president’s acolytes in the media hail the delay as a genius stroke of politics, something to get the Democrats past the 2014 congressional elections before “the fiasco for the ages” is displayed in full.

The president knows better. If this is a genius stroke of politics, he would have called the correspondents into the Rose Garden and, flanked by Cabinet ministers, announced the delay to cheers and applause.

Over the weeks and months leading to November 2014, as The Times observes, the Republicans will have ample opportunity to apply their ammunition to a very fat and attractive target. Even now, the lawyers are searching for clients and precedents to attack the legality of Mr. Obama’s delay.

But do they have the balls to do it.

The language of the Affordable Care Act sets out in Section 1513 in “black-letter law” that its provisions “shall apply to months beginning after December 31, 2013.” The language is plain and clear; only a lawyer or judge could misunderstand it.

So the political move may in fact, be illegal… 🙂

Plain and clear though the language is, Obamacare was carelessly written and pounded through Congress with such speed and abandon that no one had time (or inclination) to see what was in it. Now we know, and the best is yet to come.

IBD: The IRS scandal has created a further chokepoint to force the reconsideration of Obama-Care. If House Republicans stand firm and refuse to fund any expansion of the IRS to administer ObamaCare, the public will support them in any confrontation with Obama.

Thousands of new IRS agents and employees costing billions will be needed to determine and verify eligibility for the ObamaCare tax credits for the purchase of health insurance. They are also needed to enforce the employer mandate, if it ever becomes effective, requiring employers of more than 50 full-time workers to buy certain health insurance for their workers.

They will also enforce the individual mandate requiring every individual without employer insurance to purchase the health insurance mandated by the federal government. This includes verifying that the insurance purchased by employers and individuals meets federal requirements, including designated benefits.

Without those new IRS resources Obama-Care will cause even more chaos, which we predict will include increasing the number of uninsured, rather than achieving universal coverage.

That’s because both employers and individuals will scramble to avoid the mandate, and many, especially healthy younger adults, will rely on the regulations requiring insurers to sell to them no matter how sick they become, at the same price as for those not sick.

The chaos will also include the soaring health insurance premiums we are already seeing because of the guaranteed issue and community rating regulations and all the additional required “free” benefits. That will further increase the number of uninsured.

Lower Incomes, Higher Unemployment

ObamaCare — and the uncertainty that surrounds it — will exacerbate declining real incomes and persistent high unemployment among middle-class working people as employers reduce millions to part-time employment, and restrict employment altogether, to evade ObamaCare.

This is part of the reason for the delay in the employer mandate, but a one-year delay is not a fix. Rising health insurance premiums are another form of “taxation,” burdening further an economy still in recession.

The ObamaCare chaos will further restrict access to health care in the form of $716 billion in Medicare cuts, and the limits on health care access contained in health insurance offered on the ObamaCare exchanges (attempting to keep costs down).

Such chaos will increasingly force congressional Democrats to consider alternatives to ObamaCare. House Republicans should take advantage of that by targeting some of the most politically vulnerable components of ObamaCare, namely:

• Passing a bill prohibiting ObamaCare from denying health care to anyone based on age.

• Repealing the Medicare cuts contained in ObamaCare. Medicare’s chief actuary says those cuts will cause chaos as a result of closed hospitals and other facilities and denials of health care for seniors.

• Repealing the ObamaCare Independent Payment Advisory Board (IPAB), which has the authority to adopt further cuts to Medicare without congressional approval.

• Also voting to repeal the unpopular Obama-Care medical device tax and the counterproductive $100 billion a year tax on health insurance (which would also increase the uninsured).

• Repealing as well the ObamaCare slush fund that smuggles billions of taxpayer dollars to left-wing, “progressive,” Obama political activists ostensibly to help explain how to navigate ObamaCare, but actually to help further build a national political machine, effectively taking the Chicago political machine national.

• Voting to give Obama his one-year delay in the employer mandate, along with a one-year delay in the individual mandate, and the rest of the ObamaCare taxes. Or maybe they should just vote to delay the whole thing to 2017, after the next presidential election.

These actions are not intended to “fix” Obama-Care, which is not fixable, but only to further highlight what is wrong with it and challenge Democrats to abandon it. These actions will build the momentum for what ultimately needs to be done: House approval of a full Republican alternative to ObamaCare.

That were ignored 5 years ago by Democrats….and would still be ignored now because Democrats suffer from a terminal case of elitist narcissism.
They believe they, Homo Superior Liberlis, are the vastly superior beings and are incapable of error or even of listening to the prattle of lesser beings.
There’s the fact that they waited 90 years for their Holy Grail wet dream and they won’t give up it no matter how much YOU suffer.
So the Best is yet to come. 🙂

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The Face of Caring

You thought ObamaCare was and it’s Death Panels were going to be bad. Well how about 9-1-1 Pizza Delivery.

You’re in a Nursing home where if you hurt yourself or have a life threatening injury the staff will stand around and bureaucratically argue with 9-1-1 or they’ll just order them like Pizza Delivery.

30 Minutes or less, Because We Care.

And the fact that is perfectly legal makes it even more outrageous. And whether it saves her life or not just standing there arguing that you can’t do anything is just not human.

Who Needs Death Panels.

A nurse’s refusal to give CPR to a dying 87-year-old woman at a California independent living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.

The harrowing 7-minute, 16-second call also raised concerns that policies at senior living facilities could prevent staff from intervening in medical emergencies. It prompted calls for legislation Monday to prevent a repeat of what happened Feb. 26 at the Glenwood Gardens in Bakersfield.

Lorraine Bayless collapsed in the dining room of the retirement home that offers many levels of care. She lived in the independent living building, which state officials said is like a senior apartment complex and doesn’t operate under licensing oversight.

“This is a wakeup call,” said Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee. “I’m sorry it took a tragedy like this to bring it to our attention.”

Yamada cautioned that while it’s not yet known whether intervention would have saved the woman’s life, “we want to investigate because it has caused a lot of concern and alarm.”

Independent living facilities “should not have a policy that says you can stand there and watch somebody die,” said Pat McGinnis, founder of California Advocates for Nursing Home Reform, a consumer advocacy group. “How a nurse can do that is beyond comprehension.”

Now for the ObamaCare-style Reply from the facility:

The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse in a written statement, saying she followed the facility’s policy.

“In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives,” Toomer said. “That is the protocol we followed.”

Pizza Delivery. Medical Care by Bureaucracy. Because They Care!

ObamaCare is already here. And it will improve everything! 🙂

He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.

I’m sorry, you moved into  Pizza Delivery Care, not a full-service Restaurant.

Residents of independent living communities can still take care of themselves, but may need help getting to doctor’s appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.

So there just a shuttle service. Fine. But to stand there for 7 minutes while someone is dying and doing nothing is just not right.

“I understand if your boss is telling you, you can’t do it,” the dispatcher said. “But … as a human being … you know, is there anybody that’s willing to help this lady and not let her die?”

“Not at this time,” the nurse answered.

How cold is that. How inhuman. How Bureaucratic.

And ObamaCare, Government Bureaucrats are going to make this better?

Not a Chance in Hell!

Our Caring, compassionate, all-knowing, all-superior responders at the Huffington Post (that banned me yesterday): Who in their right mind would give CPR to an 87 year old?

The Person with an ounce of humanity. I hope this person when they are 87 finds out the answer to their question. 🙂

James Capretta described the real plan by which the president and his allies aim to close the fiscal gap. Their goal, says Capretta, is to work by stealth, so voters never fully realize that the government has adopted their strategy. The first part of the plan involves taxing “the rich” for Medicare and health insurance, but without Reagan-style indexing of taxes to inflation. That way, inflation-driven “bracket creep” will raise health-care taxes on the middle class without congressional Democrats ever having to vote for new taxes. 

The second part of the plan involves IPAB-imposed price controls and the large-scale rationing of health care that implies. But to work, IPAB’s authority has got to extend beyond Medicare. The idea, says Capretta, is to wait until the massive financial strains brought on by Obamacare bring calls for cost control. That’s when the Democrats will push for IPAB’s authority to be extended beyond Medicare to all of Obamacare, at which point we’ll be very close to a single-payer health-care system with Canadian-style rationing. (NRO)

IPAB is a (ObamaCare) panel of unelected, government-appointed bureaucrats set up under the guise of “efficiency” and “clinical effectiveness” to “recommend” cuts to Medicare services in order to “bend the cost curve downward.” That is government-speak for “spend less money on patient care.”

IPAB is a threat to your health, and your life, if you are the patient whose care is denied because of your age, your condition, and cost based on how many “quality” years you are expected to live.

IPAB is set up to function exactly like the rationing board of the National Health Service (NHS) in Britain, called National Institute of Clinical Excellence (NICE). The strong arm of NICE prevents NHS doctors from prescribing state-of-the-art drugs for breast, stomach, lung, and prostate cancer or diseases like multiple sclerosis, rheumatoid arthritis, and many others.

IPAB is also charged with slowing the growth of payments to doctors and hospitals, reducing the rate of medication reimbursement under Medicare, and “reducing waste” in Medicare spending. “Waste,” however, is defined solely by bureaucrats, and may include medicine you actually need.

Or CPR. 🙂

An 80-year-old patient recently said, “The pharmacist just told me that Medicare is no longer going to pay for my heart medicine because I am now too old.” His choice? Pay out of pocket or die.

Recently, the government quietly directed Medicare to cut reimbursement for 4 million diabetic seniors by 66% and also reduced the number of companies that are allowed to supply blood sugar monitoring supplies from more than a thousand to 15. Older patients are already being hurt by Obamacare reductions in Medicare services. (CP)

You’re too old. Worthless. And you Cost too Much.
Now that’s the “caring” “Compassionate” Left not throwing Grandma off a Cliff! 🙂
ObamaCare will send out for you because They Care. 🙂
Michael Ramirez Cartoon
Political Cartoons by Nate Beeler
Political Cartoons by Bob Gorrell

 

Connections

Michael Ramirez Cartoon

Barack Obama, knight of the peevish countenance, illustrated William F. Buckley’s axiom that liberals who celebrate tolerance of other views always seem amazed that there are other views.

America can be the society it was when it had a spring in its step, a society in which markets — the voluntary collaboration of creative individuals — allocate opportunity. Or America can remain today’s depressed and anxious society of unprecedented stagnation in the fourth year of a faux recovery — a bleak society in which government incompetently allocates resources in pursuit of its perishable certitudes and on behalf of the politically connected. (George Will)

Speaking of connections…

The Obama campaign apparently didn’t look backwards into history when selecting its new campaign slogan, “Forward” — a word with a long and rich association with European Marxism.

Many Communist and radical publications and entities throughout the 19th and 20th centuries had the name “Forward!” or its foreign cognates. Wikipedia has an entire section called “Forward (generic name of socialist publications).”

“The name Forward carries a special meaning in socialist political terminology. It has been frequently used as a name for socialist, communist and other left-wing newspapers and publications,” the online encyclopedia explains.

The slogan “Forward!” reflected the conviction of European Marxists and radicals that their movements reflected the march of history, which would move forward past capitalism and into socialism and communism.

But I’m sure it’s just a coincidence. Nothing to see here… 🙂
The Childish Attack
The endless array of childish attacks and ad hominems that Liberals can come up with is psychologically fascinating, if your into psychosis and pathological behavior.
“When I got on the stage, I met this very spirited fellow who claimed to be Mitt Romney,” Obama told Denver supporters. “The real Romney has been running around the country for the last year promising $5 trillion in tax cuts that favor the wealthy.”
And the Democrats were the ones complaining after the debate about respect. 🙂
Developing?

Sources told Secrets that the Obama campaign has been trying to block the story. But a key source said it plans to publish the story Friday or, more likely, Monday.

According to the sources, a taxpayer watchdog group conducted a nine-month investigation into presidential and congressional fundraising and has uncovered thousands of cases of credit card solicitations and donations to Obama and Capitol Hill, allegedly from unsecure accounts, and many from overseas. That might be a violation of federal election laws.

The Obama campaign has received hundreds of millions in small dollar donations, many via credit card donations through their website. On Thursday, the campaign announced a record September donor haul of $150 million.

At the end of the 2008 presidential campaign, the Obama-Biden effort was hit with a similar scandal. At the time, the Washington Post reported that the Obama campaign let donors use “largely untraceable prepaid credit cards that could potentially be used to evade limits on how much an individual is legally allowed to give or to mask a contributor’s identity.”

The Democrats cheating? Naw, never happens. <fake cough> Voter ID fraud…

We’ll see if this come to pass and if it does how fast the Ministry of Truth will try to nuke it and bury it.

Racist! Again…

Mitt Romney “slyly” proved he’s a racist last night while describing his tax plan. Did you notice? No? Anyone? Harper’s Magazine’s Kevin Baker embarrassed himself in accusing Romney of trying to lock down his allegedly-racist base during last night’s debate.

“[Obama]didn’t show a spark of anger, even when Romney slyly found a way to call him a boy, comparing Obama’s statements to the sorts of childish lies his ‘five boys’ used to tell,” Baker laments today. “How the right’s hard-core racists must have howled at that! Mitt, at long last, has secured his base.”

Actually, the entire debate audience laughed at Romney’s clever, innocuous way of rebutting Obama’s attack. Here’s what Romney said to Obama, per the White House transcript:

I will not reduce the share paid by high-income individuals.  I know that you and your running mate keep saying that, and I know it’s a popular thing to say with a lot of people, but it’s just not the case.  Look, I’ve got five boys.  I’m used to people saying something that’s not always true, but just keep on repeating it and ultimately hoping I’ll believe it. (Laughter.)  But that is not the case, all right?  I will not reduce the taxes paid by high-income Americans.

Baker is tilting at windmills, at best. Why? “Maybe it helps their self-esteem to pretend that, instead of defending a failed presidency and a lousy economic recovery, they are living 50 years ago, standing alongside freedom riders and marchers in the segregated South,” The Washington Examiner speculated recently in response to liberal pundits endless ability to connect modern politics to slavery.

After all, if you disagree with Obama, you must be a racist! 🙂

George Will again…

Late in the debate, when Romney for a third time referred to ObamaCare’s creation of “an unelected board, appointed board, who are going to decide what kind of (medical) treatment you ought to have,” Obama said, “No, it isn’t.” Oh?

The Independent Payment Advisory Board perfectly illustrates liberalism’s itch to remove choices from individuals, and from their elected representatives, and to repose the power to choose in supposed experts liberated from democratic accountability.

The Statist Course

Beginning in 2014, IPAB would consist of 15 unelected technocrats whose recommendations for reducing Medicare costs must be enacted by Congress by Aug. 15 of each year. If Congress does not enact them, or other measures achieving the same level of cost containment, IPAB’s proposals automatically are transformed from recommendations into law. Without being approved by Congress. Without being signed by the president.

These facts refute Obama’s Denver assurance that IPAB “can’t make decisions about what treatments are given.” It can and will by controlling payments to doctors and hospitals. Hence the emptiness of Obamacare’s language that IPAB’s proposals “shall not include any recommendation to ration health care.”

By ObamaCare’s terms, Congress can repeal IPAB only during a seven-month window in 2017, and then only by three-fifths majorities in both chambers. After that, the law precludes Congress from ever altering IPAB proposals.

Because IPAB effectively makes law, thereby traducing the separation of powers, and entrenches IPAB in a manner that derogates the powers of future Congresses, it has been well described by a Cato Institute study as “the most anti-constitutional measure ever to pass Congress.”

But unless and until the Supreme Court — an unreliable guardian — overturns it, IPAB is a harbinger of the “shock and awe statism” (Indiana Gov. Mitch Daniels’ phrase) that is liberalism’s prescription for curing the problems supposedly caused by insufficient statism.

Before Denver, Obama’s campaign was a protracted exercise in excuse abuse, and the promise that he will stay on the statist course he doggedly defends despite evidence of its futility. After Denver, Romney’s campaign should advertise that promise.

And beat him to political death with it.
FEAR IS HOPE!
And Change is Bad!
The new “Hope and Change” theme of the Obama Campaign.

NOVEMBER IS COMING!

Political Cartoons by Steve Kelley

 

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

The Stakes Are Raised

Who cares if we don’t have a budget — let’s spend more! President Obama has decided to raise the debt ceiling once more, and forget about needing Congressional approval. Thanks to the agreement reached in August, it’s still going up.

President Obama formally notified Congress on Thursday of his intent to raise the nation’s debt ceiling by $1.2 trillion, two weeks after he had postponed the requestto give lawmakers more time to consider the action.

Congress will have had 15 days to say no before the nation’s debt ceiling automatically is raised from $15.2 trillion to $16.4 trillion.

In a letter to House Speaker John A. Boehner (R-Ohio), Obama wrote that ”further borrowing is required to meet existing commitments.”

Obama had sought to make the request at the end of last month, when the Treasury came within $100 billion of its borrowing limit. However, with Congress on recess, lawmakers from both parties asked the president to hold off. The House is out of session until Jan. 17, and the Senate until Jan. 23.

Since then Treasury officials have used special revenue and accounting measures to maintain the nation’s solvency. Yet the White House cast the delay as a technicality, saying there is no chance the limit will not be increased, even if Republican lawmakers attempt to object.

Hey, what’s another trillion? Chump change at this point.(townhall.com)

When in Debt Spend Even More!

Yet the White House cast the <previous> delay as a technicality, saying there is no chance the limit will not be increased, even if Republican lawmakers attempt to object.

Under an agreement reached in August, Congress and the White House moved to raise the debt limit in three increments while also implementing $2.4 trillion in budget cuts. The deal, however, also gave Congress the option of voting to block each of the debt-ceiling increases by passing a “resolution of disapproval.”

Even if such a resolution were passed, Obama could veto it, and he could be overridden only by a two-thirds supermajority in each chamber.

In September, when the first debt-limit hike was scheduled to take effect, the Republican-led House passed a disapproval resolution, but the Democrat-controlled Senate blocked it and the debt ceiling was raised

White House officials said they do not expect the Senate to support a disapproval resolution this time even if the House passes one again. (WP)

Democrat Control anyone?

Oh right, it’s a “do nothing” Congress and everything is their fault…

Obama said, “Everything that we fought for is now at stake in this election.”

Very true. Liberal Socialism is on the line.

I just wish it was a firing line. But I’m not sure the Republicans aren’t the Gang Who Couldn’t Shoot Straight! 😦

Under any of these possibilities, the fact remains that he is hellbent on accelerating his present course, not reversing it, on dictating, not working within his constitutional constraints, much less building a bipartisan consensus.

Hubris and defiance are his trademarks, not humility. He said, “If you’re willing to work even harder in this election than you did in the last election, I promise you, change will come.”

And considering the “change” we already have I pity the fool who wants more of it.

He has repeatedly indicated that he is frustrated with the process of republican government and that he would be much more comfortable as a dictator.

Just consider how brazenly Obama has pursued his unpopular agenda even while facing re-election. Think how he joked about having made a hollow promise of shovel-ready jobs when there is no such thing and how he is unchastened by the colossal waste of Solyndra and pursuing more of the same. Consider how he cavalierly refuses to account for his promise to keep unemployment capped at 8 percent and how he assured us, on his honor, that his designated stimulus cop, Vice President Joe Biden, wouldn’t allow a dollar of waste to go unpunished in his stimulus plan. Chew on his refusal to listen to the public when it resoundingly rejected Obamacare, rebuffing his agenda in the U.S. Senate election in Massachusetts and again in the 2010 congressional elections. Ponder his petty partisanship, bullying, demonizing and class warfare and his frequent invocation of the race card. Can you conceive of how he’d act as a four-year lame duck?

You all surely heard Obama, thinking he was speaking only to friends, boast that he was for a single-payer plan but that it might take 15 years to implement it. Remember this when his supporters tell you Obamacare won’t degenerate into socialized medicine. Those waivers he unilaterally issued to buy off companies now won’t be available next time around when the full force of Obamacare rains down its dark waters.

Think about his Independent Payment Advisory Board, which will have 15 bureaucrats once Obamacare is up and running, when he won’t have to worry about 2016. Before you pooh-pooh this, you’d better do your research on his health care mentors’ (e.g., Tom Daschle, Donald Berwick) philosophy about the macabre rationing of health care for the aged.

So, call me an alarmist if you will, but I think it’s almost irrational not to be very concerned about an Obama second term. Even if you don’t subscribe to some of the horror scenarios of death panels and the like, how about his intention to continue to press forward with his radical green agenda despite the fact that it won’t work to reduce global temperatures and despite the public’s opposition to it?

More importantly, how about his absolute refusal to restructure entitlements or his refusal to lead his party’s Senate to pass a budget after 1,000 days? Or his insistence on another stimulus package when unemployment — even using the distorted metrics the administration is now using — is still at 8.5 percent and it would add another half-trillion dollars to the national debt?

By rights, Obama shouldn’t get 10 percent of the vote in November. Even those who want to punish the “wealthy” should understand that once you completely gnaw off the hand that feeds you, you will starve, too.(David Limbaugh)

The record of President Obama’s first three years in office is in, and nothing that happens now can go back and change that. What that record shows is that President Obama, with his throwback, old-fashioned, 1970s Keynesian economics, has put America through the worst recovery from a recession since the Great Depression.

The recession started in December, 2007. Go to the website of the National Bureau of Economic Research (www.nber.org <file://localhost/owa/redir.aspx>) to see the complete history of America’s recessions. What that history reveals is that before this last recession, since the Great Depression recessions in America have lasted an average of 10 months, with the longest previously lasting 16 months.

When President Obama entered office in January, 2009, the recession was already in its 13th month. His responsibility was to manage a timely, robust recovery to get America back on track again. Based on the historical record, that recovery was imminent, within a couple of months or so. Despite widespread fear, nothing fundamental had changed to deprive America of the long term, world-leading prosperity it had enjoyed going back 300 years.

Supposedly a forward looking progressive, Obama proved to be America’s first backward looking regressive. His first act was to increase federal borrowing, the national debt and the deficit by nearly a trillion dollars to finance a supposed “stimulus” package, based on the discredited Keynesian theory left for dead 30 years ago holding that increased government spending, deficits and debt are what promote economic growth and recovery. That theory arose in the 1930s as the answer to the Great Depression, which, of course, never worked.

Unemployment actually rose after June, 2009, and did not fall back down below that level until 18 months later in December, 2010. Instead of a recovery, America has suffered the longest period of unemployment near 9% or above since the Great Depression, under President Obama’s public policy malpractice. Even today, 49 months after the recession started, the U6 unemployment rate counting the unemployed, underemployed and discouraged workers is still 15.2%. And that doesn’t include all the workers who have fled the workforce under Obama’s economic oppression. The unemployment rate with the full measure of discouraged workers is reported at http://www.shadowstats.com <file://localhost/owa/redir.aspx> as about 23%, which is depression level unemployment.

Under President Obama, America has suffered the longest period with so many in such long-term unemployment since the Great Depression.

Going to be a fun year. Enjoy Friday the 13th! 🙂

 

A Year In Review

Here’s a look at the Patient Protection and Affordable Care Act’s year in review.

– Jan. 14: Kansas announces its intention to become the 26th state to file suit against the federal government to stop implementation of the health care overhaul.

– Jan. 19: The House of Representatives votes to repeal the health care law.

– Jan. 26: Illinois-based pharmaceutical company Abbott Labs cuts 1,900 jobs “in response to changes in the health-care industry, including U.S. health-care reform and the challenging regulatory environment.”

– Jan. 31: A second federal district judge rules that the law is unconstitutional.

– Feb. 2: All 47 Republican senators vote to repeal the Affordable Care Act, but the measure fails.

– Feb. 16: Health and Human Services Secretary Kathleen Sebelius testifies before the Senate Finance Committee and admits that the CLASS Act, a key portion of the law that was touted as a $70 billion savings, is “totally unsustainable.” But not to worry: Sebelius says her department has the authority to rework the legislation to make CLASS tenable.

– Feb. 18: The House votes to block federal funding to implement the Affordable Care Act. The Congressional Budget Office also estimates that repealing the law would add $210 billion to the combined federal deficits from 2012 to 2021.

– Feb. 22: A federal judge tosses a lawsuit claiming that the Affordable Care Act violates the liberties of those who choose to rely on God to protect and heal them instead of buying health insurance.

– March 3: The House votes to end an unpopular tax paperwork-filing requirement for businesses tucked into the health care law.

– March 23: The law turns one year old. On the same day, the House Committee on Energy and Commerce finds that the temporary Early Retirement Reinsurance Program will spend its allotted $5 billion far earlier than its Jan. 1, 2014 expiration date.

– March 30: The CBO estimates that health care reform will cost $1.1 trillion, an increase of $90 billion from its February estimate.

– May 17: The Daily Caller reports that 20 percent of new waivers from the law have gone to gourmet restaurants, nightclubs and fancy hotels in former House Speaker Nancy Pelosi’s district.

– June 8: A McKinsey & Company survey of over 1,300 private sector employers found that 30 percent of employers would definitely or probably stop offering insurance to their employees after the law is implemented in 2014.

– June 18: HHS announces that it is axing waivers from the law. After over 1700 of them, 24% of them are for Public and private sector UNIONS and “small” employers like McDonalds. And they only stopping kissing up because of too much bad press.

– June 21: A glitch in the law, discovered after Obama signed it, would allow middle-class Americans to get subsidized health care intended for poor people, the Associated Press reports. Medicare’s chief actuary says the policy “doesn’t make sense.”

– June 29: In the face of a constitutional challenge, the Sixth Circuit Court of Appeals rules in favor of the law.

– July 18: An Employment Policies Institute report finds that the Affordable Care Act would incentivize employees to switch to a government-subsidized insurance exchange even if employers were to continue their health care coverage, costing taxpayers “significant[ly].”

– July 19: The bipartisan “gang of six” puts forward a debt-reduction plan that would repeal the CLASS Act.

– Aug. 1: HHS issues a regulation requiring all group health insurance plans to cover FDA-approved “contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.” Even if you are morally opposed to Planned Parenthood. 🙂

Now that’s “Pro-Choice” !!!!

– Aug. 12: The Eleventh Circuit Court of Appeals rules that the law’s individual health insurance mandate is unconstitutional.

– Sept. 8: The Fourth Circuit Court of Appeals rejects a pair of challenges to the law on procedural grounds. It does not rule on the law’s constitutionality.

– Sept. 15: A bicameral Republican report accuses Democratic supporters of the health care law of recklessness for promoting the CLASS Act despite knowing that the program would eventually blow up the budget.

– Oct. 5: The signatures of about 1.6 million petitioners pressing for the repeal of the Affordable Care Act are delivered to Capitol Hill at a press conference.

– Oct. 13: A federal inspector general finds that the IRS is having trouble collecting the 10-percent federal tanning tax established by the law.

– Oct. 14: HHS completes its 19-month review of the CLASS Act, determining that “we do not have a path to move forward,” Sebelius says. CLASS remains on the books, but the administration essentially gives up on it.

– Nov. 4: Tennessee Rep. Phil Roe and 23 Republican colleagues send a letter to IRS Commissioner Douglas Shulman objecting to a new IRS rule authorizing subsidies for participants in the yet-to-be-created federal health care exchange program. They argue that the agency is seeking to rewrite legislation, something it is not allowed to do.
Conservative experts say the IRS rules are covering up a glitch in the original law that provides subsidies for people enrolled in state exchanges, but not federal exchanges. Shulman does not agree with their analysis.

– Nov. 9: The National Federation of Independent Business releases a report saying that in 2012 the law’s new health insurance tax will reduce private sector jobs by between 125,000 and 249,000.

– Nov. 10: The Beckett Fund for Religious Liberty announces it is suing HHS on behalf of Belmont Abbey College, a Catholic educational institution. The lawsuit claims the Aug. 1 regulation violates the college’s teaching on contraception, sterilization and abortion.

– Nov. 14: The Supreme Court agrees to hear arguments on the Affordable Care Act.

– Nov. 16: Forty-seven percent of Americans favor repeal of the law, Gallup finds.

The latest Rasmussen Reports national telephone survey shows that 55% of Likely U.S. Voters at least somewhat favor repeal of the health care law passed by Congress in March 2010, while 35% at least somewhat oppose repeal. The intensity remains on the side of the law’s opponents since these findings include 42% who Strongly Favor repeal versus 26% who are Strongly Opposed.

– Nov. 29: Massachusetts Democratic Rep. Barney Frank joins the effort to repeal the Independent Payment Advisory Board, a key portion of the law that would “recommend levels at which Medicare recipients, including seniors, can
be reimbursed for health care expenses.”

– Nov. 30: The House energy committee votes to repeal the CLASS Act.

– Dec. 15: The Obama administration announces that the number of young uninsured Americans has fallen by 2.5 million, attributing it to his law’s provision permitting young adults to stay on their parents’ health care plans
until age 26. (yeah and their parents are not underemployed) 🙂

– Dec 16: Seeking to defuse a potential showdown over a key part of the new healthcare law, the Obama administration moved Friday to let states, rather than the federal government, define which medical benefits insurance companies will have to offer consumers starting in 2014. That allows state leaders to retain more control of health insurance even as the law extends a new federal guarantee that all Americans can get coverage, even if they are sick.

But it’s just a “pre-rule”.

By giving states authority to define the scope of covered benefits, the Obama administration potentially sidestepped an ugly showdown between consumer and business groups in the run-up to the presidential election. Administration officials also may have undercut a charge from opponents of the law that the federal government is usurping state authority. (aka The 10th Amendment argument)

That’s tricky territory for the administration, which is trying to avoid the “big brother” label on health care.

“However, flexibility must yield to reliable, comprehensive coverage of benefits for consumers.… It is essential that HHS provide strong oversight and enforcement.”

The proposed rules, which will take months to finalize. What do you want to bet it will right up to the March arguments in the Supreme Court. 🙂

Gee, I’m not a little cynical. I’m nothing BUT cynical. 🙂

That means that some states may require insurers to cover services such as chiropractic therapy or in vitro fertilization, while others may not. The rules will not affect co-payments, cost sharing and deductibles, which play a major role in determining premiums.
– Dec. 18: Health care experts doubt that the federal insurance exchange program will be fully operational by the Jan. 1, 2014 deadline, since many states have refused to implement the state exchange program, the Washington Post  reports.

– Dec. 19: The Supreme Court announces it will hear an unprecedented week’s worth of arguments in March 2012 to determine whether the health care overhaul law is constitutional.

So it’s all politics and chaos. They passed the buck so that them not sawing off the finger on your right hand would also you to not notice they want to or have sawed over your legs.

But don’t worry, when the IRS comes knocking on your wallet, it’s only a “penalty” nothing to be concerned about. 🙂

Political Cartoons by Gary Varvel

Political Cartoons by Lisa Benson

 Political Cartoons by Bob Gorrell

How to Avoid ObamaCare :)

“I can make a firm pledge.  Under my plan, no family making less than $250,000 a year will see any form of tax increase.  Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes,”
President Obama, September 12, 2008

REAL ESTATE SALES TAX
Beginning January 1, 2013, ObamaCare imposes a 3.8% Medicare tax on unearned income, including the sale of single family homes, townhouses, co-ops, condominiums, and even rental income.

In February 2010, 5.02 million homes were sold, according to the National Association of Realtors.  On any given day, the sale of a house, townhome, condominium, co-op, or income from a rental property can push middle-income families over the $250,000 threshold and slam them with a new tax they can’t afford.

This new ObamaCare tax is the first time the government will apply a 3.8 percent tax on unearned income.  This new tax on home sales and unearned income and other Medicare taxes raise taxes more than $210 billion to pay for ObamaCare.   The National Association of Realtors called this new Medicare tax on unearned income “destructive” and “ill-advised” and warned it would hurt job creation.

  •  It raises taxes by more than a half-trillion dollars over the next 10 years B the largest tax increase in American history.
  • It cuts more than a half-trillion dollars from Medicare to finance a new entitlement, and includes a series of additional gimmicks that hide the true cost of the legislation.
  • It adds to an already unsustainable rate of government spending growth that will overwhelm the Federal budget and sacrifice the Nation’s future prosperity.

But if you can change it, Armageddon! Grandma being thrown off a cliff! Medicare will end and Seniors will be thrown out into streets to fend for themselves against the evil corporate pack wolves and they will be ripped apart by the evil capitalists!!!

You can’t live without Government controlling of your life! 🙂

Want to avoid Obamacare:

President Obama’s solicitor general, defending the national health care law on Wednesday, told a federal appeals court that Americans who didn’t like the individual mandate could always avoid it by choosing to earn less money.

Neal Kumar Kaytal, the acting solicitor general, made the argument under questioning before the U.S. Court of Appeals for the Sixth Circuit in Cincinnati, which was considering an appeal by the Thomas More Law Center. (Listen to oral arguments here.) The three-judge panel, which was comprised of two Republican-appointed judges and a Democratic-appointed judge, expressed more skepticism about the government’s defense of the health care law than the Fourth Circuit panel that heard the Virginia-based Obamacare challenge last month in Richmond. The Fourth Circuit panel was made up entirely of Democrats, and two of the judges were appointed by Obama himself.

So Obama solicitor general says: If you don’t like mandate, earn less money.
Which by the way qualifies you for, wait for it: GOVERNMENT ASSISTANCE!! 🙂
TA DA!
The so-called “hardship exemption” in the health care law is limited, and only applies to people who cannot obtain insurance for less than 8 percent of their income. So earning less isn’t necessarily a solution, because it could then qualify the person for government-subsidized insurance which could make their contribution to premiums fall below the 8 percent threshold.
Amazing how that happens. 🙂

The new Medicare investment tax provides a disincentive for business expansion. The National Federation of Independent Business (NFIB) reports, “The $250,000/$500,000 thresholds only apply to the sale of a primary residence, so the tax will hit other property sales harder.”

NFIB also points out that this tax “marks the first time that non-wage income is designated to fund Medicare.” Beyond its marginal effects on real estate sales, the new application of the Medicare tax to investment income will have substantial effects on the economy at large. Analysts in Heritage’s Center for Data Analysis write, “Raising the tax burden on investment income further damages the economy and ultimately affects all members of society.” Their findings show that this tax will result in lost job opportunities, a reduction in productivity, losses in gross domestic product, and reductions in household income.

So is there a sales tax on real estate included in the health care law? In some cases, yes. But will the same provision that taxes some profits from real estate cause widespread damage to the economy? Absolutely.

The issue is not whether Medicare costs should be controlled but how. Congress can pursue one of two routes: (1) It can change the structure and culture of Medicare to empower patients to make health care decisions in order to achieve the best value, forcing plans and providers to compete for their dollars (cue the liberals screaming “ending Medicare”), or (2) it can further empower bureaucracy to impose top-down controls on the costs of services. This can indeed reduce spending, but it guarantees a simultaneous reduction in the quality of health care Americans enjoy today.

The first is the path taken by Budget Committee Chairman Paul Ryan (R–WI) in his fiscal year 2012 budget proposal. Heritage’s Robert Moffit and James Capretta write that a premium support system like the one proposed by Ryan would:

…give Medicare patients control over the flow of dollars and freedom to make decisions about how they access medical services. This will stimulate intense market competition among plans and providers, control costs, and promote rapid innovation and higher productivity through the efficient delivery of quality care, thus guaranteeing value in return for retiree premiums and taxpayer dollars.

Last week, President Obama embraced the alternative: toughen up the bureaucracy and ratchet down Medicare payment to doctors and hospitals. The President described strengthening the Independent Payment Advisory Board (IPAB), a 15-member board of unelected officials created under Obamacare to rein in the cost of Medicare.

Under Obamacare, the board can tweak Medicare to hold growth in spending beneath its target, mainly by making cuts to provider reimbursement rates. Reducing provider payments means reduced senior access to physicians, another form of rationing of health care that already occurs to some extent in Medicare today.

Strengthening IPAB could have even more alarming consequences. The President suggested further reducing the growth rate target IPAB would act to achieve. The White House would “give IPAB additional tools to improve the quality of care while reducing costs, including allowing it to promote value-based benefit designs that promote proven services like prevention without shifting costs to seniors.” In addition, it would “give IPAB additional enforcement mechanisms such as an automatic sequester as a backstop for IPAB, Congress, and the Secretary of Health and Human Services.”

So you can trust the Government to take care of you, or you can just die horribly or just take a poverty-inducing job –according to Democrats.
Now don’t you feel better! 🙂
Are you Swelling with All that Hope & Change! 🙂
Political Cartoons by Chuck Asay

Political Cartoons by Chip Bok