ObamaCare problems and solutions

“A government which robs Peter to pay Paul, can always count on the support of Paul.” — George Bernard Shaw

“If you like your health care plan, you can keep it.” Do you remember that promise? President Obama spoke those words dozens of times. Well, it wasn’t true – and he knew it. His own Department of HHS estimated and published in the Federal Register in 2010 that 93 million Americans would have their policies canceled in order to meet the requirements of ObamaCare. For the next three years, Obama continued to tell people they could keep their plans, even though he knew it was not true.

The fact checking organization, PolitiFact, rated Obama’s statement as “Lie of the Year” for 2013. The Washington Post’s Fact Checker gave it four Pinocchios and also ranked it “Lie of the Year.”

New Hampshire’s Senator Jeanne Shaheen and Congresswoman Carol Shea-Porter joined in Obama’s lie of the year, repeating it many times. It is possible that they did not know it was a lie, but they certainly should have known it.

Then last year, cancellation letters went out to some 4 million Americans. Millions of people were perfectly happy with their plans, but the ObamaCare law did not allow them to keep their plans. Virtually every major NH newspaper has run stories about the turmoil caused by ObamaCare-mandated cancellations.

People lost the plans they liked, may have lost their nearby hospital, may have lost the doctor they’d been visiting for decades. In New Hampshire, the one and only insurer on the ObamaCare exchange nixed 10 of the 26 New Hampshire hospitals. In parts of the state, you may have to drive 2 or 3 hours, halfway across the state to go to a new hospital, driving right by your old, much closer hospital. Some people had to give up the doctor they have been seeing for decades and find a new doctor perhaps hours away.

Even worse is that the new ObamaCare policies don’t cover care in hospitals outside NH. Some of the best doctors and hospitals in the country are in Boston, but NH citizens cannot go there. The Union Leader reported about a woman who was told by her Nashua hospital that her cancer was untreatable. Under her old insurance she was allowed to go to a Massachusetts hospital for treatment and now three years later she is doing well. Under her new ObamaCare insurance she would be dead.

And then there are the premiums and deductibles. I have talked with people who say the combination of higher premiums and higher deductibles is costing them an extra $1,000 per month. I asked an insurance agent if her clients were seeing increases like that. She responded that most were not quite that high, but she could believe that some were paying that much extra. Another insurance agent told me that his clients were seeing up to a 100% increase but the average was about 20% to 40% increase. 

Nationally, Aetna’s CEO reported that premiums have increased an average of 30% to 40%. He also reported seeing lower employment overall and more part-time employment. A large union similarly reported seeing a shift to part-time work by companies seeking to avoid ObamaCare’s requirements. The Congressional Budget Office recently predicted that ObamaCare during the next ten years will cause job losses equivalent to 2.5 million people.
 
It’s no surprise that a recent Gallup poll found that more than twice as many Americans say that ObamaCare has hurt them or their families compared to the number it has helped. It might be a surprise that most (63%) say it has made little difference but that is only a matter of time. Most people get their insurance via their employer and that part of ObamaCare has been delayed and delayed – for political reasons.

As the New York Times reported, “[The recent change] is designed to provide political cover for Democratic senators facing tough re-election campaigns.” The law as written would have had millions more cancellation notices going out a month or two before Election Day. So with a stroke of his pen, without any authority granted to him, Obama decided to change the law so that the cancellation notices would go out AFTER the election.

The Wall Street Journal notes that “if [ObamaCare] were really working the way it should, senators who voted for it wouldn’t be running away from it, and the administration wouldn’t be forced to choose between enforcing its provisions and protecting the Democratic majority.”

As much as nervous politicians are shying away from ObamaCare, so also are the uninsured. The Washington Post reports that “The new health insurance marketplaces appear to be making little headway in signing up Americans who lack insurance, the Affordable Care Act’s central goal, according to a pair of new surveys. Only one in 10 uninsured people who qualify for private plans through the new marketplaces enrolled as of last month.”

The first step in fixing a problem is recognizing that there is a problem. NH Democratic leadership seems oblivious to any problems with ObamaCare, jobs, and the economy. NH Republicans know that there are problems and that we can help solve those problems. The guiding principle is that people should be able to choose what they want, not what some politicians in Washington tell them they should want.

Advertisements

What Is Seen and What Is Not Seen

“Suppose you were an idiot, and suppose you were a member of Congress; but I repeat myself.” — Mark Twain

The great French economist Frederic Bastiat observed that “In the economic sphere an act, a habit, an institution, a law produces not only one effect, but a series of effects. Of these effects, the first alone is immediate; it appears simultaneously with its cause; it is seen. The other effects emerge only subsequently; they are not seen; we are fortunate if we foresee them.

“There is only one difference between a bad economist and a good one: the bad economist confines himself to the visible effect; the good economist takes into account both the effect that can be seen and those effects that must be foreseen.”

The same is true in the sphere of public policy. The bad economist or the thoughtless politician (but I repeat myself) sees only the direct effect of a law; he doesn’t foresee the indirect effects. In many cases the politician may consider only the short-term effects that might help him win the next election; he may not consider at all the long-term effects.

Bastiat noted that “it almost always happens that when the immediate consequence is favorable, the later consequences are disastrous, and vice versa.” So when a politician urges a great new solution to some problem – or typically, the same old ineffective solution to a problem – the long-term result very often is more harm than good.

One such example was alcohol Prohibition almost 100 years ago. The problem of alcohol may have been bad, but Prohibition made the problem much worse, to the point that Prohibition was later repealed. Another example was a luxury tax on yachts to “soak the rich”. Even a mediocre economist or a slightly thoughtful politician could have foreseen the disaster it turned out to be. The tax collected virtually nothing from the rich but did send many blue collar boat builders to the unemployment line. Two years later Congress repealed the law.

With the greatest intentions of reducing poverty, politicians have enacted policies that, in the short-term, help people survive one month until the next government check, but the unseen long-term effect is to trap people in poverty, sometimes for generations. If we truly care about helping people – and I think most of us do – then wouldn’t it be better to find long-term solutions that help people escape poverty?

As long ago as the 1980s, better economists and more thoughtful politicians saw the indirect effects of the welfare system – it “fostered a permanent underclass dependent on government handouts.” In 1996, a Republican Congress and Democrat President Clinton passed welfare reform with the goal of reducing the dependency trap and helping people escape poverty. Ten years later, The New Republic, a liberal magazine, looked back and editorialized that the reform “worked much as its designers had hoped [foreseen].” Since then, less thoughtful politicians seeing only the easily visible effects of welfare, and not seeing the long-term consequences, have undone most of the successful reform.

Our disability system likewise helps disabled people survive month-to-month but traps them in poverty. Wouldn’t it be better to find long-term solutions, using some amazing modern technology to help them overcome their disabilities, become productive, and no longer trapped in poverty?

Some short-sighted politicians want to extend the length of unemployment benefits beyond 26 months, but the long-term effect can be permanent unemployment. Studies have found that someone unemployed for more than six months has very little chance of ever getting a job.

Other bad economists and thoughtless politicians suggest raising the minimum wage. The immediate effect would be to slightly raise the pay for a small number of people – but cause others to lose their jobs. The long-term consequence would be to destroy many more entry-level jobs, making it harder and harder for teenagers to enter the work force.

When was the last time you saw a full-service gas station? That used to be a good first job for many young kids. Washing dishes was another good first job. Kids learned the self-discipline of showing up on time every time. While on the job they often picked up skills from the auto mechanics or cooks around them. But as the minimum wage rose, machines replaced those jobs. If it continues to rise, we will see machines taking orders for fast food, flipping burgers, and delivering the goods. The long-term effect of raising the minimum wage is disastrous for millions of young people.

Some politicians saw ObamaCare as a good idea; they did not foresee the terrible consequences. Today, some people think we will see good effects if we adopt the ObamaCare expansion of Medicaid. Not only do they fail to see the indirect, long-term terrible effects, they don’t even see the bad effects that have already occurred elsewhere. To put it simply, Medicaid is an inefficient, incredibly expensive program that provides even worse health outcomes than for people who are uninsured. Expanding it would cost even more than now predicted and would lead to much higher taxes.

To achieve better results – better economy, more good jobs, higher pay, less poverty, lower cost health care – we need to see not just the immediate effects of a policy, but to foresee the long-term effects.

Health Insurance is not Health Care

Tammy Bruce opines that ObamaCare is not just a train wreck, because after all, once a train wreck is over, it is over. It doesn’t keep on going. No, ObamaCare is more like a cancer, growing and destroying everything.

A California man bought insurance on the ObamaCare exchange, then called a doctor for an appointment. He called every single doctor who was listed as being in-network, but none of them actually was.

In the normal world, this would be called “fraud.” In Obama’s America, it’s called a “snag,” and on a national scale, the Obama regime labels it “Shut up, Fox News!”

After all, isn’t the goal getting everyone insured? Who cares if you can’t actually see a doctor or get health care, because everyone will get a terrific piece of paper that says “health insurance policy.” Equality, at last — everyone’s got the same thing; namely, nothing at all.

A woman cancer patient enrolled in ObamaCare, then went to see her oncologist, only to be greeted by a sign at the door announcing that they did not accept any of the ObamaCare plans. She says that she is, “a complete fan of the Affordable Care Act, but now I can’t sleep at night.”

When the Congressional Budget Office forecast that ObamaCare would cause 2.5 million people to lose their jobs, the White House responded that those people were just a “small percentage of the economy.”

Back here in New Hampshire, Jeanne Shaheen and Carol-Shea Porter say that they would vote for ObamaCare all over again if they could. Whose side are they on?

Medicaid is a cruel program

“If we wish to be compassionate with our fellow man, we must learn to engage in dispassionate analysis. In other Walter E. Williams

Would you believe that many politicians over-promise and under-deliver? They promise you that a new law will fix some terrible problem, but usually it does not fix the problem, and often it makes the problem worse.

Too many politicians look only at the stated goals of a program. They believe so much in the goals that they refuse to believe any harm could result. They don’t look beneath the surface for possible unintended consequences. Even when other people do find bad side-effects in the bill, the true believers ignore the potential problems.

Thus is the case with expanded Medicaid. The same politicians who thought ObamaCare was a good idea and promised us that “If you like your health insurance, you can keep your health insurance”, those same politicians now tell us that expanding Medicaid is a good idea.

Sadly, Medicaid is a cruel program that hurts the very people it’s meant to serve. One commentator wrote: “Imagine a government-run health care program in which medical access is severely limited, that is racked by uncontrollably rising costs, and that in many instances results in demonstrably worse health outcomes than having no insurance at all. Such a program isn’t a mere hypothetical; it already exists, and it’s called Medicaid.”

More and more doctors are refusing to accept Medicaid because the system doesn’t pay enough to cover their expenses. Would-be patients spend hours on the phone trying to find someone willing to treat them. If they do succeed in finding a doctor, the appointment is, on average, three weeks later than someone with private insurance.

And it gets worse…, multiple studies have shown that Medicaid patients are more likely to die from surgery than privately insured patients and sometimes even more likely to die than uninsured patients. A Univ. of Pennsylvania study of colon cancer found that the mortality rate for Medicaid patients was 27% higher than for uninsured patients. A Florida study found that Medicaid patients were more likely than uninsured patients to have late-stage prostate cancer, breast cancer, or melanoma.

On broader measures of health, the Oregon Medicaid health experiment found no significant difference between Medicaid patients and uninsured patients in objectively measured physical health outcomes. Put simply, Medicaid did not make patients any healthier, though it did make them feel more financially secure.

Expanded Medicaid has been tried and has failed. The state of Maine expanded their Medicaid program ten years ago. Every predicted benefit failed. Politicians said it would reduce the number of uninsured. Wrong. Politicians said it would reduce emergency room visits. Wrong. Politicians said it would relieve uncompensated care. Wrong. The only significant change was that thousands of Mainers switched from private insurance to Medicaid.

There was one absurd result from Maine’s Medicaid expansion: Since the eligibility rules differ for expanded Medicaid and regular Medicaid, 10,000 able-bodied, childless adults received benefits while 3,000 elderly and disabled were put on a waiting list.

A pernicious aspect of Medicaid is that it traps people on the edge of poverty. The eligibility rules make it very difficult for someone to escape poverty and move up the ladder of success. A young person entering the workforce, earning $14,856 gets free health care. But if he or she earns just one dollar more, then that same young person not only loses the free coverage, but becomes obligated to purchase coverage or else face a penalty. This is a terrible incentive that encourages people to stay poor.

Isn’t it a good thing to learn more skills, get a better job, work more overtime, earn more money, save toward the future? Medicaid and similar entitlement programs punish people who try to better themselves and become self-sufficient, not dependent on government. Why should we encourage people to be involved in such a terrible system?

Proponents of expanded Medicaid rarely, if ever, discuss the adverse health outcomes for people on Medicaid. They never talk about the perverse incentives that can keep someone trapped in near-poverty forever.

What proponents mostly talk about is getting “free” money from the federal government. It is as if the poor are mere pawns for collecting more money. But does anyone really believe that the money is “free”? The federal government is running gigantic deficits. It has borrowed trillions and trillions of dollars. Our children, grandchildren, and their grandchildren will be stuck paying off this debt.

And the money isn’t free even in the short term. The feds talk about paying 100% of the cost for two years, but can we really believe that promise? And the federal budget negotiators are already talking about reducing the 100% promise because the costs keep going higher and higher and higher.

Many opponents of expanding Medicaid worry that the ever-increasing costs to NH taxpayers will lead us inevitably toward a sales or income tax.

The ObamaCare Medicaid expansion is bad for the people it claims to help, bad for the taxpayers, and bad for the future of New Hampshire. We should fix the broken system, not expand it.

Poll: Record high number oppose ObamaCare

A record high number of registered voters (59%) oppose ObamaCare and a record low number (36%) favor it. Interestingly, the increase in opposition comes from Democrats and independents. 30% of Democrats, up from 22%, oppose the law. Among independents, 64% (up from 53%) oppose it.

Some apparent reasons for opposition to the law include the fact that majorities think the new law will increase their taxes (63 percent), increase their insurance costs (62 percent) and increase the federal deficit (56 percent).

Meanwhile, just one voter in five thinks Obamacare will increase the quality of their health care (19 percent).  More than twice as many expect the quality of their care to get worse (39 percent) and another 37 percent think it will stay the same.

  • By 42%-27% voters think that Obama’s policies have hurt, not helped, the economy
  • A whopping 74% feel as if the country is still in a recession
  • By 55%-30% they think cutting taxes and reducing regulations would help the economy
  • 55% vs 37% think that long-term unemployment benefits discourage people from trying to find work
  • A majority (52%) think the government should provide unemployment benefits for at most one year

Train wreck update

The problems with ObamaCare are not just the website. Actually, the website failure is perhaps the least of the problems. For those who managed to buy their insurance on the website, their problems are just beginning.

Consider this woman who discovered that having insurance and receiving health care are two different things. When she went to the hospital, she was told that her policy number didn’t work and she would have to pay for her care herself. Then a few days later, she received an ID card so she made an appointment.

When she got to her doctor, she was told that she had not designated him as her primary care physician so she could not see him. Next step was even more hours and hours on hold getting that straightened out. She finally has her next appointment and is hoping she’ll finally get the health care she wants.

(The title of this post I have stolen from the great Glenn Reynolds of Instapundit fame. ObamaCare is an ongoing train wreck and I expect many more posts in this series.)

Millennials Are Tiring of Liberal Failures

National Review predicts that 2014 will be “the year that a majority of millennials become disillusioned with their allegiance to today’s liberal movement and look elsewhere for political relevance.”

A poll by Harvard University’s Institute of Politics found strong majorities – nearly 2:1 – opposing Obama’s handling of the economy, health care, and the federal deficit. “A majority of Americans under age 25–the youngest millennials–would favor throwing Obama out of office.”

The Pajama Boy ObamaCare ads did not go over well with millennials.

The real Pajama Boy has a 50 percent chance of being unemployed or underemployed, on average is laden with thousands of dollars of student-loan debt, and is increasingly likely to still live at home with his parents.

Millennials “realize that a government that can’t design a website can’t be expected to manage the intricacies of the entire health-care industry. In the wake of the news that the NSA collects mountains of metadata, they also fret that the government that wants you to talk about health care could (with a warrant) listen in on that very conversation.”

Other data suggest that millennials share conservative views of government:

  • 51% believe that when government runs something, it is usually wasteful and inefficient
  • 86% support private Social Security accounts
  • 74% would change Medicare so people can buy private insurance
  • 63% support free trade
  • only 38% support affirmative action

Here is the opening for conservatives to win back millennials. “Conservatives must offer positive, uplifting solutions that emphasize upward mobility, opportunity, and personal liberty through education, job creation, and reforming the over-intrusive federal government.”