I just finished watching the movie “Wag The Dog” starring Dustin Hoffman, Robert DeNiro, Anne Heche, and Woody Harrelson. It is movie worth seeing again to understand the Obama administrations campaign to promote Obamacare.
To 'wag the dog' means to purposely divert attention from what would otherwise be of greater importance, to something else of lesser significance. By doing so, the lesser-significant event is catapulted into the limelight, drowning proper attention to what was originally the more important issue.Just days before a presidential election, a Washington, D.C. spin doctor, distracts the electorate from a sex scandal by hiring a Hollywood film producer to construct a fake war with Albania.
Paul Krugman’s recent Obamacare article contains multiple misdirections and half-truths. It offers fictitious examples that when stitched together sound as if Obamacare is the greatest thing that ever happened to the American people.
Nothing could be further from the truth.Paul Krugman declares that healthcare reform has worked in Massachusetts since 2006. Therefore, Obamacare, which is essentially the same program, can work in the rest of the nation.
“Massachusetts has had essentially this system since 2006; as a result, nearly all residents have health insurance, and the program remains very popular. So we know that ObamaCare — or, as some of us call it, ObamaRomneyCare — can work.
Does Massachusetts’ healthcare reform really work?
It is true that nearly all Massachusetts residents are insured. The Massachusetts government subsidized healthcare insurance sold in the Massachusetts exchange. Physicians’ and hospitals’ reimbursement is only about 10% more than what Medicaid pays.
Massachusetts physicians seem to be less willing to see the newly insured (with exchange subsidies) than Medicaid patients even though the reimbursement is 10% more than they recieve for Medicaid patients.
Physicians are also less likely to accept Medicaid patients than privately insured patients. This has resulted in a physician shortage for recipients of Medicaid.
In Worcester Massachusetts there is a 3 months wait to see a primary care physician. There is scalping for physician appointments in Worcester.
Patients make appointments and then sell those appointment times to other patients that have to see a physician quickly. The other option is to go to the emergency room.
Many of the healthcare policy wonks that wrote the Massachusetts law wrote the Obamacare law. These same healthcare policy wonks believed that once everyone was insured, patients would go to the doctor’s office for primary care rather than to the hospital emergency room.
There has been a decrease in the demand for care as a result of a decrease in the supply of physicians. The result has been that hospital emergency room traffic is higher today than before health reform in Massachusetts.
There has been an increase in community healthcare centers manned by physician substitutes. This traffic to community health centers is almost one-third higher than it was before reform.
The time it takes to get medical care is growing in every city and town in Massachusetts. The wait to see a new doctor in Boston today is two months. This is the longest wait in the entire country.
The only thing that has changed in Massachusetts is the cost of healthcare. A few years ago the federal government had to bail out Massachusetts before it went bankrupt. Massachusetts received 8 billion dollars for healthcare reform from President Obama.
“On balance, the only thing that seems to have changed in Massachusetts is that patients are waiting longer. They are going to the same places to get care that they went to before. They are getting the same care from the same providers. In the process, more money is being moved around. A lot more money.”
Paul Krugman states “There are, however, millions of Americans who don’t receive insurance either from their employers or from government programs.”
I agree this must be fixed. However, I believe Obamacare is going to make things worse.
This is also true. However you cannot force businesses to do things they do not want to do as Obamacare is attempting to do. You also cannot increase medical benefits without raising healthcare insurance prices and permit the insurance industry to take 40% off the top.
The healthcare insurance industry will be taxed for every policy sold and the cost will be passed on to consumers.
You also cannot stop excessive demand for healthcare unless you provide incentives to consumers to decrease demand. Obamacare provides incentives to increase demand by expanding healthcare entitlements. The result will be a further increase in federal and state taxes.
The tax increase will further decrease investment and in turn increase unemployment.
Meanwhile all large and small companies are decreasing full time employment to under 30 hours a week to avoid penalties for not providing healthcare insurance.
Who is getting stuck?
Ordinary consumers are getting stuck. Things are getting worse, not better.
In some states, like California, insurers reject applicants with past medical problems. In others, like New York, insurers can’t reject applicants, and must offer similar coverage regardless of personal medical history (“community rating”).
Community rating is a concept associated with health insurance, which requires health insurance providers to offer health insurance policies within a given territory at the same price to all persons without medical underwriting, regardless of their health status.
Pure community rating prohibits insurance rate variations based on demographic characteristics such as age or gender, whereas adjusted or modified community rating allows insurance rate variations based on demographic characteristics such as age or gender in a region or city.
It has nothing to do with requiring the issuing of healthcare insurance.
He says by having community ratings, “it leads to a situation in which premiums are very high because only those with current health problems sign up, while healthy people take the risk of going uninsured.”
This is a misinformed statement. If there are many young people in a community the insurance rates should be lower regardless of whether they have insurance.
The claims experienced by the healthcare insurer will be higher if the young people do not sign up for insurance. Therefore the healthcare industry wants to set prices on claims not community performance.
Again, the government should not be able to force consumers to purchase a product they do not want. The Supreme Court said the government could tax consumers if they do not purchase healthcare insurance.
If the tax is 10% of the cost of insurance and you cannot afford the insurance you would pay the penalty and forgo the insurance. A consumer would also try to avoid the penalty.
Paul Krugman proclaims the principles Obamacare demands.
First, community rating everywhere — no more exclusion based on pre-existing conditions.
This is good but costly unless you change the profit structure for the healthcare insurance industry.
Second, the “mandate” — you must buy insurance even if you’re currently healthy.
This is against the law.
Third, subsidies to make insurance affordable for those with lower incomes.
This is also O.K. but it will create a situation that is unsustainable for the federal government. The federal government is going to want to stick the unsustainable costs on to the states after the first three years of complete federal funding. The federal government cannot afford the first three years.
Paul Krugman then goes on to play the very effective blame game.
“Some people are too poor to afford coverage even with the subsidies. These Americans were supposed to be covered by a federally financed expansion of Medicaid, but in states where Republicans have blocked Medicaid expansion, such unfortunates will be left out in the cold.”
I thought the Obamacare was going to set up health insurance exchanges in states that refused to participate.
Paul Krugman goes on to say,
“There will probably be a lot of administrative confusion as the law goes into effect, again especially in states where Republicans have been doing their best to sabotage the process.”
Maybe, just maybe Texas and the governors of the other 24 states that are not participating because they are smart. They see the coming train wreck. They understand that Obamacare is unsustainable. They do not want to be stuck with the obligation to adopt an unsustainable program. They want to avoid bigger state deficits. They want to avoid raising state taxes for a program that cannot work.
If the Obama administration wants to execute the program let it do it on its own.
The Obama administration has not taken steps to set up health insurance exchanges in states that are not participating.
They are taking steps to develop a campaign to promote Obamacare and steps to blame the states that are not interested in participating in its demise.
Paul Krugman is a pawn for the Obama administration. He is helping the administration construct a similar blame game scenario that had been so effective in passing Obamacare and in winning reelection for President Obama.
The states that are not participating should organize and offer a strong offense describing the obvious reasons they are not participating in the health insurance exchanges.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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