Comments on Obamacare

In this entry are comments that were submitted on March 20 responding to a variety of posts on the health care bill. Since those posts are now so far down the page, and come from the pre-Obamacare Era, I’m putting them in this one entry. Most of them are not about the debate, but about the substance of the bill, so they are still relevant.

Re: OBAMACARE GENERAL

Joseph C. writes:

Unfortunately, this monstrosity seems set to pass. They likely have the votes. All current machinations are aimed at figuring which Democrats are in the most vulnerable districts and which are “safe.” Once this is decided, the ones whose votes are not “needed” will cast a “brave” NO vote, leaving just enough margin for the bill to pass with the 216 or 217 needed.

LA replies:

It turned out that Joseph was correct. Many of the Dem No’s had promised to vote yes if their vote was needed at the last minute.

John Hagan writes:

Howard Dean sees what’s coming, and I also agree with Clark Coleman. Once McCain lost we knew there was going to be a price to pay with the possibility that America could very well be damaged in significant ways. But this health care bill is structured in such a way (as Howard Dean explains ) that it leaves the democratic party naked before the public in such a unique manner that it will not be able to defend itself, or recover from the political annihilation that awaits it.

I suspect that with states opting out of Obamacare, lawsuits challenging the constitutionality of the government forcing citizens to purchase a private product, and Republicans sweeping election after election that this chaos will carry over to 2012 and sweep Obama away. Obama and the Democrats have been exposed in a unique way this year. By passing this bill into law the left will be exposed for the self-loathing, irrational nation-killers that they are.

Jack R. writes:

I went to the St. Patrick’s Parade today in Rockville Centre Long Island, a middle/upper middle class town.

Chuck Schumer marched by and was booed, with some men yelling “Vote No.”

He acted like he heard nothing, and looked like the slimiest man I’ve ever seen.

Jake Jacobsen writes:

Something that struck me as I was contemplating the coming health care debacle a couple of months ago is how this is right out of the Communist playbook, seriously …

Re: By its built-in logic, Obamacare will cause the health care industry to go bankrupt within months

MJB writes:

As a retired health care workcer, I cannot fault one statement in the doctor’s comments. But I can give you some perspective to validate his comments. First some guidelines:

When one turns 65 one is eligible to sign up for Medicare. One CANNOT sign for just Social Security. If one doesn’t sign up for Medicare, one is denied social security.

I am not familiar with Medicare Advantage, so my next guidelines apply to only fee-for-service:

Doctors could charge $1000 for an office visit, but Medicare will allow only what they determine that doctors may be paid. For example, my cardiologist charges $125 for an office followup vist. Medicare says he may only be paid $58.11—of which Medicare pays $26.81 and my medigap insurance pays $31.30. My primary care doctor gets even less. These doctors accept “assignment” from Medicare—which means that the amount that Medicare allows is all the doctor can get. If the doctor does not accept “assignment” then he may charge only 115 percent of what Medicare allows. Most doctors accept assignment, so I assume that the required paper work and bookkeeping is not worth the effort for a few extra dollars.

Hospitals are not much better off. My hospital charged $7000 for an ER visit and an emergency heart catheterization for an acute chest pain episode. They received $750 for ER visit, EKG, chest xray, stat labs, emergency heart cath, all supplies, equipment, medications, and post-cath observation for a couple of hours. I doubt that they recovered their actual costs. (My own chest pain episode.)

I hope these all-too-typical examples show why allowing evieryone to sign up for Medicare won’t solve cost problems. And Medicare isn’t free. My Medicare part B premiums, my Medigap insurance premium (Medicare pays only 80 percent of ALLOWED charges,) and my part D premiums add up to $4000 yearly. And there are small increases in all yearly because we age yearly. I can pay increasing premiums because I lived frugally and saved for my retirement (no cell phone, no cable tv, very few vacations, etc.)

I can see NO WAY to pay for nationalized health care, including what we already have (Medicare, Medicaid, VA.) Not to mention the additional borrowing that will be necessary, many years of underemployment ahead, continued high immigration of the poor of the Third World, peak oil, etc. Just call me a “Doomer.” I think health “reform” will pass and I think the national debt will cause the U.S. to implode before the total implosion of our medical system.

Kathlene M. writes:

You wrote that “The author of the FR article says that doctors treating Medicare-Medicaid patients only get reimbursed 70 percent of their costs. Meaning they are losing money for every Medicare patient they see. Can someone explain how such a system came into being, and why the doctors ever accepted it at all?”

When I’ve asked one doctor I know why doctors accept Medicare patients if the reimbursement is 70 percent, one answer is that Medicare’s payments are quick and reliable once set. Doctors know that Medicare will follow through with the promised set payment, once the doctors submit their paperwork correctly. And the payment is quick, around 14-21 days.

In comparison, private insurance companies play coding/reimbursement games with doctors even if there are agreed-upon rates and the submitted paperwork is correct. And the payment is slow, around 45-60 days. Insurance companies will often try to pay less than the agreed fees, using coding “errors” or “downcoding” practices (i.e., changing the doctor’s reimbursement code), to mention a few. This requires the doctor to resubmit paperwork 2-3 times to get the proper reimbursement, or charge the patient the difference when that is allowed. Yes, medicare has its paperwork-submission games, but private insurance companies’ paperwork/reimbursement games are far worse.

So health insurance reform is needed, just not in the form of this Healthcare Reform bill.

Would James N. agree with this assessment?

Re: Admirable but inadequate: the arguments the Republicans should make, but don’t

A reader writes:

I don’t think anyone has said it better.

LA wrote to Clark Coleman:

Do you have any criticisms, suggestions about this entry?

Clark Coleman replies:

I think that politicians too often go for the lowest common denominator arguments, the most utilitarian, the least philosophical, because they think that philosophical arguments will sail right over the heads of many voters. In some cases, they are probably correct. But I think that philosophical arguments need to be made alongside utilitarian arguments, in order to make some voters think.

The philosophical argument that I have been waiting for someone to make (not just politicians, but conservative bloggers and radio hosts) is that a government takeover of health care will kill the unique spirit of America. Instead of freedom reigning in the hearts of Americans, they will look to government for solutions. Instead of controlling their own destinies, they will adopt the European mindset of thinking “the government needs to do something” about every problem. When you are an empowered, informed consumer of health care, as with the Golden Rule plan I recently outlined, you have an independent spirit. You can change insurance companies or hospitals or doctors when you have a problem. When your only recourse is to write your congressman and seek his “constituent services” to deal with your bureaucratic impasse, you become a passive Euro-wimp. It affects your whole approach to life.

For the last 12 months, who has been saying that in public?

Re: Should we prefer that the bill pass, for the same reason that we refused to vote for McCain?

LA to Clark Coleman:

Also, I just noticed your subject line, “Serene in the eye of the ObamaCare storm,” and included it in the post

Are you saying that you personally are serene in the eye of the storm?

Clark Coleman replies:

Yes. I truly cannot foresee the future, and don’t know if it is better for the monstrosity to pass or fail.

Vivek G. writes:

My take on the matter is: We should want the bill not to pass. We are free to hope, that even if we fail, and the bill passes, it will hopefully have some better effect on conservative movement and so on. To want to fail in the vain hope that afterwards there may be inspiration for bigger success is something that I find unpalatable. It is one thing to accept the inevitable gracefully after it has happened, and have enough enthusiasm to rise again. But it is another matter altogether to wish for the inevitable hoping that it will lead to greater enthusiasm for future uprising. Somehow it sounds negative. On a spiritual note, it sounds more like we wanting someone (possibly oneself) to sin, so that later the one may feel stronger repentance, and therefore greater urge to strive for the kingdom.

LA replies:

I agree entirly, and that has always been my position.

HOUSE WILL VOTE ON BILL IN THE NORMAL MANNER

Rick U. writes:

This is the worst news of the day as it would seem to indicate they have the votes to pass the monster.

Posted by Lawrence Auster at March 23, 2010 11:52 AM | Send