The President's Backwards is the new Forwards Speech on Obamacare
When the President spoke about the Affordable Care Act on October 20, 2016, he not only showed a relentless ignorance about the law and its impact on our healthcare crisis circa 2008, but frighteningly ignored the very reality of the Clinton's and Trump's "plans" for Obamacare which do NOT include his particular vision for the future of his botched plan--and make no mistake, Obamacare is NOT here to stay, unless it's in name only.
Consumers were omitted from the start: Obama ran us through the healthcare crisis as he defines it--"rising health costs were eating into workers’ paychecks and straining budgets for businesses and for governments." Unfortunately, that part about "eating into workers' paychecks," the consumer concerns that are part of our healthcare crisis were NOT helped by Obamacare and in many cases were worsened, because the law established new minimum standards that embrace insurance company desires to provide the finite costs of preventive checkup services AT THE EXPENSE of meaningful coverage for the unknown and limitless costs of obtaining NEEDED health services in the US today.
Obamacare partnered with insurance companies and businesses in order to save COMPANIES and government money on what they PAY on behalf of insureds, this is the magical number of "per capita" spending that Democrats have bragged about, which unfortunately hasn't REDUCED health CARE expenses of what we're charged, has not REDUCED health insurance costs, but has REDUCED how much is paid by PAYERS, government and companies on behalf of the individuals who are now FORCED to purchase health insurance under the Affordable Care Act.
For those who are dragging out charts to disprove this, just consider how much we're charged for medical services, which has gone up, and ask yourself if the payers, insurers and government are paying LESS per capita (for us) to receive services that cost more how are they doing that? The answer is obvious--WE are paying more in the form of copayments, coinsurance, deductibles, and out of pocket maximums which have gone up every year.
The "examples of success," that Obama discusses of two individuals who are here today thanks to Obamacare, are actually examples of quite the contrary. The baby needing heart surgery was eligible for programs that were independent of Obamacare, specifically "Social Security Administration's Compassionate Allowance program," and "Children's Hospital of Philadelphia qualify for financial aid programs through the institution," http://www.americanthinker.com/blog/2012/09/dnc_starts_with_a_new_obama_low.html.
No lifetime limits is also NOT 100 percent truthful: Actually, there are loopholes to the no lifetime limit cap, https://www.healthinsurance.org/faqs/is-it-true-that-under-the-aca-insurers-cant-cap-how-much-theyll-pay-out-over-the-course-of-your-lifetime/.
The second adult child who got the care she needed was actually insured through her parents' health insurance, an option that many insurance companies offered prior to Obamacare because they could capture those young-healthies through their parents' insurance and parents would pay for it.
While Obama tried to con us circa his 2008 boasting, the second case brags about the case is NOT what Obamacare's government-insurance company partnership was designed to do, quite the contrary, it was about capturing the young-health population to pay for statistically sicker-older groups by creating a mythical "single risk pool." Even Obama contradicted the "success" story by whining that young people haven't bought enough insurance: "And so, as a consequence, in those states enrollment in the plan — especially enrollment of young people — has lagged," (Obama, Remarks by the President on the Affordable Care Act, whitehouse.gov).
Obama's examples of the success of the Obamacare are actually in defiance of Obamacare, one relying on both a hospital and other federal program and one that includes the statistically rarer instance of when a young-healthy needs expensive medical services.
Obama then asserted that "Eighty percent or so of Americans get health care on the job, through their employer, or they get health care through Medicaid, or they get health care through Medicare." Actually this too is fudged. Employers account for slightly over half of insurance provided (http://kff.org/report-section/ehbs-2015-summary-of-findings/) so the 80 percent number is pretty much a conglomerate, the same way those people on Medicaid ARE counted when it comes to the "20 million enrollment" number even though we know that Obamacare enrollment this year was at a MAXIMUM, as defined by the government at 11.1 million.
So why does this matter? First, because employer provided health insurance is hanging on for a couple of reasons that are vulnerable to a governmental sweep of the pen:
One, there is a tax benefit to employers who provide health insurance--which actually did not go unnoticed in Obamacare's planning. Obamacare's goal was to REDUCE the spending of corporations on health insurance (with its minimum standards) in order to INCREASE the taxes paid by corporations which could not take a bigger tax deduction for more expensive health insurance (that's why the Cadillac tax was devised but met with objections and is now delayed until 2020).
Second, there is a penalty attached to larger employers who DON'T provide health insurance options.
BOTH of these reasons that keep employer health insurance in business are in jeopardy with the sweep of a pen that changes either the penalties imposed for not providing health insurance OR the deduction available if employer health insurance is provided. What we do know is that the Democrats' original goal was to REDUCE employer insurance in order to increase employers' bottom line without the tax deduction for providing benefits in order to enrich the government with higher taxes.
Obama himself confirmed the insurance company-company partnership that helped both reduce PER CAPITA costs (the amount paid on behalf of us, the insureds) by noting that Obamacare gave us free preventive care--the finite costs of a checkup. He also lumped in there the paid incentives to providers for utilizing the cost savings programs of forced prevention (which actually encourages DEFENSIVE medicine).
Then Obama addressed the enormous increases in what we're paying blaming it on EMPLOYERS, "Now, some people may say, well, I’ve seen my copays go up, or my networks have changed. But these are decisions that are made by your employers. It’s not because of Obamacare. They’re not determined by the Affordable Care Act." That would be a lie--Obamacare INTENDED just such an effect, the old skin in the game argument that would make people wiser consumers by forcing them to pay more.
First, Obamacare has FORCED WELLNESS http://conoutofconsumer.blogspot.com/search?q=forced+wellness which not only incentivizes defensive medicine which protects providers by sending everyone for all sorts of "free" checkups but then charges more the minute they're referred to another provider to further check out results.
Secondly, Obamacare established FORCED provisions of Obamacare to "include" these checkups which insurers clearly stated they would have to charge more for.
And like any law, Obamacare created MINIMUM standards that showed how little insurance companies could offer to comply with the law.
Obamacare deincentivized RESPONSIVENESS TO CONSUMERS by forcing every company to merely meet minimum standards and forcing consumers to purchase the products offered.
Third, the GOVERNMENT decides out of pocket maximums each year and every year the government has increased those out of pocket maximums which are up to $7,150 for an individual and $14,300 for families, https://or.accessrga.com/blog/blog/healthcare-reforms-updates/2017-out-of-pocket-maximum-oppm-limits-announced.
Fourth, Obama's Administration INCREASED the payroll tax by letting a prior limit on that lapse which is significant because Hillary Clinton's runningmate Kaine said that's how Clinton plans to pay for her government expenses, by lifting the payroll cap, INCREASING the payroll tax again.
Fifth, Obama's Administration INCREASED how much we have to lay out before we can get the medical deduction from 7.5 percent of our incomes to 10 percent of our incomes.
The speech was therefore a rehash of Obamacare nonsense in the circa 2008 sales pitchy-preachy style that conned us so long ago and ended up with whining about Republicans.
But unable to acknowledge his own failures, Obama bizarrely went backwards, as if he were running for President again, explaining his "plan" for the future of Obamacare. Weirdly he advised "expanding Medicaid," into the states that didn't do so. Clinton has promised to resurrect the original financial incentives where the federal government picked up the majority if expense a state incurred from "new Medicaid," enrollees which declined as the years wore on, going backwards and again offering the original deal to the states that have not expanded Medicaid. This already DIDN'T WORK and would require a NEW PROVISION OF OBAMACARE TO RESURRECT.
Then Obama went off into real fantasy arguing that the exchanges don't work in states "where the governor or legislature is hostile to the ACA." Really weird. California, http://www.latimes.com/business/la-fi-covered-california-rates-20160718-snap-story.html, and New York are scheduled to have enormous increases in exchange plans, http://www.bloomberg.com/news/articles/2016-05-18/obamacare-plans-in-new-york-seek-to-raise-premiums-by-17-percent, hardly states unfriendly to Obama and his "plans."
Ironically, Obama calls "repeal" going "backwards," for our healthcare crisis, yet his ideas are ALL circa 2008 or self-congratulating using the fibbed figures (selective "metrics" surveys and the like) as his big ideas for change, which for any person is obviously the fatal flaw of Obamacare--these are old ideas that didn't work the first time around, they will not work the second and therefore the law is unfixable without CHANGING it to Obamacare in name only.
Whether it's Clinton's ideas to let noncitizens enroll and sweeten the pot for them with additional tax credits or it's the Republican plan to replace Obamacare yet simply rename the individual mandate to "continuous coverage," for consumers, it doesn't matter at this point because what both parties want goes back to Obamacare's original failure as defined by the President: It was supposed to address --"rising health costs were eating into workers’ paychecks and straining budgets for businesses and for governments," (Obama, 10/20/2016) and it FAILED to address the consumer prong of the problem and worsened that problem in order to achieve the second two goals.
What Obamacare really showed us is the con, the pitch to reduce government, employer and insurance company costs while failing to address the endless price-gouging costs we're charged by providers, balance billing, the unavailability of the best providers for needed medical services and care under most insurance plans, the failure to address the ever-rising out of pocket maximums, the increasing hoops we're forced to go through to satisfy the desires of providers to practice defensive medicine and with all of that the fact that MEDICAL ERROR is the third leading cause of death in the US--in other words the very same healthcare crisis we had circa 2008.
The real issue is providing people with OPTIONS, which could include the expanded use of releases like the ones we have to sign now before medical procedures to OPT OUT of defensive testing WE choose not to get instead of encouraging such practice because providers don't consider the wear and tear on our emotions, our wallets and sometimes our lives from increased exposure to medical testing even IF it's "included" as part of the inflated prices we pay for health insurance.
We also need to regain our former consumer OPTION and power of voting with our wallets and our feet--If an insurance plan doesn't meet our needs, we can opt out. That was a big part of the uninsured "problem" to begin with, people were going broke when they got sick who HAD insurance. Forcing us to purchase health insurance without meaningful caps on what we spend--the medical deduction, the out of pocket maximum, the amount we have to pay in deductibles, copays, and coinsurance, is simply a continuation of the same problem but worse because we can no longer vote with our dollars and our feet.
We also need to incentivize the OPTION for those who can afford it to pay for another's health insurance, one adult paying for another adult's health insurance with a tax credit for them for reducing the uninsured rate and controlling those who need entitlement programs like Obamacare and Medicaid. With today's employment situation many parents pay for their grown children's health insurance well beyond the age of 26, and others also pay for insurance policies for those they know--incentivize that.
We also need to illegalize balance billing, including arrangements where participating providers bring in nonparticipating providers who can charge whatever the market will bear and get a kickback of profit.
We also need to have an assets test for Obamacare entitlements because currently millionaires who can fudge their incomes to fall within Obamacare income requirements are eligible for government entitlement payments.
We also need to move the expense of pursuing and recovering fraudulent insurance company payments, which companies are currently disincentivized to do because under Obamacare's 80-20 or 85-15 rule they must eat into the money they spend their own way, the 20 or 15 percent, in order to pursue fraud which deincentivizes them from pursuing fraud because they can simply raise their rates to cover such expenses and instead make it part of the legitimate 80 percent portion of the formula to the dollar amount extent they succeed in recovering fraudulently paid dollars.
We must also acknowledge the reality that some states did NOT expand Medicaid and that those states should receive the DSH payments (disproportionate hospital share) by government designed to covered their uninsured populations to provide those poor who are uninsured (and there are millions) hospital options. Recall, DSH payments were reduced premised on the original forced expansion of Medicaid provisions that were stricken down by the Supreme Court yet those provisions were not modified.
We must get rid of Obamacare's payment to providers for end-of-life counseling that includes encouraging patients to accept their own deaths with the "cost" of taking a chance on another treatment as a consideration. Similarly, we must REMOVE this summer's CMS rule that further restricted the availability of short-term health insurance policies that attract many younger people because they believe those young people will be forced into the mythical single risk pool created by Obamacare.
We must in other words acknowledge a few things---
Health insurance is not health care but a consumer financial product that only works when it protects people from the unexpected costs of needed medical services and care.
Health insurance as a consumer financial product should not be forced on consumers who should be trusted to determine their own ability to pay for and live with the offering a consumer financial product because that not only treats consumers like morons, but deincentivizes insurance companies from coming up with plans that meet consumer needs.
We must establish a nationally enforced standard of prices for medical care and services that is based on a regional average just like Obamacare does for the price of insurance policies. Neither Obamacare, its original goals, nor the candidates who are running are addressing these consumer needs.
Consumers were omitted from the start: Obama ran us through the healthcare crisis as he defines it--"rising health costs were eating into workers’ paychecks and straining budgets for businesses and for governments." Unfortunately, that part about "eating into workers' paychecks," the consumer concerns that are part of our healthcare crisis were NOT helped by Obamacare and in many cases were worsened, because the law established new minimum standards that embrace insurance company desires to provide the finite costs of preventive checkup services AT THE EXPENSE of meaningful coverage for the unknown and limitless costs of obtaining NEEDED health services in the US today.
Obamacare partnered with insurance companies and businesses in order to save COMPANIES and government money on what they PAY on behalf of insureds, this is the magical number of "per capita" spending that Democrats have bragged about, which unfortunately hasn't REDUCED health CARE expenses of what we're charged, has not REDUCED health insurance costs, but has REDUCED how much is paid by PAYERS, government and companies on behalf of the individuals who are now FORCED to purchase health insurance under the Affordable Care Act.
For those who are dragging out charts to disprove this, just consider how much we're charged for medical services, which has gone up, and ask yourself if the payers, insurers and government are paying LESS per capita (for us) to receive services that cost more how are they doing that? The answer is obvious--WE are paying more in the form of copayments, coinsurance, deductibles, and out of pocket maximums which have gone up every year.
The "examples of success," that Obama discusses of two individuals who are here today thanks to Obamacare, are actually examples of quite the contrary. The baby needing heart surgery was eligible for programs that were independent of Obamacare, specifically "Social Security Administration's Compassionate Allowance program," and "Children's Hospital of Philadelphia qualify for financial aid programs through the institution," http://www.americanthinker.com/blog/2012/09/dnc_starts_with_a_new_obama_low.html.
No lifetime limits is also NOT 100 percent truthful: Actually, there are loopholes to the no lifetime limit cap, https://www.healthinsurance.org/faqs/is-it-true-that-under-the-aca-insurers-cant-cap-how-much-theyll-pay-out-over-the-course-of-your-lifetime/.
The second adult child who got the care she needed was actually insured through her parents' health insurance, an option that many insurance companies offered prior to Obamacare because they could capture those young-healthies through their parents' insurance and parents would pay for it.
While Obama tried to con us circa his 2008 boasting, the second case brags about the case is NOT what Obamacare's government-insurance company partnership was designed to do, quite the contrary, it was about capturing the young-health population to pay for statistically sicker-older groups by creating a mythical "single risk pool." Even Obama contradicted the "success" story by whining that young people haven't bought enough insurance: "And so, as a consequence, in those states enrollment in the plan — especially enrollment of young people — has lagged," (Obama, Remarks by the President on the Affordable Care Act, whitehouse.gov).
Obama's examples of the success of the Obamacare are actually in defiance of Obamacare, one relying on both a hospital and other federal program and one that includes the statistically rarer instance of when a young-healthy needs expensive medical services.
Obama then asserted that "Eighty percent or so of Americans get health care on the job, through their employer, or they get health care through Medicaid, or they get health care through Medicare." Actually this too is fudged. Employers account for slightly over half of insurance provided (http://kff.org/report-section/ehbs-2015-summary-of-findings/) so the 80 percent number is pretty much a conglomerate, the same way those people on Medicaid ARE counted when it comes to the "20 million enrollment" number even though we know that Obamacare enrollment this year was at a MAXIMUM, as defined by the government at 11.1 million.
So why does this matter? First, because employer provided health insurance is hanging on for a couple of reasons that are vulnerable to a governmental sweep of the pen:
One, there is a tax benefit to employers who provide health insurance--which actually did not go unnoticed in Obamacare's planning. Obamacare's goal was to REDUCE the spending of corporations on health insurance (with its minimum standards) in order to INCREASE the taxes paid by corporations which could not take a bigger tax deduction for more expensive health insurance (that's why the Cadillac tax was devised but met with objections and is now delayed until 2020).
Second, there is a penalty attached to larger employers who DON'T provide health insurance options.
BOTH of these reasons that keep employer health insurance in business are in jeopardy with the sweep of a pen that changes either the penalties imposed for not providing health insurance OR the deduction available if employer health insurance is provided. What we do know is that the Democrats' original goal was to REDUCE employer insurance in order to increase employers' bottom line without the tax deduction for providing benefits in order to enrich the government with higher taxes.
Obama himself confirmed the insurance company-company partnership that helped both reduce PER CAPITA costs (the amount paid on behalf of us, the insureds) by noting that Obamacare gave us free preventive care--the finite costs of a checkup. He also lumped in there the paid incentives to providers for utilizing the cost savings programs of forced prevention (which actually encourages DEFENSIVE medicine).
Then Obama addressed the enormous increases in what we're paying blaming it on EMPLOYERS, "Now, some people may say, well, I’ve seen my copays go up, or my networks have changed. But these are decisions that are made by your employers. It’s not because of Obamacare. They’re not determined by the Affordable Care Act." That would be a lie--Obamacare INTENDED just such an effect, the old skin in the game argument that would make people wiser consumers by forcing them to pay more.
First, Obamacare has FORCED WELLNESS http://conoutofconsumer.blogspot.com/search?q=forced+wellness which not only incentivizes defensive medicine which protects providers by sending everyone for all sorts of "free" checkups but then charges more the minute they're referred to another provider to further check out results.
Secondly, Obamacare established FORCED provisions of Obamacare to "include" these checkups which insurers clearly stated they would have to charge more for.
And like any law, Obamacare created MINIMUM standards that showed how little insurance companies could offer to comply with the law.
Obamacare deincentivized RESPONSIVENESS TO CONSUMERS by forcing every company to merely meet minimum standards and forcing consumers to purchase the products offered.
Third, the GOVERNMENT decides out of pocket maximums each year and every year the government has increased those out of pocket maximums which are up to $7,150 for an individual and $14,300 for families, https://or.accessrga.com/blog/blog/healthcare-reforms-updates/2017-out-of-pocket-maximum-oppm-limits-announced.
Fourth, Obama's Administration INCREASED the payroll tax by letting a prior limit on that lapse which is significant because Hillary Clinton's runningmate Kaine said that's how Clinton plans to pay for her government expenses, by lifting the payroll cap, INCREASING the payroll tax again.
Fifth, Obama's Administration INCREASED how much we have to lay out before we can get the medical deduction from 7.5 percent of our incomes to 10 percent of our incomes.
The speech was therefore a rehash of Obamacare nonsense in the circa 2008 sales pitchy-preachy style that conned us so long ago and ended up with whining about Republicans.
But unable to acknowledge his own failures, Obama bizarrely went backwards, as if he were running for President again, explaining his "plan" for the future of Obamacare. Weirdly he advised "expanding Medicaid," into the states that didn't do so. Clinton has promised to resurrect the original financial incentives where the federal government picked up the majority if expense a state incurred from "new Medicaid," enrollees which declined as the years wore on, going backwards and again offering the original deal to the states that have not expanded Medicaid. This already DIDN'T WORK and would require a NEW PROVISION OF OBAMACARE TO RESURRECT.
Then Obama went off into real fantasy arguing that the exchanges don't work in states "where the governor or legislature is hostile to the ACA." Really weird. California, http://www.latimes.com/business/la-fi-covered-california-rates-20160718-snap-story.html, and New York are scheduled to have enormous increases in exchange plans, http://www.bloomberg.com/news/articles/2016-05-18/obamacare-plans-in-new-york-seek-to-raise-premiums-by-17-percent, hardly states unfriendly to Obama and his "plans."
Ironically, Obama calls "repeal" going "backwards," for our healthcare crisis, yet his ideas are ALL circa 2008 or self-congratulating using the fibbed figures (selective "metrics" surveys and the like) as his big ideas for change, which for any person is obviously the fatal flaw of Obamacare--these are old ideas that didn't work the first time around, they will not work the second and therefore the law is unfixable without CHANGING it to Obamacare in name only.
Whether it's Clinton's ideas to let noncitizens enroll and sweeten the pot for them with additional tax credits or it's the Republican plan to replace Obamacare yet simply rename the individual mandate to "continuous coverage," for consumers, it doesn't matter at this point because what both parties want goes back to Obamacare's original failure as defined by the President: It was supposed to address --"rising health costs were eating into workers’ paychecks and straining budgets for businesses and for governments," (Obama, 10/20/2016) and it FAILED to address the consumer prong of the problem and worsened that problem in order to achieve the second two goals.
What Obamacare really showed us is the con, the pitch to reduce government, employer and insurance company costs while failing to address the endless price-gouging costs we're charged by providers, balance billing, the unavailability of the best providers for needed medical services and care under most insurance plans, the failure to address the ever-rising out of pocket maximums, the increasing hoops we're forced to go through to satisfy the desires of providers to practice defensive medicine and with all of that the fact that MEDICAL ERROR is the third leading cause of death in the US--in other words the very same healthcare crisis we had circa 2008.
The real issue is providing people with OPTIONS, which could include the expanded use of releases like the ones we have to sign now before medical procedures to OPT OUT of defensive testing WE choose not to get instead of encouraging such practice because providers don't consider the wear and tear on our emotions, our wallets and sometimes our lives from increased exposure to medical testing even IF it's "included" as part of the inflated prices we pay for health insurance.
We also need to regain our former consumer OPTION and power of voting with our wallets and our feet--If an insurance plan doesn't meet our needs, we can opt out. That was a big part of the uninsured "problem" to begin with, people were going broke when they got sick who HAD insurance. Forcing us to purchase health insurance without meaningful caps on what we spend--the medical deduction, the out of pocket maximum, the amount we have to pay in deductibles, copays, and coinsurance, is simply a continuation of the same problem but worse because we can no longer vote with our dollars and our feet.
We also need to incentivize the OPTION for those who can afford it to pay for another's health insurance, one adult paying for another adult's health insurance with a tax credit for them for reducing the uninsured rate and controlling those who need entitlement programs like Obamacare and Medicaid. With today's employment situation many parents pay for their grown children's health insurance well beyond the age of 26, and others also pay for insurance policies for those they know--incentivize that.
We also need to illegalize balance billing, including arrangements where participating providers bring in nonparticipating providers who can charge whatever the market will bear and get a kickback of profit.
We also need to have an assets test for Obamacare entitlements because currently millionaires who can fudge their incomes to fall within Obamacare income requirements are eligible for government entitlement payments.
We also need to move the expense of pursuing and recovering fraudulent insurance company payments, which companies are currently disincentivized to do because under Obamacare's 80-20 or 85-15 rule they must eat into the money they spend their own way, the 20 or 15 percent, in order to pursue fraud which deincentivizes them from pursuing fraud because they can simply raise their rates to cover such expenses and instead make it part of the legitimate 80 percent portion of the formula to the dollar amount extent they succeed in recovering fraudulently paid dollars.
We must also acknowledge the reality that some states did NOT expand Medicaid and that those states should receive the DSH payments (disproportionate hospital share) by government designed to covered their uninsured populations to provide those poor who are uninsured (and there are millions) hospital options. Recall, DSH payments were reduced premised on the original forced expansion of Medicaid provisions that were stricken down by the Supreme Court yet those provisions were not modified.
We must get rid of Obamacare's payment to providers for end-of-life counseling that includes encouraging patients to accept their own deaths with the "cost" of taking a chance on another treatment as a consideration. Similarly, we must REMOVE this summer's CMS rule that further restricted the availability of short-term health insurance policies that attract many younger people because they believe those young people will be forced into the mythical single risk pool created by Obamacare.
We must in other words acknowledge a few things---
Health insurance is not health care but a consumer financial product that only works when it protects people from the unexpected costs of needed medical services and care.
Health insurance as a consumer financial product should not be forced on consumers who should be trusted to determine their own ability to pay for and live with the offering a consumer financial product because that not only treats consumers like morons, but deincentivizes insurance companies from coming up with plans that meet consumer needs.
We must establish a nationally enforced standard of prices for medical care and services that is based on a regional average just like Obamacare does for the price of insurance policies. Neither Obamacare, its original goals, nor the candidates who are running are addressing these consumer needs.
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