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All the Bad News
About Obamacare, Single Payer, and Medicaid Expansion SINGLE PAYER - a colossally bad idea for lots of reasons - “This is a great service for all of us.” - “You’re the only one doing anything on this. It’s very helpful.” - healthcare policy analyst REPEAL OBAMACARE NOW! - legalize true catastrophic insurance - return Medicaid to a poverty program End the Obamacare Congressional Exemption! |
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7/28/22 - Wrong Way Obamacare
Senate Democrats and the White House reached agreement on another big tax-and-spend bill that would, among other things, extend expanded Obamacare subsidies for three years, well past the next presidential election - how convenient. The agreement was made possible when Senator Joe Manchin reversed himself on key provisions. A vote could come next week.
The subsidies were expanded in March 2021, supposedly temporarily as part of COVID relief. Continuing jumbo Obamacare subsidies is a bad idea for several reasons. First, they subsidize wealthy people who make three times the national median income. They can receive $7,800 a year in taxpayer money to subsidize their health insurance. Are you kidding me? Second, the jumbo subsidies hide the true cost of insurance. Premiums were slated to go up substantially - an average of 10 percent nationally - but they would go up less if the bill is passed. Democrats were freaking out about huge price increases hitting consumers right before the November elections and they would lose votes as a result, but they won’t have to worry if the bill becomes law. Third, the jumbo subsidies would cost far more than the Democrats claim. A CBO analysis shows the subsidies would add $248 billion to the federal deficit over the next decade. Fourth, 2.3 million people would lose their job-based coverage as employers fob off health insurance costs to the federal government. It’s never a good idea to deliberately make more people dependent on the government, but that’s what the Democrats live for.
Obamacare is still a turkey, jumbo subsidies or no. The Affordable Care Act has steadily become less affordable over time. In 2015, half of middle-class families paid 7.7 percent or more of their income on the lowest-cost ACA bronze plan. But in 2019, the cost swelled to 11.3 percent and, for 55 to 64-year-olds, 19 percent. Also, drug spending went up 2 percent a year between 2015 and 2019 for people in large group plans, but 11 percent for those with individual plans because of Obamacare’s guaranteed issue preexisting condition coverage, restrictions on true underwriting, and other regulations.
We have fresh reminders of other problems with Obamacare: It limits popular short-term health insurance, which prevents some people from getting insurance at all. It bans physician-owned hospitals, which makes zero sense unless you’re a special interest afraid of competition from people who know what they’re doing. Finally, the lies used to sell this turkey continue. Joe Biden recently claimed 100 million people would lose their health insurance if Obamacare’s preexisting condition coverage went away. That was too much even for the left-wing Washington Post which gave Biden two Pinocchios for his specious claim. Biden inflated the number by including people who would face price increases, but not lose their coverage. He also included people on employer plans which typically had preexisting condition coverage before Obamacare ever came along.
Never-ending jumbo subsidies, a string of broken promises and lies, declining affordability, herding people into government dependency - there’s not a lot to like here. We’ve gone the wrong direction and the Democrats remind me of ‘Wrong Way’ Corrigan who tried to fly from New York to California, but ended up in Ireland. Wish us the luck of the Irish - we’re going to need it.
Senate Democrats and the White House reached agreement on another big tax-and-spend bill that would, among other things, extend expanded Obamacare subsidies for three years, well past the next presidential election - how convenient. The agreement was made possible when Senator Joe Manchin reversed himself on key provisions. A vote could come next week.
The subsidies were expanded in March 2021, supposedly temporarily as part of COVID relief. Continuing jumbo Obamacare subsidies is a bad idea for several reasons. First, they subsidize wealthy people who make three times the national median income. They can receive $7,800 a year in taxpayer money to subsidize their health insurance. Are you kidding me? Second, the jumbo subsidies hide the true cost of insurance. Premiums were slated to go up substantially - an average of 10 percent nationally - but they would go up less if the bill is passed. Democrats were freaking out about huge price increases hitting consumers right before the November elections and they would lose votes as a result, but they won’t have to worry if the bill becomes law. Third, the jumbo subsidies would cost far more than the Democrats claim. A CBO analysis shows the subsidies would add $248 billion to the federal deficit over the next decade. Fourth, 2.3 million people would lose their job-based coverage as employers fob off health insurance costs to the federal government. It’s never a good idea to deliberately make more people dependent on the government, but that’s what the Democrats live for.
Obamacare is still a turkey, jumbo subsidies or no. The Affordable Care Act has steadily become less affordable over time. In 2015, half of middle-class families paid 7.7 percent or more of their income on the lowest-cost ACA bronze plan. But in 2019, the cost swelled to 11.3 percent and, for 55 to 64-year-olds, 19 percent. Also, drug spending went up 2 percent a year between 2015 and 2019 for people in large group plans, but 11 percent for those with individual plans because of Obamacare’s guaranteed issue preexisting condition coverage, restrictions on true underwriting, and other regulations.
We have fresh reminders of other problems with Obamacare: It limits popular short-term health insurance, which prevents some people from getting insurance at all. It bans physician-owned hospitals, which makes zero sense unless you’re a special interest afraid of competition from people who know what they’re doing. Finally, the lies used to sell this turkey continue. Joe Biden recently claimed 100 million people would lose their health insurance if Obamacare’s preexisting condition coverage went away. That was too much even for the left-wing Washington Post which gave Biden two Pinocchios for his specious claim. Biden inflated the number by including people who would face price increases, but not lose their coverage. He also included people on employer plans which typically had preexisting condition coverage before Obamacare ever came along.
Never-ending jumbo subsidies, a string of broken promises and lies, declining affordability, herding people into government dependency - there’s not a lot to like here. We’ve gone the wrong direction and the Democrats remind me of ‘Wrong Way’ Corrigan who tried to fly from New York to California, but ended up in Ireland. Wish us the luck of the Irish - we’re going to need it.
Give It a Rest, Bernie
May 16, 2022
Bernie Sanders reintroduced Medicare for All legislation in the Senate, recently. He should give it a rest. His single payer proposal hasn’t gotten any better with time. Witnesses and Republican senators tore it to shreds in a hearing last week.
Sen. Ron Johnson of Wisconsin pointed to the government’s “miserable failures” on testing, restrictions on treatment, and its other sorry responses to the COVID pandemic. “Why in the world would anybody put government more in charge of health care?,” he asked. He said there will be more bureaucracy, not less, if the government takes over all healthcare, producing less innovation and higher costs.
Sen. Rick Scott of Florida said Bernie’s plan would abolish Medicare and private insurance. Worse, it would “have the federal government deciding which procedures you get and when you get them. Think about that...Do you want the government to make these choices for you?”
A healthcare policy expert testified Bernie’s plan to pay doctors and hospitals 30 to 40 percent less would force many physician practices and hospitals to close or significantly cut back on services (p.11). If you think we have a doctor shortage now, just wait. She further testified Bernie’s plan would also cut access to new medications and pull the rug out from under new drug development, including new cancer treatments (p.13). She noted single payer supporters keep saying nationalized healthcare would cut administrative costs, but claims would still need to be processed which means the administrative cost differential would largely be a wash (p. 13).
A budget expert testified the additional cost of Bernie’s 2017 plan, over and above current federal healthcare spending, would be around $38 trillion in the first 10 years (p.2). If you add in current spending, the total cost is more like $60 trillion (p.3). You could double all personal and corporate income taxes, and it still wouldn’t be enough to pay for single payer (p.2). As I’ve commented before, there’s never enough money to pay for single payer. The National Health Service in Britain is always running out of money and asking for more.
The arguments for and against single payer haven’t changed much in years. Arguments against single payer coming back around recently include it would raise taxes thereby reducing GDP and the incentives to work and invest; produce massive fraud; and lead inescapably to rationing and long wait times as other countries have found out. Most insidious of all, though, is how single payer will completely politicize all of medicine. The kind of care you get will depend on who you know in high places. Care will be doled out to privileged classes, perhaps even by race and ethnicity. The federal government is already moving in that direction, now requiring private insurers selling Medicare Advantage plans or Obamacare plans through government exchanges to report race and ethnicity data beginning in 2023 (p. 1).
Bernie and his supporters know all about these problems, but never talk about them. All you get from them is happy talk. That should make you deeply suspicious of their motives. Do they really want better healthcare for all, or are they just looking for a way to control the people, as a congressman let slip during the Obamacare fight?
When Bernie and other single payer supporters stop the happy talk and start addressing the very real problems their proposals will cause, then I might start to listen. Until then, my message to them is ‘in the future, you will control no one and be happy.’
May 16, 2022
Bernie Sanders reintroduced Medicare for All legislation in the Senate, recently. He should give it a rest. His single payer proposal hasn’t gotten any better with time. Witnesses and Republican senators tore it to shreds in a hearing last week.
Sen. Ron Johnson of Wisconsin pointed to the government’s “miserable failures” on testing, restrictions on treatment, and its other sorry responses to the COVID pandemic. “Why in the world would anybody put government more in charge of health care?,” he asked. He said there will be more bureaucracy, not less, if the government takes over all healthcare, producing less innovation and higher costs.
Sen. Rick Scott of Florida said Bernie’s plan would abolish Medicare and private insurance. Worse, it would “have the federal government deciding which procedures you get and when you get them. Think about that...Do you want the government to make these choices for you?”
A healthcare policy expert testified Bernie’s plan to pay doctors and hospitals 30 to 40 percent less would force many physician practices and hospitals to close or significantly cut back on services (p.11). If you think we have a doctor shortage now, just wait. She further testified Bernie’s plan would also cut access to new medications and pull the rug out from under new drug development, including new cancer treatments (p.13). She noted single payer supporters keep saying nationalized healthcare would cut administrative costs, but claims would still need to be processed which means the administrative cost differential would largely be a wash (p. 13).
A budget expert testified the additional cost of Bernie’s 2017 plan, over and above current federal healthcare spending, would be around $38 trillion in the first 10 years (p.2). If you add in current spending, the total cost is more like $60 trillion (p.3). You could double all personal and corporate income taxes, and it still wouldn’t be enough to pay for single payer (p.2). As I’ve commented before, there’s never enough money to pay for single payer. The National Health Service in Britain is always running out of money and asking for more.
The arguments for and against single payer haven’t changed much in years. Arguments against single payer coming back around recently include it would raise taxes thereby reducing GDP and the incentives to work and invest; produce massive fraud; and lead inescapably to rationing and long wait times as other countries have found out. Most insidious of all, though, is how single payer will completely politicize all of medicine. The kind of care you get will depend on who you know in high places. Care will be doled out to privileged classes, perhaps even by race and ethnicity. The federal government is already moving in that direction, now requiring private insurers selling Medicare Advantage plans or Obamacare plans through government exchanges to report race and ethnicity data beginning in 2023 (p. 1).
Bernie and his supporters know all about these problems, but never talk about them. All you get from them is happy talk. That should make you deeply suspicious of their motives. Do they really want better healthcare for all, or are they just looking for a way to control the people, as a congressman let slip during the Obamacare fight?
When Bernie and other single payer supporters stop the happy talk and start addressing the very real problems their proposals will cause, then I might start to listen. Until then, my message to them is ‘in the future, you will control no one and be happy.’
Obamacare: Where Does It Hurt?
April 4, 2022
The problems with Obamacare are well-known. So are the lies.
Let’s start with the lies. Obamacare fans are still crowing about the program’s record enrollment this year - 14.5 million. Undoubtedly, it will be mentioned when former President Obama visits the White House tomorrow to celebrate Obamacare. What they’re not telling you is they promised 21 million people would sign up for Obamacare when it was passed. I don’t see how falling 50 percent short of your goal is anything to crow about. And the only reason enrollment is high this year is because Obamacare subsidies are temporarily jumbo-sized. Temporarily. An HHS report indicates enrollment could fall back to 11 million next year if the bigger subsidies are not made permanent.
Now for the problems. President Obama promised families would save $2,500 a year on their health insurance, but premiums have tripled since Obamacare was signed into law. Congressman Byron Donalds says he’s never paid higher premiums than under Obamacare. But locking higher subsidies into place permanently, as Biden and the Democrats want to do, will be inflationary. Higher subsidies will cost $220 billion over the next decade and, thanks to looser eligibility requirements, benefit the wealthy - people making more than six figures - more than low income families. It’s foreseeable health insurers will raise prices. The problem will be worse in the one-third of counties that still only have one or two Obamacare insurers; they’ll raise prices even more. This is so typical of Democrats - they cause a problem, then turn around and say, ‘oh, but we’ll HELP you,’ offering Band-Aids to fix the problems they created in the first place. It’s one of their machines for buying votes.
And you’ll notice Obamacare pushed government assistance into the middle class, way beyond the poverty level where government assistance programs first started. Making it so the middle class and now even well-off people can’t function without the assistance of the federal government - what do you suppose that’s about? Whatever the Democrats’ ulterior motive, it’s the wrong direction. And it’s a trap. Democrats are working to cut off escape routes like short-term plans so there’s no escape. The increased availability of cheaper short-term plans was very popular under Trump, but Democrats want to cut them to three months with no renewal. [Heartland Institute Health Care News, p. 5]
The problems with Obamacare don’t end there. Obamacare’s crowning achievement was supposedly covering people with preexisting conditions, but stories persist of cancer victims being denied coverage. No, you can’t keep your doctor and you can’t keep your plan. Obamacare’s regulatory burden has cost small business $64.6 billion and more than 3.3 billion hours of lost productivity. Some insurers continue to trip up on Obamacare’s adverse selection problem - the idea that the sickest people sign up for Obamacare plans. Adverse selection hits the insurers’ bottom line and they’re getting out of the marketplace. That problem is baked into Obamacare’s design and can’t be fixed. Finally, Obamacare did nothing to fix the problem of people not going to the doctor because they can’t afford it.
We’re stuck with all these problems for the moment, because there’s no chance of repealing Obamacare any time soon. But that doesn’t mean we should accept this crazy contraption as normal or fall for it the next time the Democrats promise us the earth, the moon, and the stars.
April 4, 2022
The problems with Obamacare are well-known. So are the lies.
Let’s start with the lies. Obamacare fans are still crowing about the program’s record enrollment this year - 14.5 million. Undoubtedly, it will be mentioned when former President Obama visits the White House tomorrow to celebrate Obamacare. What they’re not telling you is they promised 21 million people would sign up for Obamacare when it was passed. I don’t see how falling 50 percent short of your goal is anything to crow about. And the only reason enrollment is high this year is because Obamacare subsidies are temporarily jumbo-sized. Temporarily. An HHS report indicates enrollment could fall back to 11 million next year if the bigger subsidies are not made permanent.
Now for the problems. President Obama promised families would save $2,500 a year on their health insurance, but premiums have tripled since Obamacare was signed into law. Congressman Byron Donalds says he’s never paid higher premiums than under Obamacare. But locking higher subsidies into place permanently, as Biden and the Democrats want to do, will be inflationary. Higher subsidies will cost $220 billion over the next decade and, thanks to looser eligibility requirements, benefit the wealthy - people making more than six figures - more than low income families. It’s foreseeable health insurers will raise prices. The problem will be worse in the one-third of counties that still only have one or two Obamacare insurers; they’ll raise prices even more. This is so typical of Democrats - they cause a problem, then turn around and say, ‘oh, but we’ll HELP you,’ offering Band-Aids to fix the problems they created in the first place. It’s one of their machines for buying votes.
And you’ll notice Obamacare pushed government assistance into the middle class, way beyond the poverty level where government assistance programs first started. Making it so the middle class and now even well-off people can’t function without the assistance of the federal government - what do you suppose that’s about? Whatever the Democrats’ ulterior motive, it’s the wrong direction. And it’s a trap. Democrats are working to cut off escape routes like short-term plans so there’s no escape. The increased availability of cheaper short-term plans was very popular under Trump, but Democrats want to cut them to three months with no renewal. [Heartland Institute Health Care News, p. 5]
The problems with Obamacare don’t end there. Obamacare’s crowning achievement was supposedly covering people with preexisting conditions, but stories persist of cancer victims being denied coverage. No, you can’t keep your doctor and you can’t keep your plan. Obamacare’s regulatory burden has cost small business $64.6 billion and more than 3.3 billion hours of lost productivity. Some insurers continue to trip up on Obamacare’s adverse selection problem - the idea that the sickest people sign up for Obamacare plans. Adverse selection hits the insurers’ bottom line and they’re getting out of the marketplace. That problem is baked into Obamacare’s design and can’t be fixed. Finally, Obamacare did nothing to fix the problem of people not going to the doctor because they can’t afford it.
We’re stuck with all these problems for the moment, because there’s no chance of repealing Obamacare any time soon. But that doesn’t mean we should accept this crazy contraption as normal or fall for it the next time the Democrats promise us the earth, the moon, and the stars.
Single Payer: The Left Never Quits, So Neither Can We
March 25, 2022
I know the Left never quits, but this is ridiculous.
The Left has been pursuing its dream of controlling the people through healthcare for more than a century. Those chasing the dream in Vermont had a rude awakening a few years ago when the Democrat Governor killed a single payer proposal after realizing it would bring payroll taxes to 25 percent to pay for it. But now they’re back, pushing a bill that would phase in single payer in Vermont over ten years. Apparently, it’s the boil-the-frog-slowly theory - hoping people won’t notice a huge tax increase if taxes are raised a little at a time as the state takes over more pieces of the healthcare system.
Meanwhile, a single payer healthcare bill in California died last month after its main sponsor pulled it from the floor for lack of votes. Even Democrats don’t all agree single payer is a good idea. The bill would have cost $400 billion a year, doubling California’s budget. It would have turned everything upside down even though only a tiny fraction of California residents are without insurance or public healthcare assistance. But you can bet the radical nurses associations and other Leftists will try to bring single payer back next year.
Leftists are still chasing the dream of single payer at the federal level, as well. The socialist sympathizer Pramila Jayapal is back with another single payer bill which has 120 co-sponsors in the House. But if they can’t get the whole enchilada at once, salami-slicing their way to single payer will do. Super-sizing Obamacare subsidies is just the first slice. To paraphrase a Tibetan proverb, beware of salami offered on a sharp knife.
Public option insurance, now in its second year in Washington state, is another slice. But it’s not going so great, there. Enrollment is nothing to write home about. Advocates are already talking about forcing hospitals to participate because hospitals won’t voluntarily join public provider networks on their own. Other states planning public option insurance are looking at this and building coercion into their plans right from the start. America, land of the free - unless you’re a hospital, I guess.
A single payer bill being considered in New York would raise taxes to unprecedented levels. The bill would spread the misery around through hikes in payroll taxes, income taxes, and capital gains taxes which would more than double the state’s already stratospheric tax take. The bill would hit self-employed people especially hard. Careful what you wish for. High state tax rates means wealth will pick up and move to another state. Just ask Maryland which tried to institute a millionaire’s tax some years ago.
Meanwhile, more towns are virtue-signaling their support for single payer. The most recent town resolutions are pending in Ft. Collins where the Democratic Socialists of America are involved, and Cleveland Heights. Gotta hand it to the Left. Pretty clever to get politicians to vote for something their town will never have to pay for. Great way to make it look like the idea is gaining momentum.
The Left has also taken the fight for single payer to the AMA, the membership of which narrowly defeated a support proposal in 2019, encouraging supporters to try again. It’s a certainty the fight’s not over there yet, given that the AMA has recently gone Woke, urging doctors to recognize their minority patients as “oppressed” and “historically marginalized”.
There are lots of reasons to oppose single payer. In my most recent commentary on this subject [1/14/22], I talked about how healthcare will become totally politicized and doled out the way Washington wants, not the way you want and you won’t have any options left. Today, I’ve mentioned tax hikes in single payer proposals in Vermont, California, and New York. The CBO found a year ago financing federal single payer could double income tax rates, or worse. It found more recently single payer could cut GDP by 10 percent if you take away the assumption it could be financed by cutting the federal budget in other places. It’s not likely you could ever cut the budget enough in other places to pay for single payer. That leaves destructive tax hikes as the most likely outcome if the Left succeeds.
The Left never quits, so we must keep fighting. Remember, single payer is not about healthcare. Relatively few people are without insurance, government healthcare assistance, or the means to pay for it themselves. This means the fight is about controlling the people through their healthcare, not about healthcare itself, just like the congressman let slip during the Obamacare fight. The Left makes single payer sound so sweet, but what it really means is the Left’s complete domination over the rest of us. It comes down to this: Do you want to keep your freedom or not?
March 25, 2022
I know the Left never quits, but this is ridiculous.
The Left has been pursuing its dream of controlling the people through healthcare for more than a century. Those chasing the dream in Vermont had a rude awakening a few years ago when the Democrat Governor killed a single payer proposal after realizing it would bring payroll taxes to 25 percent to pay for it. But now they’re back, pushing a bill that would phase in single payer in Vermont over ten years. Apparently, it’s the boil-the-frog-slowly theory - hoping people won’t notice a huge tax increase if taxes are raised a little at a time as the state takes over more pieces of the healthcare system.
Meanwhile, a single payer healthcare bill in California died last month after its main sponsor pulled it from the floor for lack of votes. Even Democrats don’t all agree single payer is a good idea. The bill would have cost $400 billion a year, doubling California’s budget. It would have turned everything upside down even though only a tiny fraction of California residents are without insurance or public healthcare assistance. But you can bet the radical nurses associations and other Leftists will try to bring single payer back next year.
Leftists are still chasing the dream of single payer at the federal level, as well. The socialist sympathizer Pramila Jayapal is back with another single payer bill which has 120 co-sponsors in the House. But if they can’t get the whole enchilada at once, salami-slicing their way to single payer will do. Super-sizing Obamacare subsidies is just the first slice. To paraphrase a Tibetan proverb, beware of salami offered on a sharp knife.
Public option insurance, now in its second year in Washington state, is another slice. But it’s not going so great, there. Enrollment is nothing to write home about. Advocates are already talking about forcing hospitals to participate because hospitals won’t voluntarily join public provider networks on their own. Other states planning public option insurance are looking at this and building coercion into their plans right from the start. America, land of the free - unless you’re a hospital, I guess.
A single payer bill being considered in New York would raise taxes to unprecedented levels. The bill would spread the misery around through hikes in payroll taxes, income taxes, and capital gains taxes which would more than double the state’s already stratospheric tax take. The bill would hit self-employed people especially hard. Careful what you wish for. High state tax rates means wealth will pick up and move to another state. Just ask Maryland which tried to institute a millionaire’s tax some years ago.
Meanwhile, more towns are virtue-signaling their support for single payer. The most recent town resolutions are pending in Ft. Collins where the Democratic Socialists of America are involved, and Cleveland Heights. Gotta hand it to the Left. Pretty clever to get politicians to vote for something their town will never have to pay for. Great way to make it look like the idea is gaining momentum.
The Left has also taken the fight for single payer to the AMA, the membership of which narrowly defeated a support proposal in 2019, encouraging supporters to try again. It’s a certainty the fight’s not over there yet, given that the AMA has recently gone Woke, urging doctors to recognize their minority patients as “oppressed” and “historically marginalized”.
There are lots of reasons to oppose single payer. In my most recent commentary on this subject [1/14/22], I talked about how healthcare will become totally politicized and doled out the way Washington wants, not the way you want and you won’t have any options left. Today, I’ve mentioned tax hikes in single payer proposals in Vermont, California, and New York. The CBO found a year ago financing federal single payer could double income tax rates, or worse. It found more recently single payer could cut GDP by 10 percent if you take away the assumption it could be financed by cutting the federal budget in other places. It’s not likely you could ever cut the budget enough in other places to pay for single payer. That leaves destructive tax hikes as the most likely outcome if the Left succeeds.
The Left never quits, so we must keep fighting. Remember, single payer is not about healthcare. Relatively few people are without insurance, government healthcare assistance, or the means to pay for it themselves. This means the fight is about controlling the people through their healthcare, not about healthcare itself, just like the congressman let slip during the Obamacare fight. The Left makes single payer sound so sweet, but what it really means is the Left’s complete domination over the rest of us. It comes down to this: Do you want to keep your freedom or not?