Arguing Over Who Gets The Goodies Under UK Rationing

Journalist Christine Odine raises the uncomfortable question about health rationing in the UK, "Why should fat people take precedence over the elderly in the NHS?"

When the government is in charge of health care, it will inevitably lead to arguments about who receives medical care and whose care is denied. Which means, those with the most political clout (or with politically popular diseases) will get their care at the head of the rationing line -- at the expense of those without such clout. If you have an unpopular disease, you're out of luck.

Let's hope we don't get to that point here in the US.

Quick Links: Armstrong, Incentives, Free Rider Myths, Opportunity

At the TOS blog, Ari Armstrong notes how, "Force Begets Force Under Health Mandates".

More performance measure FAIL: "Hospital pay incentives fail to help patients".

Avik Roy: "Myths of the 'Free Rider' Health Care Problem".

(Note: I don't necessarily support some of Roy's proposed alternatives to EMTALA unless they are part of a transition to total elimination of government interference in health care. Voluntary charity can and should be the method that the truly need receive emergency health care if they cannot otherwise afford it.)

Investor's Business Daily: "If The Court Dumps ObamaCare, Republicans Must Be Ready"

(I especially like how the article offers politically-realistic free-market reforms that would move our country's health system in the right direction.)

Hsieh PJM OpEd: "ObamaCare's Other Infringements"

PJ Media has published my latest OpEd, "It's Not Just the Mandate: ObamaCare's Other Infringements".

Here is the opening:

ObamaCare supporters were hit with more bad news recently when the Congressional Budget Office announced that the health care law would cost nearly twice the original estimates: $1.76 trillion over ten years rather than $940 billion. Of course, such "unexpected" cost overruns are nothing new for government programs. When Medicare was passed in 1965, it was predicted to cost $12 billion by 1990. In reality, it cost a whopping $110 billion, almost 10 times more than predicted.

But the escalating economic costs of ObamaCare will pale in comparison to the escalating losses of freedom.

The infringement of personal freedom receiving the most attention lately has been the "individual mandate" requiring Americans to purchase health insurance. This issue is at the heart of the current legal challenge before the U.S. Supreme Court.

But ObamaCare imposes numerous other mandates and controls, including the following...

(Read the full text of "It's Not Just the Mandate: ObamaCare's Other Infringements".)

Post-SCOTUS Commentary: Wolf, Rhoads, Simberg, LA Times

As one might expect, there's been lots of analysis and commentary of the Supreme Court arguments over ObamaCare.

In general, pundits opining on how SCOTUS will rule on ObamaCare reminds me of the TV commentators discussing how an NFL referee might rule when his head is under the instant replay hood. It's an interesting way to fill air time. But no one but the ref really knows what the final decision will be.

That said, I did want to flag a few pieces that caught my eye:

Milton Wolf, "Obamacare's inescapable death march" (Washington Times, 3/28/2012)

(Note: I agree with Milton that ObamaCare will eventually fail, even if the Supreme Court doesn't overturn it. The big questions would be how long will it take, how hard will the politicians try to prop it up with even worse laws, and how many more people will they harm in the process.)

Jared Rhoads, "Two more encouraging things from the oral arguments on the individual mandate" (Center for Objective Health Policy, 3/28/2012)

Rand Simberg, "The White House/Media Cocoon on ObamaCare" (PJ Media, 3/28/2012)

Los Angeles Times, "Supreme Court appears poised to nullify entire healthcare law"

I'm sure there will be lots more commentary to follow!

SCOTUS Day 2

Here are some links and commentary on the Day 2 arguments at the Supreme Court, concerning the individual mandate.

WSJ, 3/27/2012: "Conservative Justices Challenge Government Over Health Law"

NYT, 3/27/2012: "Hard Questions From Justices Over Insurance Mandate"

Fox News, 3/27/2012: "Health care law endures tough questioning from swing justice at Supreme Court showdown"

Multiple websites have copies of the audio and transcript for those who are interested.

Quick Links: Mandatory Medicare, Medicaid and ERs, Picture

Quin Hillyer discusses the latest in Hall vs. Sebelius.

As of now, the federal courts have ruled that if someone wishes to opt out of Medicare, they must also give up all their Social Security benefits (which would place a heavy financial burden on many senior citizens). In other words, the courts have stated that because Medicare is an "entitlement" that one must accept those benefits (and corresponding restrictions). But the legal challenge against this rule has moved forward another step.

US News: "Medicaid Patients Go to ERs More Often".

As many have observed, Medicaid patients have "coverage", but have a difficult time getting access to actual medical care. Thus, they are still using ERs for primary care. This problem will only get worse as ObamaCare expands "coverage" by expanding Medicaid.

Avik Roy: "Here, in one graphic, is what’s wrong with American healthcare"

SCOTUS Rundowns

The 3 days of ObamaCare arguments before the US Supreme Court start today. Here are a few helpful links for those wanting to follow the action:

Doug Mataconis, "ObamaCare Goes Before The Supreme Court: A Preview".

Center for Objective Health Policy: "Guide to SCOTUS Review of Health Reform Law" (and PDF version).

Wall Street Journal: "Liberty and ObamaCare" (3/22/2012)

David Catron: "Supreme Court Primer: How the process works for oral arguments"



(Direct YouTube link.)

WSJ: Is Concierge Health Care Worth It?

The 3/23/2012 Wall Street Journal has some helpful tips for those considering signing up for a "concierge" physician: "Is Paying for 'Concierge' Health Care Worth It?"

The article discusses some questions to ask including:

Is this right for me?
Will you take my insurance?
What happens if I get sick while I'm out of town, or while you're on vacation?
Do you make house calls?
How will you handle my medical records?
What if I change my mind or don't like the service?

(Read the full text of "Is Paying for 'Concierge' Health Care Worth It?")

Beware that some states (like Oregon) are trying to restrict this practice model, by requiring these doctors to register their practices with the state's insurance department on the grounds that they're accepting fees for the promise of future medical care.

(WSJ link via Dr. Art Fougner.)

McBride: Courts, ObamaCare, and Limited Government

Attorney Katelynn McBride of the Institute for Justice has nice OpEd in the 3/23/2012 Minnesota Public Radio News entitled, "Health care law shows why we need courts to guard against government overreach".

In her piece, she makes some key points about the courts and limited government:

It does not appear that the supporters of health care reform gave any serious consideration to the law's constitutionality, a question that is scheduled for three days of argument before the U.S. Supreme Court next week. The unseemly process by which the law was enacted, and the apparent failure to consider its profound constitutional concerns, are precisely why we need an engaged judiciary to review and, when necessary, check the power of the Legislature...

The Constitution was designed to prevent runaway government like we have today and to account for the fact that, as Thomas Jefferson warned, "The natural progress of things is for liberty to yield and government to gain ground." The Framers knew perfectly well that legislatures are not inclined to recognize limits on their own authority.

When they do not, it is the job of the courts to enforce the Constitution. Increasingly, however, courts are not doing that job. A study by the Institute for Justice last fall found that the Supreme Court struck down just two-thirds of 1 percent of federal laws enacted between 1954 and 2002...

(Read the full text of "Health care law shows why we need courts to guard against government overreach".)

We don't know how the US Supreme Court (SCOTUS) will decide after they hear arguments next week. But they do hold in their hands the future of 1/6th of the US economy -- and our essential freedoms.

For a nice flowchart on the upcoming SCOTUS arguments scheduled for March 26-28, 2012, please see this nice one-page infographic by the Center for Objective Health Policy (PDF or JPG).

Elder: ObamaCare Still a Disaster

In the 3/22/2012 TownHall.com, Larry Elder observes, "ObamaCare Still a Disaster -- No Matter How the Supreme Court Decides".

One excerpt:

...In addition to the excise tax on medical device manufacturers, ObamaCare imposes many more taxes, including the following: an individual mandate excise tax for adults who don't purchase "qualifying" health insurance; an employer mandate tax for those companies who don't offer health coverage; and a surtax on investment income -- making the rate as high as 43.4 percent on gross income from interest, annuities, royalties, net rents and passive income for families making more than $250,000.

Given this, will we see the same private-sector investments in the health care field, as ObamaCare imposes ever more regulations designed at increasing "accessibility" and "controlling costs"?

Elder also discusses how ObamaCare won't control costs, either. And will create a "brain drain" similar to what has already happened under Great Britain's socialized system.

Read the full text of "ObamaCare Still a Disaster -- No Matter How the Supreme Court Decides".

Wolf on ObamaCare After 2 Years

Dr. Milton Wolf gives a retrospective review of ObamaCare 2 years after its passage into law in the 3/21/2012 Washington Times, "Obamacare: It's a big, disastrous deal".

Some of the lies told about ObamaCare by its supporters include:

You can keep your own insurance
Taxes will not be raised
Premiums will go down
It will create jobs

For details of these broken promises and more, read the full text of Washington Times, "Obamacare: It's a big, disastrous deal".

There's a damned good reason that the Obama administration is not taking the opportunity to trumpet the 2-year anniversary -- because they know it's a huge political loser.

Let's make sure they remember this come November 2012.

CO Doctors Limiting Medicare Patients

The 2/28/2012 Boulder Daily Camera reported that, "Colorado docs often refuse or limit new Medicare patients".

From the article:

Colorado Public News called family, general practice and internal medicine physicians across the state, using the nation's official website that lists thousands of doctors the site claims treats patients on Medicare. Of 100 contacted, only 34 said they would readily accept a new patient.

Of the remainder, 40 said they would not add a new patient on traditional Medicare. Another 26 limit new clients, making decisions on a case-by-case basis, or placing patients on waiting lists of up to six months. That adds up to 66 -- or two-thirds -- refusing or limiting new patients...

Dr. Jonathan Zonca, of Ascent Family Medicine in Denver, is taking new Medicare patients. But he said he hesitated after figuring out that Medicare had paid half of what other insurance plans did, over three years.

"That's a real hard way to make money and pay our staff and pay our rent, especially in Denver -- it's pretty expensive rent," he said.

Medicare also pays more slowly than other insurance plans...

(Read the full text of "Colorado docs often refuse or limit new Medicare patients".)

Remember, Medicare is "single payer" government health care for the elderly. But Medicare doesn't pay enough to allow doctors to take good care of their patients. And the proposed "payment reforms" have been a failure.

Yet there are still many who want to expand this dysfunction government model to encompass all of American health care.

(Via Brian Schwartz.)

Quick Links: Amerling, Palmisano, IPAB, End of Private Insurance

Dr. Richard Amerling: "The Clouded Utopian Vision For Healthcare Ignores Reality".

Dr. Donald Palmisano: "Repeal IPAB Now".

D4PC Signs on to Coalition Letter Concerning Dangers of IPAB. You can read the letter here.

Sally Pipes: "The End of Private Health Insurance In America".

Whole Truth Commercial

The group AmericanDocs4Truth.org has produced a clever commercial, responding to the infamous "Granny" video promoted by the leftists. This is the 60-second short version:



Here is the 4:30 longer version:



For more information on some free-market reforms that would move America in the right direction, see this 12-point plan by Dr. Jane Hughes.

(Eventually, we should privatize all government health programs including Medicare and Medicaid and get the government completely out of health care, except for protecting individuals against force or fraud. Dr. Hughes' proposals would be an excellent start in this direction.)

Catron: Of Obamacare and Appeals to Supreme Beings

David Catron has a new American Spectator piece, "Of Obamacare and Appeals to Supreme Beings".

In his OpEd, Catron lays out the various spurious legal arguments being made by the Obama administration to support their health care plan. Let's hope the justices see past all the smoke and mirrors and uphold Americans' individual rights.

Quick Links: Employment, Awakening, Washington Medicaid

Michael Randall tells his personal experience of problems caused by government linking health insurance to employment.

(And I very much appreciated his citing my earlier PJM piece, "Free Market Lessons from Contraception Fight".)

Dr. Meg Edison of Docs4PatientCare has created a nice short video, "Awakening of the American Doctor":



Dr. Doug Perednia discusses, "Denying payment for unnecessary emergency room visits". In particular, he highlights the perverse thinking behind the new guidelines in Washington state:

So here's the actual logic underlying this new Washington Medicaid initiative:

* ER docs and hospitals are required by federal law to see and evaluate anyone who walks in – at their own expense if necessary.

* If a Washington State Medicaid patient walks into the ER with a non-emergency and the doctors and hospitals see them as required by law, Medicaid will refuse to pay on premise that the provider are "abusing the system" and being lousy "stewards of care and safety and the public resources"

* Since the doctors and hospitals are abusing the system by simply being there and doing what the federal government has said they must, they should not even be allowed to try to bill the patient directly for the visit.

Quick Links: Ethics Corruption, White House, MA Costs, CA Shortages

Dr. Jeffrey Singer does a nice job discussing, "The Coming Medical Ethics Crisis". The subtitle: "How the government is putting the medical profession -- and your health -- at risk". (Via Brian Schwartz.)

Here is the White House PR strategy to defend ObamaCare in the coming weeks.

NPR and Kaiser Health News report that Massachusetts legislators still trying to figure out how to reduce rising health costs. Their solution: More government controls.

California legislators realizing that "coverage" doesn't equal actual care.

Losing Your Insurance

The Washington Times reports, "Health care reforms could cost 20m work coverage".

This is based on information from the Congressional Budget Office and the Joint Committee on Taxation. Basically, President Obama's claim that "you could keep your insurance if you like it" won't apply to millions of Americans.

At best, workers dumped from their current plans might be able to scramble for some sort of coverage on government-run exchanges. But those policies will be loaded with expensive mandates on terms dictated by government and/or special interest groups with "pull" to determine what's considered an "essential benefit". People will have to pay for services they might not otherwise choose in a genuine free market (such as in vitro fertilization services or alcoholism treatment).

Furthermore, to save money these "qualified" (i.e., government-approved) plans will likely have to omit coverage for various services the government has decided are unnecessary, such as screening mammograms below age 50 or PSA prostate tests for men. The latest addition to this list of "nonessential" benefits will likely be annual Pap smears for cervical cancer screening). Through these exchanges, the government -- not you and your doctor -- will determine what's "essential" and what's "nonessential" to your health.

Forcing people out of their current coverage and into government-run insurance allows the Left to pin the blame on the "free market", while essentially herding Americans into state-run medicine.

Don't let them get away with this slippery sleight-of-hand.

The Myth of the Free-Market American Health Care System

At the Forbes blog, Avik Roy discusses "The Myth of the Free-Market American Health Care System".

His basic point is an important one that bears repeating: America does not currently have a free-market medical system. In particular, he notes:

In reality, per-capita state-sponsored health expenditures in the United States are the third-highest in the world, only below Norway and Luxembourg. And this is before our new health law kicks in...

The thing to remember in America is that we have single-payer health care for the elderly and for the poor: the two costliest groups. In addition, the relatively healthy middle class has heavily-subsidized private health insurance, in which few individuals have the freedom to choose the insurance plan they receive. Neither of these facts commend the American health-care system to devotees of the free market.

Avik Roy does praise statist elements in some other countries' health systems, such as Switzerland and Singapore -- which I disagree with. But those are topics for a separate day.

(Via Dr. Matthew Bowdish.)

Quick Links: UK Elders, IPAB, Costs

The 3/14/2012 Telegraph reports that in the UK National Health Service, "More than half care home residents denied basic care". (Via Kelly V.)

Dr. Jane Orient asks, "Is the payment board a death panel?" (Washington Times, 3/8/2012)

The Washington Examiner reports on the latest CBO report detailing how ObamaCare will cost far more than originally projected.