Saturday, December 14, 2013

Obamacare Has Lost the Uninsured

Reason ^ | DEC 13 | Peter Suderman 

Let that sink in: What that means is that regardless of how bad the old system—the system that for whatever reason left them uninsured—was, a majority of people without health coverage now think that Obamacare makes it worse.

That’s how poorly the rollout of the health law is perceived to have gone. The exact group the law was designed to help have instead turned on the law. It’s never been particularly popular with the wider public, but now even those who were supposed to be beneficiaries are skeptical.
That’s more than a political problem. It’s a policy problem—a threat to the law’s viability, especially when combined with other recent poll numbers showing that young people, who are crucial to the law’s coverage scheme, are rejecting the law as well. A Harvard Institute of Politics Poll released earlier this month found that 56 percent of young adults age 18-29 don’t approve of the health law. Only 29 percent of uninsured young adults said they expected to enroll.
As the sharp declines of the last few months show, poll numbers can always shift, sometimes rapidly. But if these low numbers persist, it represents a body blow for the law. It’s telling that Americans are now so soured on Obamacare that a majority say they would prefer to go back to the old system, flaws and all. As this week’s Reason-Rupe poll found, 55 percent of Americans now say they prefer the old, pre-Obamacare health care regime.
Numbers like those will help fuel efforts to repeal or otherwise block the law, regardless of whether or not there’s a replacement. They should also make Obamacare-friendly Democrats up for reelection more than a little nervous.

As it turns out...

What If No Doctor Will See You?

Townhall.com ^ | December 14, 2013 | John C. Goodman 


At this point we have no idea how many people will become newly insured under ObamaCare. For the first year out, the number of people with insurance may actually go down! But the administration's goal is to insure an additional 30 million people and eventually a lot of those people will acquire health plans. When they do, the economic studies predict that they will try to double their use of the health care system.
Adding to this increased demand will be new mandated benefits. The administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Then there are new benefits for women, including free contraceptives. And all of us will be entitled to a long list of preventive services — with no deductible or copayment.
But the health care system can't possibly deliver on all these promises. The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform. The result will be increased rationing by waiting.
Take preventive care. The health reform law says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health, scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary care physician's time each year, or 7.4 hours per working day.
And all of this time is time spent searching for problems and talking about the search. If the screenings turn up a real problem, there will have to be more testing and more counseling. Bottom line: To meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.
When demand exceeds supply in a normal market, the price rises until it reaches a market-clearing level. But in this country, as in other developed nations, Americans do not primarily pay for care with their own money. They pay with time.
How long does it take you on the phone to make an appointment to see a doctor? How many days do you have to wait before she can see you? How long does it take to get to the doctor's office? Once there, how long do you have to wait before being seen? These are all non-price barriers to care, and there is substantial evidence that they are more important in deterring care than the fee the doctor charges, even for low-income patients.
For example, the average wait to see a new family doctor in this country is just under three weeks. But in Boston, with ObamaCare-type reform, the wait is about two months.
When people cannot find a primary care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms. Yet one study found up to 20% of the patients who enter an emergency room leave without ever seeing a doctor, because they get tired of waiting. Be prepared for that situation to get worse.
When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008, for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.
However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.
As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare's newly created health insurance exchanges.
Their wait will only become longer as more and more Americans turn to concierge medicine for their care. Although the model differs from region to region and doctor to doctor, concierge medicine basically means that patients pay doctors to be their agents, rather than the agents of third-party payers such as insurance companies or government bureaucracies.
For a fee of roughly $1,500 to $2,000, for example, a Medicare patient can form a new relationship with a doctor. This usually includes same day or next-day appointments. It also usually means that patients can talk with their physicians by telephone and email. The physician helps the patient obtain tests, make appointments with specialists and in other ways negotiate an increasingly bureaucratic health care system.
Here is the problem. A typical primary care physician has about 2,500 patients (according to a 2009 study by the Centers for Disease Control and Prevention), but when he opens a concierge practice, he'll typically take about 500 patients with him (according to MDVIP, the largest organization of concierge doctors). That's about all he can handle, given the extra time and attention those patients are going to expect. But the 2,000 patients left behind now must find another physician. So in general, as concierge care grows, the strain on the rest of the system will become greater.
I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health care system, with those who can afford it getting more care and better care.
In the meantime, the most vulnerable populations may have less access to care than they had before ObamaCare became law.

What Will It Take?

PJMedia.com ^ | December 13, 2013 | David Solway 

Let me begin with a categorical statement that, given current events and recent political history, can be easily defended: Barack Hussein Obama is a willful, indoctrinated child of the Left with strong Islamic sympathies who is not fit to govern. Indeed, he would not be fit to govern Lower Slobovia, let alone the United States of America. Obama is a historic disaster of the first magnitude and, if not restrained, he will see to the irrevocable decline of the country which foolishly elected him, leaving the world on the brink of a conflict — or in the midst of one — whose repercussions cannot be underestimated.
Accompanying the undeniable havoc and damage that Obama is wreaking on his country and equally on its allies — Honduras, Saudi Arabia, Egypt, Poland, Czech Republic, Israel, and possibly Taiwan — is the sense of helplessness that overcomes one when writing or speaking about a rogue president and his destructive administration. I feel this personally, having done my utmost in books, articles and lectures, from 2008 to the present, to warn whomever might read or listen that Obama represented a greater threat to the U.S. and the oddly named “free world” than any of our most dedicated and belligerent enemies. Even prior to his nomination as the Democratic candidate for the presidency, my distrust of this man was proprioceptive. And after his Missouri address, I wondered why anyone would want to “fundamentally transform” a country which, for all its flaws, perched atop the pinnacle of success in comparison to any other country.
(Excerpt) Read more at pjmedia.com ...

Exercise just as good as drugs in war on major disease

telegraph.co.uk ^ | 12/14/2013 | Laura Donnelly 

Exercise could be as effective as some of the best drugs which protect against major diseases, research has found.
A study of more than 300 trials has found that physical activity was better than medication in helping patients recovering from strokes - and just as good as drugs in protecting against diabetes and in stopping heart disease worsening.
The research, published in the British Medical Journal, analysed data about studies on 340,000 patients diagnosed with one of four diseases: heart disease, chronic heart failure, stroke or diabetes.
Researchers said the findings suggested that regular exercise could be "quite potent" in improving survival chances, but said that until more studies are done, patients should not stop taking their tablets without taking medical advice.
The landmark research compared the mortality rates of those prescribed medication for common serious health conditions, with those who were instead enrolled on exercise programmes.
(Excerpt) Read more at telegraph.co.uk ...

Podesta Will Peddle Green Agenda - disclosure report "hottest read in Washington"

National Review ^ | Dedember 14, 2013 | Matthew Continetti 

".......“Podesta has no financial interest in the Keystone XL decision,” says Credo Action. Is that truly the case? I am not saying that John Podesta is directly invested in companies that will profit if Keystone is defeated. What I am saying is that the connections between VIPs and think-tank donors and corporate boards and lobbying clients are hard to disentangle. It is so easy for a reporter to lose the thread, especially when that reporter is already inclined to think that the motives of his subject are pure. Podesta’s fame and power have certainly helped line the pockets of his brother, for example. The Washington Times reports that the Podesta Group’s income grew from $10 million in 2007 to as much as $30 million in 2010, with 2013 revenue “estimated to be around $20 million.”

John’s compensation is a trickier matter. His business relationships are not as formalized or as regulated as his sibling’s. His various postings and seats and memberships and appointments are hard to pin down. An article in Friday’s New York Times cites a Podesta aide “working with him on the disclosure report he is preparing.” That report soon will be the hottest read in Washington. Podesta’s not a monk. In addition to his role advising Steyer, and the $200,000 he receives in compensation from CAP, he sits on the board of Portland-based Equilibrium Capital — in which he also had “a small ownership stake” — advises government contractor Gryphon Technologies for $100,000 a year, and was paid $90,000 this year consulting for the HJW Foundation, which also gives money to CAP. And he is a member of the board of directors of Joule, a Massachusetts-based energy company that is “developing a revolutionary platform for renewable fuel and chemical production that is expected to eclipse the scalability, productivities, and cost efficiency of any known alternative to fossil fuel today.” John Kerry appears in a photo on the “about us” section of the company’s website. Joule knows who powers its batteries.

Podesta has revolutionized the influence game by giving it the patina of intellectual respectability. Traditional lobbying has become blasé; it’s much better, much nobler, to enlist corporate “partnerships” in the progressive cause. As first reported by The Nation, the Center for American Progress has a number of corporate sponsors that pay hundreds of thousands of dollars to join its “Business Alliance.” In return for payment these corporations gain access to the center’s scholars, its leadership, and its events with major Democratic officials. On Friday CAP released a list of its 2013 “corporate supporters,” including multinationals such as Citigroup and Coca-Cola and Daimler and Samsung; firms such as Albright Stonebridge and McLarty Associates and the Livingston Group that represent foreign interests; and affiliates of foreign governments such as the Taipei Economic and Cultural Representative in the United States and the Japan Bank for International Cooperation."........ More

Who Funds the Far Left? You’ll Be Surprised

Powerline ^ | 12-13-13 | John Hinderaker 

The Center for American Progress is a left-wing organization that is closely associated with the Obama administration. Its principal product is a web site called Think Progress. Think Progress is part of the internet cesspool that modern liberalism has become. Written by hack left-wing bloggers, it is bitterly hostile to free enterprise. It is a low-rent site that traffics in the most absurd smears and conspiracy theories. Many have wondered for some years who finances far-left web sites like Think Progress. As of today, we know at least part of the answer, as CAP released its corporate donor list for the first time.
CAP says that individuals and foundations account for more than 90% of its funding, and corporations only around 6%. It would be interesting to see the individual and foundation donor list; my guess is that left-wing foundations, most of which spend money left by dead conservatives, would loom large. But what corporations fund Think Progress’s anti-free enterprise propaganda? The full list is here; it includes:

(Excerpt) Read more at powerlineblog.com ...

10 Quotes That Help Explain Why So Many Conservatives Don't Trust The Republican Party!

Townhall.com ^ | December 14, 2013 | John Hawkins 

If things are going badly, we're told the GOP should compromise on what it believes in to start winning elections again. If things are going well, we're told we must turn a blind eye to the GOP abandoning its beliefs so as not to ruin the great year we're going to have. The establishment Republicans who are always arguing in favor of trading off dearly held principles in return for magic beans always claim they're doing it to win elections, but it's hard to miss the fact that they don't actually seem to be any better at winning elections than the grassroots conservatives they seem to write off as amateurs. Setting that aside, winning elections isn't an end unto itself. You win elections in order to implement your agenda, which win or lose, the GOP never seems to be all that interested in. If you disagree with that, point out all the great domestic victories we achieved when the GOP controlled all three branches of government during the Bush years. When Democrats pulled that same trick off, they attempted to fundamentally transform America while Republicans passed tax cuts and then moved on to big government wish list items like Medicare Part D, raising spending on the Arts and the now universally hated No Child Left Behind.
The sad fact of the matter is that while liberals have a very good idea of where their representatives stand on almost everything, there's NOT A SINGLE ISSUE where conservatives can just trust Republicans to live up to their campaign promises. We have to raise holy hell just to get the Republicans to do what they promised when they were campaigning. If the Republicans could simply be counted on to do what they said they were going to do and showed a modicum of respect for the people who put them in office, there would be very little intraparty fighting. Instead, politicians in D.C. incessantly do things to aggravate their own supporters and then ask the people who put them in office to set aside their disappointment in the name of party loyalty. That seems a little backwards given that the politicians and the Party don't elect the base; the base elects the Republican Party. The politicians who make promises to get elected are the ones who owe people, not the grassroots conservatives who put them in office and are now dismayed at their behavior.
If the Republican Party wants to end all these primary challenges, stop the intraparty fighting and get everyone to sing Kumbayah, it's really not that hard to do. Do what you say you're going to do, treat the opinions of your base with respect, and stop picking fights with the people who put you in power by saying things like....
1) "Read my lips: no new taxes." -- George H. W. Bush's famous pledge not to raise taxes, which he broke.
2) "The Budget Control Act (Sequestration) represents a victory for those committed to controlling government spending and growing our economy. I applaud Speaker Boehner’s leadership in stopping tax increases on job creators, rejecting President Obama’s demands for a blank check to keep borrowing, and advancing real spending cuts and controls. The agreement – while far from perfect – underscores the extent to which the new House majority has successfully changed Washington’s culture of spending. No longer can Washington endlessly spend money it does not have." -- Paul Ryan, who just worked with Democrat to gut the sequester cuts he called a "victory" and "real spending cuts and controls."
3) "I am strongly against amnesty. The most important thing we need to do is enforce our existing laws. We have existing immigration laws that are not being adequately enforced. Nothing will make it harder to enforce the existing laws, if you reward people who broke them. It demoralizes people who are going through the legal process, it’s a very clear signal of why go through the legal process, if you can accomplish the same thing if you go through the illegal process. And number two, it demoralizes the people enforcing the laws. I am not, and I will never support any effort to grant blanket legalization/amnesty to folks who have entered, stayed in this country illegally." --Marco Rubio
4) “They were elected, nobody believes that there was a corrupt election, anything else,” McCain said. “But I also think that when, you know, it’s always the wacko birds on right and left that get the media megaphone." Asked to clarify, McCain said he was referencing ”Rand Paul, Cruz, Amash, whoever.” -- Former GOP Presidential nominee John McCain on the most popular conservative politicians with the conservative grassroots.
5) "Frankly, I just think (conservative groups have) lost all credibility." -- House Minority Leader, John Boehner on conservative groups who, unlike him, actually believe in all the things he campaigns on when he runs for election.
6) "And then, he says, the next president, whoever he is, 'would have to call a truce on the so-called social issues. We’re going to just have to agree to get along for a little while,' until the economic issues are resolved." -- Former Indiana Governor Mitch Daniels suggested we blow tens of millions of social conservatives who make up part of the core of the GOP base.
7) “I’ll just say this about the so-called porkbusters. I’m getting damn tired of hearing from them. They have been nothing but trouble ever since Katrina.” — Former Senate Minority Leader Trent Lott complains about the Porkbusters group that demanded he cut spending and kill earmarks.
8) "With his record of reform in Florida, I know that Governor Crist will bring a fresh perspective to Washington in our efforts to fight for lower taxes, less government, and new job creation for all Americans." -- Senator John Cornyn, the Senate's Minority Whip, endorsing Charlie Crist, who ended up switching parties and speaking at the Democrat Convention.
9) "The problem with the Tea Party, I think it's just unsustainable because they can never come up with a coherent vision for governing the country. It will die out." -- Lindsey Graham
10) "I’ve abandoned free-market principles to save the free-market system." -- George W. Bush explaining his support for the corporate bailouts in TARP.
Incidentally, the solution to all of this is not to leave the Republican Party. To the contrary, it's to treat the Republican Party like a puppy that's having difficulty with house training. When Republicans do the right thing, praise them, support them and do what you can to help them out. When they do the wrong thing, rub their noses in it. Attack Republicans who betray their principles relentlessly, primary them at every opportunity and take over the Republican Party so we can shove the politicians who won't listen to us to the side. While we will never be able to build an entire party full of men like Ted Cruz, Mike Lee and Rand Paul, we can make it miserable enough for bad actors that the go-along-to-get-along Republicans will conclude it's better to work with us than face primaries and incessant attacks from their own side in the new media. Most people don't realize it, but we have already started moving the Republican Party to the Right and the time will come when Republicans are just as afraid of their base as Democrats are of Planned Parenthood and the unions. It's not going to happen overnight, but if we keep going after Republicans who sell us out, even the ones that are as hostile as John McCain, Peter King and Lindsey Graham will eventually have to get on board if they want to keep their jobs.