If you logged on to Facebook, or for that matter, any social media yesterday, you probably saw the headline. 75 Year old Japanese man died after being turned away fro m 25 emergency rooms a total of 36 times in 2 hours. The hospitals involved claim they had no bed for him, and a shortage of doctors to treat any more patients. Unbelievable, I agree, and I know what you are thinking: “good thing that would never happen in America.” Unfortunately, it was not long ago that would never have happened in Japan either. 10 years ago if you would have suggested to experts this would happen, most would have laughed. So, could this happen here? We may just be a few years away from it becoming possible.
The America of today is eerily similar to the Japan of a decade ago. Though the mostly-government healthcare system has worked for a generation in Japan, it is now taking on water faster than the ageing population can bail it out. Japan has a rapidly aging population, and a falling birth rate; just like we do. The Japanese national debt is limiting their ability to sustain the ageing population, and the medical system is the clearest symptom of the problem. As a population ages it typically pays less taxes; retired people made up the bulk of Mitt Romney’s infamous 47%. But unless there are people to replace those retiring, either by immigration or birth, the government has less money to support the extra healthcare costs that also come with an aging population. Trying to do more with less has never been a quality the government can hang its hat on.
I wrote months ago why I believed Obamacare would not work; well, here it is in practice. Obamacare will push tens of millions of people onto Medicaid, those who cannot afford the rising cost of insurance and those unfortunate enough to be demoted to part time hours, many elderly, and of course, those whose employers choose to pay the fine that is roughly 1/3 of what the cost would be if they were forced to provide insurance. The result of this will be placing the cost of healthcare for millions squarely on the shoulders of the government.
As we see in Japan, people who do not directly pay for their own healthcare have little incentive to stay out of the healthcare system. If the government is going to foot the bill, why not go to the doctor every time you sneeze? This seems to be the rationale in Japan, where clinics and hospitals are very over crowded, and patients often wait hours just to see the doctor for 30 to 90 seconds. I experienced this same pattern while living in Australia. This means that Japan is facing a doctor shortage due to the influx of patients; ergo, their overcrowding. Doctors often have to see 100 or more patients per day. This leads to patients depending more and more on medication and less and less on actual healthcare from their physician.
The United States has been facing a doctor shortage for a few years now, and it is only expected to get worse. Our national debt is climbing at alarming rates. Our population is ageing. Our healthcare system is becoming more and more subsidized. Our hospitals are already overcrowded. These are many of the same challenges Japan faced at the turn of the century. Not to mention their economic slowdown from a collapse of their manufacturing.
Might the path the United States is following lead to a 75 year old man dying because no emergency room could take him? The answer is, probably not. Immigration, one of our largest means by which we replace our work force, has long been almost non-existent in Japan. Also, the cost of healthcare has never come close to the cost in the United States. Furthermore, the Japanese healthcare system is much more centralized than Obamacare is—at least for now. Even still, the similarities are alarming. Many, myself included, feel many of the inefficiencies in Obamacare were designed to lead to a universal healthcare system. The older our population becomes the more we will need healthcare. If our doctor shortage continues, and we become a more universal healthcare system it is plausible that an ambulance in America may drive around for 2 hours begging 25 different hospitals to admit their patient.
6 March 2013
It is now a fact of life; the United States healthcare system will be reformed. With the Republican failures on Election Day, we now know Obamacare will take full effect in 2014. So, is it going to work?
We know it will raise taxes; in fact, the assertion from President Obama that he will not raise taxes on the middle class makes no sense; the tax increase on middle class families from Obamacare will be higher than going over the fiscal cliff. One wonders why President Obama is so worried about a recession from the fiscal cliff, but not from Obamacare? The tax increases under the fiscal cliff total around $600 billion; the tax increases under Obamacare total $700 billion, or more. This is all beside the point, because if Obamacare can save families money on insurance and medical costs, a tax increase may come out neutral on their bottom line. So the overwhelming question is the Affordable Care Act will be able to accomplish everything it is supposed to. The evidence says that this is a long shot.
Those who believe in the law point to the Canadian health system or the Swedish health system to prove that it will work. For starters, Obamacare is not a government healthcare system; it is a private system with Goliath amounts of regulation. Moreover, Patriotslog has noticed an interesting pattern with government healthcare systems: the larger the population of a nation, the less sustainable the system becomes; this is even becoming the case in Canada. For instance, to sustain the government healthcare system in Australia, France, or Britain taxes are over the 50% level (plus national sales taxes in many other nations). Have you ever wondered why the austerity measures in Greece and Spain are not fixing the debt issues? One would think that with all the pay cuts, pension cuts, and program freezes the debt issue would be well on its way out the door, but it is not, and healthcare is a major reason.
Healthcare will always take up a huge portion of a federal budget; this is why regular austerity cuts have not had the effect the people in Greece have expected. They continue to protests the deeper and deeper cuts to programs, pensions, and pay because cuts to these are not making as significant a difference as hoped for. We are not unique in the United States. Medicare and Medicaid alone take up over 21% of the federal budget–and this does not even include the expansion of Medicaid under Obamacare! Not to mention the fact that the United States does not even have a national healthcare system…at least not yet.
Most of the costs of Obamacare are expected to be paid for by the $716 billion in cuts to Medicare. If the government can find $716 billion in additional revenue we may not see taxes go up as steep as many suspect; but the question has to be asked: if the government can find $716 billion in cuts to Medicare, why have they waited until now to do it? There are only two possible answers: first, the President was not being honest when he said Medicare benefits would not be affected, or the government actually cannot make those cuts.
Patriotslog suggests it is a bit of both. President Obama has already made cuts to Medicare Advantage; are these cuts to “Medicare”? Not in the most strict interpretation. Medicare Advantage plans essentially replace Medicare parts A and B (which are technically the legal definition of Medicare), so the president has already shown he will disrupt benefits to many Medicare beneficiaries, though as long as he leaves part A and B benefits as they are he is not technically lying. Moreover, those who will have their Medicare benefits cut might just have the same benefits restored on Medicaid. Seniors benefits might not be affected because they will be shifted under the massive expansion of Medicaid.
Even all these cuts will not amount to the $716 billion in cuts the budget calls for. The remainder will be from cutting waste and fraud, and the amount doctors and hospitals are paid by the Medicare program. The government already expends so much effort to combat fraud and waste; does the president actually expect a sudden change in fraud and waste, or better policing against it simply because his law says so? I know politicians have egos, but that impressive narcissism. So we are left with cuts in payments to make up the rest of the cost. History shows this will not work. The government has attempted to cut payment amounts under the Medicare program 34 different times, and all have failed. Most of these actually resulted in higher costs. Moreover, a bill was also passed in the Clinton administration to cut physicians fees; Congress has subsequently passed a waiver of that bill every year since it was passed. Why?
If you cut the amount Medicare pays physicians they will stop accepting Medicare; ergo, Medicare becomes irrelevant. If Medicare is irrelevant it does not matter what we do to the benefits, because they cannot be used. The solution to this would be to force doctors, by law, to accept Medicare. This in turn would raise the cost of providing care for the rest of the nation. This is clear to Congress, which is why they pass the waiver each year.
Another aspect of Obamacare is to penalize employers who do not provide healthcare to their employees. With the cost to insure an employee running about $6000 per year, forcing an employer to take on this expense is an economic deadweight. An employer could pay the $2000 fine for not ensuring an employee, give the employee a $3000 per year raise, and still come out on top as compared to providing
insurance. This will push scores of thousands more onto the expanding Medicaid program, adding an additional expense to the government. The other consequence is that businesses can (and have said they plan to) push employees
down to part-time employment. Every person in the nation might have to have two jobs just to keep a 40 hour work week. Another popular idea among businesses is to lay off employees. If a company has 50 employees they have to pay a $40,000 fine for not providing insurance. This seems extreme, but there are already nearly 2.5 times as many businesses with 49 employees than there are with 50. This uncertainty is one of the biggest reasons the economy has been so slow in recovery. Companies have been sitting on their money; now that they know exactly the uphill battle that faces them, they will invest, and the economy will grow, but Obamacare certainly makes that hill a steeper incline.
So where is the government going to find the money to pay for all of this expansion of Medicaid given the unlikelihood of the government actually being able to cut $716 billion with their current plan? Taxes; lots of taxes. Mitt Romney may have been right when he called Obamacare the single largest tax increase in history; time will tell. One wonders if it would not simply be more efficient–particularly with the amount of taxes we will have to pay–to initiate a government healthcare system. Maybe that was the plan all along.
18 November, 2012
President Obama has changed tunes and started singing his re-election song; to Patriotslog, it sounds off key. Until recently, I probably would have voted for President Obama to have a second term; not that I think he is a great President, just that I am not thrilled with any other option we have. Aside from the terrible assault on freedom that is the individual mandate, I did not really have a problem with anything President Obama has done in his first term; until he began his campaign. Though he has excelled in national security, his recent antics have been so outrageous that he no longer has my vote.
OUTSOURCER IN CHIEF: The attacks on Mitt Romney illustrate exactly how desperate the President is to slur his image. Attempt after attempt to pin outsourcing at Bain Capital to Mitt Romney are not only ridiculous, they are pathetic. Mitt Romney took a leave of absence from Bain, and literally fixed the 2002 Winter Olympics. For anyone who is familiar with business–and this makes it appear that President Obama is not–a leave of absence is a standard practice. Mitt Romney retained his title and position at the company, but had no managing influence or day to day control over Bain. Yes they outsourced jobs, but Mitt Romney had nothing to do with that. This is directly parable to a star athlete being injured; they are still part of the team, however they have no influence over the outcome of games. It would be ridiculous for a coach to blame an injured athlete for a loss, yet this is what Obama is trying to do. If you do not follow that logic, then use this logic to reconsider. There are many witnesses and accounts of Mitt Romney working 16 hours a day to turn around the Olympics; it is not only highly unlikely, but nearly impossible that he could have done this while managing Bain at the same time. Moreover, it is not just ironic, but down right hypocritical for the President to claim some moral high ground on the basis of outsourcing. An amateur attempt at research easily reveals that more jobs have been outsourced and lost under President Obama than under nearly any other President–and he has not even served one full term. Read the rest of this entry
You heard it here first. Patriotslog reporting live from the Supreme Court on the decision finally made regarding the Obesity Initiative for Nutrition and Care act of 2048, commonly referred to as OINK. After being tied up in the court system for six years we finally have the verdict. According to the 8 to 7 split decision on the Supreme Court, the government can in fact create mandatory diet plans for all residents (both citizens and illegal immigrants via the Immigration compromise of 2023) of the United States. It is expected that former First Lady Michelle Obama will be delivering an address on her lifelong initiative from her home any minute now. After her many years of hard work and dedication to “save Americans from themselves”, we may finally see the national obesity rate drop below 96%. Former Congresswoman Michelle Bachmann is refusing to comment on the ruling, and in an apparent attempt to starve herself to death in protest has barricaded herself in her nursing home room, refusing to speak to anyone. Her only correspondence is a hand written sign taped to the outside of her door which states: “They can tell me what to eat, but the sure can’t force me to eat it.” Not yet, anyway. However, one has to wonder how long it will be until legislation is passed which states they can. Read the rest of this entry
This coming week the Supreme Court will hear three days of oral arguments; the length of the arguments indicates what a monumental case this is. The last time the court designated 6 hours of arguments was in 1966. As patriotslog has previously written, the universal health care system is not a good idea. On paper and in theory it works out splendidly; however, in practice, it never produces the results envisioned by the creators. It is expected that the issue at the forefront of the case in the Supreme Court is the issue of the individual mandate for health insurance coverage the law created. Does the government have the power to force each citizen to purchase health insurance, whether they feel a need for it or not? This issue has largely defined the Obamacare argument, though it is only a small part of the effect carried by the legislation. To be fair, the Affordable Care Act legislation does provide some needed reforms to health care which largely benefit the American people. Among these are the legislation to make illegal the practice of denying coverage based on a pre-existing condition; premium hikes being subject to review; a mandated percentage of revenue for health insurance providers being spent on care, as opposed to advertising or management; premiums cannot be higher for women than for men, as they have been in recent history; and premiums cannot be raised for individuals who develop a disability such as asthma or diabetes. One can debate the fairness of these provisions as well as the need for them; but with the price of health care continuing to rise it is almost unanimous that something must be done. President Obama feels these provisions are the answer the public needs. Read the rest of this entry
This week the news has been hijacked by the debate over President Obama mandating religious institutions to provide contraception coverage in their healthcare plans. The debate has become increasingly irritating because there are so many more noteworthy things of report this week. The economy is continuing to grow, the United States and Afghanistan have reportedly began talks with the Taliban which could end the war, a new online privacy bill was introduced in the senate, Iran apparently sent war ships to Syria to help their military, and the list can go on. However on top of all of this, the only news we have heard all week is the back and forth battle over mandating contraception coverage. The discussion should have ended last week when President Obama compromised on his politically sensitive mandate, but the intensity has only ramped up. The compromise would have allowed religiously affiliated institutions to be exempt from paying for the contraception, shifting the burden to the insurance companies, where the Obamacare law mandates insurance companies provide contraception anyway; after the debate continued all week long, and polls which showed President Obama was in the politically popular side of the argument, the President has apparently decided there will be no compromise. Religious institutions will not have a choice, and they will provide contraception to women despite their religious objections. Even a comment made as a joke by an aid to Rick Santorum about women practicing abstinence has become a political firestorm. Read the rest of this entry
It has become the campaign banner for Republican candidate in elections nationwide, and this week the United States Supreme Court has finally determined it will hear the case concerning the Patient Protection and Affordable Care Act. The Supreme Court reviewed the case on Nov. 10 and decided to take the case because of the division among the circuit courts on the ruling. This means that sometime next year we will have the long awaited decision on whether the Affordable Care Act, which has come to be known across the country as Obamacare, is or is not in fact constitutional. At the core of the argument is whether or not the federal government can legally mandate that every American purchase health insurance. Other mandates of the law, such as a child staying on their parents’ insurance plan until age 26, are not being challenged in their constitutionality. Read the rest of this entry
Amid all the debt crisis talk, the discussions centered on creating jobs, the political street fight over raising tax revenue, and the finger pointing from S&P and wall street, we have but one presidential candidate who has a universally approved proposal to put money back in the pockets of American citizens. Minnesota Congressional Representative Michele Bachmann promised voters Tuesday that if she was elected “[we] will see gasoline come down below $2 a gallon again. Read the rest of this entry