Oh-Mama!-Care
by Bill Sardi
Oh mama, the Affordable Care Act is unfolding in all its ugly glory.
Americans are just now learning exactly how this
piece of healthcare legislation is going to play
out, and the realization of what it has morphed
into is quite a disgusting chapter in current American history.
Now before I proceed in telling you what
Obamacare has morphed into, I want to go off on a tangent for a moment.
On a momentary tangent: the unbanked
In another industry, banking, there is a large
segment of the population that is unbanked just
like there is a large portion of the American
population that is uninsured healthcare-wise.
According to a federal government survey (there
they go snooping again),
<http://www.fdic.gov/householdsurvey/2012_unbankedreport.pdf>more
than one in four households (28.3 percent) are
either unbanked or under-banked, conducting some
or all of their financial transactions outside of
the mainstream banking system.
An estimated 8.2 percent of US households are
unbanked. This represents 1 in 12 households in
the nation, or nearly 10 million in total.
Approximately 17 million American adults live in
unbanked households. The federal government knows
precisely how many unbanked Americans there are
by ethnicity, education, income level, age and even geography.
According to the federal government,
<http://www.fdic.gov/householdsurvey/2012_unbankedreport.pdf>29.3%
of American homes do not have a savings account.
(Translation: they are not allowing banks to use
their money as capitalization for lending schemes
that have fallen into chaos as banks over-extended credit in recent times.)
The federal government knows how the unbanked
operate financially, how often they obtain payday
loans, use pawn shops, use rent-to-own offers,
etc. The federal government says it has a
"statutory mandate to estimate the proportion of
households that do not fully participate in the
banking system." (Page 4 of
<http://www.fdic.gov/householdsurvey/2012_unbankedreport.pdf>FDIC
National Survey of Unbanked and Underbanked
Households.) The data appears to have been
tabulated for the good of bankers, not the citizenry.
There is good reason why the subject of unbanking
is brought up in a report about the healthcare
uninsured. The new federal health law, called the
Affordable Care Act (ACA), which requires most
Americans (except Congress) to carry health
insurance starting in January 2014, presents a
problem since insurance companies generally
accept checks or credit cards as payment for
premiums, but just how are the unbanked going to make payments?
The unbanked and the uninsured
Will insurance companies require new enrollees to
produce a bank account number?
<http://www.kaiserhealthnews.org/stories/2013/may/20/insurance-marketplaces-bank-account-cash-unbanked.aspx>This
subject is being discussed.
Surely the IRS, which is the enforcement arm of
the Affordable Care Act (you pay a fine if you
don’t buy health insurance, and it will be taken
out of your bank account), needs a bank account to raid.
By the way, also recognize that transaction fees
for credit cards or pre-paid debit cards can run
as high as 4%, which can be quite a bite out of
the profits from private insurance plans under
the Affordable Care Act. (Another bonanza for the bankers?)
I’m just wondering, if the IRS is not just
limited to extraction of financial penalties from
non-participants directly from their bank account
and elects to take monthly insurance premiums
directly out of a person’s bank account and
forward them on to the insurance carrier,
wouldn’t that serve to eliminate the 4% transfer
fee? Is that why the IRS has been brought into this program?
Federal government stands in for bankers and insurance men
The federal government sees itself as an agency
both to promote (coerce) banking among the
unbanked on behalf of the banking industry and to
strong-arm Americans into buying health insurance
on behalf of the health insurance industry. The
latter is what the Affordable Care Act is all about.
Now it has been said that America has turned into
an example of crony capitalism-- when industry
pays off government to obtain a preferential
business climate. But America has morphed into
something worse than that. It has become a
fascist state when it creates public mandates citizens must adhere to.
Forced or coerced vaccination as medical fascism
For example, federal and state governments coerce
Americans to undergo vaccination via school and
work programs. Vaccine makers don’t have to incur
marketing costs, kids have to be vaccinated to
get into school, young men and women to enter the military, etc.
This might be acceptable if vaccination were all
that it is claimed to be. But it isn’t. The flu
vaccination program is a sham. Flu vaccination
doesn’t address the primary strain of the flu in
circulation each flu season and doesn’t prevent
deaths among high-risk groups – the elderly and
the very young. Yet the Centers for Disease
Control essentially serves as a free publicity
agency for vaccine makers, spreading fear over
imagined pandemics to promote sales of vaccines.
The same goes for the HPV (human papilloma virus)
vaccine claimed to save young sexually active
girls from acquiring a virus that may end up
causing cervical cancer years in their future.
But HPV clears in 70% of infected individuals on
its own. Vaccination only protects from 2-4
strains of HPV, not all 30 strains.
<http://knowledgeofhealth.com/human-papilloma-virus-vaccine-redux/>Provision
of folic acid and vitamin C appears to quell HPV
infection better than vaccines. But state and
federal governments are unceasingly pushing this vaccine on the public.
Affordable fascism
Congressman Ron Paul describes the Affordable
Care Act as an example of
<http://www.washingtontimes.com/blog/inside-politics/2011/nov/16/paul-obama-health-care-more-fascism-socialism/>fascism
in healthcare, not just socialized medicine.
When the Supreme Court upheld that the federal
government can force its citizens to buy
something, in this instance health insurance, it
stepped over the line from crony capitalism to fascism.
To be precise, the Supreme Court justices did in
fact rule that the Affordable Care Act exceeds
Congress’ authority under the Commerce Clause of
the Constitution, but
"<http://www.cato.org/sites/cato.org/files/serials/files/regulation/2013/1/v35n4-5.pdf>read
the statute not to impose a strict mandate to
purchase health insurance but instead to levy a
Constitutionally valid tax for failure to do so."
This is an unfathomable trick -- you pay a fine for not doing something.
Not socialized medicine, semi state-run enterprises
The U.S. government isn’t providing healthcare
funded out of taxes like socialized medicine in
Sweden or Canada. The U.S. is said to be
<http://www.nytimes.com/2013/06/25/health/us-unveils-health-care-web-site-and-call-center.html?_r=0>recruiting
9000 "customer service representatives" to man
telephone lines (call 800 318-2596 or visit
www.healthcare.gov ) and answer questions about
private health insurance packages being offered under the Affordable Care Act.
Say again? Yes, you heard it right, the federal
government is incurring the marketing and
recruitment costs for private insurance firms and
even answering the phone for them! It’s everything but a state-owned business.
While it is said 56 million Americans are
uninsured, actually
<http://www.thewisdomjournal.com/Blog/8-ways-to-reform-health-care-without-a-government-takeover/>only
about 11 million (3.6%) were truly uninsured. The
more broadly disseminated figure of 56 million
uninsured Americans included 17 million who
elected not to purchase health insurance even
though they had sufficient income to buy it. That
is the primary target group insurance companies
are covertly employing government to coerce into buying their product.
Free advertising and promotion
In some instances the States are funding the
promotion of their healthcare exchange. For
example,
<http://www.medpagetoday.com/Washington-Watch/Reform/40157>California
is putting up $43 million, Illinois about $28
million,
<http://www.pbs.org/newshour/bb/health/jan-june13/colorado_06-25.html>Colorado
$12 million. Colorado has 13 participating
insurance companies getting the benefit of all
this for free. Then the federal government is
getting asked to kick in an additional $125
million for the Rocky Mountain state. Don’t you
wish your business had a free telephone room and
a government subsidized payment plan, and free
advertising via federal and state agencies?
Will it live up to its mandate to save money?
Is the affordable care act going to save newly
eligible Americans money on health insurance premiums?
In Colorado the bare-bones, plain vanilla
insurance package for an
<http://www.pbs.org/newshour/bb/health/jan-june13/colorado_06-25.html>individual
40-year old nonsmoker is reported to start at
$177/month. That "bronze level" insurance package
in Colorado is going to cost $2124 a year, or
about 11% of income of a low-income wage earner
($23,550 is just above the poverty line).
Insurance subsidies may not be available to those
individuals with an income just above the poverty
level ($23,550 for an individual or up to four
times that amount -- $94,200 -- for a family of four).
Let’s see how much money this low-income wage
earner has left after the federal government takes its taxes out of his check.
If this insured person earns just above the
poverty level of income ($23,550) and his
employer kicks in half of FICA (deductions for
Medicare and Social Security -- 7.65%), then
another $1801 is deducted from his paycheck
(double this amount if self-employed).
Then there is 15% federal income tax, or about
another $3000. So this 40-year old low-income
worker is paying $3000 income tax, $1801 FICA and
having to spend $2124 for health insurance, which
leaves him ~$16,626 to live on.
Guesstimating just $800/month for housing and
$200/month car payment -- deduct another
$12,000/year, leaving this worker with about
$4626/year to pay for food, clothing, car
insurance, gasoline, etc. Driving 12,000 miles a
year in a vehicle that gets 20-MPG = 600 gallons
X $4.00/gallon = $2400 for gasoline, leaving
$2226 ($6 a day) for food, clothing, auto insurance, etc.
This is barely do-able, so it’s no wonder so many
Americans decided to chance it and go without
health insurance. Even with the Affordable Care
Act, the uninsured may decide to take the penalty
($95 in 2014, $365 in 2015 and $695 in 2016).
Does the ACA prevent personal bankruptcy?
With the Affordable Care Act in place for this
hypothetical American worker, insurance plans
cannot raise his premium more than 10% without
public justification (whatever that means), and
he cannot be arbitrarily removed from coverage,
and pre-existing conditions do not make him
ineligible, and there are no lifetime spending
limits on his care. His selected health plan must
spend 80% of its revenues on delivery of care or rebate money back.
So it sounds like this fellow at least may avert
personal bankruptcy if an unexpected and costly
health crisis occurs. But that is not quite the case.
There are
<http://www.medpagetoday.com/Washington-Watch/Reform/40156>out-of-pocket
costs for health care in ACA insurance packages
being offered. For exchange-sold plans, the
maximum annual out-of-pocket cost is $6350 per
individual, or $12,700 per family. But that is not all.
The cost of medical care is covered but
prescription drugs may not be covered entirely.
This could still leave our beleaguered worker
with a bill for $13,000 out-of-pocket, certainly
enough to force him into bankruptcy.
Oh, mama, the little guy is still getting pounded.
The White House is bragging the
<http://www.whitehouse.gov/blog/2013/06/06/good-news-americans-saved-billions-thanks-affordable-care-act-and-medical-loss-rebat>Affordable
Care Act has already saved Americans about $2.1
billion in rebates that have been paid by health
plans that didn’t spend at least 80% of their
revenues on provision of care. Americans are
never going to see through this ruse -- the token
rebates are simply being publicized to make the
federal government look good while it takes
billions of dollars of administration and
marketing costs off the table for the insurance companies.
Will it save money?
The problem is, to BE EFFECTIVE, the Affordable
Care Act has to take a big bite out of healthcare
-- hundreds of billions of dollars. The
Congressional Budget Office says
<http://www.consumerreports.org/cro/magazine/2012/06/many-common-medical-tests-and-treatments-are-unnecessary/index.htm>up
to 30% of health care in the U.S. is unnecessary.
<http://lewrockwell.com/sardi/The%20unfunded%20liability%20in%20Medicare,%20the%20trustees%20tell%20us,%20is%20$34%20trillion%20over%20the%20next%2075%20years.>Medicare
faces unfunded future liabilities totaling $34 trillion over the next 75 years.
While
<http://www.healthcare.gov/law/resources/authorities/title/iv-prevention-of-chronic-disease.pdf>Title
IV, Section 4202 of the Affordable Care Act
spells out the components of a wellness program
to include nutritional counseling, physical
activity plan, alcohol and smoking cessation
counseling, stress management, and dietary
supplements that have health claims approved by
the Secretary of Health Education & Welfare (that
list doesn’t even include vitamin C cures
scurvy), doctors simply aren’t trained to provide
preventive services that they often consider
beneath their training. Furthermore, the fee-for-
service system that is now in place prioritizes
services that produce the most insurance reimbursement.
The Affordable Care Act runs off in two divergent
directions. One is to prescribe a regimen of
preventive measures (vaccinations and health
screenings like mammograms and colonoscopies)
that will surely raise health care costs as more
undetected and untreated pre-disease is detected,
while at the same time the Affordable Care Act
says it is going to ferret out waste fraud and
abuse, invoke price controls and conduct
comparative effective research to determine which
treatments are the most cost effective.
Treatment effectiveness analysis
Evaluation of treatment effectiveness -- let’s see if that ever happens.
For example, preventive health screenings may be
of limited benefit.
<http://lewrockwell.com/sardi/sardi219.html>Colonoscopies
offer only a remote chance of ever benefiting a
patient.
<http://knowledgeofhealth.com/mammography-madness/>Mammography
may actually increase the risk for cancer.
Ineffective and problematic drugs pose another
difficulty. For example, there are an estimated
<http://usatoday30.usatoday.com/news/health/story/health/story/2011-11-15/In-battle-of-cholesterol-drugs-Lipitor-as-good-as-Crestor/51205856/1>$11
billion of statin cholesterol-lowering drugs sold
in the U.S. annually, many for healthy patients
whose doctor thinks they need prevention of
mortal heart attacks. But statin drugs do not
reduce the risk for mortal heart attacks,
<http://www.ahrp.org/cms/index2.php?option=com_content&do_pdf=1&id=432>they
meagerly reduce the risk for a non-mortal heart
attack by 1 in 200 healthy users over a 5-year
period. In healthy adults, statin drugs are more
likely to induce side effects like diabetes,
muscle degradation, liver toxicity or even mental
decline than to prevent a heart attack. The risks
outweigh the benefits. But is the federal health
program going to reject Medicare payments for
statin drugs? I wouldn’t bet on it, not with Big
Pharma’s Congressional lobbyists in place.
What about cancer therapies? There are no cures
for cancer.
<http://www.preventcancer.com/losing/nci/manipulates.htm>The
cancer care industry makes specious claims
survival times are being lengthened, but in fact
all that is being done is tumors are being
detected and treated at an earlier and smaller
stage.
<https://galileo.seas.harvard.edu/images/material/2800/1140/Bailar_CancerUndefeated.pdf>Patients
are still dying on the same calendar day.
<http://www.ncbi.nlm.nih.gov/pubmed/15630849>Chemotherapy
only contributes to the 5-year survival of cancer patients 2-3% of the time.
Another example is thyroid cancer. The 5-year
survival of thyroid cancer patients is said to be
96%, but even with 37,000 cases being detected
and treated annually,
<http://knowledgeofhealth.com/how-to-access-implement-new-cancer-immuno-therapy-from-japan/>the
number of deaths from thyroid cancer (1600 per
year) has not budged in 30 years.
Is the Affordable Care Act going to disapprove
payment for these ineffective therapies at the
risk of being criticized of rationing care for dying patients?
Manpower problems
Another issue in delivering healthcare under the
Affordable Care Act is manpower. With millions
more previously uninsured Americans now gaining
insurance coverage, will there be enough doctors to go around?
In
<http://www.abc15.com/dpp/news/region_phoenix_metro/central_phoenix/Arizona-facing-doctor-shortage>Arizona
there is speculation there aren’t enough doctors
to provide the care for these newly insured
patients. There is similar concern being
expressed in
<http://www.postcrescent.com/article/20130629/APC0101/306270449/State-works-avoid-doctor-shortage>Wisconsin
and
<http://www.csmonitor.com/USA/2013/0622/Obamacare-Will-it-worsen-Missouri-s-doctor-shortage>Missouri.
Here is another instance where the Affordable
Care Act is talking out of two sides of its
mouth. It wants price controls, it wants to cut
physician’s fees, but for States that are
expanding their Medicaid program to accommodate
uninsured citizens, physician reimbursement may
not be adequate to provide the promised care.
For example, Medi-Cal is said to be
"<http://www.medpagetoday.com/Washington-Watch/Reform/40157>such
a broken system with really abysmal reimbursement
rates" that providers are electing not to
participate. Medi-Cal pays $18-24 for a basic
office visit, which is scheduled to fall to
$14-15 as State budget problems are addressed.
Summary
The Affordable Care Act could implode on its very
first day. Its most disturbing reality is that it
doesn’t serve the little guy very well. However,
it does reduce recruitment costs and expands the
list of customers for insurers. It may also be
used as a covert way to coerce unbanked Americans
to put their money in banks. Americans just above
poverty-line income levels, who may be eagerly
awaiting receipt of an insurance card for the
first time, may not have enough money to pay for
out-of-pocket costs, may not even be able to find
a participating doctor to deliver care, may not
avert personal bankruptcy in the event of an
unexpected costly health emergency, and may not
even be able to pay for insurance premiums
themselves. Oh mama, the Affordable Care Act may
be a failure right out of the starting gate.
Mama, say it isn’t so!
http://lewrockwell.com/sardi/sardi264.html
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