By J.T. Hatter


 Published Originally at American Thinker

October 1, 2012


 Obama Speech to Congress September 9, 2009

Obama Lied: Health Care Died

 In 2009, Obama addressed a joint session of Congress to lay out his program for health care. He unflinchingly told the assembled elected officials one whopper after another, amid a rising chorus of boos and loud grumbling. It got to be too much for Congressman Joe Wilson, of South Carolina, who shouted, “You lie!” to the President as he was speaking. Both political parties roundly condemned Wilson for his outburst. He was called a racist, of course, among other things, and he later apologized for his indiscretion. But Joe Wilson was right on the money.

 Obama lied to the American people when he said that under ObamaCare the cost for health care would not go up, that the middle class would not spend “a single dime” in increased taxes to pay for it, that ObamaCare would actually reduce the federal deficit by the cost savings it would create, that you could keep your current doctor, and that 30 million more people would have health care coverage. None of this was true. And Obama knew it when he said it.

 The facts are that Obama and his Democratic Party comrades fudged the numbers, engaged in enormously fraudulent accounting tricks, double-counted Medicare funds, dissembled about what ObamaCare would really entail (“We have to pass the bill so that you can find out what is in it.”), and completely misinformed Congress and the public about the scope and impact of these new laws and entitlement programs.

 But now, the facts are beginning to roll in and the Democrats’ health care chickens are coming home to roost. When Obama campaigned in 2008 he said he would reduce health care premiums for families by $2,500 in his first term. The Kaiser Family Foundation reports that annual average family insurance premiums have gone up by $2,730 in Obama’s first term—not down. Kaiser currently reports that health premium costs increased 4% this year alone.

 Obama told the American people that his health care program would cost “only” 940 billion dollars over ten years. The Congressional Budget Office (CBO) now has rescored ObamaCare and says that the program’s gross cost is $1.762 trillion dollars from now to FY 2022. This estimate does not include administrative and other costs, which will add hundreds of billions of dollars more.

 The CBO estimate suggests an offsetting cost reduction of about 0.51 trillion dollars would be realized from receipts from “penalty payments”, fees, and increased taxes. According to Supreme Court Justice John Roberts, these “penalty payments” are actually taxes. There are twenty new taxes in ObamaCare. Yes, Obama lied about our taxes going up. ObamaCare may be the biggest and most expensive lie told in American history.



Seniors Hurt the Worst

 The Romney camp is getting a lot of mileage about the damage ObamaCare does to health care for seniors. Look for Florida to get a blitz campaign on this message. The fact is that senior citizens stand to lose the most from ObamaCare. Obama and the Democrats robbed 716 billion dollars from Medicare to pay part of the cost of ObamaCare. This severely damaged the Medicare Advantage (MA) program, among others. The MA program allows seniors to receive medical coverage through private insurance plans of their choosing. One of the main thrusts of ObamaCare is to debilitate and eventually eliminate the private health insurance industry. The Democrat’s first prize of battle is the MA program, which the Heritage Foundation says will lose an average of $3,714 worth of annual benefits. They expect that ObamaCare will cut MA program enrollment by 50% by 2017. Let me repeat that: ObamaCare will cut MA enrollment by half and reduce benefits for those who can remain in MA. I can’t see seniors standing for this.

 ObamaCare cuts payments to health care providers and will cause an estimated 15% of Medicare Part A providers to become unprofitable in the next decade. The Heritage Foundation cites the Centers for Medicare and Medicaid Services (CMS) on this subject as follows,


Over time, a sustained reduction in payment updates, based on productivity expectations that are difficult to attain, would cause Medicare payment rates to grow more slowly than, and in a way that was unrelated to, the providers’ cost of furnishing services to beneficiaries.

 ObamaCare is designed to run not only private insurance companies, but also doctors and hospitals out of business.

 But the ObamaCare assault on seniors doesn’t stop there. ObamaCare places a 2.3% excise tax on medical devices and a 3.8% Medicare tax on unearned investment income. Older folks use more medical devices and have more investment income, so these new taxes hurt them directly.

 ObamaCare imposes a tax, disguised as a “fee”, on brand name drugs in Medicare and other government programs. Obama has also imposed a new federal excise tax on so-called “Cadillac” health plans the Democrats don’t like. The 40% tax is designed to make the premium plans unaffordable to those willing to pay for them, and to punish the wealthy who want them at any cost. ObamaCare beats down seniors in many other ways and yes, there are death panels—which will result in health care rationing and worse.

 Senior citizens will suffer the most from ObamaCare. However, seniors made up 16% of the electorate in 2008 and went for McCain by 53 to 47%. The Democratic Party regards seniors as “underperformers” in 2008 and is desperately wooing them this year. Seniors currently represent 21% of the vote and they’re not happy with Obama—for good reason. Wait ‘til the Democrats get a peek at the senior vote in 2012.


Your New Health Care System

Chart Prepared by the Senate Joint Economic Committee

Health Care Battlegrounds

 ObamaCare expands Medicaid, which is a poorly performing, bankrupt federal program that is in severe need of reform and cutting. The Democrats targeted the poor for roughly half of the thirty million uninsured people they said would receive health care coverage under their plan. Medicaid currently provides for sixty million “poor” people. Obama wants to add 15+ million more. But states are balking at the budget busting expense for their share of the expanded Medicaid program. And the Supreme Court recently ruled that the federal government couldn’t use financial penalties to force the states to comply with Medicaid Expansion requirements. This is a devastating blow to the entire ObamaCare scheme.

 At least 13 states have said that they may opt out of the Medicaid program for new patients and about 20 states are inclined against Medicaid expansion. HealthDay offers this observation,


“I look at the states as the next critical battleground,” said Robert Doherty, the American College of Physicians’ senior vice president for governmental affairs and public policy. If some states decline to extend Medicaid, the nation will end up with coverage like “Swiss cheese” with holes for “the poorest of the poor,” he said.

 Obama has created more than just a Medicaid health care battleground in the USA. When Supreme Court Chief Justice John Roberts cast the deciding vote upholding most of ObamaCare, it meant that states were supposed to immediately set up the American Benefits Health Exchanges. These health care exchanges are the principle implementing conduit of the law, and provide the means through which the American people and small businesses will be forced to purchase their federally subsidized and managed health care plans. But what if states refuse to set up these insurance exchanges?

 About a dozen states have said they’re not going to set up the American Benefits Health Exchanges required under ObamaCare. The federal government has responded by saying that it will come into the states and set up the exchanges if the state governments won’t set them up. The Kaiser Family Foundation blithely describes it this way,


If a state fails to set up an Exchange by January 1, 2014, the DHHS Secretary will establish and operate an Exchange in the state, either directly or through an agreement with a nonprofit entity.

 Over half the states sued the federal government to stop ObamaCare, saying it was unconstitutional. We lost. And now we have states suing the federal government over implementation requirements, including the insurance exchanges. About half the states are pursuing the requirements for setting up the exchanges. Kathleen Sebelius, the HHS Administrator, has admitted that there isn’t enough money to set up the exchanges, and has gone back to Congress with a request for another billion dollars to get the exchanges rolling. But the House of Representatives isn’t coughing up the money. Michael Cannon at the CATO blog says the ObamaCare exchanges just aren’t happening.

 The battle continues. What an unbelievable mess Obama has made of the American health care system. ObamaCare has created legal battlegrounds all over the country. Several states have passed laws providing that their citizens cannot be required to purchase federal health insurance. Some states are suing over implementation provisions.

 Once states start to opt out of the Medicaid Expansion, and refuse to set up or participate in the exchanges, then the federal government’s only option is to sue the states to force compliance or set up offices in the states and run the programs from Washington. Attorney General Eric Holder and Administrator Kathleen Sebelius will be glad to do this. But will they be around in 2013?


Image by Newsbusters


ObamaCare: The Kiss of Death

 Obama has failed miserably. He has created a gargantuan abomination of a new federal entitlement program that we can’t afford and won’t work. The only certain outcome of ObamaCare is that it will destroy the best health care system in the world.

 ObamaCare Summed Up In One Sentence is a video of Dr. Barbara Bellar brilliantly dissecting what is wrong with ObamaCare. This video has gone viral across the nation because it resonates with the 65% of Americans who don’t want anything to do with ObamaCare.

 ObamaCare is blatantly unconstitutional, no matter what John Roberts thinks, and the American people instinctively know this. After the passage of ObamaCare our government can force us to do anything. The Constitution, Bill of Rights and the concept of sovereign states rights have been thrown out the window. We no longer have constitutional government nor are we ruled by the consent of the governed. We have an elite ruling class that can legally make us do anything. Thanks to Obama and Justice Roberts.

 It isn’t merely the cost of the outrageous government takeover of one fifth of the American economy that rankles. It isn’t just the fact that ObamaCare is going to take the best health care system in the world and run it into the ground that angers Americans. Obama has engineered a law that gives our government the absolute right to rule every aspect of our lives. Just like they do in communist nations.

 Socialist revolutionaries understand that a universal health care system run by the central government is the essential key to transforming the United States into a socialist nation. This has been Obama’s true objective all along.

 ObamaCare is the kiss of death to democracy, liberty and freedom, and the high quality health care we have enjoyed in the USA. The main issue in this presidential election campaign isn’t about healthcare or jobs: it’s about freedom vs. socialism.

 A vote against Obama, and for Romney, is a vote to save health care in America. But more importantly, it is also a vote to save America.


URIBE: Obamacare prevents quality care – Washington Times


URIBE: Obamacare prevents quality care – Washington Times.

Government meddling driving doctors from medicine

By Dr. Constance Uribe

Americans are so focused on the availability of health care provided by the Affordable Care Act that they completely overlook the quality of care they might receive. Government interference, intrusive mandates and cumbersome regulations are making it impossible to continue providing high-quality care.

Physicians across the nation have been planning for the worst, and an exodus of more than 100,000 doctors is expected by 2020. I will be closing the doors of my office in December after 32 years in surgical practice.

Patients will be lucky to see a physician because fewer will be available. The government does not recognize the term “physician” anymore. A fully trained doctor of medicine or doctor of osteopathic medicine who completed a residency and became board-certified will be rare because the lesser-trained licensed health care provider will be the norm.

Since the 1980s, my career has been riddled with regulations created by a government bent on controlling every aspect of patients’ lives. The coup de grace was delivered by the Affordable Care Act, but the blindfold was placed by President George W. Bush.

By executive order, Mr. Bush in 2004 created the position of national coordinator for health information technology. This allowed for the establishment of a health information technology storehouse. Funding for this came from President Obama’s American Recovery and Reinvestment Act of 2009.

To insure buy-in from all health care providers, the government had to create meaningful incentives, the first of these being marginal payback for compliance. What started out as voluntary soon became mandatory. While physicians may have received partial reimbursements from the government to equip their offices with the computer systems, these did not come close to meeting the costs of implementation.

Mandates meant as meaningful incentives are quickly turning into penalties. Physicians see deductions on already-lowered Medicare payments because of failure to use e-prescribing. They are threatened with further deductions if they do not have electronic medical records in place by 2014.

The practicing physician is buried in more mandates, more regulations and more penalties. As entry of patient data into the computer becomes more burdensome, it does not take long to discover that the system has been designed for auditing purposes, not for charting purposes.

Not only are health records no longer protected within the walls of a medical office, but physicians are complaining about the time consumption, computer errors and false sense of security created as a scheme rather than a service. One physician wrote on a blog, “It adds an hour of work to my day and makes my office notes sound like they were written by an imbecile.”

From the patient’s viewpoint, the physician has turned his attention to clicking computer keys with eyes glued to the screen. Data entry now takes priority over quality time.

The Affordable Care Act will finish driving the wedge between the doctor and the patient and put an end to a once-sacred relationship. Not only will the current mandates remain in place, but physicians will be inundated with the new insurance exchange identification numbers, authorizations, codes and denials.

My office staff puts the patient’s interest first and tries to follow Medicare guidelines, yet we have problems getting insurance carriers to cover routine procedures without writing letters and making myriad phone calls. With my upcoming retirement comes the relief of no longer screaming four-letter words into the phone at uneducated bureaucrats and medical directors committed to pigeonholing people and withholding care.

The health information technology storehouse gives the government more ammunition to track physicians, enforce new evidence-based standards and grade physicians accordingly. The grading, called “pay for performance,” will be another way for the government to cut costs under the guise of improving health care.

If the health care provider fails in a certain category such as infection rate or mortality rate, his reimbursement will be affected. With this type of incentive for physicians, high-risk patients will have difficulty finding access to quality care. The art of medicine is becoming the trade of medicine.

The health information technology storehouse and the Affordable Care will rip total control of patient care from the hands of physicians. Anyone who believes differently is as delusional as the congressional leaders who passed the legislation in the first place. Then again, no one bothered to read it.

Dr. Constance Uribe is a general surgeon and author of “The Health Care Provider’s Guide to Facing the Malpractice Deposition” (CRC Press, 1999).


Big Lies in Politics – Thomas Sowell – Townhall Conservative Columnists

Big Lies in Politics – Thomas Sowell – Townhall Conservative Columnists.

The fact that so many successful politicians are such shameless liars is not only a reflection on them, it is also a reflection on us. When the people want the impossible, only liars can satisfy them, and only in the short run. The current outbreaks of riots in Europe show what happens when the truth catches up with both the politicians and the people in the long run.

Among the biggest lies of the welfare states on both sides of the Atlantic is the notion that the government can supply the people with things they want but cannot afford. Since the government gets its resources from the people, if the people as a whole cannot afford something, neither can the government.

There is, of course, the perennial fallacy that the government can simply raise taxes on “the rich” and use that additional revenue to pay for things that most people cannot afford. What is amazing is the implicit assumption that “the rich” are all such complete fools that they will do nothing to prevent their money from being taxed away. History shows otherwise.

After the Constitution of the United States was amended to permit a federal income tax, in 1916, the number of people reporting taxable incomes of $300,000 a year or more fell from well over a thousand to fewer than three hundred by 1921.

Were the rich all getting poorer? Not at all. They were investing huge sums of money in tax-exempt securities. The amount of money invested in tax-exempt securities was larger than the federal budget, and nearly half as large as the national debt.

This was not unique to the United States or to that era. After the British government raised their income tax on the top income earners in 2010, they discovered that they collected less tax revenue than before. Other countries have had similar experiences. Apparently the rich are not all fools, after all.

In today’s globalized world economy, the rich can simply invest their money in countries where tax rates are lower.

So, if you cannot rely on “the rich” to pick up the slack, what can you rely on? Lies.

Nothing is easier for a politician than promising government benefits that cannot be delivered. Pensions such as Social Security are perfect for this role. The promises that are made are for money to be paid many years from now — and somebody else will be in power then, left with the job of figuring out what to say and do when the money runs out and the riots start.

There are all sorts of ways of postponing the day of reckoning. The government can refuse to pay what it costs to get things done. Cutting what doctors are paid for treating Medicare patients is one obvious example.

That of course leads some doctors to refuse to take on new Medicare patients. But this process takes time to really make its full impact felt — and elections are held in the short run. This is another growing problem that can be left for someone else to try to cope with in future years.

Increasing amounts of paperwork for doctors in welfare states with government-run medical care, and reduced payments to those doctors, in order to stave off the day of bankruptcy, mean that the medical profession is likely to attract fewer of the brightest young people who have other occupations available to them — paying more money and having fewer hassles. But this too is a long-run problem — and elections are still held in the short run.

Eventually, all these long-run problems can catch up with the wonderful-sounding lies that are the lifeblood of welfare state politics. But there can be a lot of elections between now and eventually — and those who are good at political lies can win a lot of those elections.

As the day of reckoning approaches, there are a number of ways of seeming to overcome the crisis. If the government is running out of money, it can print more money. That does not make the country any richer, but it quietly transfers part of the value of existing money from people’s savings and income to the government, whose newly printed money is worth just as much as the money that people worked for and saved.

Printing more money means inflation — and inflation is a quiet lie, by which a government can keep its promises on paper, but with money worth much less than when the promises were made.

Is it so surprising voters with unrealistic hopes elect politicians who lie about being able to fulfill those hopes?

Dictator Obama Issues New Threat to Supreme Court over ObamaCare – Canada Free Press

Dictator Obama Issues New Threat to Supreme Court over ObamaCare – Canada free Press.

By Sher Zieve

In his latest display of his full USA federal government dictatorship over both the American people and the former co-branches of government, Dictator Obama is warning the Supreme Court to either rule in his favor or face severe consequences. 


Fox News’ Martha McCallum advised Thursday that the Obama Administration has been quietly sending missives to the Supreme Court threatening that if it doesn’t rule in his favor on ObamaCare, Medicare will face disruption and “chaos.”  Therefore, if SCOTUS rules in favor of the US Constitution, Obama & Co will begin its campaign to either destroy Medicare or make those on it suffer greatly.  The Obama syndicate is said to be threatening to hold off Medicare payments to doctors and hospitals if SCOTUS does not comply with Obama’s demands and submit to him. 

As an additional example of Obama’s illegal and (I believe) highly treasonous behaviors, on 1 May and 2 May Obama issued two additional unconstitutional and illegal Executive Orders.  The first E.O., issued 1 May 2012, makes the USA subject to “international regulations” as opposed to looking to and following the US Constitution.  Also, with this new E.O., the US FDA will now be able to be bypassed by International committees—thus, replacing the FDA with any international group which may be chosen.  In essence, Obama is quickly eliminating US Sovereignty and selling the USA to the international “community.” 


The second E.O. issued in 2 days was signed by Obama on 2 May 2012.  This E.O. instructs the USA to bow to international regulations instead of the US Constitution and Businessweek reports:  “Obama’s order provides a framework to organize scattered efforts to promote international regulatory cooperation, the chamber’s top global regulatory official said today.

“Today’s executive order marks a paradigm shift for U.S. regulators by directing them to take the international implications of their work into account in a consistent and comprehensive way,” Sean Heather, vice president of the chamber’s Center for Global Regulatory Cooperation, said in an e-mailed statement.”  This also brings the USA closer to becoming a “North American Union” and—also—eliminating its sovereignty—in toto.

Suffice it to say, no one in Congress has issued even the proverbial “peep” over either of these illegal “orders.”  Do the American people really want to continue to live under this blatant tyranny? 

The second question is “Will the Supreme Court of the United States of America bow to Obama and give up its co-equal status to the dictator as the US Congress has already done?”  If so,  perhaps its time for We-the-People to recruit the Honduran Supreme Court who, along with their military, ousted its then President Manuel Zelaya who had become a dictator.  Oppression under the Obama syndicate becomes worse each and every day, folks.  Will we ever choose to go back to the sunshine?

BLAHOUS: Health care law cripples U.S. finances – Washington Times



BLAHOUS: Health care law cripples U.S. finances – Washington Times.

Most affordable outcome would be total repeal

By Chuck Blahous

One of the motivating principles underlying the passage of comprehensive health care reform was that it would substantially improve the federal fiscal outlook. But many are skeptical of claims that the law, known as the Affordable Care Act, or ACA, will simultaneously extend the solvency of Medicare, provide subsidized health coverage to more than 30 million new people and yet somehow reduce federal deficits. They are right to be skeptical.

The legislation greatly exacerbates projected federal deficits and increases an already unsustainable federal commitment to health care spending. Many do not understand these harsh realities because traditional government accounting methods – while useful in many respects – often obscure significant costs. Comparing the health care law to prior law, rather than the “alternate baseline” used by government scorekeepers, gives a complete estimate of the legislation’s fiscal effects.

Based on analyses published by the Congressional Budget Office (CBO) and the Medicare actuary, I project that relative to prior law, the legislation will add at least $1.15 trillion to net federal spending and more than $340 billion to federal deficits over the next 10 years, and far more thereafter. This sobering outcome arises even if all goes relatively well – that is, if the law’s cost-saving provisions are all successfully implemented. If, instead, future Congresses act roughly consistent with historical precedent, the law will add more than $500 billion to federal deficits in the next 10 years – growing to $600 billion by 2021.

One of the key issues in understanding the law’s fiscal effects pertains to its use of Medicare savings. The law contains several provisions to slow the growth of Medicare costs, and under law, Medicare can spend the full proceeds of these savings. Government scorekeeping conventions, however, ignore this effect. Meanwhile, the law also establishes an expensive new health care benefits program to be financed with these same savings. Together, these provisions spend far more than the law saves and will substantially increase federal debt.

There also is significant risk that the law’s new programs will cost more than originally estimated. Take, for example, its new subsidized health exchanges. As currently designed, the subsidy levels would require low-income people to shoulder a rising share of their health care costs over time. The exchanges also are designed so that one low-income person will get a substantial direct federal subsidy when he buys insurance through the exchanges, but his equally low-income neighbor with employer-sponsored insurance will not. This could create substantial pressure on Congress to expand the subsidies later to address perceived inequities.

Similarly, many of the law’s cost-saving provisions may not produce all of the savings now projected. Already highly controversial is the law’s establishment of a new Independent Payment Advisory Board (IPAB) to produce Medicare savings. These might be legislatively overridden, or IPAB itself eliminated. Furthermore, many of the law’s tax provisions are designed, like the current alternative minimum tax (AMT), to capture rising numbers of taxpayers over time. If Congress acts to forestall these tax increases, as it has with the AMT, revenues from these provisions will be far less than currently assumed.

None of this is to assert that these cost-saving provisions are necessarily the wrong policy choices, only that their proceeds cannot safely be spent until we are certain these savings have accrued.

Many have wondered how possible Supreme Court rulings on the law’s constitutionality might affect its finances. As the above analysis shows, the worst-case fiscal scenario would be to uphold the law in its entirety. Similarly, the best-case realistic scenario would be to strike down the law in its entirety. An even better hypothetical outcome from a financial perspective would be to uphold the law’s cost-saving provisions while striking down its coverage expansion, but no one expects this.

A more complicated situation would arise if the court strikes down the law’s insurance-purchase mandate but leaves its other provisions intact. CBO has estimated this would improve the federal fiscal impact by $282 billion over 10 years. This would ameliorate its fiscal damage but not by enough to turn the law into a net improvement. Such an outcome also would have severe adverse effects for consumers and insurers, increasing insurance premiums by 15 percent to 20 percent (according to CBO) if the law is not otherwise modified.

That comprehensive health care reform has made our untenable fiscal situation still worse represents a substantial failure of governance. To fulfill its original promise of bending down the federal health care cost curve, the vast majority of its subsidized coverage expansions would need to be repealed. Alternatively, aiming for a weaker standard in which the law is allowed to add to federal costs but not to deficits, roughly two-thirds of the law’s health exchange subsidies would need to be scaled back or other budgetary offsets found.

Whichever fiscal goal is pursued, it is imperative that corrections be enacted before the law is fully effective in 2014. History shows clearly that it is very difficult to contain the rising cost of a federal entitlement once individuals have grown dependent on it. Only by scaling back the new spending commitments made under the law will health care reform make the positive contribution to the federal fiscal outlook that experts across the ideological spectrum agree is required.

Chuck Blahous is a senior research fellow at the Mercatus Center at George Mason University and public trustee for Medicare and Social Security. He is author of the center’s new study, “The Fiscal Consequences of the Affordable Care Act.”

WEST: Why Obamacare is bad for America’s health – Washington Times

WEST: Why Obamacare is bad for America’s health – Washington Times.

Expensive overreach could prove fatal if not struck down

By Rep. Allen B. WestThe Washington Times

On Monday, the Supreme Court will consider the legality of the Patient Protection and Affordable Care Act, also referred to as Obamacare. The high court will pore over Article 1, Section 8 of the Constitution to determine the true meaning behind the words, “The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common Defense and general welfare of the United States; To regulate Commerce with foreign Nations and among the several states, and with the Indian Tribes.” The 2012 Supreme Court must determine whether the Founders had any intention of mandating the behavior of private enterprises and individuals.

To me, the answer is obvious: absolutely not.

Our nation was founded on the Declaration of Independence. Freedom of choice and a free market are at the core of our nation’s soul. A governmental mandate for the behavior of individuals and private enterprises is anathema to what our founders intended. The prospect of having an unelected panel of bureaucrats determining fundamental decisions about our individual health care is perhaps the most personal and intimate intrusion into our lives. The concept of this absurd and dangerous law surely ranks with the grievances laid down 236 years ago.

In January 2011, Florida federal District Judge C. Roger Vinson ruled the individual mandate unconstitutional, stating: “Never before has Congress required that everyone buy a product from a private company (essentially for life) just for being alive and residing in the United States. If [the government] has the power to compel an otherwise passive individual into a transaction… it is not hyperbolic to suggest that Congress could do almost anything it wanted.” Today, this prediction is being attempted before our very eyes.

With Obamacare, insurance companies will be forced to provide contraceptive products free of charge. Why just contraception? Will the government next force insurance companies to provide surgical procedures free of charge? Where does it end? Perhaps supermarkets should be compelled to offer apples and carrots free of charge to ensure children have access to healthy food.

Beyond exerting oppressive control over individuals and private enterprises, Obamacare circumvents the foundation of our own legislative structure.

At the heart of the Affordable Care Act is the Independent Payment Advisory Panel (IPAB), made up of 15 unelected officials appointed by the president to reduce Medicare spending. The IPAB will be tasked with and given the authority to reduce costs to the government by, among other things, limiting reimbursements to doctors. It doesn’t take a brain surgeon to recognize that this will lead to more physicians leaving the Medicare system, reducing access to care for our seniors and limiting available treatments.

But this isn’t the most frightening part. Any recommendations by the IPAB automatically become law. The only way around this unprecedented amount of power for Washington bureaucrats is an act of Congress, with a three-fifths supermajority in the Senate. In other words, the unelected IPAB, appointed by the president, essentially becomes its own shadow legislative branch.

The fundamental structure of our government, with three co-equal branches and a careful system of checks and balances, is being usurped. Our freedoms and liberties are being chipped away, bit by bit. Our country is being transformed step by incremental step into a centrally planned, stringently controlled bureaucratic nanny state, and what I find most frightening is that a portion of our populace willingly dons the shackles, and like lemmings, marches to our demise.

Perhaps some Americans are simply unaware of the exorbitant monetary cost of this governmental behemoth. The numbers don’t lie, and they are dangerous:

c $1.76 trillion from American taxpayers to pay for Obamacare over 10 years, nearly double the $940 billion forecast when the bill was signed into law (Congressional Budget Office). c $52 billion in new taxes on businesses as employers are forced to provide health insurance. (CBO). c $800,000 fewer U.S. jobs. (CBO). c $47 billion in new taxes on drug companies and medical device makers, costs that surely will be passed down to patients, particularly our senior citizens.

c Families earning more than $250,000 a year will see more taxes, as Obamacare adds a new tax to investment income, including capital gains, dividends, rental income and royalties.

c Insurance premiums are expected to increase 1.9 percent to 2.3 percent in 2014 and up to 3.7 percent by 2023 because Obamacare adds a premium tax on health insurers offering full coverage.

The Patient Protection and Affordable Care Act is unworkable and destined to fail. One need only look back a few years ago to the last big government program with the word “affordable” in it. Barney Frank’s Affordable Housing Act managed, in less than a decade, to demolish the housing market, weaken financial institutions and wipe out the net worth of millions of Americans.

What makes anyone think government intervention in health care will be successful? Obamacare is unconstitutional, anti-constitutional and, most certainly, an awful piece of American policy. Let’s hope after next week’s Supreme Court decision it also becomes a short-lived piece of American history.

Rep. Allen B. West is a Florida Republican.

The Obamacare Hydra – Michelle Malkin – Townhall Conservative Columnists

The Obamacare Hydra – Michelle Malkin – Townhall Conservative Columnists.

The Obamacare Hydra - Michelle Malkin - Townhall Conservative Columnists

The Hydra was a mythical swamp beast whose multiple heads grew back after being severed. Obamacare is a real Washington monster whose countless hidden bureaucracies keep sprouting forth even after they’re rooted out. As soon as combatants lop off one of the law’s unconstitutional agencies, another takes its place.

On Thursday, as the behemoth federal health care law marked its second anniversary, House Republicans repealed the infamous Independent Payment Advisory Board. The mother of all death panels, IPAB would have unprecedented authority over health care spending through a rogue board of 15 Medicare spending czars. The House repeal has a snowball’s chance in hell of surviving the Senate. But IPAB’s legality is being challenged in federal court by the conservative Arizona-based Goldwater Institute. And the more the public knows about these freedom-usurping, taxpayer-soaking institutions buried in the health care law the less they like it.

Seven House Democrats crossed the aisle to vote for the GOP majority rollback. Analysts on both sides of the political aisle have decried IPAB’s complete lack of accountability and insulation from judicial review. Critical decisions about public and private health insurance payment rates would be freed from the normal administrative rules process – public notice, public comment, public review — that governs every other federal commission in existence. Rep. Todd Akin, R-Mo., summed up bipartisan opposition: “IPAB embodies the very thing Americans fear most about ObamaCare — unaccountable Washington bureaucrats meeting behind closed doors to make unilateral decisions that should be made by patients and their doctors.”

The problem with piecemeal repeal is that for every old IPAB, there’s a new, multibillion-dollar bureaucracy waiting in the Obamacare wings. Senate Republicans and fellow medical doctors Tom Coburn and John Barrasso point to a $10 billion entity called the “Innovation Center” that “would test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid and the State Children’s Health Insurance Program (CHIP).”

According to a new Congressional Research Service analysis of this little known office to be operated by the Centers for Medicare and Medicaid Services, there would be “no administrative or judicial review” of the director’s payment experiments. Coburn and Barrasso explain that “(t)his means that the administrator of CMS is the sole individual in the entire federal government with the power to decide whether or not models tested negatively impact seniors’ quality of care and meet the financial requirements spelled out in law.”

This “innovation” super-czar would be allowed to tinker behind closed doors — and then impose whatever experiments the “innovation center” chooses without any checks or balances on the methods or results. Moreover, at least two other sub-offices within CMS (subject to normal open meetings and open records rules) have already been tasked with researching payment and delivery models. Health care blogger Tevi Troy at NationalReview.com warns: “The ‘innovation’ center appears to be one more way in which the health-care law is going to interfere with the practice of medicine, and one that physicians should start paying more attention to.”

It’s not just physicians who need to pay attention. Every taxpayer has a stake. At the end of the month, this shadowy agency will start doling out $1 billion in grants to payment experiment groups and data-tracking system builders. Sounds like yet another pipeline for political payoffs and Chicago-style boodle that will result in less patient autonomy, fewer health care choices, more government intrusion and lower-quality care.

Final diagnosis: The Obamacare beast won’t die until it’s eradicated completely, root and branch.

Obamacare drives up health care costs for everyone – San Francisco Chronicle

Obamacare drives up health care costs for everyone -San Francisco Chronicle.

Sally C. Pipes

The Centers for Medicare and Medicaid Services recently released their annual report on health care spending in America. And surprise, surprise – spending continues to grow. It amounted to 17.9 percent of the nation’s gross domestic product in 2010, or $2.6 trillion. But the annual rate of growth was lower than it had been most of the past 50 years – just 3.9 percent.

Naturally, the Obama administration took credit for this sliver of good news. “Thanks to the Affordable Care Act, we’re keeping costs down and making health care more affordable,” wrote Nancy-Ann DeParle, deputy chief of staff for policy, on the official White House Blog.

But an in-depth look at that report reveals that Obamacare has done little thus far to slow the growth of American health spending. In fact, the federal health care reform effort is already increasing the share of spending shouldered by taxpayers. Worse yet, the implementation of Obamacare has barely begun.

As the law’s various provisions begin to take effect, the pace of spending will only accelerate. The report was clear about what’s restraining health care spending – and it’s not Obamacare. As the report put it, the “impact of the recent recession continued to affect the purchasers, providers and sponsors of health care.” The agency’s researchers went on to cite “[p]ersistently high unemployment, continued loss of private health insurance coverage, and increased cost sharing” as reasons that “led some people to forgo care or seek less costly alternatives.” In other words, it’s the economy, stupid.

Obamacare may have actually increased national health spending. According to the centers’ report, “the projected net effect of (Obamacare’s) provisions on health spending in 2010 was approximately 0.2 percentage point.” That’s not much of an increase – but it’s an increase nonetheless. Senate Republicans have pointed out that the centers’ latest report is consistent with its April 2010 prediction that Obamacare would increase national health spending by $311 billion in the next decade.

And the government has gotten a head start on all that new spending. Federal health care disbursements increased from $530 billion in 2007 to $743 billion in 2010 – a jump of 40 percent. Medicare spending grew at a 5 percent clip, while Medicaid spending rose 7.2 percent, more slowly than the previous year. As a percentage of total health care spending, federal, state and local government expenditures increased from 41 percent in 2007 to 45 percent in 2010.

The president’s health care law will only exacerbate these long-term trends once it goes fully into effect. In 2014, the centers project that health spending will rise 8.3 percent, thanks in large part to Obamacare’s expansion of Medicaid to bring health care to 30 million more Americans and its new subsidies for Americans to purchase health insurance in the state-based exchanges. And by 2020, officials estimate that government will account for half of American health care expenditures.

But what about private health insurance? While campaigning for the White House, President Obama repeatedly pledged that his health reform package would lower the average family’s annual premiums $2,500 by the end of his first term. He’s got about a year to fulfill his promise – and it doesn’t look as if he’ll succeed. The report pegged the growth in spending for health insurance premiums at 2.4 percent in 2010. Meanwhile, survey data from the Kaiser Family Foundation reveal that the average annual premium for family coverage hit $15,073 in 2011, a 9 percent increase over 2010. And according to a survey conducted by the Mercer consultancy, employers expect the cost of health benefits to rise by 5 percent this year.

With all these data in the mix, it’s hard to see how the White House could crow about “keeping costs down and making health care more affordable.” Instead, Obamacare is driving up health costs for Americans today – and saddling the next generation with trillions of dollars in new health care liabilities.

Sally C. Pipes is president and CEO at the Pacific Research Institute. Her latest book is “The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare,” (Regnery 2012).

ORIENT: Is the payment board a death panel? – Washington Times


THE NATURAL (Photo credit: SS&SS)

ORIENT: Is the payment board a death panel? – Washington Times.

Denial of treatment will be curtains for uninformed patients

By Dr. Jane M. Orient – The Washington Times

The curtain seems to be rising on Act 2 in the saga of piecemeal repeal of the Patient Protection and Affordable Care Act, or Obamacare. The first part to fall was the financially unsustainable long-term care portion, the Class Act. The next target is the Independent Payment Advisory Board.

Even the American Medical Association, which endorsed Obamacare, is calling for repeal of the advisory board, citing worries about “formulaic” payment cuts, lack of stakeholder opportunity for “meaningful dialogue” with Congress and potentially limited access to care. As usual, the AMA is focused on the money.

The AMA avoids strong words like “death,” “dictatorship,” “rationing” and “unconstitutional.” Its concern about the specifics of the Independent Payment Advisory Board is also a diversion from the basic principles and mechanisms already in place, in which the AMA is complicit and heavily invested.

The worst part about the Independent Payment Advisory Board is the absolute power that is vested in an unaccountable 15-member oligarchy. If there ever was an unconstitutional delegation of power, this would be it. But there is no point in investing years and millions of dollars in taking the board’s decisions to the Supreme Court. Congress has ruled out any review of its diktats, either administrative or judicial.

Congress has always had the power to restrict the jurisdiction of the courts, and this instance shows that it has not forgotten. Congressmen usually try to duck their obligation to abide by their oath to uphold the Constitution by pretending that the Constitution is not what the document says but what five Supreme Court justices ultimately rule.

Rep. Peter A. DeFazio, Oregon Democrat, when asked about the constitutionality of the individual health insurance mandate in Obamacare – for which he voted – said: “Well, um, I’m not a lawyer. … That’s why we have courts. Congress often passes laws that are of dubious or questionable constitutionality.”

Congress created the Independent Payment Advisory Board, and it can and must do away with it. That would set a good precedent for a lot of its other ruinous creations, but it wouldn’t rescue Americans from the prospect of death by Medicare rationing.

With the Independent Payment Advisory Board gone, there still would be the Medicare Payment Review Commission and Medicare’s elaborate system of price controls – diagnosis-related groups or hospitals and the Resource-Based Relative Value Scale for physicians. The AMA owns the codes that determine whether Medicare can pay for a procedure, and the AMA/Specialty Society Relative Value Scale Update Committee determines how Medicare dollars shall be divided. The committee has a lot in common with the Independent Payment Advisory Board.

Covert rationing is rampant even now, though largely undetected. Medicare patients can tell when their appointments are denied or delayed, but cannot learn so easily when they are denied access to care because doctors don’t tell them it exists.

Services that can’t be paid for will disappear.

The key, unasked question, which Congress, Medicare and the AMA are trying to duck, is whether Americans have the right to spend their own money to obtain necessary, lifesaving care, even if “covered” (but denied) by insurance. Or must they be at the mercy of the Centers for Medicaid and Medicare Services, the Department of Health and Human Services, Blue Cross or other insurer, the Independent Payment Advisory Board or its successor? May physicians find a way to provide care that their patients value and accept compensation, or must all medical dollars flow through government-approved gatekeepers?

Many Medicare officials, and the AMA, are acting as if their desired answer is no.

What makes the Independent Payment Advisory Board or its equivalent a death panel is not constraints on what Medicare may pay, but the ban on balance billing or private payment.

When Josef Stalin decided to starve Ukraine, he confiscated all the food and exported it to the West or destroyed it. He also made it a crime to buy, sell or exchange things for food. He had a lot of people shot, but the vast majority simply perished of deprivation – the ultimate consequence of socialism.

If Americans lose the liberty to provide for their own medical care, some will get “free” contraceptives, abortions, mental health screenings or whatever else the czars think they should have. Others will get the “red pill” or the “blue pill” on the way to their premature deaths.

Dr. Jane M. Orient is executive director of the Association of American Physicians and Surgeons.

ARMSTRONG: Obamacare grants doctors liberty to withhold care – Washington Times

ARMSTRONG: Obamacare grants doctors liberty to withhold care – Washington Times.

Plan rewards physicians for scrimping on treatment

If you haven’t noticed it yet, you soon will. The Obama administration has launch-ed a full-court press to sell the president’s “signature” achievement, Obamacare, or the Affordable Care Act, to the American public as well as to the 800,000 American physicians it directly impacts.

As one of those doctors, it was no surprise when an article in the Journal of the American Medical Association by lead author Dr. Ezekiel Emanuel attempted to convince American physicians that they will enjoy expanded autonomy and greater liberty under the new act.

Dr. Emanuel helped create the 2,700-page law and has now been enlisted to sell it. As a bioethicist of considerable acclaim, Dr. Emanuel goes to great lengths to establish his case, maintaining that with new payment models promoted by the law, doctors will be in a position to free themselves from the fee-for-service system that he and others have worked to vilify in the physician-patient relationship. What he misses entirely is that it’s the opaque economic arrangement caused by our third-party payment systems, not the honest exchange of payment for a service that is the root cause of the soaring costs in American health care today.

The law promotes a “new” model, the Accountable Care Organization (ACO), in which an entity that covers a specified number of Medicare patients is given a fixed pot of money. This is quite similar to the HMO capitation systems that caused tremendous backlash in the early 1990s. In both, if the doctors can provide care for less than what is in the pot over a defined period, they get to share the leftovers. If, however, the doctors overspend the pot, they are financially liable for the consequences. With sleight of hand and fanciful re-packaging, Dr. Emanuel attempts to convince physicians that this gallows for private practice somehow improves and enhances autonomy. Nice try, but doctors have been fooled once, which is quite enough.

Do you see the problem? It should be obvious to all physicians and the public. When you see your doctor, what do you want the caregiver to have foremost in mind: your medical needs or the doctor’s income? Is this ethical? Hardly. But this is the reality of any payment model that ties physician income directly to the unstated decision to withhold expensive services. Either consciously or subliminally, the message is the same: The less you spend on patient care, the more you gain financially. This is the reality of the ACO model and the “new ethics” of government cost control in medicine, courtesy of the Affordable Care Act. Shouldn’t economic and professional decisions be transparent in medicine, where doctors and patients make joint decisions based upon available resources, not some underlying, unspoken financial advantage for the physician to offer the patient less.

This administration held up the Mayo Clinic, the Cleveland Clinic and others as shining examples of the best medical systems in the country. They didn’t tell you that when Dr. Charlie and Dr. Will Mayo opened the Mayo Clinic in 1889 and when Dr. George Crile and colleagues opened the Cleveland Clinic in 1921, they were not coerced by any government entity or law to provide honest medical care under the most ethical economic model that exists – fee-for-service – in which the doctors care for the patient and the patient pays the doctor.

Using the terms “autonomy” and “liberty” in the same paragraphs as descriptions of Affordable Care Act and the ACO is disingenuous at a minimum and laughable when you know even a portion of what this law contains. Obamacare endows the office of the secretary of Health and Human Services with more power than any Cabinet officer in history and to virtually control the American health care economy by 2014. Any argument asserting that autonomy and liberty are enshrined in the thousands of pages of regulations emanating from the Cabinet secretary is risible.

What occurred with the Catholic Church and its associated organizations over contraception services last week is only a small preview of what is in store for the remainder of the United States. Attempts to frame this law as promoting enhanced physician autonomy and liberty is akin to rearranging the furniture in a prison; you can seat yourself on the loveseat or a chair, but you can’t leave the premises.

The Mayos and Crile would not be amused. My sense is that the founders of our nation would spit on Dr. Emanuel’s shoes – or worse.

Dr. Richard A. Armstrong is the chief operating officer of Docs4PatientCare (docs4patientcare.org).