Doctors Fired, Administrators Hired: America’s Naivety Leads To Bad Medicine

by Austin Hill

A question for the American Medical Association:  What were you thinking?

Despite the national news media’s near-complete refusal to report it, the news was no less real. United Healthcare, a managed care health services company based in Minnesota, is underway with laying-off “thousands” of physicians in Connecticut.

 The reason? The company won’t dare say this, but they had to do something to stave-off their decline in revenues, a phenomenon brought about by – you guessed it – the new federal healthcare law, AKA “Obamacare.”

President Obama once famously promised “if you like your doctor, you can keep your doctor,” but that promise is not being kept for Medicare patients in Connecticut. The physicians who are losing their employment are specifically assigned to treat Medicare benefits’ recipients there. And this may be only the beginning of Medicare patients “losing their doctor,” because the Obamacare law reduces funding for the elderly and disabled recipients of Medicare benefits, just as it takes-on the burden of funding new websites, databases, subsidies for those who will receive health insurance “for free,” and lots and lots of new federal “administrators.”

The sad truth, though, is that the association that purports to represent the entire medical profession – the “AMA” – actually supported Obamacare for a time, before they officially and viscerally opposed it.  And ironically, they opposed Medicare before they officially and viscerally supported it.  Without any particular commitments to economic principles and with a seemingly naive understanding of public policy, the AMA has welcomed the government’s encroaching control over their profession.

It started in the early 1960’s when the idea of Medicare was first proposed. The AMA warned their members that the government’s “intrusion” in to their profession could disrupt doctor-patient relationships, and lobbied Congress against passage of the Medicare legislation.

But soon after the implementation of Medicare, the AMA recognized the benefits of the government’s steady stream of revenues and began to support it. And for most of the last half-century or so the AMA has aggressively lobbied Congress against any and all proposed Medicare funding reductions.

In 2009 when Obamacare was originally proposed, the association opposed the idea. By 2010, however, amid social pressure and promises of good times for physicians from the administration, the AMA decided that they sort of agreed to the Obamacare “in principle,” and refused to oppose it. Then in 2012, after Obamacare had  become law and a couple of months before the November presidential election, the AMA came out in full-force opposing Obamacare while urging its members to vote for Mitt Romney.

Too little, too late, AMA. As President Thomas Jefferson once said, “a government big enough to give you everything you want is a government big enough to take away everything you have,” and the results of the AMA’s foolish flirtation with the government’s redistribution of economic resources illustrates this profound truth vividly.

As if this folly isn't sufficiently tragic, consider this:  as featured on the Fox Newschannel, a private corporation called “Benefits Coordinators” is on the prowl for prospective staffers  to educate government employees on how to utilize their health insurance benefits.  Apparently the health benefits plans that the federal government offers its employees is so circuitous and confusing that the government “had to” hire a private corporation to educate the recipients on how to use the benefits.

 The company advertises earnings of “$120,00 to $180,000 a year” for this kind of work. And the expansion of the administrators’ roster is happening in the same week as the reduction of the physicians’ list.

 

Our government is well on its way to producing less healthcare and more bureaucratic red tape, all the while the cost of healthcare rises for those who actually pay for it. Will Americans ever wake up to the most basic principles of economic and public policy issues? Or will we continue to childishly continue to believe in the magical promises of politicians?

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Don’t Let This Happen To Your Profession: AMA Culpable In Our Government Healthcare Fiasco

by Austin Hill

If you think Obamacare is bad for consumers and patients think about this: how would you like to spend between twelve and sixteen years of your life in grueling and expensive academic training, only to have politicians and bureaucrats dictating to you  years later how you will practice your craft and how much money you’ll be allowed to earn?

Let’s be clear about medical doctors. Any individual who can genuinely earn the title “M.D.” is worthy of significant respect, and one would hope that an entire association of M.D.’s would be equally as worthy. Unfortunately the American Medical Association – the professional group that has purported to represent physicians in the U.S. for over a century - managed to foolishly get itself caught in the crossfire of the “Obamacare” war over the past few years. Now,  MD’s – both those few who remain members of the AMA and the majority of physicians who are not members – as well as the practice of medicine itself, are all set to be big losers in the coming months and years.

According to their website, the association’s stated mission is “to promote the art and science of medicine for the betterment of the public health; to advance the interests of physicians and their patients; to promote public health; to lobby for legislation favorable to physicians and patients; and to raise money for medical education.” It is also noteworthy that the group originally opposed Medicare, the U.S. federal government’s program that provides healthcare reimbursements for elderly and disabled persons, fearing that “undue government intrusion” in the medical profession would damage the doctor-patient relationship and be detrimental to the profession itself.

But soon after Medicare’s beginnings in 1965, the A.M.A. changed their position. The association’s members and leadership both realized that government-funded health care through Medicare produced a steady stream of patients and more guaranteed reimbursements for services – in short Medicare in its early days guaranteed wages for MD’s. Thus for all of my lifetime, the A.M.A. has aggressively lobbied the U.S. Congress against cuts in Medicare funding as they have periodically been proposed.

Over the years the A.M.A. has also supported tight government limits on medical school entries – likely because doing so limited the “supply” of new M.D.’s, drove up the demand for existing MD’s, and thereby enhanced the wages of those who actually managed to get in to the profession. On this point the late Economist Milton Freidman once noted that the A.M.A. had become a “guild,” and was shielding its present-day members from the potential competition of future would-be Doctors.

Yet after decades of love and appreciation for the ways in which big government can shelter you from market competition and put money in your pocket, and with its membership dramatically in decline, the A.M.A. changed its public policy stance in mid-2009. After only a few months of President Obama in the White House, it was at that time that the association reverted back to being skeptical of government power, and publicly opposed President Obama’s healthcare “reforms”.  

The federal government had at that point been exhibiting a years-long pattern of dictating to physicians how much they would be paid for specific procedures (rather than allowing doctors to set their own rates for services), and A.M.A. membership had begun to dwindle party as a result of this loss. The association thus surmised that Obamacare would give the government even more power to determine how much doctors could be paid, and told the President “no” regarding his early legislative efforts.

But months later the A.M.A. changed their minds again. Facing pressure from both the White House, and President Obama’s “Organizing for America” community organizer group, the A.M.A. hedged a bit back in 2010 and sheepishly agreed to Obama’s reforms “in principle.” This caused even more member physicians to leave the association, even as the President portrayed it as a “courageous” move.

But wait, there’s more! In June of 2012, less than four months before the presidential election, the A.M.A. changed its collective minds yet again, when the association’s President Dr. Peter Carmel announced their “official” renewed opposition to Obamacare. At the association’s annual summer convention, Carmel declared what many of us had been concerned about for quite some time; that placing more government bureaucrats and lawyers between a patient and a physician, Obamacare would make healthcare more expensive and less rewarding for all involved. Further, Carmel noted that President Obama’s  law does not address the dwindling of Medicare reimbursements to M.D.’s, nor does it address the ever-escalating threat of medical malpractice lawsuits, a major source of healthcare cost increases.

And now here we are, a little more than a year after the A.M.A. “officially” decided that Obamcare was a bad deal, and we’re all experiencing the anguish of the federal take-over of the medical profession.  The otherwise honorable and essential work of high educated physicians will be gradually replaced with less educated and less costly nurses and “P.A.’s” (physician’s assistants);  existing physicians will have their reimbursement rates further reduced; veteran doctors are already leaving the profession or abandoning their small private practices to find a job at larger hospitals and corporately owned facilities; and some physicians are fighting to continue practicing their craft entirely apart from any involvement with insurance companies (check out the website Iwantdirectcare.com for evidence of healthcare without insurance).

President Thomas Jefferson once famously said that “a government big enough to give you everything you want, is a government big enough to take away everything that you have." The A.M.A.’s flirtation with the guarantee of patients via Medicare, and the present-day derailing of the medical profession via Obamacare, illustrates Jefferson’s wisdom quite vividly. 

The A.M.A.’s foolishness demonstrates the destructive combination of being high trained in one’s profession, yet not comprehending the most basic facets of government, economics, and public policy.  

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Boehner: 'The Cave-Man' Does It Again!

It is not often that we encounter a politician that is so completely mindless and spineless as is John ‘The Cave-Man’ Boehner.

Boehner talks tough for days, weeks, or even months; but when it’s time to put the pedal to the metal, he crumbles like a saltine cracker under a sledge hammer

John Boehner fails at his sworn oath to uphold the Constitution,  at his duty to represent the people of Ohio, and at his responsibilities as ‘Speaker of the House".

The Constitution states that our government shall consist of three but equal branches; these are the Executive branch, the Legislative branch, and the Judicial branch.   The Constitution also defines the powers and duties of each branch.

For the purpose of this discussion limit the powers to spending and the making and the execution of laws--

o   The President has the duty to spend money as and only as Congress has authorized, and to   enforce  the laws as passed by Congress

o   The Congress has the duty to authorize spending and to enact Laws.

Somewhere in the Constitution, John Boehner seems to have found a passage that tells him that he has the duty to rubber stamp what the (or any) President wants, “because he won the election.

A question for Mr. Boehner:  If Congress is intended to approve everything that the President wants, why did the Founding Fathers bother with establishing a Congress

Case in point:  “During a private conference call, the Cave-Man ordered the House Republicans NOT TO DEFUND OBAMACARE!

The National Revue reported that, “John Boehner strongly hinted on a conference call with House Republicans that the upcoming continuing resolution will not be a do-or-die fight over ObamaCare spending.   Our intent is to move quickly on a short-term continuing resolution that keeps the government running.

Congress is being flooded with calls, emails, and faxes demanding that Congress kill ObamaCare.  Major polls all indicate that the vast majority of voters want ObamaCare stopped

ObamaCare has already cost thousands of people their jobs, and projects are that 10’s of thousands more will be furloughed. 

ObamaCare has already destroyed the 40-hour workweek, and it will prevent thousands of new jobs from being created.

Yet, the Cave-Man is telling House Republicans:  Don’t listen to the demands of the American people, don’t full fill your oath to uphold the Constitution, and don’t do what is best America.  If you attempt to defund ObamaCare you won’t just piss-off the President, you will piss me off too!

 If the polls in Ohio mean anything, John Boy is serving his final term in Congress.  I can’t say that I will be sorry to see him go, but I will wish him well in his retirement and I hope, for his family’s sake, his wife makes all of the important decisions.

We need to keep the pressure on the other members of the House and make it clear that if they follow the Cave-Man and do not vote to defund ObamaCare, they won’t be getting your support in the next election.

Boehner doesn’t seem to care that Obama makes law through Executive orders, or reallocates money, or even reneges on deals; but he really got hot under the collar when Mark Levin said that because he was so willing to let ObamaCare destroy the nation without so much a whimper, that we should hence forth rename it BoehnerCare.

Remember from now on it is BoehnerCare.

 Comments are invited!

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Obamacare 2.0: What Are Healthcare Practitioners Thinking?

by Austin Hill
As the battle rages-on over the implementation of the federal “Obamacare” law, there is an important question that rarely ever gets asked: what do actual health care practitioners think of it? Without the practitioners themselves, there would be no healthcare. Yet politicians, government bureaucrats, insurance executives and healthcare administrators have so thoroughly co-opted any discussion on the subject that actual healthcare professionals – doctors, nurses, physician’s assistants and the like – often appear as mere pawns in a big government game.

One might think that the American Medical Association (“AMA”) would have something coherent to say about the present state of things, or that they might even have some ideas about healthcare that are better than those being pushed by politicians. I’ll have more to say about the AMA in a moment, but first, here’s a name with which we should all become acquainted: the Citizens’ Council For Health Freedom.

Advocating for a private sector, free-market approach to healthcare, the CCHF has quite a bit to say about the practice of medicine, as does the organization’s President and Co-Founder, Twila Brase. “We’re moving away from the mission of medicine and more towards the business of healthcare, and these two endeavors are not the same thing” Brase claims. “We’re moving in the wrong direction.”

Brase, who by profession is a Registered Nurse, notes that CCHF’s beginnings date back to 1994. “At that time, Bill and Hillary Clinton were in the White House and the threat of a government take-over of the medical profession was becoming apparent. I began holding meetings and speaking about the issue, and in 1995 we officially incorporated. The interest in what we propose has become even greater since President Obama’s healthcare law has come in to existence.”

Brase believes that one of the greatest weaknesses of the Obamacare agenda is the state-by-state insurance exchange set-ups that are intended to be use as regional Obamacare implementation mechanisms. “If people refuse to participate in these things and there aren’t enough young healthy people who are willing to pay the increasing insurance rates, then there won’t be enough paying customers in the exchanges to financially support people who aren’t paying for their insurance at all, or who have medical conditions and who consume lots of healthcare and drive up the expenses of the exchange,” she notes. “I suspect that some of these state exchanges are going to financially collapse, all on their own.” As an alternative means of taking care of those who can’t afford healthcare all on their own, Brase recommends private sector charitable organizations that are supported by tax incentives. “But we need to discourage people from enrolling in the exchanges. People need to understand that the exchanges are intrusive and all they offer is government coverage. We call it Medicaid for the middle class.”

Contrast the CCHF’s vision, with the ever-changing vision of the much-older American Medical Association. The AMA’s stated mission is to promote the art and science of medicine for the betterment of the public health; to advance the interests of physicians and their patients; to promote public health; to lobby for legislation favorable to physicians and patients; and to raise money for medical education. Given their stated commitments to these high-minded ideals, back in the 1960’s the AMA originally opposed Medicare, the government healthcare program for senior adults, fearing undue government intrusion in the medical profession.

But soon after Medicare’s beginnings, the A.M.A. changed their position – presumably they realized that government-funded health care through Medicare produced a steady revenue stream of payments going from the federal government to individual practitioners, and it seemed like a beneficial thing at the time. Thus for all of my lifetime, the A.M.A. has aggressively opposed any cuts at all in Medicare funding.

By mid-2009 the A.M.A. reverted back to being skeptical of government power again, and publicly opposed President Obama’s healthcare “reforms”. The Obama Administration then countered the A.M.A.’s opposition with a pro-Obama political group calling themselves “Doctors For America,” and essentially took the public spotlight away from the AMA, in terms of their influence over the public policy debate.

Compared to the nearly 1 million M.D.’s practicing in the United States, D.F.A.’s approximate membership of 10,000 is tiny. Yet the pro Obama MD group made a huge p.r. impact in 2009 and 2010, complete with photo-ops of “Doctors” dressed in white lab coats and wearing stethoscopes standing beside the President at his podium. The D.F.A. was also able to get the A.M.A. to hedge a bit back in 2010, as the AMA announced that they changed their position again and supported Obama’s reforms “in principle.”

But then in June of 2012, A.M.A. President Dr. Peter Carmel announced at the Association’s annual convention their renewed opposition to Obamacare. He declared what many of us have been concerned about for quite some time – that the law doesn’t address the greatest problems with healthcare in America, and in a variety of ways makes matters worse.

So what is the biggest difference between the wisdom of the AMA and the CCHF? While the AMA has had an on-again off-again relationship with big government, Brase and the other members of the CCHF understand the basic economics of their own profession. They are also wise enough to understand the threat of third-party intrusions in the practitioner-patient relationship, and ethical enough to care about that threat. “When other people hold the dollars, the mission of medicine is compromised” Brase reminds people frequently. “Whether it’s the government, or an insurance company, the agendas of the people with the money ultimately take precedence over the needs of the patient.”

Are practitioners beginning to see the light as Brase and her associates do, or are they still inclined to play the “pawn” role in the government’s agenda? “I’m hopeful that more of my fellow practitioners are seeing things more clearly” Brase notes, “but I think the loudest demands for change in the practice of medicine are going to come from the patients, first.”

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Three Years On: Here’s Why Obamacare Has Become Irresistible

by Austin Hill
It has been federal law for three years. It has brought chaos to the labor markets. It has cost people their livelihoods and it is more unpopular than ever.

So why does “Obamacare” (officially known as the “Affordable Care Act”) remain so irresistible for so many of our fellow Americans? Because at its core Obamacare is not about health care, so much as it is about the redistribution of wealth, and for those who are on the receiving end of the redistribution the agenda is completely irresistible.

When the federal government doles-out cash, it’s difficult to say “no.” That’s why many of our nation’s top business consulting firms are cashing-in, as state government officials hire the consulting firms to figure out how to set up the new federal health care bureaucracies, complete with their own state-specific websites and call centers.

How difficult and costly could it be, do you suppose, to set up a website and a call center for the residents of one individual state? In the world of private enterprise, most small to midsize companies doing business within a specific region of the U.S. would be foolish to spend much more than a hundred thousand dollars for their customer service website and the infrastructure for a call center, and in many cases the project could be completed for much less.

But with Obamacare, the “customer service” element has become more of a “corporate welfare” element. Companies, careers, and personal fortunes are being made by people who are “” the states, as firms bill the individual states millions of taxpayer dollars for the website and call center set-ups (and the Obama administration frequently offers to reimburse the states for the set-up costs).

Take for example a company called Leavitt Partners, LLC. Founded by the former Republican Governor of Utah (and former U.S. Secretary of Health and Human Services) Michael Leavitt, the company describes itself as a “healthcare intelligence business,” and is focused solely on state-by-state Obamacare compliance (they have already completed Utah’s insurance exchange start-up).

We’re talking here about Michael Leavitt, the former Utah Governor who last year endorsed and campaigned on behalf of Mitt Romney, the presidential candidate who pledged to “end” Obamacare. Yes, that Michael Leavitt is making millions advising the states on how to comply with the monstrosity that his pal Mitt wanted to eliminate.

How much money is in play for these companies? Consider that last fall representatives from Leavitt’s company traveled north and proposed to build an exchange for their tiny nieghboring state of Idaho, a state with a population of less than 1.7 million people. Once the Leavitt representatives unveiled their proposed price tag to build an exchange - $70 million-an incredulous member of Idaho’s state insurance task force asked “does Governor Leavitt really believe that this is a good idea?”

Company associate Brett Graham replied with the nuanced explanation that “Governor Leavitt doesn’t like the feds dictating to the states,” however, the Governor also believes that the states should “stand inside the circle with the feds rather than stand outside of it”- which was an artful way of saying “yes, Governor Leavitt likes this and wants to get paid to show you how to do it.”

Leavitt’s proposal was not the most expensive that the sparsely populated Idaho received. The global accounting and consulting firm KPMG weighed-in with a price tag of $77 million, and when a state official asked what the residents of Idaho would get in return for such a large expenditure, KPMG representative Andrew Gottschalk was vague: “It’s hard to explain exactly what you get…It’s hardware, it’s software, there’s infrastructure, there’s people and staffing” he stated. “There would likely be a call center. It’s all kinds of things… there’s a lot of stuff….but it’s hard to be specific.”

States spending millions of taxpayer dollars, and receiving “all kinds of things” and “a lot of stuff” in return. That’s our present-day reality with Obamacare. Along with Leavitt Partners and KPMG, global consulting firms Maximus and Mercer are also cashing-in. These firms employ well educated, highly skilled professionals with JD’s, MBA’s, and advanced degrees in information systems and healthcare management, most of whom would undoubtedly reject the idea that they are welfare recipients. As the Maximus corporate website states, “we leverage our extensive experience and strong commitment to ethics to provide high quality services and solutions.”

Along with the Obamacare cash that’s flowing in to private consultants’ accounts, there’s the money that’s being handed-out to state and county governments under the auspice of Medicaid expansion. A key component of Obamacare was to have mandated that the individual states reduce eligibility requirements for Medicaid, and expand the number of participants in their respective programs. However, the United States Supreme Court overturned that component of the Obamacare law, so expansion of Medicaid is an elective choice for each of the states.

But not to worry, the President has made the expansion of the federal Medicaid welfare program irresistible, as the Administration is offering to pay 100% of the expansion costs for the first three years, for states that agree to the expansion this year. That’s why, for example, New Jersey Governor Chris Christie, who has refused to allow an Obamacare insurance exchange in his state, nonetheless agreed to the Medicaid expansion – when you can get the fed’s to pay for people’s “free” healthcare, that alleviates the state and county agencies from paying for it. It creates an addiction to federal spending, but if you’re in charge of a state or federal agency, it makes sense on some level.

This is the reality of Obamacare. It’s wildly unpopular for the masses, but irresistible for those on the receiving end of the money grab.

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Obamacare, Socialism, And Rick Perry’s Assumptions

by Austin Hill
“The popular media narrative is that this country has shifted away from conservative ideals, as evidenced by the last two presidential elections. That’s what they think. That might be true if Republicans had actually nominated conservative candidates in 2008 and 2012.”

Governor Rick Perry (R-Texas) drew applause with that line, as he spoke at last week’s “Conservative Political Action Conference’ (“CPAC”) in Maryland. And if there’s any sure-fire way to draw applause from a conservative audience in 2013, taking a swipe at both the media and the Republican Party is probably a good strategy.

Yet if there is somehow a false narrative in “the media” about America abandoning conservative ideals, it may also be true that the notion of America adhering to some set of conservative ideals is, perhaps, a bit of a false narrative as well. Implicit in Perry’s message is the assumption that, if only a “truly conservative” presidential candidate had appeared at the top of the ballot in the 2012 presidential election, then the outcome of the election would have been quite different, and our nation’s public policy would therefore look very different. And there is no doubt some grain of truth to his claim – neither fiscal conservatives nor social conservatives had any particular affinity for Mitt Romney, and this was probably part of what led to the lackluster voter turnout.

Yet evidence suggests that, even in heavily Republican regions of the country, very left-leaning, socialistic, Obama-styled public policy ideas are nonetheless thriving. Voters in these regions may give lots of lip service to things like the sanctity of life and traditional marriage, but the ideals of limited government and fiscal conservatism seem to have been abandoned in favor of President Obama’s explosive growth of social welfare programs. This would seem to refute Governor Perry’s assumptions about our country – and it should be alarming to all Americans.

Consider, for example, the predominantly Republican state of Arkansas (a state that Romney won in 2012). The state’s Governor, Mike Beebe, and U.S. Senator Mark Pryor are both Democrats. But Lieutenant Governor Mark Darr, U.S. Senator John Boozman, all four of the state’s U.S. House members and the majorities in both the state House of Representatives and State Senate, all belong in the Republican category.

Yet despite all the “R’s” that abound in the state, Arkansas has nonetheless gone full-tilt with the implementation of Obamacare. This is to say that the state has implemented a government-run health insurance exchange (26 states in the country have thus far refused to do this), and they have also voluntarily chosen to lower eligibility standards for Medicaid and, thus, to expand the number of Medicaid recipients.

Jay Bradford, Commissioner of the Arkansas Department of insurance, openly admits that the implementation of the insurance exchange will actually raise the price of insurance that cash-paying consumers have to face, but notes that the federal government is currently offering so much money in subsidies so insurance companies can offer either free or reduced-rate coverage (to those who qualify), that the opportunity was too good to pass-up. One can imagine that the decision to expand Medicaid in Arkansas was also based on another one of the President’s “too good to pass up” offers, in as much as the Obama Administration is currently offering to pay 100% of a state’s Medicaid expansion costs (the offer expires at the end of this year).

In case that isn’t sufficiently eye-opening, consider Idaho (yet another state that Mr. Romney won last year). Every one of Idaho’s statewide elective offices, including the office of Governor, Lieutenant Governor, Attorney General, Superintendent of Education, Controller, Treasurer, and Secretary of State, is occupied by a Republican. The state’s two U.S. Senators, and its two U.S. House of Representatives members, are all Republicans. And the Republican Party holds super-majorities in both the state House of Representatives, and the state Senate.

Yet, despite Idaho being an extremely “red” state, a majority of Republicans in the state House and Senate have nonetheless sided with the minority of Democrats in the legislature and have voted to implement an Obamacare insurance exchange in the state (Republican Governor C.L. “Butch” Otter has been pushing his party to do this since last December). Estimates are that, despite the state’s tiny population of less than 1.8 million, insurance companies that operate in the state will take in upwards of $200 - $300 million in federal subsidies, once the insurance exchange is put in place.

Both Arkansas and Idaho have historically qualified as “pro life” states. Socially conservative Protestantism reigns supreme in Arkansas, while both Mormonism and Protestant Evangelicalism are predominate among the Idaho electorate. And three weeks ago Arkansas adopted the toughest statewide abortion restriction in the country. Yet these two states have both embraced Obamacare, despite the fact that the Obamacare insurance exchanges promise to provide funding for abortion-inducing drugs, and, likely, for the procedure of “mechanical abortion” itself.

The point of all this is obvious: in regions of the country where voters still profess to be “conservative,” “pro life,” and “Republican,” they are nonetheless empowering state and local leaders who are bringing about very liberal, socialistic public policy and who are expanding government dependency. Ideas about competitive private enterprise, private sector charity, and personal self-sufficiency are giving way to the promises of government welfare, even as the rhetoric of “traditional marriage” and “the sanctity of life” remains intact.

Rick Perry may be right, and America may once again “choose conservatism” as long as it is presented by the proper candidate.

It may also be true that Barack Obama has more fundamentally altered the fabric of America than anybody cares to admit.

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Obamacare 2013: Now Playing At A State Capitol Near You

by Austin Hill
If elected, Mitt Romney vows to “end” it.

If re-elected, Barack Obama says he’s “open to amending” it.

But regardless of who wins the presidency next month, conscientious voters need to know this: Obamacare is already costing taxpayers lots of money, and within the next few months it will cost millions of dollars more.

It’s bad enough that President Obama’s “if you like your Doctor, you can keep your Doctor” promise has proven false. And it’s bad enough that his promise to “bend the healthcare cost curve downward” has proven to be fictitious, as well (according to MIT Economist Jonathan Gruber prices for private insurance will likely increase 30% by 2016 – this, despite Gruber’s support of the President’s claims in 2009).

Now, state governments are spending taxpayer-funded time and resources figuring out how to comply with the federal mandates. The Obamacare law has imposed a deadline of November 16th, whereby the states must explain to the U.S. Department of Health and Human Services what they intend to do about the establishment of their respective “healthcare exchanges” - the government organized group of standardized health insurance plans from which citizens private citizens and organizations will be permitted to purchase health plans – and the states are deciding now how to proceed.

According to the law, each state can choose one of three options when it comes to setting up an exchange: A) the state can establish an exchange on its own; B) the state can let the federal government set up an exchange on the state’s behalf; or C) the state can choose a “hybrid” approach, and co-mingle both state and federal authorities and resources and produce an exchange together.

Back in August of this year, members of the U.S. House of Representatives heard testimony about the exchanges from Michael Cannon, Director of Health Policy Studies at the Cato Institute. Cannon noted at the time that, given the way the Obamacare law is written, the sitting Secretary of Health and Human Services (whomever that happens to be at any given time) has broad authority to impose requirements and restrictions on a “state exchange,” regardless of whether the individual state government constructs the exchange or if the federal government does it for the state. In cases where a state seeks to set up an exchange, the federal government will ultimately determine which health insurance plans will be “allowed” to be bought and sold in that state, and what those health insurance plans will cover.

Cannon spelled-out this reality in no uncertain terms: “If what you want is a federally run health insurance exchange in your state – a government agency controlling the private health insurance market – if what you want is the federal government to control your state, the best thing you can do is establish an exchange” he told the congressional members. He also noted that once a state makes the overture towards creating an exchange, there is probably no turning back on that decision, legally speaking; the state at that point will have forfeited its sovereignty and will likely not regain it.

For states that don’t want a “federally run health insurance exchange,” Cannon had a fascinating suggestion: don’t do anything. “If the state does not establish an exchange then there might not be an exchange at all” Cannon noted. The reason for this is simply because Congress never approved any funding for the state health insurance exchanges, and given how politically unpopular Obamacare is today, Congress probably won’t approve any such funding for the foreseeable future.

Meanwhile, state government officials are consulting with outside “experts,” and each other, in hopes of determining how to proceed. Just last week, a task force selected by Idaho Governor Butch Otter met and heard over six hours of testimony from both private consultants, and officials from other states.

Bruce Greenstein, secretary of the Louisiana Department of Health and Hospitals, told the Idaho task force that Louisiana has chosen not to create its own exchange.“There is really no way to effectively estimate the state’s costs for creating an exchange and the provisions in the law are vague,” he said. His associate, Carol Steckel, added that “we view this law as a ‘one size fits all’ effort that cannibalizes the private insurance markets. It doesn’t work for us here in Louisiana.”

Jonathan Hurst, a policy advisor to Texas Governor Rick Perry, described the insurance exchange mandate as a “logistical and administrative nightmare,” and noted that “90 percent of the rules that will govern these things have yet to be written” (the hastily drafted Obamacare law makes reference to “future rules” that haven’t been established yet). Hurst said that Texas is not pursuing a state exchange, noting that there are “too many risks and unknowns” in the law, and a state that pursues an exchange today could be held liable for violating rules that will be established sometime later.

Perhaps most striking was the testimony heard in Idaho from representatives of KPMG, the global accounting and professional services firm. Hired by Idaho to research the costs of creating a state exchange, KPMG reported the price to be approximately $77 million to design and implement the exchange, with recurring operational costs estimated to be $10 million annually.

When asked by one of the Idaho task force members what the state would get in return for this estimated $77 million expenditure, KPMG representative Andrew Gottschalk was vague: “It’s hard to explain exactly what you get…It’s hardware, it’s software, there’s infrastructure, there’s people and staffing” he stated. “There would likely be a call center. It’s all kinds of things… there’s a lot of stuff….but it’s hard to be specific.”

But there are two things we can be specific about. As states spend taxpayer dollars crafting programs and plans, the cost of healthcare continues rise.


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Job Creation Nation: America Faces Harsh Realities In 2013

by Austin Hill
The political conventions have passed, the August jobs report is out, and many Americans are said to be “giving up hope.”

So how can we jumpstart our greatest engine of economic growth – the American small business market – and get our economy growing again?

Regardless of which presidential candidate wins this November, in 2013 Americans will have to focus on saving, and expanding, the small business marketplace. The sector of our economy that makes up nearly 60% of the entire American private sector workforce, and creates between 60 and 80% of all new jobs, has been under attack over the past few years by politicians who have created lots of bad laws.

And if Americans are serious about expanding actual employment (rather than merely expanding government welfare and entitlement programs), then we will have to make better choices at the ballot box, and hold our elected leaders responsible for making serious changes. To start, let’s consider consider this harsh reality: the so-called “fiscal cliff” is real, and President Obama’s proposed solution to it is potentially lethal.

Under current federal law, both income tax rates and Social Security tax rates are set to rise dramatically on January 1st of 2013. Along with these tax increases, a dramatic reduction in government services will take hold at the same time.

This confluence of private citizens having more of their money taken away (higher taxes), and a reduction of government services (which means that private citizens will have to fill the gap and spend more of their own money) is expected to trigger a new recession next year. As a means of preventing a “double dip,” both Republicans and Democrats in the Congress have proposed that taxation rates be frozen where they are at, and held steady in 2013.

But President Obama has insisted that taxes should be raised on so-called “rich people” next year, and has refused to do what most economists and many members of his party have said is the one thing that could save us from another downturn.

And with the President polling as well as he is, it seems apparent that millions of Americans are far more excited about his “make the rich pay” rhetoric than they are aware of the consequences of his proposals. Obama supporters may get their wish in November, but it will come at a painful price – a price that all of us will pay.

And here’s another harsh reality: Americans need to get comfortable with other people’s financial successes. Since the early days of his first presidential campaign in 2007, Barack Obama has been pouring fuel on the fires of resentment and envy towards the wealthy. As a political strategy this has worked well for the President, but as government policy this has been bad for all of us.

The President’s tax-hike push is a perfect example, as many of America’s small businesses are set-up under the I.R.S. code as “Sub-chapter S” corporations. These are businesses wherein the company profits are reported to the I.R.S. directly as personal income by the business owners and are subject to personal income tax rates – and many of these business owners are being targeted by President Obama for an income tax-hike.

If the President gets his wish, and the government begins confiscating more money from the owners of Sub-chapter S corporations, by definition this leaves less money in these corporations for hiring and expansion. Thus Americans have a choice to make – do we want to employ our President for another four years so he can satiate the hatred some of us have towards “the rich” and take away more of their money? Or would we like private business owners to have money available to employ more of us? From the way things appear right now, we probably can’t do both.

And here’s harsh reality number three: Americans have to stop Obamacare from wiping-out small businesses. A central feature of this law is the mandate that businesses provide healthcare insurance to their workers. It sounds great – workers will now be “guaranteed” health insurance – but once again, the “make somebody else pay” approach is heaping more weight on the shoulders of small business owners.

Americans must decide how serious they are about job creation – even if it means that some jobs won’t include health benefits. If we honestly want employers to employ more, we must force the Congress and the President to fix this devastating component of Obamacare next year.

And here’s yet another harsh reality: Americans must stop making small businesses a scapegoat on illegal immigration. Roughly two-thirds of Americans want our national borders secured and a coherent immigration policy, yet for over a decade Washington has refused to do the former and has scarcely attempted the latter.

Amid the frustration, businesses have become the target of Americans’ wrath. If business owners would simply quit hiring illegals -so the reasoning goes -the illegals would go away.

Mitt Romney has pledged that, if elected, he will seek to require American employers and workers to register with the federal government’s “e-verify” website, as a means of policing the problem. But this adds even more bureaucratic burdens to small business owners, and ignores our failed immigration policies and un-secured borders.

Do we want politicians who merely tell us what we want to hear? Or do we want leaders in our government who can actually enable businesses to grow? Americans must become more discerning-and face some harsh realities.
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It Is ObamaCare That Throws Grandma Off Of The Cliff

Doctors take a stand on ObamaCare!

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