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Archive | Healthcare

How Obamacare Will Hurt doctors

Writes Dr. Mark Siegel in the NY Daily News:

A study just published in the prestigious journal Science reveals that new Medicaid patients in Oregon were 40% more likely to use the emergency room than the uninsured were. This finding is not a surprise to me or most physicians — we have known that truth for years.

But it does undermine one of the basic philosophical and practical underpinnings of Obamacare: the notion that expanding insurance will invariably unclog ERs, improve primary and preventive care, prevent diseases and lower costs.

The study underlines the findings of a prior survey by the PricewaterhouseCoopers consulting firm that indicated that Medicaid patients are 35% more likely to use the ER unnecessarily than are the uninsured.

The reason for ER overuse is simple: Medicaid patients (like all insured patients) feel that their insurance card entitles them to health care anytime they want it. When office doctors aren’t available to provide it, they go to the hospital to get it.

Read the rest of How Obamacare will hurt doctors.

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WSJ: Obama Repeals ObamaCare

From WSJ.com:

Under pressure from Senate Democrats, the President partly suspends the individual mandate.

It seems Nancy Pelosi was wrong when she said “we have to pass” ObamaCare to “find out what’s in it.” No one may ever know because the White House keeps treating the Affordable Care Act’s text as a mere suggestion subject to day-to-day revision. Its latest political retrofit is the most brazen: President Obama is partly suspending the individual mandate.

The White House argued at the Supreme Court that the insurance-purchase mandate was not only constitutional but essential to the law’s success, while refusing Republican demands to delay or repeal it. But late on Thursday, with only four days to go before the December enrollment deadline, the Health and Human Services Department decreed that millions of Americans are suddenly exempt.

Individuals whose health plans were canceled will now automatically qualify for a “hardship exemption” from the mandate. If they can’t or don’t sign up for a new plan, they don’t have to pay the tax. They can also get a special category of ObamaCare insurance designed for people under age 30.

Read the rest: Obama Repeals ObamaCare

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The Walmart Approach To Heart Surgery in India Cuts Costs by 98%

India’s Walmart of Heart Surgery Cuts the Cost by 98% – Businessweek

Devi Shetty keeps photographs of Mother Teresa and Mahatma Gandhi on his desk, and he’s obsessed with making cardiac surgery affordable for millions of Indians. But these two facts are not connected. Shetty’s a heart surgeon-turned-businessman who founded a chain of 21 medical centers around India. Every bit the capitalist, he has trimmed costs by buying cheaper scrubs and spurning air-conditioning and other efficiencies. That’s helped cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,555)—half of what it was 20 years ago. He wants to get it down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the Centers for Medicare & Medicaid Services.

“It shows that costs can be substantially contained,” says Srinath Reddy, president of the Geneva-based World Heart Federation. “It’s possible to deliver very high-quality cardiac care at a relatively low cost.”

Medical experts like Reddy are watching closely to see if Shetty’s severe cost-cutting can serve as a model for making life-saving heart operations more profitable and more accessible to patients in India and other emerging nations. “The current price of everything that you see in health care is predominantly opportunistic pricing and the outcome of inefficiency,” says Shetty, who opened his flagship hospital, Narayana Hrudayalaya Health City, in Bangalore in 2001.

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Obamacare Rolls On and On

Insurance companies will have to pay out an average of 32 percent more for medical claims on individual health policies under President Obama’s overhaul, the nation’s leading group of financial risk analysts has estimated.That’s likely to increase premiums for at least some Americans buying individual plans.

The report by the Society of Actuaries could turn into a big headache for the Obama administration at a time when many parts of the country remain skeptical about the Affordable Care Act.

While some states will see medical claims costs per person decline, the report concluded the overwhelming majority will see double-digit increases in their individual health insurance markets, where people purchase coverage directly from insurers.

The disparities are striking. By 2017, the estimated increase would be 62 percent for California, about 80 percent for Ohio, more than 20 percent for Florida and 67 percent for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.

The report did not make similar estimates for employer plans, the mainstay for workers and their families. That’s because the primary impact of Obama’s law is on people who don’t have coverage through their jobs. [Link]

 

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Food Nazis: Whose life is it anyway?

Spiked has two interesting articles on eating. One is about the “war against obesity” (newly declared) because fat people, it is alleged, are a drag on the environment and on society.  Body-mass challenged people ought to be compelled to consume less and register at the local gym to work off all their ripples and redundant pounds. Frank Furedi makes short shrift of this policy, which the health Nazis in the U.S. arduously campaign to have implemented, as well, starting with Big Gulps and banana-split milkshakes, among other enjoyables.

The overbearing omniscience of obesity objectors.

http://www.spiked-online.com/site/earticle/12558/

Barbara Hewson, in the meantime, asks the question: If a person wants to die, why would the state be so interested in keeping her alive, and be willing to spend a small fortune of taxpayer money to attempt it? Suppose she signed the necessary paperwork in the way of medical directives that would allow her to die on her own terms? Suppose the state overrode her intentions and prescribed a regimen that would kill her in the end? What purpose would be served?  Whose life is it anyway? Has the state first dibs on your existence? Hewson doesn’t answer these questions, but comes close to it.

http://www.spiked-online.com/site/earticle/12559/

Very interesting reads.

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Obama’s Legal Minions Name Their Enemy

From The Atlanta Journal-Constitution:

Provisions of the federal Affordable Care Act, also known as ObamaCare, “may violate the constitution of Ayn Rand, but they do not violate the Constitution of the United States,” acting solicitor general Neal Kumar Katyal told a three-judge panel of the 11th Circuit Court of Appeals Wednesday. Conversely, attorney Paul Clement, representing Georgia and 25 other states, framed the issue of mandated purchase of health insurance as an issue of liberty. “Can the federal government compel an individual to take part in commercial activity in order to better regulate that individual?” he asked the judges. [ObamaCare gets put through judicial wringer | Jay Bookman

And what does Ayn Rand have to say about the constitution?

The American system of checks and balances was just such an achievement. And although certain contradictions in the Constitution did leave a loophole for the growth of statism, the incomparable achievement was the concept of a constitution as a means of limiting and restricting the power of the government. [...] 

Today, when a concerted effort is made to obliterate this point, it cannot be repeated too often that the Constitution is a limitation on the government, not on private individuals—that it does not prescribe the conduct of private individuals, only the conduct of the government—that it is not a charter for government power, but a charter of the citizens’ protection against the government. [“The Nature of Government”, The Virtue of Selfishness]

The clause giving Congress the power to regulate interstate commerce is one of the major errors in the Constitution. That clause, more than any other, was the crack in the Constitution’s foundation, the entering wedge of statism, which permitted the gradual establishment of the welfare state. But I would venture to say that the framers of the Constitution could not have conceived of what that clause has now become. If, in writing it, one of their goals was to facilitate the flow of trade and prevent the establishment of trade barriers among the states, that clause has reached the opposite destination. [“Censorship: Local and Express”,  Philosophy: Who Needs It 184]

This view is apparently what the Nihilist’s of the Obama administration disagree with.

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Video: The Doctor Cog in the Obamacare Washington Machine

Health Care Reform: Setting Doctors Free [Livestream]

Dr. John David Lewis: Obamacare is a moral assault on free people, and an attack on human life itself.

Government medicine treats doctors as cogs in a giant machine, run from Washington, as if treating patients required no independent thought or action. Twenty-eight states have filed suit against Obamacare, claiming it is unconstitutional. But it is much worse than that. It is a moral assault on free people, and an attack on human life itself. John Lewis has a unique perspective on this issue, both as an advocate for individual rights and as a cancer patient. Don’t miss this hard-hitting lecture on the deepest evil of government medicine.

John David Lewis is a Visiting Associate Professor in the Philosophy, Politics, and Economics Program at Duke University, and a senior research scholar in history and classics at the Social Philosophy and Policy Center, Bowling Green State University. He has taught at the University of London and Ashland University, and is a fellow of the Anthem Foundation for Objectivist Scholarship. He has a PhD in classics from the University of Cambridge. He is an outspoken proponent of free market medicine.

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If Obamacare is so great, why do so many people want to get out from under it?

Writes Michael Barone at the Washington Examiner:

[...] If Obamacare is so great, why do so many people want to get out from under it? More specifically, why are more than half of those 3,095,593 in plans run by labor unions, which were among Obamacare’s biggest political supporters? Union members are only 12 percent of all employees but have gotten 50.3 percent of Obamacare waivers.

[...] Punishing enemies and rewarding friends — politics Chicago style — seems to be the unifying principle that helps explain the Obamacare waivers, the NLRB action against Boeing and the IRS’ gift-tax assault on 501(c)(4) donors. [Obama skirts rule of law to reward pals, punish foes]

 

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As Good As One Could Expect: Notes on Judge Vinson’s Opinion of Obamacare

Amy Peikoff writes in her blog, Don’t Let It Go, on Judge Vinson’s 78 page opinion in which he held that Obamacare was unconstitutional:

[...] When I first read the opinion, I was not pleased. I was not pleased that Vinson began by using an Originalist approach; I was not pleased that he seemed to concede the propriety of treating the Constitution as, in effect, a “living” document; I was not pleased that he implied that the Supreme Court could — in fact that he seemed to invite them to — eliminate the activity/inactivity distinction. I feared that the Supreme Court might just decide that, in our modern commercial age, yada, yada, yada, an economic decision can constitute “activity” for purposes of the Commerce Clause, and that Vinson hadn’t done enough to prevent this. I found his basic argument — that, given the current state of Commerce Clause jurisprudence, if this law were to be upheld, no real distinction could be made between the “individual mandate” and anything else Congress wanted to make people do, and therefore, if this law were to be upheld, our government would no longer be a limited one whose powers are enumerated — terribly unsatisfying. But today, after sleeping on it (even if only for a few hours), and having a brief interchange with an actual Constitutional Lawyer, I realize that my expectations are unrealistic. This is about as good as one could expect.

First, even if Vinson were an Objectivist, his job would be to apply the law, as it exists, to the facts of the case before him. Thus, even if he rejected the Originalist approach, he would still be stuck with the language of the Commerce Clause itself, plus all of the horrible precedent expanding Congress’s powers under that clause. Especially given that Vinson is a district court judge, it seems the best he can do is to explain why, in the context of this binding precedent, Obamacare goes too far, and is therefore unconstitutional. So, given that I’ve concluded this was Vinson’s assignment, is there something significant he could have done that would have been more satisfying to me? I did find his expressing “reluctance” in striking down the legislation to be annoying. I mean, at least he needn’t be reluctant! He is, after all, assuming he is right, saving us from a government whose powers are no longer enumerated and limited, right? He should be glad about this! I also was annoyed that he seemed to be inviting the Supreme Court, twice during the course of his opinion, to reformulate its Commerce Clause jurisprudence in a way that allows them to uphold this legislation. However, what I realized today is the only significant thing I found missing was some sort of argument as to why it must be an activity that Congress regulates under the Clause. I wanted some sort of positive justification for the activity/inactivity distinction. It was no good to just hang one’s hat on the idea that, if you get rid of this distinction, Congress could do whatever it wants. I needed more!

What sort of argument could one provide?

Find out in her enlightening post, Notes on Judge Vinson’s Opinion.

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Obamacare: Null and Void

From Judge Rules Health Care Law Is Unconstitutional:

A U.S. district judge on Monday threw out the nation’s health care law, declaring it unconstitutional because it violates the Commerce Clause and surely reviving a feud among competing philosophies about the role of government.

Judge Roger Vinson, in Pensacola, Fla., ruled that as a result of the unconstitutionality of the “individual mandate” that requires people to buy insurance, the entire law must be declared void.

[...]

“While the individual mandate was clearly ‘necessary and essential’ to the act as drafted, it is not ‘necessary and essential’ to health care reform in general,” he continued. “Because the individual mandate is unconstitutional and not severable, the entire act must be declared void.”

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Dr. Hendricks on Obamacare (1957)

“I quit when medicine was placed under State control some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I could not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, but ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness at which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in the operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”
– Dr. Hendricks, a fictional character in Ayn Rand’s novel Atlas Shrugged, published in 1957
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