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Tag Archives: health reform

Look: More Fibbing. Obamacare Saves . . . Not So Much

Oh no. Was President Obama’s promise that Obamacare would “bend the cost curve” on health spending just a bill of goods? Could we just lump this in with “everything’s paid for” and “If you like you insurance, you can keep it” as deceptive White House advertising?

Well, yes!

At least according to the Congressional Budget Office. From Stephen Moore at the Wall Street Journal

Remember the much ballyhooed ObamaCare promise to “bend the health care cost curve down”?

Well, a new Congressional Budget Office report on the long-term trend in the federal budget finds that the costs of Medicare and Medicaid will drive federal spending and debt to all-time highs in coming decades. In one scenario, federal health-care spending doubles over the next 25 years, to 11% of GDP in 2035 from 5.6% this year. In another scenario, the debt eclipses 100% of GDP by 2021 and 190% of GDP by 2035. That’s higher than where Greece is right now, and we see what the bond vigilantes are doing there.

What is conspicuously missing from this report is the magical windfall from the new health law. CBO reports that it is “using the same growth rates that would have been applied in the absence of the legislation.” Now they tell us. Hence, Medicare alone is projected to nearly double over the next 25 years, from 3.7% of GDP to almost 7% by 2035.

CBO warns that ObamaCare’s purported payment cuts to doctors and hospitals and the hoped-for reductions in the growth of the insurance subsidies would be “difficult to sustain over a long period.” Let us translate all this mumbo jumbo: The ObamaCare cost savings are mostly bunk.

 

Americans Really Want Obamacare Repealed

A strong majority of Americans wants to repeal Obamacare, according to a poll released today by Rasmussen Reports.

The survey of likely voters finds that 54 percent at least somewhat favor repeal of the health care law while 35 percent are at least somewhat opposed. And the passion is with the opponents. Some 41 percent strongly favor appeal compared to 28 percent strongly oppose it.

Gosh, the promised White House campaign to sell and explain the law has never materialized. I guess that’s because the more Obama talked about it during the runup to passage, the less popular it became. Or so it seemed. At the very least, he didn’t help.

The Rasmussen poll is something of an outlier, but not inconsistent with other surveys. Polls in recent months by POLITICO, Hearst, and Bloomberg have shown a 6-10 percent margin for those who favor repeal.

What this means, with polling so awful a year after the legislation was passed, is that Obamacare remains a political weakness for Obama, and not one he is likely to solve before Election Day.

There may indeed be consequences to passing sweeping yet unpopular legislation. Give Obama credit, though, for not cooking up policy in the political shop on this one. This one was ideological.

Key Obama Health Cost Saver Fails to Save Much

Well, gosh, this was buried on the Washington Post website and exiled over to page six in the print edition today, so I figured I’d unearth it, wipe off the dirt, and show it to you.

One of President Obama’s key selling planks for the $1 trillion Obamacare health system revamp is that it’s going to help cut the cost of providing health care. And one of the major ways he plans to cut costs is through Accountable Care Organizations, or ACOs.

Under the law, ACOs will start to become part of Medicare starting this January.

Unfortunately, according to the results of a test program described by the Washington Post, they don’t save much money.

The idea of an ACO is that hospitals and doctors will band together into a kind of large unit to provide the best and most “efficient” care. If they obey certain standards of care and are able to achieve cost savings, ACO members will reap financial rewards, gaining a share of the savings. Which means your doctor will be answering to a Higher Authority.

No, not God, but possibly people who think they are. These people are often known as bureaucrats.

Doctors and hospitals will be incentivized to cut costs – “Hmm, let’s wait on an MRI. Why don’t we try some Tylenol first?” – and forced adhere to specific guidelines of care or be punished.

And who will set the guidelines for care? Big Brother, of course. According to the law:

The Secretary of HHS is required to determine appropriate measures to assess the quality of care furnished by the ACO, such as measures of clinical processes and outcomes; patient and, where practicable, caregiver experience of care; and utilization (such as rates of hospital admissions for ambulatory care sensitive conditions) . . . a participating ACO is eligible to receive payment for shared savings if the ACO meets the quality performance standards established by the Secretary of HHS and the ACO meets the saving requirement  . . .

Phew. Sounds like a lot of paperwork and oversight. I hope your doctor doesn’t turn out to be some kind of individualist.

In the study written up by the Washington Post, ten health systems from around the country formed an ACO and were followed for five years. Not much money got saved, even though the groups participating were long-established players and were subject to less stringent rules than those participating under the health law must submit to.

From the article:

Gail Wilensky, who ran Medicare and Medicaid under President George H.W. Bush, said  . . . it is “astounding” that savings were not greater among 10 long-established groups that she said “should have blown it out of the water. . . . It’s like, are you kidding me? . . . If it was this tough for this group that I had just assumed would be hands-down winners, what does it say for groups that don’t have a long history of coming together?”

The experiment, she and other health policy experts point out, was less risky financially for the groups than the proposed ACO rules, because the participants were not penalized for overspending.

Well, let’s try it anyway. That effectively was the quote from Medicare administrator Donald Berwick, who, you may remember, was never confirmed by Congress but rules his kingdom nevertheless.

Pelosi’s District Gets Extra Obamacare Waivers

It’s good to be the queen.

In an example of the type of reporting we don’t see enough of these days, the Daily Caller reveals that last month, nearly a fifth of the waivers from Obamacare requirements went directly to House Minority Leader Nancy Pelosi’s district.

Of the 204 new Obamacare waivers President Barack Obama’s administration approved in April, 38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district . . .

Pelosi’s district secured almost 20 percent of the latest issuance of waivers nationwide, and the companies that won them didn’t have much in common with companies throughout the rest of the country that have received Obamacare waivers.

Of course, Pelosi’s district has way more constituents than most other House districts.

Wait a second . . .

Today’s Obama Poll || America Wants Repeal of Obamacare

Forty four percent of voters believe the health reform law should be repealed compared with 38 percent who do not, demonstrating a persisting thumbs down for Obamacare even after its initial measures – like guaranteeing insurance for those with pre-existing conditions and keeping young adults on their parents policies – have been rolled out.

Obama has pretty much given up trying to sell the law, rarely mentioning it much, though I suppose he’ll have to come back to it as it’s attacked by Republicans during the campaign.

The stats are included in a new poll conducted this month by Hearst Television and Franklin and Marshall College, which finds that Obama has unfortunately fixed something most people don’t believe is a problem. From the F & M report on the poll:

Americans are generally satisfied with how well the current healthcaresystem meets their needs. More than one in three (36%) says the system meets their needs very well, and another two in five (43%) say it meets their needs pretty well, leaving about one in five (20%) Americans who feel the system is not serving theirpersonal needs. These proportions have not changed since the health care reform law was passed.

Nearly nine in ten (85%) respondents report the health care they receive is about the same as it was before the health care reform law passed, and three in four (74%) say the reform law has had no effect on them personally.  More people believe the health care reform law will make the health care system worse (42%) than better (32%) and fewer than one in three (30%) believes the law will bring down the long-run costs of health care.

Obama made a choice. He had enough political capital – or personal willpower – to achieve one or two Big Things. He chose a $789 billion stimulus and Obamacare. The public doesn’t like either. He DID NOT choose immigration reform, deficit reduction or tax reform. He will have to live in 2012 with his choices.

Today’s Obama Poll || Country Divided on Health Law

The nation is about evenly divided on whether or not it likes President Obama’s health reform law, with 46 percent saying it’s a good thing Congress passed it while 44 percent say it isn’t, according to a new Gallup poll.

That’s very bad news for the president. Worse, support is down from when the bill became law a year ago. Then, 49 percent said it was good it passed and 40 percent gave passage a thumbs down.

Sentiment falls predictably along Party lines, with Republicans despising the law and Democrats loving it.

Obama as a doctorObama’s aides keep promising some kind of PR blitz to sell the law, but nothing much has materialized. Instead, bureaucrats are steadily writing regulations while the popularity of the thing steadily declines.

This is surprising in part because the bill was front loaded with a few goodies to stir some enthusiasm before cuts and problems developed.

Slackers up to the age of 26 can now linger on their parents health plans, while seniors were given a gift of $250 to help pay for their Medicare prescription drugs should they fall into the “donut hole” that ends coverage after a certain amount of purchases and then picks it up again if spending continues.

The Big Problem for Obama is that it is his signature piece of legislation. If he doesn’t run on it, Republicans will make him.

And the poll may actually understate the extent to which this law makes people mad.

While people barely approve of Congress having passed the bill, they are not buying Obama’s argument that it will improve the delivery of health care. Only 25 percent agree that the law will make their personal medical care better, while 39 percent say it will make it worse and 31 percent believe their care will stay about the same.

Three Reasons Obamacare is in Deep Doo Doo

Democrats are working hard to portray the inevitability of Obamacare, characterizing GOP efforts to repeal it as political theater while President Obama himself fights a rearguard action by suggesting he’s open to revisions.

But the spin coming out of the Democratic camp and the offers of flexibility mask a reality the White House is well aware of: Obama’s signature achievement is in serious danger of getting killed by its opponents.

There are three reasons for this.

First – and this undergirds the other two reasons by making them more likely –  Obamacare is not popular. Recent polls show opposition running ahead of support by, on average, about a seven point margin. Obama and his Democratic allies jammed nation-changing legislation through Congress even though the measure was unpopular. They promised to make people like it, and they have so far failed. It’s hard to maintain a law people don’t like.

Second, it appears Republicans may only need 50 Senate votes – assuming a Republican is elected president – to sink the law. Many have assumed until now they would have to get 60 to break a Democratic filibuster.

But according to an analysis by former Bush National Economic Council Director Keith Hennessey – an analysis that was also described today in a Wall Street Journal column by Karl Rove – Republicans can destroy much of the law through the “reconciliation” process used to pass the budget. A reconciliation bill avoids the usual Senate rules and requires only 50 votes to pass. According to Hennessey:

Reconciliation is a procedural tool primarily used to change spending and revenues, deficits and debt.  Repeal of the subsidies, the individual mandate, the insurance provisions, and the Medicaid expansions would, in each case, directly affect spending and revenues, so it would be a straight-up-the-middle use of reconciliation for deficit reduction.

Republicans need gain only three more Senate seats – hardly an improbability – to get to 50. They’ll also have to steal the White House, and that’s not an improbability, but it’s no easy task. The health care law itself, unpopular as it is, may make each of these outcomes more likely.

The third reason Obamacare is imperiled is what we’ve seen in the courts. Two federal judges have ruled against the insurance purchasing mandate, without which the law – as a practical matter and possibly as a legal matter – can’t stand. The Supreme Court will eventually decide, and many expect a 5-4 decision to go whichever way Justice Anthony Kennedy says it will go.

And don’t be mistaken, popular sentiment is a factor here too. It is often said that the Supreme Court is influenced by public opinion to a far greater degree than the Justices would acknowledge, even to themselves.

White House Accuses Fla. Judge of Political Agenda

President Obama has not been shy about trespassing the boundaries between the executive and the judiciary branches, memorably scolding the Supreme Court during his 2010 State of the Union about their decision allowing corporate spending in campaigns.

Today, Stephanie Cutter, a veteran Democratic operative who has been put in charge at the White House of making you like the health care bill, launched a personal attack on the Florida federal judge who struck down the health reform bill yesterday.

In her comments on the White House Blog, Cutter clearly suggests that “Judge Vinson” – he’s too contemptible to have a first name – is pursuing a conservative ideological agenda by “overreaching” and engaging in “activism.”

Today’s ruling – issued by Judge Vinson in the Northern District of Florida – is a plain case of judicial overreaching.   The judge’s decision contradicts decades of Supreme Court precedent that support the considered judgment of the democratically elected branches of government that the Act’s “individual responsibility” provision is necessary to prevent billions of dollars of cost-shifting every year by individuals without insurance who cannot pay for the health care they obtain.  And the judge declared that the entire law is null and void even though the only provision he found unconstitutional was the “individual responsibility” provision.

This decision is at odds with decades of established Supreme Court law, which has  consistently found that courts have a constitutional obligation to preserve as a much of a statute as can be preserved. As a result, the judge’s decision puts all of the new benefits, cost savings and patient protections that were included in the law at risk.

Under today’s view of the law, seniors will pay higher prices for their prescription drugs and small businesses will pay higher taxes because small business tax credits would be eliminated. And the new provisions that prevent insurance companies from denying, capping or limiting your care would be wiped away.

We don’t believe this kind of judicial activism will be upheld and we are confident that the Affordable Care Act will ultimately be declared constitutional by the courts.

The bold effect on the last sentence is hers.

The White House is within its right to criticize the decision. About half the Supreme Court will as well, though whether it will be almost half or a little more than half is unclear.

What’s unfortunate, in the nascent Era of Civility that I thought had fully gripped the White House, is the ad hominen criticism of a federal judge.

White House: Repeal Health Law and Sky Will Fall on Your Head

The White House has a two-pronged strategy for rebuffing efforts to scrap or alter the health care law. 1. Resort to specious arguments. This is a good idea because people might believe things that aren’t exactly true. 2. Scare the crap out of you. This is a good idea because you might decide that without… Continue Reading

End-of-Life Care Provision Back from the Dead

The Obama administration has inserted through regulation a politically explosive provision – removed from the health care reform bill to help it pass – that would pay doctors to provide counseling to patients on planning their deaths. The provision encourages doctors – by giving them money to do it – to discuss treatment options for… Continue Reading

Obama’s Health Reform – um – Misstatement of the Truth

Let’s not call people liars. Them’s fightin’ words, and right now my shoulder is sore. The word liar also presupposes more about people’s motives than I usually like to assume. People do make mistakes, even if it really, really seems like the misstatement was intentional. And then there’s wishful thinking . . . So what… Continue Reading