Tag Archives: Rationing

Obamacare’s Sobering Vocabulary Lesson

by Whitney Pitcher

Over the last three years, America has been embattled in a health care reform debate, ranging from the legislative debates to the townhalls and Tea Parties and later on to the actual vote and bill signage and Supreme Court decision. In reality though, we were never really discussing health care reform; we were discussing health insurance reform. The difference is huge and will become more and more evident as time progresses. More Americans may receive health insurance coverage as Obamacare is implemented, but that doesn’t mean that they will receive health care. We need to look no further than Medicaid to see the failures when government gets involved in health insurance and health care. Medicaid has been in place for nearly fifty years, but has the potential to greatly expand in states that choose to do so. However, Medicaid is also illustrative of how health care reform is a complete misnomer.

The New York Times finally highlighted the burgeoning doctors’ shortage on Sunday. Even prior to Obamacare’s passage, a doctors’ shortage was anticipated. However, the shortage of doctors more than doubles with the implementation of Obamacare. What do doctors’ shortages do? As the NYT story notes of current doctors shortages (emphasis added):

Experts describe a doctor shortage as an “invisible problem.” Patients still get care, but the process is often slow and difficult. In Riverside, it has left residents driving long distances to doctors, languishing on waiting lists, overusing emergency rooms and even forgoing care.

Yes, the New York Times would follow up a sentence that notes patients would receive care by noting that the doctors’ shortage would influence them to forego care hoping that their readers would miss their attempt at nuance. Medicaid, though, adds an additionally wrench in the physician shortage, as the NYT goes on to say:

Moreover, across the country, fewer than half of primary care clinicians were accepting new Medicaid patients as of 2008, making it hard for the poor to find care even when they are eligible for Medicaid. The expansion of Medicaid accounts for more than one-third of the overall growth in coverage in President Obama’s health care law.

If there is already of shortage of doctors and  Medicaid patients are hard pressed to find a physician that will take them as a patient, where is the reform of health care? It’s almost as if the government has offered to give the entire country their own car, but only gave everyone a set of keys. One of the main reasons that doctors aren’t accepting new Medicaid patients is due to reimbursement rates, which Obamacare is supposed to increase. However, while President Obama was attempting to offset the financial aspect of care on the backs of the taxpayers through projected reimbursement increases, he neglected to address tort reform, which would have decreased medical malpractice insurance for doctors, while only negatively affecting ambulance chasers and the Democratic politicians to whom they donate, not the taxpayers.

Since Medicaid is partial state funded, there is a state specific aspect of this too. Take Illinois for example, where in FY2012, Medicaid was underfunded by $2.1 billion dollars . Additionally, even if funding stayed flat as Governor Quinn projects, payment to providers is projected to average nearly a year’s delay by FY15. The state is already $8 billion behind on their bills overall, prompting the state comptroller to provide emergency funding to a mental health facility reliant on Medicaid funding to prevent the agency from closing its doors.  The expansion of Medicaid as Obamacare is implemented is supposed to make matters worse. Although the Supreme Court decision allows the states to decide whether or not they are going to expand Medicaid, true to form, Illinois Governor Pat Quinn has already indicated he will. With a growing doctors shortage, a limited number of doctors accepting Medicaid, and the potential for facilities to close due to delayed payment, it would be a miracle if a Medicaid patient even got into the doctor!

Let’s pretend though that a new Medicaid patient was able to get into the doctor, but they have a rare illness or are extremely sick and require a great deal of medications. Well, Illinois Medicaid has stated that they now will limit patients to 4 brand name drugs. This comes after last year, when Illinois cut availability of brand name psychiatric drugs. Fifteen other states have limits on brand name prescriptions as well. To be sure, there are a great deal of generic medications, but there are still situations where there are no generics available. Essentially, this is drug rationing.The implementation of Obamacare, which is predicted to double the number of Medicaid recipients in Illinois over the next ten years, will only exacerbate the problems already in place.

Obamacare may end up technically providing some form of “health insurance” to the majority of Americans. However, if past is prologue when it comes to government’s role in medicine, this will not be legitimate health care reform, as people who now may not have health insurance or health care may inevitably end up with health insurance, but with delayed or non-existent care and limits on what medication they may receive.Of course, this is not what was promised by President Obama. Julia may get her free birth control, but she will likely have a heck of time scheduling an appointment for a doctor to prescribe it for her. Moreover, this is being done on the backs of the American taxpayer, or in the case of Illinois, the $2.1 billion Medicaid underfunding  came on the heels of a 67% state income tax increase and a more than 40% increase in state corporate taxes. This is the kind of newspeak that has become commonplace in the Obama administration, but hopefully proponents of government intervention in medicine will learn a sobering lesson. Health care and health insurance are not synonymous.

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Flashback: Under RomneyCare Massachusetts Resorts To Group Visits With The Doctor

By Gary P Jackson

Since RomneyCare served as the blue print for ObamaCare, it’s important to look at some of the consequences of Mitt Romney’s creation. Health care rationing was a reality from the start, and residents of the Bay State were herded like cattle into doctors’ offices for group exams.

From the Association of American Physicians and Surgeons:

Massachusetts, the proud model for likely Obama-Kennedy reform, is trying a new answer for the problem of a severe doctor shortage: group appointments.

Deluged with demand from newly insured patients, doctors have no room on their appointment schedules for all the new patients. At Holyoke Medical Center, it takes 4 months to get an appointment. A patient with chronic Lyme disease can’t find a single primary physician in three towns who will accept a new patient, so she goes to the emergency room, recounting her history to a different intake nurse, for all medical needs, including her regular prescriptions.

The Massachusetts universal coverage law required 440,000 more people to buy insurance or sign up with expanded Medicaid, and every one of them has to have a primary doctor in order to get into the system. Yet in the past year, 18 primary physicians have left the Amherst area (All Things Considered). , NPR 11/20/08

Harvard Vanguard Medical Associates now features “shared medical appointments.” Dr. Gene Lindsey, reputedly HVMA’s best cardiologist, sees all his patients in groups. HGMA plans to offer group appointments with 50 physicians and nurse practitioners (Liz Kowalcyzk, “The Doctor Will See All of You Now,” Boston Globe 11/30/08).

One group appointment, featured in a Boston Globe video showed nine patients seated in folding chairs around a table with snacks. Dr. Erickson shook hands with each of them and examined them one by one, discussing their medical details aloud. The video showed him listening to and percussing chests through clothing.

[ …. ]

Patients have to sign a form promising not to reveal information they learn about other patients.

The doctor can bill for nine individual visits for the time period in which he previously could have seen only four to six individual patients. He can thus increase his productivity without having to work more.

There were 58 comments posted by Dec 1, and not all patients were pleased.

One wrote: “Nice business model if you can achieve it. Convince state lawmakers to require everyone to ‘get’ medical insurance which is really privatized medical taxation. Now convince the check-writing insuracrats that it’s justified to pay you the same for less service. Sorry, sharing the appointment with others is less service. This is little different than a taxi driver charging each of five passengers the same fare to go from location A to destination B. At least the taxi driver doesn’t provide less service.

Another wrote: “There aren’t enough doctors because doctors are required to practice high-speed cookbook medicine…. So the answer is to speed it up more so patients can listen to canned speeches together?

Other descriptions: “Third-world standard of care: many people being seen by a doctor at the same time, sharing…germs.” A “commoditization” of human beings. Having to listen to all the other patients is a “tax on people’s time.

[ …. ]

The appointments are “voluntary“—although possibly the only kind available for months.

Read more here.

This was written in 2008, not long after RomneyCare was put into practice. Since then it’s become a bigger disaster. The Dayton Tribune reports: Romneycare is bankrupting Massachusetts:

Romneycare in Massachusetts has proven that not only does government run healthcare not work it has crippled the state’s economy. And Massachusetts, often referred to as Taxachusetts is one of the heavies taxed states in the country so raising taxes even more to cover these costs is not really an option for them, but it undoubtedly won’t stop the liberal policy makers there from trying anyway. After all these government bureaucrats aren’t on the same healthcare system the rest of the ‘little’ people are on. They get the best coverage available at the expense of the taxpayer.

Read more here.

More on Massachusetts’ forced rationing of health care:

A 10-member Massachusetts state healthcare advisory board unanimously recommended that the state begin rationing healthcare to keep the state’s marquee universal health care program afloat financially.

The July 16 recommendations, the Boston Globe explained, would result in a situation where “patients could find it harder to get procedures they want but are of questionable benefit if doctors are operating within a budget. And they might find it more difficult to get care wherever they want, if primary doctors push to keep patients within their accountable care organization.

The Globe stressed that the recommendations would “dramatically change how doctors and hospitals are paid, essentially putting providers on a budget as a way to control exploding healthcare costs and improve the quality of care.” “Budget” is a more politically acceptable word for rationing. The Globe also noted that “consumer advocates said patients are going to have to be educated about the new system.” Yes, apparently they will have to get used to having their healthcare rationed.

Read MUCH more here.

Even worse, Romney’s “man caused disaster” is costing the rest of the country as well. Massachusetts received massive amounts of federal dollars to prop RomneyCare up. [emphasis mine]

The Massachusetts fiscal crisis is extraordinary because the state has been raking in the bucks from federal stimulus money for its healthcare experiment. The nonpartisan Massachusetts Budget and Policy Center noted:

Nationally, one of the largest single allocations within the American Recovery and Reinvestment Act (ARRA) is more than $128 billion provided to states for health care. Massachusetts will receive an estimated $17.7 billion through ARRA programs, grants, and direct benefits.

This means Massachusetts, with just two percent of the nation’s population, will receive nearly 14 percent of stimulus money for healthcare, seven times its share.

But that hasn’t been enough money for the burgeoning Massachusetts healthcare budget, already under assault by high premiums for state employees and Medicare and Medicaid premiums.

Massachusetts State Treasurer Tim Cahill warns that Romneycare “is bankrupting the state and would have bankrupted our state if not for the federal government being overly generous with Medicaid reimbursements over these last four years. They’ve really propped the system up to keep it in place.”

Yet, over in Washington, D.C., Democratic leaders trumpeted the similar healthcare package on the federal level as a deficit reducer.

If the American taxpayer is having to bail out Massachusetts because of RomneyCare, just who in the hell is going to bail out the United States if ObamaCare isn’t repealed?

Read more here.

When one reads about the monster Mitt Romney created, it’s a long tale of disaster after disaster. It’s highly unpopular with the people of the Bay State. It’s caused Massachusetts residents nothing but grief.

RomneyCare served as the blueprint for ObamaCare. It’s the canary in the coal mine. It’s why we must repeal ObamaCare in it’s entirety, and never allow Mitt Romney, or anyone like him, near elected office again.

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