Wednesday, April 30, 2014

ObamaCare Dilemma: Economic Growth  and Employment Versus the Uninsured  and Narrowing of Health Care Choice**

On this side lay Scylla while on that Charybdis in her terrible whirlpool was sucking down the sea.

Homer(700 BC), Odyssey XII

The strongest principle of growth lies in human choice.

George Eliot (1811-1880)

ObamaCare reminds me of the Greek myth of Scylla and Charybdis.  Scylla was a loathsome dark monster (the uninsured), inhabiting an inacessible  cave on an unscalable rock;  Charybdis ( capitalism ) was  a fatal whirlpool (sucking down the poor).

The two represent the dreadful alternatives between which one must make a choice.

In the case of ObamaCare, the choice may be between economic growth , which in the U.S. in the first quarter of 2014 was a dreadful 0.1%,  and the narrowed choice of health care providers and health exchange plans  offering average premium increases of 47% and $6000 deductibles.

Texas is a good example of the dilemma facing Americans.  Texas has the nation’s second highest GDP growth rate of 4.8% (after shale-rich North Dakota at 13.4%), yet Texas ranks dead last in the number of uninsured at 26.3%.   

The American people have made their choice. The Texas population has grown 20.1% versus 9.0% for the rest of the U.S.  over the last decade.  Texas added 1.3 million people from 2010 to 2013, more than any other state, pushing past 26 million.   Its unemployment rate is 5.5% compared to the U.S. average of 6.7%.  Half of the nation’s 10 fastest growing cities are in Texas.

Liberals heap  scorn on Texas, accusing Texans of being all hat and no saddle,  all business and no heart.  But people from other states,  including liberal California,  do not agree. One quarter of Texas new residents hail from the Golden State.   And international and national corporations  do not agree.. Toyota just moved its North American headquarters to Plano, Texas.  

Physicians are also moving to Texas in record numbers because of its lower taxes,  lower costs of doing business, and low malpractice rates. As I indicated in a July 1, 2012 blog, Texas may represent the future of health care. Three quarters of Texas physicians are from other states.

All of this inward migration to Texas indicates that robust economic growth  and low unemployment  are higher priorities for Americans and their physicians than ObamaCare.

The moral of this tale may be: Don't mess with Texas.  It knows what it is doing.

Tweet:   Economic growth and unemployment are more important than ObamaCare  for Americans and their physicians.

** For comment or contact,  call Dr. Reece at 1-860-395-1501 or email me

Tuesday, April 29, 2014

ObamaCare and the 3Rs**

Reading,  ‘Riting, and ‘Rithmetic

Reading, ‘Riting, and ‘Rithmetic are education basics.  In talking of ObamaCare, however, if you are a vulnerable Democrat  running for reelection to Congress,  you avoid the other  3Rs -  Reform,  Recovery, and Rationing.  

Reading about your chances for "Reform" is depressing (“Outlook Bleak for Democrats,” Washington Post, April 28; “ObamaCare Approval Rating, a Drag on Fellow Democrats,” Real Clear Politics, April 28).

'Riting about it is hazardous. You may be quoted by the opposition as hopelessly naïve and out of touch with reality.

And the 'Rithmetic s daunting  when you consider its impact on premiums,  deductibles, costs,  and the economy.  It is a exercis in math  with more negatives than positives. 
In the words of Alice in Wonderland,  Reform  is about “Reeling and Writhing, to begin with, and the different branches of Arithmetic – Ambition, Distraction, Uglification, and Derision.”

Reform,” of course, refers to ObamaCare, which was designed to wipe out the uninsured and to replace it with government subsidies and Medicaid expansion.  "Reform" was intended to cement the legacy of the President and his party as purveyors and guarantors of the entitlement state and to cement their hold on political power.  Instead “Reform” has become an albatross,  if you believe the polls, which are 96% negative on dislike of the health law; the President’s approval rating, which has dipped to 41%, and the disinclination of Democrats to even talk about reform,  especially in those seven red states up for Senatorial grabs.

As far as the second “R”, Recovery, the question is” What 'Recovery'”?   Over the last 5 years,  economic growth has averaged 1.8% compared to 3% to 4% growth in other recoveries since World War II.  And last month,  a NBC/Wall Street Journal poll showed 57% of Americans think the U.S. is still in a "Recession", another “R” word to be avoided except to say the "Recession" is due to those  double R, “Rotten Republicans,” who got us in the deep  hole we are in today.

The 3rd R,  Rationing,  is another No-No word for Democrats. It smacks of socialism and the rationing that always goes on in countries with that form of government.  But, alas, “Rationing” in subtle forms is precisely what Americans are getting -  “Rationing” of numbers and information as to who makes up those 8 million who signed up for health exchanges, “Rationing”, pardon“Narrowing of the Networks, “ of the hospitals and doctors who will accept health exchange patients, “Rationing” by waiting as you try to find a primary care doctor or a specialist who will accept you as a patient at those low government rates, “Rationing” of resources for Medicare Advantage patients, and “Rationing” of personal liberties and choices of  heath plans.

Tweet: 3Rs that Democrat congressional candidates avoid are woes of Reform, Recovery, and Rationing, which ObamaCare  hasbegotten.

For comments, contact Doctor Reece at 1-860-395-1501 or


You hit singles, you hit doubles; every once in a while we may be able to hit a home run.

President Obama at April 28, 2014 news conference on Ukraine

Think of the Presidency as a series of baseball games. Each game has hits, runs, and errors. Each game has a winner and loser.   Each game is part of a long season and a pennant race.  Each game has an opponent.  

The baseball field has an infield – domestic policy- and an outfield – foreign policy.  The infield players are members of the President's  administration.   The outfield players are the state department and your military advisors. The vast audience now at the park consists of 315 million Americans.

Now consider the current ObamaCare game.  It is the fourth inning (The President is just over half way through his second term).  The outcome remains in doubt.  The President's  opponents, the Republicans, a ragtag team with established players and rookie upstarts, are putting up a tough fight.   The President 's team  have just been up to bat, and they  have just scored  8 million runs.   The President claims  he has  hit a home run, and the game is over.  His opponents, and the umpires dispute his call, and so does the crowd at the park.

His troubles are twofold:   

·         The fat lady has yet to sing, and she will not sing under after the November midterms, which is analogous to the All-Star break half-way through the season.

·         The other side has still not had all its turns at bat.  They will swing for the fences until November, and no one   knows  how many  runs they will score.

For the President to declare he's the winner because his team has  8 million runs is a bit of a stretch.   Let’s call it the 5th year stretch.    He may think you’ve crossed home plate, and that, as President, you’re the winner. But the outcome remains in doubt.

You will not know how much your 8 million runs mean until the statistician sorts out the  numbers behind your runs.  And the runs may look meaningless when the health plans announce their premium hikes in late May or early June, just halfway through the election season.   If premiums double, as WellPoint and health care agents expect,  8 million runs may  be inadequate to win the game.   

It’s a long season, Mr. President, and in this particular game. You have just hit a single.  You are now trying to steal  second base.     Your opponents hope to cut you down by executing  a double play by winning the House and Senate.    

The throw from the catcher may be on time or  late.  The catcher is right handed, and his vision is partially obscured by a left handed batter.   The outcome of the game hangs in the balance.     The other team is error-prone, and results of other games in other fields of play – the economy, other states, and foreign policy – may determine the outcome of this particular game.

Tweet:   Obama Care can be compared to a baseball game, with hits, runs, and errors, and an uncertain outcome until the final inning is played.

**To comment on this blog or contact the author, call 1-860-395-1501 or e-mail doctor.

Monday, April 28, 2014

The Hard Choice**

A Hobson’s choice is a free choice when only one choice is offered.

Definition,  Hobson’s Choice

In a presentation I am giving before a group of hospital chaplains,  I comment:

“There are two ways of looking at health reform – from top-down government or bottom-up markets."

It’s a hard choice.  How does one strike the balance between economic growth, which unevenly  lifts all boats with freedom to choose;  and  economic stagnation, which treats everybody equally, but leaves everyone in the boat choiceless and voiceless?

Tweet:  Churchill: “The chief vice of capitalism is the unequal sharing of blessing: the chief virtue of socialism is the equal sharing of misery.”

** For comment or contact, call Richard Reece MD at 1-860-395-1501 or e-mail me at