Friday, September 13, 2013
A Big "F--king"Deal!
This is a big f- - king deal!
Vice-President Biden in a whispered aside to President Obama upon signing of Patient Protection and Affordability Act
Vice President Biden was absolutely correct. ObamaCare is a big deal, a very, very big deal. It is the biggest deal in in American legislative history. It may be the most expensive too, if Medicare-Medicaid is any example. In 1965, the twin programs were forecast to cost $9 billion by 1990. Today their cost runs $1 trillion, give or take a few $ 100 billion. ObamaCare is at the heart of the current Democrat-GOP negotiations to reset the debt ceiling, to cut government spending, to defund or not to defund the health law, to keep the government open or to close it down temporarily, and to avoid blame should the government be shut down if negotiations fail. The latest GOP proposal is to delay Obamacare for a year in exchange for increasing the debt limit and rescinding the sequester.
From the GOP side, Obamacare is a big deal because.
· It affects every American – rich or poor, old or young, sick or well, insured or uninsured – and will require increased taxes to implement.
· It has no real cost controls. Indeed according to Congressional Business Office, its costs may double or triple over the original estimate of $984 billion over the next decade.
· It is widely considered to be a hiring and innovation suppressant and big factor in the slow 2% growth of the American economy.
· It is the root cause of the current bitter political partisanship, which dates back to the March 23, 2010 passage of Obamacare without a single Republican vote and without consulting GOP leadership.
· It is “highly disruptive”, as evidenced by the outspoken opposition of American unions over Obamacare provisions that effect 20 million of their members.
· It is riddled with political favoritism, as is clear from multiple waivers and exemptions to Congress members and their staffs and to various Obama allies.
· It threatens to turn America into a “part-time nation,” as corporation rush to reduce the 40 hour work week to 29 hours to avoid Obamacare penalties.
· It may cause businesses to drop health benefits to as many as 20 million workers, including retirees.
· It is a philosophical clash between proponents of Big Government and Limited Government based on free market capitalism.
· It promotes widespread government dependency, e.g. 50 million on food stamps,” and makes nonworking and disability payments as attractive as employment.
· It ends the dream of a genuine partnership between the federal government and state governments.
On the Other Hand
On the other hand, ObamaCare has its positives. As President Harry S Truman said, “Give me a one-handed economist! All my economist say, on the one hand or the other.”
On the other hand, ObamaCare protects patients with pre-existing illnesses or who have exceeded spending limits, young adults up to age 26 under their parents’ plans, seniors who have fallen into the donut hole. It offers free preventive care. It proposes health exchanges, where people can pick and choose the best plans for themselves, even though they may to drop current plans or doctors and choose from limited networks as major insurers drop out of some state markets. It protects the old and some of the middle class by forcing the young to pay their “fair share.” It proposes to convert health care into a “Science” from an "Art” by paying more for comparative performance and outcomes and by claiming it can use computers to judge what doctors are efficient, what doctors are inefficient, what care works, what care doesn’t work, and who should be rewarded and who shouldn’t be.
Besides, we do not yet whether premiums will rise or fall. Premiums vary with the state. It is too early to tell whether costs overall will rise.
Anyway, Obamacare might even work as predicted, given time, cooperation, and coordination between the politically conflicted, the government-addicted, businesses-afflicted, workers-evicted from their current plans and doctors, and unrestricted government spending.Tweet: No matter how you slice or dice it, Obamacare is a huge personal and economic issue for the United States and all of its citizens
Posted by Richard L. Reece, MD at 10:09 AM
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