Tuesday, July 14, 2015

ObamaCare Octopus

I awoke this morning thinking about how I should organize the 2470 Medinnovation blogs I have written since ObamaCare passed on March 23, 2010.

Chronologically to show how the law has evolved?

Topically do demonstrate how the law effects different groups in different ways at different times?

Philosophically to highlight the different idaological moral and economic points of view?

Metaphorically in an attempt to simplify a multidimensional, convoluted, complicated subject.

If I were to choose the latter, what metaphor would I use? The Octopus would be my choice.

The Octopus is top-down creature who scours the bottom of the sea bed. It has 8 tentacles with suckers which it may use for different purposes. In the case of health reform, the fleshy body of the octopus could represent the power of centralized government, seeking nourishment by bottom feeding.

The tentacles might stand for entangling bureaucracies, compromise of free market principles, adverse effects on individual freedoms, protection of the uninsured, unintended undermining of the economy and the middle class, a profound restructuring of the massive $3 trillion dollar health system.

The octopus metaphor just might work. I have used it in 3 previous blogs.

“The ObamaCare Octopus,” May 4, 2012

“More on the ObamaCare Octopus,” May 21, 2013

“How to Debated the ObamaCare Octopus.” October 3, 2012

In the first of these blogs, I defined Octpus a cephalopod mollush with a soft body, and a large head with an underside ante 8 arms with suckers.

I went on:

“ Obamacare is a wondrous, wily, and wide-reaching creature. It has a large bi-lobed brain. One side of the brain is called Medicare, the other Medicaid. ( to these one can now add ObamaCare and health exchange plans.

It has a large budget, officially $1 trillion, but nearer $1.3 trillion if one includes ancillary health programs such as those for Veterans and others. Collectively it spends 50% of all health care dollars.

It has a large ink-sac – with chambers for black, red, and purple ink. The black chamber is the smallest and is said to represent “savings,” which have yet and may never be seen. The red chamber is huge, and Obamacare continually squirts red ink out of it, to the tune of $1.76 to $2.23 trillion over the next 10 years, depending on which federal agency. the CB0 or OMB, you ask. The purple chamber is the most effusive. It is capable of gushing gobs of purple prose to mask the red ink.

The octopus is highly mobile and continually changeable. It moves fast both at the bottom and top of the ocean know as American society. It has been known to sprout wings, if the political occasion demands. It can assume the hues required to sooth and seduce allies and enemies. It even has a megaphone, called the mainstream media, to broadcast its message, or to hide its intent as it glides along the bottom or occasionally rises to the surface.

Its real power lies in its eight tentacles. These tentacles can vacuum up monies and liberties and suck them up into the central brain, which is crawling with experts, bureaucrats, administrators, and elites of every stripe, all of whom know now to distribute power and redistribute other peoples’ money.


· One tentacle reaches into the pocket of taxpayers, from which it will extract at least $500 billion to pay for new entitlements.

· A second tentacle sucks $575 billion out of Medicare, through such “savings” incurred by dismantling Medicare Advantage and herding patients, doctors and hospitals in Accountable Care Organizations.

· A third tentacle feeds its expanding brain and soft body by tamping down Medicare physician incomes and hospital revenues to below those of Medicaid by 2019.

· A fourth tentacle presses down on State Medicaid budgets, adding 32 million initially and 46 million more by 2020 while suctioning money out of State budgets for education, transportation, and other social services.

· A fifth tentacle is placed down upon patients, who will be losing their existing health plans and doctors, because of federal rules, regulations, and costs.

· A sixth tentacle draw upon large and small employers who will be required to offer coverage, accept high cost government programs, or pay financial penalties.

· A seventh tentacle will be applied to healthy young families and adults, who are already seeing costs rise and benefits shrink, and who object to having to pay for comprehensive plans they feel they do not need.

· An eight tentacle is Obamacare’s operating system and underlying values which are fundamentally at odds with the principles of limited government under the U.S. Constitution.

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