Where’s Obama?

I shot an arrow into the air,
It fell to earth, I know not where.

Longfellow (1807-1882), The Arrow and the Song

So all who hide too well away
Must speak and tell us where they are.

Robert Frost(1874-1963) Revelation

With his approval rating at an all-time low of 40%, President Obama is hard to find on the campaign trail.

Vulnerable Democratic candidates do not ask him to speak or appear at their events for fear of losing their tight races. Alison Grimes, Democrat running against Mitch McConnell for Senator in Kentucky, even refuses to say whether she voted for Obama, while other Democrats avoid the subject of Obama altogether.

Where will you find Obama?

The answer is three fold.

One, at fundraisers for the Democratic Party. He has appeared at more than 400 fundraisers during his presidency, and this year been at 58 fundraising events.

Two, where the rich capitalists and the wealthy celebrities reside. These people, sometimes labeled “crony capitalists,” generally live in New York City and environs, California, or in metropolitan areas with high profile academic centers.

Three, where the influential women are. Women favor Democrats, and in health care , where they make 80% of health care decisions for families,

These factors were in evidence this week at the Los Angeles home of actress Gwyneth Paltrow, who swooned when introducing the President, saying she could hardly speak because he was “so handsome.”

And indeed handsome and attractive he is – to women - but not to men and Republicans. Democrats have spent as much as 60% of their $120 million in midterm TV advertising to the “war on women,” focusing on abortion, women’s health, contraceptive coverage, and equal pay for equal jobs.

By throwing $70 million dollars at the women issue, Democrats hope to survive, even thrive, after the midterms. Republicans lose single women by as much as 20 points, black women by 85 points, Hispanic women by 57 points. Times, however, may be changing. A George Washington University poll has Republicans winning married women by 16 points, white married women by 23%, and losing single women by only 2 percentage points.

As for men, polls in Kentucky , Colorado and Alaska have Republicans winning men by 11 to 19 points. Men judge Obama more harshly on the economy, health care, and foreign affairs (Kimberly Strassel, “American is ‘War on Women” Weary,” WSJ, October 10, 2014).

The Democratic and Obama agenda makes sense when you consider the fact that there are more women than men, money wins elections, and Obama knows where to go where the money is.

October Surprises

The single most surprising thing you encounter in government is competence because it’s so rare.

Daniel Patrick Moynihan (1927-2003), Democratic Senator from New York

In American politics, an October Surprise is a news event partisans use to discredit the opposition.

Take yesterday’s 334 point decline in the Dow Jones average. The magnitude of that drop surprised Americans. It was being attributed to tumbling oil promises and stagnant economic growth, particularly in Europe. Some Republicans were saying the huge decline was reminiscent of Black Tuesday, October 29, 1929, when the world’s economy collapsed and we entered the Great Depression.

Critics say America’s corporate income tax, the highest in the world, restrictive regulations, high income taxes, and ObamaCare’s negative affect on hiring full-time workers, are responsible for the decline. That's unlikely since the Dow Jones went up 200 points earlier in the week, and we still have the most resilient economy in the world.

Other October “surprises” include hundreds of thousands of health plan cancellations, and rapid increases in premiums and deductibles, both set to go into effect before November 1. Rate increases average 9.8% t0 18.3% in Vermont, 15% in Kentucky, and 22% in Virginia. Health plans say they must cancel plans and raise rates to cover losses caused by ObamaCare regulations imposing 10 essential health “one-size-fits-all” benefits for all plans.

The government will cover losses through 2017 by bailing out insurers, but plans say then all hell will break loose with explosions in costs, hence the need to cut costs, raise rates, and narrow networks to less costly hospitals and doctors now.

Or ponder the news that the Supreme Court may announce in October it will take up the case of whether it legal for federal health exchanges to offer subsidies when the health law says only state exchanges can do so. Can you imagine the outrage when people are asked to pay back subsidies?

Or look at all those national polls indicating that the Republicans, who have vowed to replace or repeal or defund ObamaCare, will probably win the Senate by 52 to 47, and you have even higher levels of uncertainty and anxiety.

Throw in the “surprises” that healthcare.gov’s front end didn’t work and its back end is still under repair, the failed promises that you could keep your doctor and health plan, ISIS winning the war in Iraq and Syria, Ebola on the loose outside of Africa, and October polls saying 27% of Americans are not satisfied with the way the country is being run (Gallup) and only 13% trust government" to do the right thing most of the time"(CNN), and it should come as no surprise that Republicans are delighting in highlighting October’s surprises.

ObamaCare Waves

What Are the Wild Waves Saying?

J.E. Carpenter, Title of Song, 1850

As November 4 midterm approaches in 26 days, Obamacare waves are breaking upon the beaches.

Today Fox News’ Jim Angle ran a story “More Health Plans To Be Cancelled Under ObamaCare.” Angle reports 13 states will cancel hundreds of thousands of health plans plans before November 1 because the plans do not comply with ObamaCare requirements.

Most prominent among these states will be Virginia, It will cancer 250,000 plans. These cancellations may not sit well with the electorate, who will go to the polls on November 4.

Obama has told the public 37 times they can keep their doctors and health plans, and voters may be growing leery of Obama’s dashed promises.

Waves

President Obama himself must be growing weary of these waves. The waves include waves or high premiums and deductibles, waves of discontent over hassles of signing up for healthcare.gov, waves, waves of closures of small rural hospitals, waves of small businesses hiring only part-time rather than full-time workers to avoid ObamaCare penalties, waves of doctors not accepting health exchange plans, waves of people opting-out of health insurance and paying the penalties instead, and, of course, waves of withering GOP criticisms over ObamaCare disruptions.

Then there are those waves of media reports.

• “ObamaCare Waves Reach Shores of Local Hospitals, “ Blytheville Courier News, June 22, 2014

• “GOP Maps Out Waves of Attacks Over Health Law,” New York Times, November 20, 2014


• “The 2014 ObamaCare Tax Wave,” Politico, January 6, 2014

• “Second Wave of Health-Insurance Disruptions Affects Small Businesses,” Washington Post, January 11, 2014


• “Get Ready for Second Waves of ObamaCare Market Dispuptions,” Hot Air, January 11, 2014

What are these wild waves saying? Are they saying these waves are forerunners of a big Republican wave with the election of a GOP Senate? Are they saying the time may be coming to wave ObamaCare goodbye?

I know not. Neither do pollsters and pundits. Voters hold the answers in their hands and heads, and even they may be undecided at this point.

The Monday Morning Health System Quarterback

To begin, I hesitate to call the U.S. health case a “system.”

What we have is a pluralistic potpourri, part-government -run, part-privately-run, non-system presiding over health care in a vast continental multicultural nation with a population of roughly 320 million people.

The government pays directly for nearly one-third of us (50 million Medicare, 65 million Medicaid, 7 million VA, and others), and just over 50% depend of government benefits. Through its vaunted health reform law, government tries to fence in 100% of us through a combination of barbed wire (mandates) and bailing wire (regulations).

The intent of the government ruling party is noble (health care for all) and well-intentioned (all for one, one for all), but it has adverse consequences (unlimited government power and loss of individual freedoms), and it is extremely costly ( somewhere in the neighborhood of $1.5 trillion to $2.5 trillion over a ten year period, depending on who is doing the estimating).

The debate over where the “system” is headed boils down to clashes of -isms (socialism versus capitalism, collectivism versus individualism, elitism versus entrepreneurialism).

It also comes down to these questions:

Are we a center-right or a center-left nation?

Do we believe in equal opportunity or equal results?

Should wealth and health benefits be redistributed, and if so, how does this redistribution affect economic growth?

Which is more important – economic growth or social justice- and can we have both, or is it one or the other?

What should be the size of government?

Is the best government big government that governs most or small government that governs least?

Shall the system be more centralized in Washington, D.C., and more decentralized in the states?

Shifting Ground

While these issues are being debated and these questions are being raised, the ground is shifting under our feet.

Health care costs are being shifted from employers, who cover 150 million Americans, to employees.

Health care is shifting from individual doctors to large organizations like hospitals, health systems, and health plans.

Health care delivery is shifting from inpatient care to outpatient care.

Health care information sources are shifting to the Internet, to social media, and to big retail chains. Health care decision making is shifting from doctors to data.

Political power may be shifting from Democrats to Republicans, both at the state and federal levels.

People are shifting for themselves, with more alternative care, self-care, and home-care.

And some physicians are shifting to direct care, away from government, institutional, and insurer care.

While all of this shifting is going on, issues, costs and prices of health reform are becoming more transparent. The days of the health care quarterback sneak are over.

Thus, the people, the times, and the laws do shift. Where they stop will depend on the will, votes of the people, and actions of consumers in a consumer-based nation.

Upcoming ObamaCare Biblical Battles

If the trumpet gives an uncertain sound, who shall prepare for the battle.

The First Epistle of Paul

The race is not to the swift, nor the battle to the strong, nor yet to the wise, nor yet riches to men of understanding, nor yet favor to the men of skill, but time and chance happenth to them all.

Ecclesiastes

The battles for ObamaCare have reached biblical proportion because of its implications for Americans with two upcoming November events.

• On November 4, the battle for the Senate will end, and current odds favor a 52-47 GOP win.

• On November 15, the 30 day battle to sign up 8 to 10 million more on the health exchanges and Medicaidm before February 15, 2015, will begin.

The First Battle

The chief reason for uncertainty of these battles' outcomes is continuing uncertainty about ObamaCare – its intrinsic worth, its hard truths, its failed promises.

Uncertainty revolves around impending health plan cancellations, reversal of subsidies for those enrolled in exchanges, costs in terms of individual penalties and general rises in taxes, impact on full-time employment with benefits, fear of rising premiums and sky-rocketing deductibles, and apprehension about more broken promises and legal challenges.

People were promised a $2500 drop in premiums for a family of four. Instead they got an increase of $5000, from $18, 074 to $23, 215.

People were promised a decrease in costs and the federal debt. Instead they have received an increase of $73 billion so far - $2 billion for the bungled website.

They were promised a decrease in premiums. The ObamaCare administrations says increases have been a modest 3%. But there are catches. For those in individual markets, premium increases have averaged 41%, And for those re-enrolling premiums are projected to go up an average of 30%, sometimes up to 100%.

Before the elections, employer-based plans, even though government has told them they do not have drop them, for business reasons, heal plans will begin to cancel plans that do more meet ObamaCare’s 10 benefit standards.

Perhaps 500,000 who enrolled the first time around may have to pay back their subsidies because they are unable to document their income or citizenship.

In year 2 of ObamaCare, penalties for being non-insured and for not enrolling in health exchanges, will increase to $325 or 2% of income, to be automatically deducted from tax credits.

Patients are complaining they cannot pay the co-payments and deductibles, which now average $6078.

As a result of these various changes or fears they will materialize, people worry about higher premiums, sky-high deductibles, tax penalties, loss of health plans or doctors, or inability to find an affordable plan or a doctor.

In the eyes of the ObamaCare administration, the enrolling of 15.3 million who signed up the first year ( 7.3 million on exchanges and 8 million in Medicaid) is an unqualified success. After all, enrolling the uninsured was the health law’s intent.

The Second Battle

But the goals of the second battle – signing up 8 to 10 million more in 30 days in exchanges or Medicaid starting November 15 will not be easy. The first sign-up period lasted 60 days.

Signing up 8 to 10 million more uninsured to become insured may be an illusion. Those who did not sign up will be harder to reach, will include many who do not understand health insurance language or English for that matter , the young and healthy who resent paying for older and sicker, and will depend on personal contact by committed but sometimes ill-trained ObamaCare navigators at communities events, hair dressing salons, ethnic groceries, and faith-based institutions rather than on online-contact or broad TV marketing campaigns.

Of the federal battle to sign up 8 to 10 million more uninsured in 30 days, the Administration's Holy Grail, perhaps after losing the first battle, Robert Laszewski, a health industry consultants say, “Holy Smokes!” By that he must have meant ObamaCare officials are smoking something, Laszewskin might also have exclaimed, “Holy Mackerel!” or “Holy Moses!”, for reaching that goal may require a biblical miracle.

Quote to Note: Fox News in White House Hen House

A true opposition party should have the courage to lay out their agenda. Hopefully also grounded in facts. There’s a reason fewer Republicans are preaching doom on the deficits – because the deficits have come down at almost a record pace and they’re now manageable. There’s a reason fewer are running against ObamaCare – because while good, affordable health care might still be a fanged threat to freedom of the American people on Fox News, it turns out it’s working pretty well in the real world.

President Obama, speech, October 2, Northwestern University