Pure Genius Or Pure Stupidity?
Stanley Feld M.D.,FACP,MACE
President
Obama’s actions as leader of this country have been either pure genius or purely
stupid.
I think it
is pure genius. He promised Americans he was going to fundamentally change
America. He has!
Americans
have been under stress during the last few weeks. First it was the government
shutdown. Now it is the nation going into default. It is common knowledge the
shutdown and default is political theater.
President
Obama has run circles around Republican in the game of political theater.
The
traditional media has ignored the underlying causes of America’s problems.
We are increasing
debt to the point of unaffordability. The only way out is to increase taxes
further or decrease government spending while lowering taxes.
Increased
deficits are not good. Deficit increases devalues our currency. America’s currency
has already been devalued by the Federal Reserve increase in printing money.
Increasing
taxes leads to decreased jobs creation. Decreased employment leads to decreased
discretionary spending. The result is decreased economic growth.
Rather
than trying to decrease spending rationally by increasing government
efficiency, President Obama has closed down silly things to make it most painful
and noticeable to the public. These noticeable services have little overhead.
These closures are not an example of reducing inefficient spending.
In the
meanwhile his administration has spent over $600 million dollars for a health
insurance exchange software program. The program is poorly designed and does
not have an integrated back end.
Even if
the software was great, the cost of healthcare insurance through the exchanges
is increased and out of reach of the individual buyers.
The cost of insurance is cheap for the poor who
qualify for government subsidies. The poor will receive a tax credit which will
be credited to the insurance company whose policy the poor person buys.
The math
is grotesque. If a healthcare policy costs $10,000 and a patient makes $30,000
dollars a year, he pays only 2% of his net income for the policy or $600 per
year. The taxpayer pays $9,400 a year for that policy.
This is
an example of hidden “redistribution of
wealth” and another entitlement.
The
Obama administration has waived the verification requirement for receiving a health
insurance exchange subsidy. Verification of need does not have to be fulfilled
by the health insurance exchanges. Anyone can lie and receive a subsidy to
purchase healthcare insurance threw an exchange.
Another
big mistake was the design of the roll out to promote electronic medical
records. After 4 years only 11% of these records are functional. Physicians have
spent money for EMRs they could not afford. Hospital systems spent money they
could not afford. The government wasted $30 -60 million dollars of taxpayers
money in the unsuccessful effort to implement EMRs.
America
is a long way away from being computerized with a functional EMR.
Accountable
care organizations (ACO) are another important cog in Obamacare’s success or
failure. The administration brags about the fact that 250 ACOs are in
development.
There
are over 5,000 ACOs that need to be developed. A premier organization such as
the Cleveland Clinic had to drop out of the program because of the cost to the
institution. The Mayo Clinic refused to participate.
At the
same time ACO’s are turning out not to be cheaper or have better outcomes than
traditional medical care.
ACOs
were supposed to improve quality. ACOs were supposed to be a free market
solution to the dysfunctional healthcare system.
The
administration has been bragging about the greatness of the VA system. The
bragging stopped when the system’s poor quality of care was exposed. Veterans
are receiving poor treatment.
Everyone
would certainly have to admit Obamacare has been disruptive to the delivery of healthcare
in America.
The
months of healthcare insurance open enrollment for people is starting. People
are starting to see massive increases in their healthcare premiums. In order to
avoid these premium increases and the Obamacare penalties, large organization
such as Home Depot are hiring only part time workers.
The
Obama administration has developed a low cost insurance plan for the McDonalds
of the world. These health insurance policies cost little a cover less.
President
Obama has also provided waivers for congress and its employees. He is at
present trying to sneak in waivers from Obamacare to unions.
“First, there was the delay of
Obamacare’s Medicare cuts until
after the election. Then there was the delay of the law’s employer mandate. Then there was the announcement,
buried in the Federal Register, that the administration would delay
enforcement of a number of key eligibility requirements for the law’s health
insurance subsidies, relying on the “honor system” instead. Now comes word that another
costly provision of the health law—its caps on out-of-pocket insurance
costs—will be delayed for one more year.”
The
Obama administration has issued a blizzard of mandates and regulations. These
regulations have increased the cost of health insurance.
The caps
on out-of-pocket insurance costs, such as co-pays and deductibles have not been
publicized. On January 1, 2014, deductibles were supposed to be limited to $2,000 per year for
individual plans, and $4,000 per year for family plans.
In
February 2014, the Department of Labor published a little-noticed rule delaying
the cap until 2015. The costs of these deductible limits were already built into
the 2014 healthcare insurance premiums and were not removed.
The
government did nothing to reduce the increased healthcare premiums after the
limits did not apply.
“Federal officials said that many insurers and
employers needed more time to comply because they used separate companies to
help administer major medical coverage and drug benefits, with separate limits
on out-of-pocket costs. In many cases, the companies have separate computer
systems that cannot communicate with one another.”
“We
had to balance the interests of consumers with the concerns of health plan
sponsors and carriers.”
How is it in the consumers’ interests to pay far
more for health insurance than they do already?
I have a theory.
President Obama’s ultimate goal is to have a complete
government takeover of the healthcare system. A takeover the government cannot
afford.
He figures by creating as much chaos as possible
now in the “not so free market healthcare system”, he can declare the free
market healthcare system has failed.
There will be a resulting public outcry for the
government to help and take over the system.
The takeover will be with a single party payer
system.
What are the chances a government takeover will
result in an efficient, cost effective system that will provide access to care
without rationing of care while being affordable?
With all the delays, exemptions and regulations,
it looks as if Obamacare is destined to fail. Obamacare is going to be
impossible to execute effectively.
Obamacare’s ultimate failure is playing right
into President Obama’s ideological goal
of a single party payer system.
President Obama is not stupid. He is a genius.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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