Thread: Obamneycare – Another Win-Win for the Oligarchs ~ Robert S. Dotson, M.D.

Obamneycare – Another Win-Win for the Oligarchs ~ Robert S. Dotson, M.D.

October 19, 2012 | Categories: Guest Contributions | Tags: Affordable Care Act, healthcare, PPACA,

“Mitt Romney is a wolf in a wolf’s clothing. Barack Obama is a wolf in a sheep’s clothing, but they both essentially have the same agenda.” – Jill Stein

“Bipartisan usually means that a larger-than-usual deception is being carried out.” – George Carlin


“But we have to pass the bill so that you can find out what is in it away from the fog of controversy.” — Speaker of the House Nancy Pelosi, remarks at the 2010 Legislative Conference for the National Association of Counties prior to passage of PPACA

October has brought the mini-series that accompanies our quadrennial exercise in faux democracy, the Presidential Debates. As has been usual for many decades, the public was entertained by carefully vetted corporatist representatives of War Party A and War Party B via the televised game show format that is sold as “serious debate” here at the End of Empire. Nothing illustrated the silliness and irrelevance of such spectacle better than the inane exchanges between Obama and Romney concerning healthcare. The charade was played out yet again when the Vice Presidential candidates, Biden and Ryan, performed in another nondebate on October 11th.


The Patient Protection and Affordable Care Act (PPACA, aka Obamacare, aka Romneycare or, most accurately, Obamneycare) is the 21st century poster child for social legislation in our corporatist state. Despite its origins, Obamneycare is simply another hand-out to the ruling oligarchy. In true New Speak fashion, despite the title patients will not be protected nor will healthcare become “affordable”.
Doubt it? Just reflect for a moment on how well We-The-People are “protected” by a government “of the corporations, by the corporations, and for the corporations.” We can be “disappeared” and “killed” at the whim of the President or his minions. We are looted daily – trillions for the banksters, trillions more for the Military-Security Complex, trillions for Empire, and declining real median incomes for the peasants.


For those with an interest in how they and their families will be impacted by Obamneycare, legislation that was actually signed into law, Public Law 111-148, the legislation can be read here:

http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf

and http://en.wikisource.org
/wiki/Patient_Protection_and_Affordable_Care_Act

Wading through 906 pages is a formidable task The law requires citizens to purchase a product under penalty of law.


Failure to purchase the required medical insurance carries significant civil penalties. Though these penalties are only monetary at this time, one can easily imagine incarceration in health care prisons in the near future. Perhaps those reported FEMA camps will be used for jailing Americans for their failure to purchase Obamneycare ordered insurance.


The mandated increase in government bureaucracy at all levels is astounding, and the sums of money and manpower that will be required to implement this law are staggering. Dozens of new grant programs, bureaucratic entities, demonstration or pilot programs, regulatory systems, compliance standards, taxes, and entitlements are found within Obamneycare diagrammed at the link below. Though this flow chart was compiled prior to finalization of PPACA, it is still accurate in its representation of the Byzantine healthcare system that has been created and is worth examining in detail.

Obamacare Complicated? Check Out The Flow*Chart - Home - The Daily Bail


Every decision, every transaction, every treatment plan, every payment, every hospital admission – in short, every contact between patient, provider, and healthcare system – will now be monitored and evaluated and ultimately dictated by the Federal Government. The Secretary of Health and Human Services is granted near god-like powers to manage this medical system, and he or she is empowered to multiply bureaucracies with the abandon of a Federal Reserve printing press in order to implement every jot and tittle of the law. The Act requires massive increases in reporting of any and every healthcare related event and similar increases in documentation of any and all interactions between patients, providers, and healthcare system.


The adoption of electronic health records (EHRs) – already underway following passage of HITECH (Health Information Technology for Economic and Clinical Health Act of 2009, part of ARRA) – will help expedite implementation of PPACA. Needless to say, all of this data management will require untold years of man hours and billions of dollars to implement. Perhaps, this mess was viewed as a solution to unemployment. If so, it certainly fails out of the starting blocks, as no products are created, no one is healed – in fact, nothing of discernible value is produced at all, except more bloat in government, more cost for the common man, less health care and more profits for the private insurance companies who sell the mandated policies.


Private health care providers do not come out as well. PPACA creates panels of experts to define what are acceptable standards of care and, of course, to insure compliance with those standards. To aid in achieving this goal, the Act increases government enforcement activities astronomically. The Feds need revenue and it has not been lost on those in power that providers are easy targets for “recovering” billions of dollars in “fraud” judgments and settlements. The government banked $4.1 billion in fraud “recoveries” in 2011 alone. Since 2009, the government’s return on “investment” in fraud recovery has been $7.20 for each dollar expended on enforcement. The preponderance of fraud appears to be billing mistakes made by clerical workers and computer programs. But government doesn’t acknowledge mistakes, only crimes.


When mandated electronic health records are merged with the on-going (and, unconstitutional) Total Information Awareness (TIA) program of the NSA, then the dystopian dream of every Central Controller will have been met. Each and every soul within Homeland Amerika will be

numbered and monitored from conception until death. It goes without saying that this control grid will provide our Ruling Elite with the tools to maximize the profit that can be extracted from each peasant unit and ensure that they are “retired” from service when their usefulness to the corporate state expires.


All of the regulatory and enforcement levers for ensuring compliance with our dystopian future are enumerated and funded within the pages of PPACA. Vast numbers of new bureaucrats at all levels (local, state, federal) are specified. These people will define standards of care, dictate where healthcare dollars are spent, determine how providers are reimbursed, identify and collect future taxes, and insure that existing corporate interests are protected from competing entities that might threaten profit margins.


It is common knowledge that the IRS will be the enforcement and administrative arm for PPACA and that as many as 16,000 new agents will be necessary to manage implementation of the new healthcare system. This seems appropriate since the Supreme Court has declared that the Act is a tax, in spite of Presidential protestations. The White House has already, in fact, transferred over $500 million to the IRS to begin work on expanding the Service and its new medical police powers. It is estimated that the IRS will spend nearly $1 billion through 2013 in information technology (IT) costs alone. Tax expert, Dan Pilla, has written a twenty page analysis of PPACA detailing its oppressive tax ramifications for residents of Homeland Amerika.
He rightly describes the IRS as the new “face of American health care.” Pilla’s research is an important and apolitical analysis of the disastrous policies set in motion by this legislation. Read it here:

http://heartland.org/sites/default/files/7-27-2012_pilla_on_obamacare.pdf

This report should be required reading for anyone sporting an “I Love Obamacare” sticker. Of course, the Republican Party faithful should not be excused from mandatory reading of this important work, especially since their standard bearer, Mr. Romney, played such a seminal roll in its creation. Romney has said that there are “a number of things” that he likes about PPACA, but he wants to impose his own version upon the peons.


So what alternatives do the competing candidates offer? Essentially, they both propose to privatize Medicare by diverting tax revenues to the subsidization of policies sold by private insurance companies. PPACA promotes the fiction that the federal government will return
“fairness” to the health care system by insuring that the “rich” contribute “their fair share.” Of course, it does nothing of the sort. Romney achieves the same result by allowing “free choice” through the use of “vouchers” (a Republican version of company store scrip).
Despite the mainstream media portrayal of the 2012 Presidential Election race as one of real choice between different political and socioeconomic world views, nothing could be further from the truth. Each major political party promotes the fiction that there is substantial difference between them on issues affecting the lives of millions of Americans and, literally, billions of our fellow humans across the planet. In reality, the two parties are the same side of the same coin, delineated by a few emotionally charged talking points. Behind the façade, any thinking human can readily discern that the policies of War Party A and War Party B are virtually the same – more military adventurism abroad and now at home, more Military-Security State, more wealth transfer from the 99% to the 1%, more corporatism in all areas of endeavor, less freedom and less security, the further de-industrialization of America under the guise of “free trade,” and the continued collapse of a once vibrant Middle Class. Both parties have scripted a “health care” system that is expensive and ineffective and sacrifices health care to corporate profits.


Both political parties have a vested interest in PPACA or its equivalent, and the parties colluded to pass the present law for the benefit of their corporate sponsors. Though both parties will doubtless fine tune the Affordable Care Act, health care has been sacrificed to private profitability.


So what does one do about any of this? Short of armed revolution, not much. The train left the station long ago. Resist however you can, but also spend time with family and friends, help your neighbor, learn new skills, grow some of your own food, and practice to be more self-sufficient and a good shot. Love much, and laugh often. Most importantly of all, learn to care for your own health needs, as much as possible, and minimize contact with the health care system.


The failure of Amerika, Inc. and collapse of Empire will give us the opportunity to build something new and better from the rubble. Come November 6th, I will be staying home and amusing myself with a good book, good conversation with friends, and, perhaps, a glass of wine. A few years ago, libertarian humorist, P.J. O’Rourke, wrote a book entitled: Don’t Vote—It Just Encourages The Bastards. Amen, P.J.


If you must vote, vote Third Party.


Obamneycare



I still pan on voting

Obamneycare Converts Health Care Into Profits

October 19, 2012 | Categories: Articles & Columns |


In the guest section there is a new contribution by Dr. Robert S. Dotson. He points out that Obamneycare is two versions of the same thing. A person has to be gullible and uninformed to believe the claims of Obama and Romney that their replacements for Medicare will save money and improve care. What the schemes do is convert public monies into private profits.


The exploding costs described by Dr. Dotson and the rising profits for private corporations are paid for by reducing health care. For example, Betsy McCaughey, former lieutenant governor of New York, writing in Investors Business Daily reports that “On Oct. 1, the Obama administration started awarding bonus points to hospitals that spend the least on elderly patients.” The result will be fewer knee and hip replacements, angioplasty, bypass surgery, and cataract operations. These procedures transformed aging by allowing the elderly, who formerly languished in wheelchairs and nursing homes, to lead active lives.


Obamacare rolls back the clock. “By cutting $716 billion from future Medicare funding over the next decade and rewarding the hospitals that spend the least on seniors, the Obama health law will make these procedures hard to get and less safe.” Doctors will be paid less to treat a senior on Medicare than to treat someone on Medicaid, a poverty program that is not financed by the payroll tax. McCaughry reports that doctors will be paid only one-third as much for treating Medicare patients as for treating a patient with subsidized private insurance and that Obamacare means that hospitals will have $247 billion less over the next decade to care for the same number of seniors.


According to McCaughey, prior to Obama raiding Medicare in order to subsidize the price of health policies sold by private insurance companies, Medicare was already paying hospitals only 91 cents for every dollar of care provided. The way Obamacare saves money is by cutting back care for the elderly and shortening their lives. As I pointed out in my last article, Obamacare is a death panel.


This doesn’t mean that Romneycare is any better. Conservatives like to pretend that the private sector is always more efficient and less corrupt than the public sector, and that replacing Medicare with vouchers toward the purchase price of a private insurance company will lower costs and improve care.


As Romney’s scheme has not appeared in federal legislation, we don’t know all the ways the interest groups would game the voucher system. However, the voucher system would add to costs by adding another level of profits. Unless the private insurance companies are to become administrators for the government and be protected from Wall Street organized takeovers for not earning high enough profits, the policies sold by the insurance companies will have profit in them.


Also, conservatives make a great deal to do about Medicare being unfunded, but what is there to fund Obamneycare except the payroll tax that funds Medicare? Obamneycare depends on the government handing out subsidies or vouchers for the purchase of private insurance policies. Neither scheme is any more funded than Medicare.


Some conservatives seem to think that because private policies are involved that health care becomes funded. What Obamneycare does is to steal from Medicare in order to finance Medicaid and private insurance policies. Both plans raise costs, reduce care for the elderly, and divert tax dollars away from health care to private profits.


Let’s examine the erroneous conservative belief that if health care is provided privately, without any government subsidies, it is funded, whereas Medicare is not funded. To pay the premium on a private policy, a person has to have an income. The premiums are thus funded by the earned income stream. If the person loses his or her job, or becomes incapacitated and cannot work, the person cannot pay the premium and the policy can no longer be funded. If the person is elderly and lacks sufficient retirement income to pay the high cost of private health insurance for the elderly, the person’s health care is no longer funded.


Medicare is funded by the same earned income stream that funds private insurance policies. Instead of paying a premium to a private company, the worker pays a payroll tax that funds his health care regardless of his employment or level of retirement income.


Conservatives claim that under Medicare, the young have to pay for the elderly. However, the young become old in turn, so the intergenerational aspect is simply a part of the human life cycle. It is the same with private medical coverage. The healthy (usually the young) pay for the sick (usually the elderly). Private insurance has an actuarial basis. Actuaries calculate premiums and risk so that the total premiums can accommodate the claims of the percentage of policyholders who become ill. The notion is false that a person with a private policy is paying for his own health care unlike a person on Medicare.


A favorite “cost-saving” scheme is to raise the retirement age for Medicare. As Dave Lindorff points out in CounterPunch (printed edition, Oct. 1-15, 2012), 90% of the cost of the Medicare program each year goes to pay for the care of the oldest 10 percent of Medicare patients. Those aged 65-70 are the most fit and cost the least. Moving the retirement age up doesn’t save any real money. It just violates the contract and takes away the coverage for which people paid during their working life.


Obamneycare takes decisions out of the hands of patients and health care providers. It reduces care for the elderly. It imposes intrusive controls and data collecting and reporting. As care providers witness care withheld and the elderly confined to wheelchairs and nursing homes and early graves, health care providers will have to become as hardened as workers in slaughter houses, or the system will implode.


Already 59% of US doctors say that they prefer a single-payer national health care system to the corporate form of medicine that has turned them into wage slaves who have to ration the time they spend with patients and the amount of care that they prescribe.


If Obama’s subsidies and Romney’s vouchers are not indexed to medical inflation, Obamneycare will provide diminishing care as the years go by. As jobs offshoring has stripped the country of middle class job growth, the incomes earned by waitresses, bartenders, hospital orderlies, and Walmart’s part-time workers will not cover shelter, food, transportation, and health care.


When Obama sold out his supporters to the insurance companies, Obama supporters lined up with the pretense that diverting Medicare money to private profits was an improvement over the current system. Obama supporters have now invested so much emotional capital in Obama’s assault on Medicare that they pretend there is some meaningful difference between Obamacare’s government subsidized private insurance policies and Romneycare’s government subsidized private medical insurance vouchers.


While the two sides yell and scream at one another, the concrete hardens around the new common policy of shorter lives for the elderly and more profits for private corporations.


Although no one in either party can define the US mission in the seven countries in which the US is conducting military aggression, wars of choice that according to Joseph Stiglitz and Linda Bilmes have already cost US taxpayers $6 trillion in out of pocket and already incurred future costs, there is no discussion of halting the wars and diverting armaments industry profits to the health care of the US population.


Thus, we are left with Dr. Dotson’s conclusion that Americans are governed for the benefit of corporate profits. Americans’ lives, health, incomes, careers, prospects, none of this matters. Only corporate profits.

Obamneycare Converts Health Care Into Profits

October 19, 2012 | Categories: Articles & Columns |


In the guest section there is a new contribution by Dr. Robert S. Dotson. He points out that Obamneycare is two versions of the same thing. A person has to be gullible and uninformed to believe the claims of Obama and Romney that their replacements for Medicare will save money and improve care. What the schemes do is convert public monies into private profits.


The exploding costs described by Dr. Dotson and the rising profits for private corporations are paid for by reducing health care. For example, Betsy McCaughey, former lieutenant governor of New York, writing in Investors Business Daily reports that “On Oct. 1, the Obama administration started awarding bonus points to hospitals that spend the least on elderly patients.” The result will be fewer knee and hip replacements, angioplasty, bypass surgery, and cataract operations. These procedures transformed aging by allowing the elderly, who formerly languished in wheelchairs and nursing homes, to lead active lives.


Obamacare rolls back the clock. “By cutting $716 billion from future Medicare funding over the next decade and rewarding the hospitals that spend the least on seniors, the Obama health law will make these procedures hard to get and less safe.” Doctors will be paid less to treat a senior on Medicare than to treat someone on Medicaid, a poverty program that is not financed by the payroll tax. McCaughry reports that doctors will be paid only one-third as much for treating Medicare patients as for treating a patient with subsidized private insurance and that Obamacare means that hospitals will have $247 billion less over the next decade to care for the same number of seniors.


According to McCaughey, prior to Obama raiding Medicare in order to subsidize the price of health policies sold by private insurance companies, Medicare was already paying hospitals only 91 cents for every dollar of care provided. The way Obamacare saves money is by cutting back care for the elderly and shortening their lives. As I pointed out in my last article, Obamacare is a death panel.


This doesn’t mean that Romneycare is any better. Conservatives like to pretend that the private sector is always more efficient and less corrupt than the public sector, and that replacing Medicare with vouchers toward the purchase price of a private insurance company will lower costs and improve care.


As Romney’s scheme has not appeared in federal legislation, we don’t know all the ways the interest groups would game the voucher system. However, the voucher system would add to costs by adding another level of profits. Unless the private insurance companies are to become administrators for the government and be protected from Wall Street organized takeovers for not earning high enough profits, the policies sold by the insurance companies will have profit in them.


Also, conservatives make a great deal to do about Medicare being unfunded, but what is there to fund Obamneycare except the payroll tax that funds Medicare? Obamneycare depends on the government handing out subsidies or vouchers for the purchase of private insurance policies. Neither scheme is any more funded than Medicare.


Some conservatives seem to think that because private policies are involved that health care becomes funded. What Obamneycare does is to steal from Medicare in order to finance Medicaid and private insurance policies. Both plans raise costs, reduce care for the elderly, and divert tax dollars away from health care to private profits.


Let’s examine the erroneous conservative belief that if health care is provided privately, without any government subsidies, it is funded, whereas Medicare is not funded. To pay the premium on a private policy, a person has to have an income. The premiums are thus funded by the earned income stream. If the person loses his or her job, or becomes incapacitated and cannot work, the person cannot pay the premium and the policy can no longer be funded. If the person is elderly and lacks sufficient retirement income to pay the high cost of private health insurance for the elderly, the person’s health care is no longer funded.


Medicare is funded by the same earned income stream that funds private insurance policies. Instead of paying a premium to a private company, the worker pays a payroll tax that funds his health care regardless of his employment or level of retirement income.


Conservatives claim that under Medicare, the young have to pay for the elderly. However, the young become old in turn, so the intergenerational aspect is simply a part of the human life cycle. It is the same with private medical coverage. The healthy (usually the young) pay for the sick (usually the elderly). Private insurance has an actuarial basis. Actuaries calculate premiums and risk so that the total premiums can accommodate the claims of the percentage of policyholders who become ill. The notion is false that a person with a private policy is paying for his own health care unlike a person on Medicare.


A favorite “cost-saving” scheme is to raise the retirement age for Medicare. As Dave Lindorff points out in CounterPunch (printed edition, Oct. 1-15, 2012), 90% of the cost of the Medicare program each year goes to pay for the care of the oldest 10 percent of Medicare patients. Those aged 65-70 are the most fit and cost the least. Moving the retirement age up doesn’t save any real money. It just violates the contract and takes away the coverage for which people paid during their working life.


Obamneycare takes decisions out of the hands of patients and health care providers. It reduces care for the elderly. It imposes intrusive controls and data collecting and reporting. As care providers witness care withheld and the elderly confined to wheelchairs and nursing homes and early graves, health care providers will have to become as hardened as workers in slaughter houses, or the system will implode.


Already 59% of US doctors say that they prefer a single-payer national health care system to the corporate form of medicine that has turned them into wage slaves who have to ration the time they spend with patients and the amount of care that they prescribe.


If Obama’s subsidies and Romney’s vouchers are not indexed to medical inflation, Obamneycare will provide diminishing care as the years go by. As jobs offshoring has stripped the country of middle class job growth, the incomes earned by waitresses, bartenders, hospital orderlies, and Walmart’s part-time workers will not cover shelter, food, transportation, and health care.


When Obama sold out his supporters to the insurance companies, Obama supporters lined up with the pretense that diverting Medicare money to private profits was an improvement over the current system. Obama supporters have now invested so much emotional capital in Obama’s assault on Medicare that they pretend there is some meaningful difference between Obamacare’s government subsidized private insurance policies and Romneycare’s government subsidized private medical insurance vouchers.


While the two sides yell and scream at one another, the concrete hardens around the new common policy of shorter lives for the elderly and more profits for private corporations.


Although no one in either party can define the US mission in the seven countries in which the US is conducting military aggression, wars of choice that according to Joseph Stiglitz and Linda Bilmes have already cost US taxpayers $6 trillion in out of pocket and already incurred future costs, there is no discussion of halting the wars and diverting armaments industry profits to the health care of the US population.


Thus, we are left with Dr. Dotson’s conclusion that Americans are governed for the benefit of corporate profits. Americans’ lives, health, incomes, careers, prospects, none of this matters. Only corporate profits.


Obamneycare Converts Health Care Into Profits - PaulCraigRoberts.org