For the past few days NPR has been acting as the propaganda organ for the presidency by touting in its national headlines the start of the changes resulting from the enacting of Obamacare six months ago. It has interviewed people who have reached lifetime limits that the plan removes. It brought in Nancy Pelosi who breathlessly praised it at the height of the evening rush hour. The Marketplace morning segment discussed its positive economic impacts.
The editors of Pravda would blush. They at least had the threat of the gulag hanging over them as they crafted each edition. The only danger a Republican presidency has is to the paint job on the bumpers of their BMWs by the cheap glue in leftist bumper stickers.
Lost in this propaganda blitz are the facts – such as the fact that Obamacare will increase the cost medical care instead of curbing it – the driving force behind Obamacare in the first place.
The Washington Examiner lays out the other facts lost in the propaganda blitz, including this gem:
» Obamacare forces states to guarantee not only payment but also treatment for indigent Medicaid patients. With many doctors now refusing to take Medicaid (because they lose money doing so), cash-strapped states could be sued and ordered to increase reimbursement rates beyond their means.
I’ve seen the impact of Medicaid first hand on my wife. The old cliche is that a conservative is a liberal that has been mugged by reality. The reality of Medicaid has mugged my wife, taking an idealistic woman who truly cares for people (unlike her husband) and beaten her down with overweight, drug abusing, disability-seeking parasites who believe they are entitled to pedicures and maid service in their trailers (through the Home Health Medicaid benefit). Yes there are people who truly deserve it, but they are overwhelmed by the unfortunates who simply don’t understand that having a pulse does not guarantee them a government check.
Obamacare seeks to expand Medicaid while ignoring the fact that physicians lose money treating Medicaid patients. Medicaid pays $.88 for every dollar a physician spends caring for a Medicaid patient. Medicaid is in fact a charity provided by physicians that is subsidized by private insurance which reimburses doctors more than their costs for treatment. Obamacare does nothing to address this yet expands the pool of Medicaid patients at the very time practices have been limiting the number of Medicaid patients they see.
Obamacare is a compromise between Democrats who believe in socialized medicine and the Democrats who recognize the limitations of socialized systems in Cuba, the UK and Canada. But from a physician’s perspective, this compromise is the worst of both worlds. Under socialized medicine doctors and other health care providers can become (in some systems) state employees who are guaranteed a salary regardless of their patient’s ability to pay. The costs of the program are in effect born by the state. In a pure free market system, physicians would be able to negotiate pay with private insurers and set rates for self-payers. Those practices which have a healthy private payer balance can offer discounted services to the poor. The costs of this system are born directly by individuals.
But under Obamacare the costs ends up being borne by physicians because states do not have the luxury of operating in deficit. States must balance their budgets, and since states bear upwards of 50% of the program’s cost and Medicaid is often the single biggest budget item, they often have no choice but to cut reimbursements to health providers.
Worse, Obamacare pushes for “outcome based medicine”; providers will be reimbursed based on health outcomes of their patients.
But doctors have problems with patient compliance now. How many health care providers tell their patients to quit smoking? Lose weight? Eat healthy? How many doctors are frustrated with their diabetic patients who fall into comas because they don’t monitor their own blood sugar?
I have issues with capitalism and medicine. Although I have been a free market capitalist most of my adult life, I recognize that health care is different and have often argued for a form of socialized medicine. The reason why I haven’t advocated for a variant of socialized medicine under the Obama Administration is the injection of government in other areas of society, and because I have yet to figure out how to socialize medicine without socializing personal responsibility.
I believe that I am responsible for my health – not my doctor, and certainly not my government. It is my fault that I down multiple double cheeseburgers at a sitting and sneak handfuls of pretzels when the Wife is not looking. So if and when I have a heart attack, why should my doctor or the federal government be held responsible?
Americans give lip service to freedom but see no connection between it and its basis – responsibility. I quit smoking 15 years ago because I got tired of being controlled by cigarettes, and quit drinking nearly 10 years ago for the same reason. I don’t possess secret knowledge that my wife’s Medicaid patients who drink and smoke lack. They know it is bad for them; they aren’t stupid. So why should doctors like my wife be paid less for caring for them when they are already in effect donating their care for free?
Medicaid and its expansion with Obamacare reward bad behavior at the expense of health care providers and taxpayers. They undermine personal responsibility. They force physicians to limit their Medicaid patient loads or face financial ruin. They bankrupt cash-strapped states, forcing cutbacks in other important services such as police and fire protection.