Obamacare may be water to the wicked witch of the west

[Corlyss_D]

Earthquake in Earthquake Country?

Is the rancorous health-care fight turning California red? If so, the most prominent victim of ObamaCare may turn out to be Barbara Boxer.

Though the GOP nomination to challenge Ms. Boxer is still up for grabs, a new Field poll shows her essentially beatable by "all of the above." Former Rep. Tom Campbell leads her by one point; Carly Fiorina trails by just a point. Most surprisingly, Ms. Boxer commands a mere four-point lead over little-known state Assemblyman Chuck DeVore.

Field Poll Director Mark DiCamillo attributes Ms. Boxer's rapidly rising unfavorable rating, which has climbed to 51% from 39% in two months, to voter revulsion over the Democratic Congress's health care tactics. The poll, he says, reflects Ms. Boxer's weakness more than any strength by her GOP challengers: "Voters are starting to be looking for alternatives to the status quo." In January, Ms. Boxer held a double-digit lead over all her GOP opponents.

Feeling the same heat is Democratic gubernatorial candidate Jerry Brown. He now trails Republican Meg Whitman by three points after leading by 10 points two months ago. In the Democratic stronghold of Los Angeles, which will be key to determining the election, the former eBay CEO is beating Mr. Brown by 14 points.

Given the powerful anti-incumbent wave building in California, Mr. Brown's latest tack is to circle the wagons with his hardcore Democratic allies. On Tuesday, he publicly called on Big Labor to "attack [Ms. Whitman] whenever we can, but I'd rather have you attack" because "I'd rather be the nice guy in this race." For her part, Ms. Boxer is calling in President Obama to host a fundraiser next month. It's unlikely to help. The president's approval rating in California is just 52%, its lowest during the president's 15 months in office and the lowest of any president at this stage save Jimmy Carter.

A Rasmussen poll last month found that 60% of California voters want to throw incumbents out, while only 17% think they should be reelected. Career politicians like Mr. Brown and Ms. Boxer appear to be swimming against a powerful and growing current as November approaches.
-- Allysia Finley

[keaggy220]

I believe after this November the record books will need to be rewritten. It's going to be amazing to watch. Virginia, which had heavy momentum toward dems for the last 10 years, is now outraged over the health care takeover. I've never seen such an abrupt and complete ideological shift from left of center to conservative right as I've seen in my own state. People who don't talk politics are speaking indiscreetly and in utter contempt at the health care takeover.

[rwetmore]

They better be careful the republicans don't gain a 2/3rds majority. That may be the country's only hope...undo and rewrite legislation without Obama being able to stop it.

[Corlyss_D]

^^^

I'm very glum about the state of the state. Entitlements never get undone, and every effort to pay for them fails. Steve Hayes read a quote from FDR about Social Security, how it would guarantee support for the elderly and poor forever and put the nation on a sound economic footing at the same time. LBJ said precisely the same thing when he bribed and extorted Medicare into existence.

From the unfunded liability portion of the US Debt Clock:

Social Security: $14.3 Trillion
Medicare: $74.9 Trillion
Prescription Drug Benefit: $19 Trillion
Total Unfunded Liability: $109 Trillion

http://www.usdebtclock.org/

Particularly intriquing is the bill for the Prescription Drug Benefit. In a recent interview, someone who was present at the creation was asked "What happened?" His response was, "3 things happened: 1) more people signed up than was anticipated; 2) more drugs were requested than anticipated; 3) they were requested soonere than anticipated." The common theme here and in all entitlemlents programs: going- in projections were horribly underestimated. In only 6 years, the prescription drug benefit liability already exceeds Social Security liability.

[keaggy220]

^^^

I'm very glum about the state of the state. Entitlements never get undone, and every effort to pay for them fails. Steve Hayes read a quote from FDR about Social Security, how it would guarantee support for the elderly and poor forever and put the nation on a sound economic footing at the same time. LBJ said precisely the same thing when he bribed and extorted Medicare into existence.

From the unfunded liability portion of the US Debt Clock:

Social Security: $14.3 Trillion
Medicare: $74.9 Trillion
Prescription Drug Benefit: $19 Trillion
Total Unfunded Liability: $109 Trillion

Insanity: doing the same thing over and over again and expecting different results.

The difference with this bill as opposed to the entitlements listed above is that the American people abhor this bill because they see the pattern of substandard services, inefficiencies and crippling debt that the government consistently provides.

The only people expecting different results are the 1 in 3 Americans who favored the bill and the dems in power. It's a sickness of control and power - leftover old schoolers from the heady days of communism. I believe this is their swan song.

We are now in new territory. A place where government has decided to takeover 1/6 of the economy with the support of only 1/3 of the population. Thanks to no drama Obama we have moved from hyper-partisan politics to complete chaos in our political system.

Whoever happens to be in power will now bend and break rules without a thought for the majority of their constituents, but play solely to their base - no matter how radical and small. I guess if your guys are in then it's a good thing...

[jbuck919]

The difference with this bill as opposed to the entitlements listed above is that the American people abhor this bill because they see the pattern of substandard services, inefficiencies and crippling debt that the government consistently provides.

I don't know about you, but most people who are not themselves elderly have elderly relatives on Medicare, and what they see is the blessing of high quality health care with the physicians of their choice, affordable if still a strain for the poorest among them. And even my father, who is under directly socialized medicine as a military veteran, always commends the quality of the service, which among other things has worked patiently with him to get his very expensive hearing aids just right. And in spite of inefficiencies in both systems, it's done at below the cost of privately paid for health care (either direct or through insurance).

And if that's not enough, keep in mind that the health care bill that actually passed is neither socialistic nor single-payer. The private sector will continue to provide the medical services and the actual insurance (for which business it will have to compete).

Does the bill have drawbacks? Probably. Some possibilities, along with some reinforcement of the points I've been making, are presented in the following article.

# The New York Times


March 21, 2010
In Reform, Boons for Hospitals and Drug Makers
By REED ABELSON

With a sweeping overhaul of the nation’s health care system, Congress would be giving the health care industry as many as 32 million additional paying customers in the next few years.

That would mean millions more Americans buying private health insurance and better able to pay for their hospital stays, doctors’ visits, prescription drugs and medical devices.

And some analysts said as the vote neared that the final legislation was shaping up as much kinder to the industry than many initially feared. Hospitals and drug makers, which supported the final legislation, would be clear beneficiaries, analysts say, even if the outlook for insurers was less certain.

Yet the bill would not create the thing that insurers feared most: a government-run public option, a health plan that would compete with the private insurers.

Over all, the legislation would be a positive for much of the industry, said Les Funtleyder, who oversees health care strategy for Miller Tabak & Company, a New York investment firm.

There is no question that insurers would face the most strikingly different business environment, with drastic changes in the way insurance is sold to individuals and small businesses, one of the industry’s most profitable areas. There would also be much heavier regulation.

“It’s a huge business risk,” said Rick Weissenstein, a health care policy analyst at Concept Capital, which follows developments for investors. “There are going to be some insurers that aren’t going to adapt very well.”

But insurers are expected to benefit from the influx of new customers after years of shrinking enrollments. About 16 million of the newly insured are expected to enroll in private plans. The rest would become eligible for Medicaid, the state-administered program for the poor, but some of those would probably sign up for privately run Medicaid plans available in different states.

One place where the rules of the insurance game may shift most significantly is in a new kind of state-supervised marketplace, called exchanges, in which insurers would be required to sell their policies for individuals and small businesses. The exchanges are expected to involve much greater regulatory oversight than insurers now typically face and to alter their business models drastically. Currently, insurers seek to protect profits by trying to enroll only the healthiest individuals, while also charging enough to recoup the expense of covering sick people. But the legislation requires insurers to cover even people with potentially costly pre-existing conditions.

The new law would also place strict limits on how much more an insurer could vary premiums among the people taking out the same policy, largely to factor in age differences.

As a result, the insurers, whose main trade group, America’s Health Insurance Plans, vehemently opposed the legislation, have been quite vocal about their concern that young and healthy people will not enroll because the new requirements will make their premiums higher to help subsidize the older and sicker.

To help spread the costs and risks of insurance, the legislation would eventually require most Americans to have insurance or pay a federal penalty. But insurers have worried that the penalties are too low or will not be enforced.

Insurers have also complained that the legislation calls for the government to begin paying them much less in federal payments for the private Medicare Advantage plans that they sell to older people as an alternative to traditional Medicare.

The insurers are also subject to a range of new fees, although the timing has been delayed.

Indeed, for anyone assessing the impact, it is important to remember that few of the legislation’s main provisions would take place immediately, noted Jason Gurda, an analyst with Leerink Swann. “Most of the health care provisions that would impact the health insurers do not kick in until 2014,” he said. “From an investment horizon, that’s a long time.”

Hospitals have little to fear. The number of newly insured is expected to decrease significantly the amount that hospitals now lose each year when they provide care to people with no means to pay.

But the expanded enrollments in the low-income Medicaid program could be a mixed blessing, analysts say, because Medicaid typically pays hospitals less than the actual cost of care. So the question becomes whether hospitals were already treating many of these patients without any reimbursement at all, or whether they will now see an influx of new money-losing Medicaid customers.

For their part, the hospitals agreed to help defray the costs of the legislation by agreeing to contribute $155 billion over 10 years, largely by accepting lower payments under the Medicare program for older Americans.

Doctors are another group likely to benefit from more paying customers, which is a reason that the American Medical Association last week began publicly supporting the legislation.

Yet doctors must still wait for Congress to handle the sharp payment cuts they perennially face under Medicare as a result of the formula the government uses to pay doctors. In recent years, Congress has annually stepped in with a so-called doc fix to stave off those cuts.

“The fact that there’s not a physician fix leaves in limbo physicians,” said Paul Keckley, the executive director of the Deloitte Center for Health Solutions, a research unit of the consulting firm.

Drug makers, meanwhile, may have the most clear reason to celebrate the legislation. Pharmaceutical companies are going to be asked to contribute $85 billion toward the cost of the bill in the form of industry fees and lower prices paid under government programs over 10 years. But they can look forward to tens of billions of dollars in additional revenue as more people with insurance visit doctors and fill prescriptions.

The legislation will also eventually close the gap in Medicare drug coverage, known as the doughnut hole, in which elderly patients must pay for prescription drugs rather than having them covered by the government. Many chose to stop taking their medicine or switched to lower-price generics.

And significantly, the legislation allowed the drug industry to “avoid any of the issues that were particularly of concern — price control or more regulation by the federal government,” said Barbara Ryan, an analyst with Deutsche Bank.

As a result, the pharmaceutical industry has been a significant proponent of the legislation, in sharp contrast to its behavior when the Clinton administration tried to pass a similar overhaul. The industry spent an estimated $100 million in TV advertising, grass-roots organizing and other marketing efforts to promote reform.

The generic side of the drug industry had somewhat less to celebrate. Legislators left intact a bill provision giving name-brand drug makers 12 years of marketing exclusivity on expensive medications called biologic drugs, which are made out of living cells. Many of those drugs, including cancer treatments, cost thousands or even tens of thousands of dollars a year.

“Real reform could have expanded access to affordable medicine to patients in need,” Kathleen Jaeger, the president of the Generic Pharmaceutical Association, said in a statement.

But generic makers could have benefited from a provision that Congress did not include in the final bill: a proposal that would have placed new restrictions on patent settlement agreements. Under such deals, some name-brand drug companies have paid or otherwise compensated generic makers to delay introducing new generics.

Critics, including the Federal Trade Commission, argue that such deals are anticompetitive. Jon Leibowitz, the chairman of the Federal Trade Commission, said last week that consumers would suffer if Congress allowed such deals to continue.

“The big winners are some of the branded pharmaceutical companies who have engaged in these deals and some of the generics who have done the same,” he said. “The big loser is the American consumer, who is going to have to pay an extra $3.5 billion a year in much-needed drugs.”

Barry Meier, Andrew Pollack, Natasha Singer and Duff Wilson contributed reporting.

[keaggy220]

The difference with this bill as opposed to the entitlements listed above is that the American people abhor this bill because they see the pattern of substandard services, inefficiencies and crippling debt that the government consistently provides.

I don't know about you, but most people who are not themselves elderly have elderly relatives on Medicare, and what they see is the blessing of high quality health care with the physicians of their choice, affordable if still a strain for the poorest among them. And even my father, who is under directly socialized medicine as a military veteran, always commends the quality of the service, which among other things has worked patiently with him to get his very expensive hearing aids just right. And in spite of inefficiencies in both systems, it's done at below the cost of privately paid for health care (either direct or through insurance).

And if that's not enough, keep in mind that the health care bill that actually passed is neither socialistic nor single-payer. The private sector will continue to provide the medical services and the actual insurance (for which business it will have to compete), and will be one of the big beneficiaries of all this.

Quit comparing medical for our veterans to the garbage that passed through last night. You are delusional if you are trying to equate them...

Medicare turns done almost twice the number of claims as private insurance and we are moving toward $100 trillion in debt because of this garbage and you call this a blessing. How absurd.

[jbuck919]

The difference with this bill as opposed to the entitlements listed above is that the American people abhor this bill because they see the pattern of substandard services, inefficiencies and crippling debt that the government consistently provides.

I don't know about you, but most people who are not themselves elderly have elderly relatives on Medicare, and what they see is the blessing of high quality health care with the physicians of their choice, affordable if still a strain for the poorest among them. And even my father, who is under directly socialized medicine as a military veteran, always commends the quality of the service, which among other things has worked patiently with him to get his very expensive hearing aids just right. And in spite of inefficiencies in both systems, it's done at below the cost of privately paid for health care (either direct or through insurance).

And if that's not enough, keep in mind that the health care bill that actually passed is neither socialistic nor single-payer. The private sector will continue to provide the medical services and the actual insurance (for which business it will have to compete), and will be one of the big beneficiaries of all this.

Quit comparing medical for our veterans to the garbage that passed through last night. You are delusional if you are trying to equate them...

You're not reading my posts very carefully if you think I'm equating them. I am not interested in debating the difference between being generous with the army and being generous with the general public. The point was that even a fully socialized government-run medical system is not the provider of "substandard services" you imagine it to be.

Medicare turns done almost twice the number of claims as private insurance and we are moving toward $100 trillion in debt because of this garbage and you call this a blessing. How absurd.

Yes, Medicare is a wonderful program that benefits millions of people. You'll be one of them someday. Corlyss is right that we have a disconnect between wanting benefits and being willing to pay for them. The solution to that is to start paying for them.

[keaggy220]

The difference with this bill as opposed to the entitlements listed above is that the American people abhor this bill because they see the pattern of substandard services, inefficiencies and crippling debt that the government consistently provides.

I don't know about you, but most people who are not themselves elderly have elderly relatives on Medicare, and what they see is the blessing of high quality health care with the physicians of their choice, affordable if still a strain for the poorest among them. And even my father, who is under directly socialized medicine as a military veteran, always commends the quality of the service, which among other things has worked patiently with him to get his very expensive hearing aids just right. And in spite of inefficiencies in both systems, it's done at below the cost of privately paid for health care (either direct or through insurance).

And if that's not enough, keep in mind that the health care bill that actually passed is neither socialistic nor single-payer. The private sector will continue to provide the medical services and the actual insurance (for which business it will have to compete), and will be one of the big beneficiaries of all this.

Quit comparing medical for our veterans to the garbage that passed through last night. You are delusional if you are trying to equate them...

You're not reading my posts very carefully if you think I'm equating them. I am not interested in debating the difference between being generous with the army and being generous with the general public. The point was that even a fully socialized government-run medical system is not the provider of "substandard services" you imagine it to be.

Medicare turns done almost twice the number of claims as private insurance and we are moving toward $100 trillion in debt because of this garbage and you call this a blessing. How absurd.

Yes, Medicare is a wonderful program that benefits millions of people. You'll be one of them someday. Corlyss is right that we have a disconnect between wanting benefits and being willing to pay for them. The solution to that is to start paying for them.

Fully socialized to a small population of heros is vastly different than fully socialized to the general public. The public demands we take care of these heros the way they deserve to be treated and when the public hears the occasional horror story of our heros being treated poorly there is outrage.

Medicare on the other hand turns down twice as many claims as private insurance and there is no public outrage because most people are healthy and they don't want to pay for the sick. After all, we are already approaching $100 trillion in debt for this entitlement.

So again, you are being delusional or disingenuous in your argument.

As for me, I'm doing my best to live an incredibly meager life so I can save enough to be self insured. I have no confidence in Medicare or our government and I want to be prepared.