Dissecting Obamacare
Posted on by Douglas Farrago MD
A 60 Minutes video worth your time.
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That was certainly NOT a great video, making cursory points while not asking the obvious follow-ons, typical of 60 Minutes emotion-as-journalism.
– The interviewed author and Leslie Stahl both glossed over the obvious cost-shifting that still remains as a significant contributor and (at least) major rationale for jacked up hospital prices.
– As usual, 60 Min. trots out an individual hard luck case to tug the heart strings; but how much of his total bills ended up as net profit? Did Stahl et al even ask? (Of course the runaround obfuscation they would have gotten would have been truly enlightening, but Leslie was probably late for her Botox appointment).
– What are the added costs to hospital charges of facility malpractice, regulatory overhead, and unfunded mandates? Hospitals have also recently been hit with huge additional costs for ICD-10 and EHR’s, to add to the usual JCAAHO idiocy, as well as Medicare, Medicaid, OSHA, and who-knows-what-else compliance?
– Whether the featured hospital CEO is a carrion eating scumbag (he may well be), it is more than hollow for a high-paid newsy to feign outrage over anyone’s salary. That dumb CEO should have fired back, “Well what is YOUR salary, Leslie?” Bet that would have shut her up, or at least been edited out.
– The author stated that ObamaCare is the “opposite” of a government takeover of health care. That is nakedly absurd. The ACA is riddled with cronyism, but it is still government force, applied through breaks, penalties, and the IRS. The drug companies and hospital corporations screwing the consumer because they have government backing is still the fault of government.
– Leslie Stahl: “To be fair hospitals do save lives.”
The best observation in this whole piece was that steel had been replaced as Pittsburgh’s major industry by health care. I suppose we need an economist to explain this, but I suspect this switch is a very poor economic indicator. We are fast becoming a national mausoleum, and the on-cue sanctimony of 60 Minutes cannot see, or is not interested in the root causes of this disaster. The premise for this piece was that lobbyists were the faults within the ACA. Wrong, the ACA is what gave those lobbyists more payola, and itself is the primary problem.
PPACA follows classic Washington design – the same design that brought us a Department of Homeland Security which consumes 250 Bn/yr, and cannot demonstrate effectiveness in any of its five core missions. We have centralized certain cannot-fail requirements in domestic protection, and clustered them in a bloated, massive department that has become senile in a decade of its creation.
PPACA was a bureaucratic stillbirth that listed certain mission-critical aspects of human healthcare, and placed them under the control of a CINO paradigm – cost is no object. The only way to mitigate the cost is to turn American medical care into the equivalent of veterinary medicine – you will get the care if you stand a chance of recouping the “loss” to the payers. No money spent for “downer” humans – the elderly, the senile, the genetically unprofitable. It is the path to re-inventing totalitarianism-in-a-box.
They shoot horses, don’t they?
Sorry, I discover that I’ve overstated the budget of DHS by a factor of three or so. I’m sure that by 2020 we’ll hit my listed quote of a quarter of a tee.
Liberalism, at its root, is the belief that the truth is an effective weapon against those who make their living by means of the lie. It assumes the power of conscience triumphs over the power of will. So many people fought the Nazi movement by courageously pointing out the truth! So many got themselves on the lists, for later!
If someone does not change as an effect of pointing out a certain truth, they are immune to it. Conscience is a powerful system in some – an evolutionary archaism, an appendix in many others.
When American healthcare hits its “hard bottom,” if it does – if people are dying broadly and start to cry out about it – why then, the Government will discover that “HEALTH CARE IS A NATIONAL SECURITY ISSUE!” and nationalize it by making it a quasi-uniformed service. Doctors and nurses will of course be drafted to serve in the national healthcare revival – get ready to march!
The nice thing about horrible ideas is that they are rarely novel – therefore, they have a comfortable familiarity, we’ve heard it all before in some or another fashion. “HEALTHCARE = NATIONAL SECURITY?” Yes, that makes sense, entirely so.
Those who still recite the phrase “brave new world” should read our colleague’s writings. Aldous Huxley trained as a physician, only to forsake the profession due to visual impairment. Do him the honor of reading his book.
Great video. Everything is so true. The one thing that did not get said, is that with Obamacare, the cost for those of us that pay for insurance through our employers has also gone through the roof. Furthermore, the individual cost for the “affordable care act” for those that do not qualify for government subsidies is ridiculously high. The cost for responsible consumers who used to have individual plans prior to the “ACA” is immeasurably higher than prior to the passage of this act.