Government dependency for many, financial servitude for others

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The purported Democrat moderates who voted for Obama Care are really, really gullible.  I have previously raised the issue of many misleading statements in the health care debate.  With respect to the budget issues, these have been aired out by many, including Congressman Paul Ryan.  However, in statement after statement avowed moderate Democrats appear oblivious to these points.  They say the Congressional Budget Office (CBO) is a neutral arbiter and so life must be fine. They believe that future Congresses will allow hundreds of billions of dollars of cuts in Medicare.   They believe that Congresses will sustain levies for taxes on certain high cost plans.  They believe that payments for doctors under Medicare can either sustain a 21% cut or be paid for from some other source that does not add to the debt.   I am not so gullible as to believe you can expand spending by $2.5 trillion from 2014 to 2023 and reduce debt.   It has never worked that way.  And CBO was forced to score savings provisions that will not occur.

Our children will not believe these stories when they get out in the workforce of the future. Because of Obama care, many younger Americans will work even longer and invest even more to pay for both the health care coverage of others and the debt amassed by the irresponsible generation before them. This pincer movement on professionals will force social change for the worse in this society. Forcing some Americans to pay for the health care coverage of others does not lower costs.

Workers who get insurance from employers will bear the brunt of the new taxes on insurers, drugs, devices and other areas.   Of the 2.5 trillion dollar spent over a ten year operating window, almost none will go to workers who work for employers who provide health insurance as a form of compensation.  Indeed union bosses appear perfectly willing to discriminate against low-income union workers in their own ranks.

The bill will also force outsourcing of low income work and encourage early retirements.  All in all, the distortions of the bill will exacerbate the divide between those responsible for sustaining society and those dependent on government.  If you work for an employer who provides coverage you are a hero and probably a chump.  You would be carrying your own weight on health coverage.  But keep in mind all those who will not carry their own weight and will expect you to pay their way.

Obama Care does little to address the issue of National costs.  The Congressional Budget Office has indicated that a certain package of medical liability reforms could reduce both National health care spending and the deficit. A recent analysis of nine million Medicaid enrolled patients in five large states found a group of patients and systems exhibiting patterns of extreme uncoordinated care. According to the study, potential average savings in the period of 2010-2018 from addressing these problems are estimated at $240 billion per year or an average.  Pricewaterhouse Coopers found an even greater amount. Their research found that wasteful spending in the health system has been calculated at up to $1.2 trillion of the $2.2 trillion spent in the United States, more than half of all health spending. Defensive medicine, such as redundant, inappropriate or unnecessary tests and procedures, was identified as the biggest area of excess.

The bill spends a lot and adds a lot of government but it is a lost opportunity to actually reduce the National cost of health care.  The health care system will be wrapped up in the dictates from this bill for years.   The bill has the Department of Health and Human Services issuing regulations under subsection 1311(h) telling doctors how to provide quality.   Other provisions require “culturally and linguistically appropriate” care.   There is a lot of government control but not much effort on reducing costs.

The rate of government expansion and debt under Obama Administration actions exceed any in the history of the U.S.   Medicare passed in 1965 amidst significant bipartisan support.  It will grow insolvent over the next couple of decades.   At least there was a 50 year run before the projected problems of tens of trillions of dollars in unfunded obligations. But the budget explosion and impact from Obama care will be much quicker.  Now we face Medicare insolvency, rising health care costs, and a vastly expanded entitlement state.   Higher taxes and greater inflation are just poised to hit next decade.

Nandan Kenkeremath worked as a senior staff on Capitol Hill for 17 years.