The Coming Consequences with Obamacare

Obamacare, or as the more erudite among us call it, the Patient Protection and Affordable Care Act will take full effect in theory this coming January of 2014. The only saving grace is that Secretary of Health and Human Services Kathleen Sebelius is well behind in formulating all of the regulations which are demanded within the thousand plus pages of the legislation. Of course the ever diligent IRS is well on their way to hiring the eventual 16,500 additional agents to enforce the taxation related to the national healthcare system. There is a feeling that something is basically wrong with a healthcare system which requires the government to hire so many additional tax enforcement agents while not having any proposals to hire a single additional doctor. Unfortunately, the lack of hiring of healthcare workers is just the tip of the proverbial iceberg of the irregularities surrounding the differences between promises and the reality of Obamacare.

 

As noted above, the lack of hiring of even a single additional doctor is troubling and only gets worse when you add that there has been no hiring of a single additional physician’s assistant, nurse, healthcare technician, orderly or other hospital worker. Making things far more ominous has been the results of numerous polls of physicians which on average have presented results indicating that anywhere from 35% to a startling 65% of those polled were seriously considering hanging up their stethoscopes rather than practice under the rules stipulated in Obamacare. If even just 10% of physicians hang up their stethoscopes the backlog of patients will be an insurmountable problem within the first year. The real problem is that it has been estimated that there could be as many as 25% increase in caseload added to the healthcare system, and that is one of the more conservative estimates. How the healthcare system will stay astride a measurably significant increase in caseload with a reduction in the available physicians to treat said patients is definitely going to present a serious problem. Either physicians will need to increase the rate at which patients are treated or add hours to each physician’s day or longer their workweek. I would not want to take any bet that physicians would face burnout in short order, simply retire or start to treat patients outside of the restrictions and requirements of Obamacare. The last of these choices would place them on the wrong side of Federal Law in short order and they would likely be closed down if not incarcerated. The government is not known for their sense of humor nor taking kindly to those who wish to operate outside their imposed systems.

 

Another realization which has been admitted by the administration and those who have investigated every letter of the Obamacare legislation is that there really will be panels which will decide who gets what levels of care and whether or not any patient will receive any care on some prorates cost-benefit analysis. The one name for the system that will be utilized has been referred to as the “Complete Lives System” which limits severely any care provided at either end of the age spectrum. Such a system if implemented would have some groups of voters up in arms in a very short time. Senior citizens would be up in arms as soon as they realized that they would not be receiving any medical procedures which carried with them anything beyond a minimal monetary outlay. That would mean no hip replacements, no cancer treatments, no surgeries of any variety, and some highly active and angry set of people who vote regularly, have the time to demonstrate and would engender sympathy from the general public, especially since most of us have parents who will someday be in this category. And the ire of the senior citizens would pale in comparison when parents are informed that their child is not worthy of any expensive procedures as they are not of sufficient age. The younger the child the less expense the care given the Complete Lives System is willing to allocate. Imagine the parents of a child born with what is now a regularly treated hearts defect commonly known as Blue Baby Syndrome. Such surgery on a newborn would fall outside of restriction on infants as they are not considered readily likely to be a cost benefit as their work-life is still a good twenty years away and so many possible complications could prevent their ever becoming a producing member of society. Another category of people who would receive next to no care would be the chronically ill be it a physical illness such as diabetes or a mental disorder as in both instances the person is considered more expensive to care for and a poor investment of medical expenditures. Yes, that’s right, in the Complete Lives System Stephen Hawking would never have become a physicist as he would have been deemed a bad health risk that would not have been likely to produce a positive financial outcome.

 

The worst problem which comes consequential to Obamacare is that it takes approximately 17% of the United States economy and makes it into a government program. Since investigations of numerous government programs has produced a result that the Federal Government must take in five dollars for every three they intend to spend, some of these researchers have found returns far worse where some departments would be fortunate to get one dollar for every five dollars collected. Even using the most optimistic return on tax dollars of three out of five dollars returned, then this will make the 17% of GDP into over one quarter of GDP at slightly over 28% of GDP. Add this significant quantity of the United States economy into the mix of other Federal expenditures and all government would then be responsible for well over half of GDP. Many economists will tell that at such size the government becomes unsustainable. Europe is currently figuring out that they can no longer continue to provide the services at current levels even with their tax rates at levels well above anywhere currently in the United States. Maybe all those who were labeled alarmists or conspiracy theorists were actually giving an accurate accounting of the unavoidable results of Obamacare would lead. All of these problems which will result from Obamacare do not take into consideration the unseen unintended consequences which seem to accompany every governmental effort. The only additional question that remains is which will compel the citizens to rebel first, the poor resulting quality of care under Obamacare or the ever spiraling upward taxes which never seem to prevent huge deficits because of Obamacare. Either way, Obamacare may just turn out to be the largest failure of the Federal Government, quite an accomplishment after the other SNAFUs we have managed to live with thus far.

 

Beyond the Cusp

 

Israeli Housing Protesters Missing During First Housing Protests

Currently Israel is undergoing a boisterous and healthy sized group of people protesting the housing shortage and high prices. The problem is multifaceted with one of the problems directly caused by government roadblocks to all forms of building and land appropriations. It takes anywhere from five to seven or more years from inception of the planning to the actualization of available apartments or housing neighborhoods. Another government related problem is the fact that almost all of the lands of Israel are State owned lands. It is going to take the goring of some sacred cows, not necessarily perfect red heifers, but still sacred cows, in order to produce a more permanent solution rather than simply taking a one time action and a quick fix. This will require a good amount of something Prime Minister Netanyahu is capable of, the raw nerve and determination to change some long held ideas of State ownership and the determined force to punch through much of the bureaucracies and eliminate numerous steps and red tape which currently clogs and delays building projects. Netanyahu will also have to face down those who now hold the preferred status and developed friendships securing a semi-monopoly on the vast majority of residential housing. The fix is going to have to be a complete regimen of prescriptions which heal an ill systemic situation with a multitude of layers and numerous hurdles that combine to cause the shortage which in turn inflates prices. The Prime Minister has done similar work very effectively as Finance Minister when he was placed in the position by Prime Minister Ariel Sharon in an attempt to render Bibi impotent to pose any challenge to Sharon’s leadership. That move backfired as Bibi gained fame by enacting changes that served the Israeli economy well, opened up competition in what had been government run agencies that were transferred into private hands, and deserves much of the credit for Israel surviving the world economic collapse with minimal hardship. Let’s hope he is up to the challenge once again.

Back to the current demonstrators who have gained monumental coverage by the liberal Israeli press who are working with the demonstration leaders in an attempt to force new elections. But where were these people way back in 2005 during the housing crisis that occurred under Prime Minister Sharon and his newly formed Kadima Party? The press was there supporting the housing crisis by calling for forcing people from their homes by the government using the force of the IDF. I do remember that some of those who are now supporting the call for Netanyahu’s head were fully supportive in 2005 of making thousands of Jews homeless with the destruction of their homes and neighborhoods. These were the Jews living and conducting their lives and businesses as part of the Gush Katif and northern Samarian neighborhoods that were surrendered to Arab control in the name of peace. Oh, that’s right, many of those supporting these new demonstrations back then had actually called for more force to be used to make these Jews leave their lives in shambles should they resist, which they did to a limited extent. But once these unfortunate Gazan and Samarian Jews were relocated into temporary trailers or other alternate residences none of the people backing the left centered current housing demonstration came out to protest for assistance for these homeless Jews. Strange, don’t you think? So, if back then Jews not having affordable housing did not cause the slightest ripple from the left, then why are they in such an uproar now?

Perhaps if we looked deeper and peeled back the onion and seek what is at the core of these demonstrations we might find something of interest that is also telling. Interestingly, when a large group of demonstrators came to join these housing rallies, they were turned away despite the fact that there have been no additional houses approved in their area in years. Oh wait. How silly of me, these Jews were the wrong kind of Jews as these were Jews from Judea and Samaria who are victims of the original ten month housing freeze to mollify the Palestinians and then subjected to Defense Minister Ehud Barak’s one man moratorium on building in Judea and Samaria. These were not real Jews, they were religious and Zionist Jews and those kinds of Jews are not welcome in these demonstrations by polite society people. So, what is really behind this movement? Histadrut national labor union chairman Ofer Eini punctured the housing protest balloon Monday morning and said he will not be part of an effort to topple the Netanyahu government. “If the objective is to bring down Netanyahu, I will not participate,” he said in an interview on Army Radio. “We are a democratic government, and we are not Egypt or Syria.” And then there is staunchly secular writer and political activist Yair Lapid stated bluntly on Monday that the target of the protests is not only the Netanyahu government but the entire establishment that promotes Judaism in public life. This does place the housing movement in another light now, doesn’t it?

But what does the public at large think? Well, a new poll carried out Sunday noted that secular Israelis think that Prime Minister Binyamin Netanyahu is the most qualified politician to lead the country. Interestingly, where 32 percent of secular Israelis between the ages of 18 and 30 chose Prime Minister Netanyahu while coming in at second with by 24 percent was Lieberman and with a mere 23 percent we find supported Livni, Prime Minister Netanyahu’s permanent opposite who votes against any and everything supported by the Prime Minister, the world be damned. This puts to lie Yair Lapid’s, left-wing politician and media personality, claim Sunday that the protest movement is comprised of secularists who represent the largest minority in the country. What else could go wrong for the belief in any validity of these demonstrations even though the problem is real and Prime Minister Netanyahu is taking steps to ameliorate the situation, hopefully with a permanent, long term solution. Well, the self-proclaimed leaders, Daphne Leef, Yigal Rambam, Regev Kontes and Stav Shafir, could make ridiculous demands such as having the Prime Minister actually at the negotiating table with them and to have the press present in the room while televising the entire negotiations. All one can do is wonder what their motivation for such ridiculous demands was, personal aggrandizement or an attempt to catch the Prime Minister in a series of gotchas embarrassing him in front of the entire nation and Israel’s enemies as well. Add to that their insistence that Netanyahu cancel the National Housing Committees Law as a precondition to the proposed televised negotiations and I think you have a complete picture of their impossible and totally preposterous demands. Perhaps the rumor that these four ‘leaders’ really were designated in advance by the New Israel Fund has a shred or two of validity.

Beyond the Cusp

Israel and the Problem Factory

Currently there are ongoing country wide demonstrations highlighting the very real housing problem. Where the housing problem is real, the demonstrations, not so much. The give-away were the series of interviews given by demonstration leaders and presumably randomly chosen demonstrators asked for reactions to the special broadcast Prime Minister Netanyahu and select members of his Cabinet addressing a proposed set of solutions. Their replies were virtually identical, all describing that the problem was far bigger than the housing problem; the problem was with the elected leaders of the country who were unfeeling of the problems the demonstrators were experiencing and the sole solution was replacing the Prime minister and his government. This exposed a running theme that has been present in much of the public demonstrations and strikes throughout Israel over the past months and revealed what this editorialist believes is the motivation behind much of the problems. This is not meant to minimize the problems, as they are real, but is meant to cast light upon why these problems seemingly are unable to be resolved.

The first of the lasting problems has been a series of labor strikes by mostly government employees which are represented by unions. These include those by social workers, transportation workers, and health care workers which include residents, doctors, etc. Each of these unions, like most labor unions, are strongly socialistic in nature and the leaders, and possibly many of the members, are strongly opposed to free market economy as opposed to their collective bargaining. One will note that the doctors not in the unions are not part of the strikes, only the union doctors who are complaining they are not making salaries commensurate with what they might make in private practice. There is an easy solution, well, not easy but obvious solution; go into private practice. Of course, private practice is fraught with challenges and uncertainty while working for the public health service, where I am sure it has its drawbacks, is steady work with a guaranteed salary, even if it is less than a successful physician in private practice. But perhaps I am being too harsh. Let’s look elsewhere and see if there might be more evidence.

There have been a series of themed demonstrations in Israel of late. There is the current housing demonstrations, which we are now told is about more than housing and only a change in the leaders of the government will suffice to make everything right with the world. Before that we had the cottage cheese price demonstrations which did not quite receive the kind of government challenging force so was quietly let to pass after some solutions were floated. Then there has been the usual uptick in leftist pro-Palestinian events that always seem to increase, or at least Haaretz and media coverage increases, when there is a conservative coalition holding the Prime minister’s office. I add this to the recent political events which have been also quite remarkable, so let’s look over there as well.

The most obvious of what could be termed the “Tzipi Livni just say no coalition” was exemplified by the anti-boycott legislation. The original legislation was cosponsored by a fair number of Kadima MKs. Before the Bill reached a reading, these cosponsors had removed their names from supporting the bill without any explanation and then voted against it. It subsequently came out that this was all the doing of Tzipi Livni who has been waging a “if I can’t be Prime Minister then nothing Netanyahu does can be supported even at the expense of Israel” jihad. There have even been a few members from Kadima who have challenged her on this blind and total refusal to recognize anything this government does which Prime Minister Netanyahu supports as legitimate or needful. These members of Kadima were quickly and quietly silenced.

Summing this all up, we are seeing a simple growing challenge from the left in an orchestrated surge to force the fall of Prime Minister Netanyahu’s coalition and nothing will be considered as going too far in this jihad. Leading this offensive is none other than Tzipi Livni under whose tutelage has moved Kadima from supposedly being a middle of the road political party to an off-roading free-wheeling far left party even further left than Meretz or possibly the Green Party. It boggles the mind that the current actions of Kadima comes from a party that includes some extremely reasonable people who are obviously being frozen out and becoming unwelcome. The most obvious of these is Shaul Mofaz, somebody respected by many across the political spectrum, not solely on the far left where Tzipi has taken Kadima. The conclusion of this comes down to asking if it is possible in anyplace that a conservative party can be allowed to rule without the press and leftist taking to the streets and any and all other means to drive them from office, all reasoning out the window? If not, then there is a definite problem in Western Democratic Governance just as problematic as should the right pull these tactics of damn the country if we are not in charge activism. Such is uncomely no matter who is behind the banners.

Beyond the Cusp