Beyond the Cusp

June 5, 2013

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

 

May 21, 2013

For a Healthy, Well Regulated Society Where Every Action is Regulated, Illegal or Mandatory

We live in the era of rule by bureaucracy. The path to this impossibility was a quick slide down a slippery slope of lazy politicians. At some point in time, the early 1960s is my best guess, our elected officials found an easier way to make laws while not needing to understand or research the particulars for the application and implementation of said laws. Their new operational model was they simply passed new legislation that gave a somewhat malleable and vague definition of the target ideas and ideals the legislation was targeted to produce and then assigned to different cabinet departments, cabinet Secretaries, select committees, or even in extreme cases some NGO to make the necessary regulations in order to fulfill the requirements stated and set in the legislation. Never in the wildest imagination of any conspiracy theory was there a more powerful way to slide down the slippery slope to a society where any and every act is either illegal or required or, in the best of cases, both. The epitome and perfection of this procedure will be taking effect throughout the rest of the year and is scheduled to be complete and workable by January 2014; but trust when we tell you that there will be more regulations spawned by this legislation in every year going forward for as far as one can envision. This strangling legislation is the Affordable Care Act which is better known as Obama Care. Most of us probably thought that everything would have been fully fleshed out and completely defined and everything that could possibly be required described in full and complete detail somewhere in the many hundreds of pages of the bill. After all, were we not told by Speaker of the House Nancy Pelosi that we had to pass the bill in order to see what was in the bill? Well, that probably meant something quite different than was understood by most of us.

 

The reality is that within the legislation were hundreds of pages enacting or setting in place the requirement for many items which had absolutely nothing to do with healthcare while also not defining definitively much of anything and simply left amorphous definitions of intent of coverage and systems and left much of the filling in of details and regulations up to Secretary of Health and Human Services Kathleen Sebelius. What is even more worrisome is that when these laws are passed such as Obama Care there is no date which prevents new regulations from being added past that point. This was a peculiarity which President Obama decided provided an unintended plethora of new regulations. In order to mine this gold mine that never stops giving technically, President Obama made a position named Regulations Czar Cass Sunstein with the given job description of reviewing government regulations in order to delete those regulations which are no longer deemed to be fulfilling any necessary purpose. The actual work being performed by Mr. Sunstein is to review all legislation passed into law over the entire history of the United States mining them for potential application of new regulations which serve the intents and ends of the Administration’s legislative and policy aims. Since any new regulations, or any regulations, which are written in order to fulfill the required implementation of passed legislation does not require debate or even the knowledge of Congress and can be completely enacted and implemented by the Administrative branch of the government. Simply put, if the President can produce justification for any regulation within any piece of existing law, then the regulation can be written, implemented, and enforced without the knowledge or action from any other branch of government. If this worries you, welcome to the scariest of secrets with which the Federal government is being grown beyond the wildest dreams of the most ardent fascist or other big government advocate.

 

Now for the really worrisome part of this story, Obama Care. Just imagine what a policy wonk given unlimited power to write regulations with the intent of controlling all actions over such areas as diet, exercise, habits, risky behavior, participation in dangerous sports, accident avoidance, and virtually anything one can imagine a person either participating or avoiding in their lives as long as these regulations can be tied in any manner to healthcare costs. We have seen a small example of such in New York City with Mayor Bloomberg and his smoking ban, trans fat ban, salt limiting, and attempted soda size limitation. When addressing all things which can be considered as potential health risks, where risk is defined as requiring healthcare expenditures, and you quickly realize that everything in life is now legally defined as something that government may choose to regulate. With government health care where the government decides what care you as a patient are entitled to receive, just imagine what requirements can be placed on one so that they can qualify for the best possible care allowed. Your diet can be controlled by requiring a scientifically specified diet with excessively restrictive meal plan. You might also be required to perform specified physical exercise routine. Should your weight deviate from the governmental norms for BMI you could be placed on an even more restricted diet to address your potential health risk. You like trail biking, sky diving, scuba diving, or any other potentially dangerous or injury prone activity? Not if you want healthcare to cover sprains, broken bones or other injuries which could result even if one does not participate in any injury risk behavior. Or perhaps in order to enjoy such activities one would be required to be licensed after taking required instruction which is required for your own good and would presumably teach you the safest manner to participate in your selected activity. Of course the fee for the licenses would be directly proportional to the risks involved in the particular activity. In all honesty, nothing in life is beyond being controlled in order to assure you remain in tip-top healthy shape in order to minimize the likelihood for you to require other than normative healthcare treatments. There is already a system which will likely be the eventuality of Obama Care which is known as the Complete Lives System. This system sets up formulae which are to be used to determine whether or not it would prove to be cost effective for government to provide healthcare services depending on the cost of the care required, the prognosis for success, the age of the patient, and numerous other cold, hard facts which then make the determination whether or not you will be treated. This system almost guarantees that there will be nothing beyond the most basic care provided to the elderly and high cost procedures would also not be approved for youth, especially if the problem will require continued care. This is as impersonal a system and arbiter for the dispensing healthcare as one could ever imagine, but then government has never been accused of being emotional or particularly caring. The future under universal government healthcare, which is inevitable under Obama Care, will result in a tangled web of regulatory requirements and restrictions which will ensnare every life and strangle from them any deviance from whatever is determined to be governmental norm. The other unavoidable result will be the absolute and complete end to personal privacy as in order to assure your life meets all health requirements, your life will necessarily have to be totally monitored. The amount of privacy that remains today, as restrictive as it may seem, will seem like unbelievable freedom in a decade or two when the government has reached the point where it must regulate all activities, diets, exercise, and all else in order to assure the healthiest of populations under its care. After all, it will be for your own good, honest.

 

Beyond the Cusp

 

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