Oh-No-bamacare

by
Bill Sardi

Recently
by Bill Sardi: Why
Gastric Bypass Surgery Cures Diabetes

“The
inherent vice of capitalism is the unequal sharing of the blessings.
The inherent blessing of socialism is the equal sharing of misery.”
~ Winston Churchill

The Supreme
Court has ruled favorably on the Affordable Care Act (ACA), a 2700-page
piece of legislation that will certainly
raise, not reduce healthcare costs, and only pretends to help
Americans live healthier.

That the uninsured
will now have coverage for their health care bills via government
subsidies needs to be stated differently – that hospitals, drug
companies and doctors are now assured they will get paid for caring
for millions of uninsured Americans. Lobbyists have prevailed in
Washington DC once again, and made it look like it was a welfare
program for the disadvantaged. In fact, it is a mandatory tax on
the very people who can afford it least.

Sept. 12,
2008:  Dover, New Hampshire Presidential candidate Obama
said: “I can make a firm pledge. Under my plan, no family making
less than $250,000 a year will see any form of tax increase Not
your income tax, not your payroll tax, not your capital gains
taxes, not any of your taxes. [YouTube
Video]

Health care
for many Americans now switches location, from the hospital emergency
room to the clinic waiting room. At least healthcare consumers can
expect a bit more padding in the chairs of the latter.

How It Works

The ACA subsidy
(tax) program works like this. Medicaid will cover families
with incomes below 133 percent of federal poverty level (FPL), which
is $22,050 (2010) for a family of four. For those above the poverty
level the Affordable Care Act kicks in. There is a sliding scale
that requires recipients pay a minimum 4% of their annual income
if family income is 150% of the FPL and 9.5% if 400% of the FPL
($3307 if making $33,075). Then whatever is not covered will be
made up for by government subsidy.

The Congressional
Budget Office estimates this subsidy will cost $113 billion annually
by 2019 for an estimated 19 million Americans with an additional
16 million covered by Medicaid at a cost of $97 billion in 2017.
It is difficult to know whether low-income families will deem a
mandated percent of their income that must go toward health insurance
is a benefit or a hindrance.

Every American
Must Buy Or Else

While such
an expansive piece of legislation is going to be difficult to translate
in simple terms to the common man, the main point that may confuse
Americans is that the ACA doesn’t mandate that Americans now purchase
health insurance from the government, it only mandates that every
American purchase health care insurance from any private carrier
they choose, carriers who now must meet certain government minimum
requirements (spend 80% of insurance premiums on providing care,
no exclusion of people with per-existing conditions, etcetera).

Another confusing
aspect of the ACA is that it levies a penalty in the form of a fine
if you don’t purchase healthcare insurance. That “fine”
is what Supreme Court Justice John Roberts ruled to be a “tax.”

Polarization
Of America

A most disconcerting
aspect of the ACA is that it further polarizes the nation. According
to a Gallup
Poll, Americans are evenly divided – 46% for versus 46% against
— on the Supreme Court’s decision to uphold healthcare reform.

Hidden Objective:
Jobs

Employment
appears to be an unstated objective in the ACA, to use the healthcare
industry as a platform to create more jobs. The healthcare sector
is a growth area for jobs, so it is a contradiction to believe anyone
is going to get healthier and need less health care while it increases
the size of the healthcare workforce. Detection and treatment
of disease, the existing paradigm, is at odds with health and wellness
promotion.

Healthcare
costs are considered part of the nation’s Gross Domestic Product
(GDP) when they should be considered a part of the “cost ledger”
on accounting books. Sickness is now a market and any real efforts
to reduce the incidence of disease will negatively affect employment
and profit projections as well as the ability of the wealthy to
pay for it all.

Burden Upon
The Wealthy

The Affordable
Care Act is not just the younger and healthier paying for the older
and sicker, it is a diminishing
number of wealthy individuals bearing the burden for the masses.

The ACA also
levies an excise
tax on wealthy individuals who can afford to purchase comprehensive
“Cadillac” health insurance plans ($27,500 per family).

Wealthy individuals,
the so-called “one-percent” (those who make over $250,000
a year) face increased taxes on their investments (dividends and
capital gains) that will have to rise six-fold over the coming decades
as projected
Medicare costs rise from $500 billion/year to $3 trillion/year.
The current $2.7 trillion in healthcare costs are expected
to grow to $4.6 trillion by 2019. So this is just the beginning
of a number of tax increases upon wealthy Americans. Long term there
is no way taxes can meet the multi-trillion dollar underfunding
of Medicare.

Obamacare is
more care, not less, and more total cost, not less, and represents
another giant wealth transfer program as the so-called wealthy bear
the burden for the poor.

No One Escapes
New Taxes

The ACA
also levies seven new taxes on Americans who earn less than $250,000
a year. The bottom
50% of wage earners (earn less than $32,396/year) who pay only 2.25%
of all collected income taxes are going to be required to buy health
insurance. The Internal Revenue Service is expected to enforce ACA
requirements. So from top to bottom of the income ladder, nobody
escapes increased taxes.

April 15,
2009: White House press briefing White House Press Secretary Robert
Gibbs, asked if the Obama tax pledge applied “to the health
care bill.”  Gibbs: “The statement didn’t come
with caveats.”
[Press
Conference Transcript]

Here is the
simplest synopsis of Obamacare I can come up with:

Wait a while,
bend over (required rectal exams, so says the new law), pay up
(or face fines, aka “a tax”), and submit to treatment
bureaucrats think is best for you, or else. 

No Turning
Back

While Americans
picket to maintain the healthcare they now enjoy, there will be
no returning to healthcare on demand. There will likely be waiting
lists for cataract/lens implant operations and other non-emergent
procedures.

This is because
Medicare
is underfunded by $25 trillion and even that figure is specious
because it relies upon 165 cost-saving changes in the health care
reform law, many that are unlikely to occur. The multi-trillion
dollar shortfall equates to $212,500 per household, but it is far
greater than that because wealthy families will have to bear most
of this cost.

How Many
Were Truly Uninsured?

It is not known
how many Americans will opt out of Obamacare and pay the penalty
tax. However, out of a population of 304 million Americans, only
about 11 million (3.6%) were truly uninsured. The more broadly
disseminated figure of 40 million uninsured Americans included 17
million who elected not to purchase health insurance even though
they had sufficient income to buy it, and ~10 million who are “not
citizens,” and 25% of the uninsured already qualify for government
health insurance program, and another 45% of the uninsured are only
temporarily without coverage because they are in between jobs, etcetera.

That leaves
~28 million uninsured who will be coerced to buy health insurance
or face onerous financial penalties, $695 a year or 2.5% of income,
whichever is higher or for a family of four earning $50,000, or
a family penalty of $2085.

Prior to the
passes of the ACA, the 17 million uninsured Americans with adequate
incomes to buy health insurance, who are likely to be generally
healthy but didn’t buy health insurance, probably paid an average
$664/year in out-of-pocket costs for health care. Now assume
these 17 million previously uninsured Americans must purchase a
$2500/year health insurance plan. That would divert an estimated
$32 billion from the consumer economy to the healthcare industry.

Forced Testing

Americans may
not know this, but Obamacare
forces Americans to undergo more needless and problematic
mammograms, colonoscopies
and PSA
tests under the guise these actually prevent disease or prolong
survival, tests that run counter to what government preventive task
forces recommend. Under Title IV, Section 4202, 4202 and 4108 the
ACA mandates screenings that simply drum up more business for doctors
and doesn’t prevent disease from occurring in the first place. For
example, I have recently written that there is only
a remote chance that Americans will ever benefit from a colonoscopy.

And, under
the guise of preventive care, Obamacare mandates insurance plans
offer coverage for contraception, something that religious
organizations have filed 23 lawsuits in 14 different states
over.

Obamacare
does not put a stop to the relentless promotion of vaccines. Are
we to undergo hundreds of vaccinations for every strain of bacterium
and virus on the planet? Other
less costly and safer alternatives are at hand but underused.

Backfire
Problems

Obamacare may
backfire and end up causing some small businesses to lay off workers
so as to get under the 50-employee point where the cost of health
insurance must be borne by the employer.  That 50^th
employee is very expensive. 

The Irony
Of The Disadvantaged And Obamacare

There is another
irony to Obamacare.  Low income Americans I speak to want Obamacare. 
They feel that other countries provide universal care, and they
want what others have been able to afford.  They want the miracle
drugs, the high-tech treatments that they see others Americans receiving.
They have no idea it is, for the most part, ineffective therapy.
But the big rub is that Obamacare recipients will be accessing a
healthcare system that is dysfunctional, overpriced and out of control. 
That Americans demand more unnecessary, troublesome, even deadly
care is certainly misdirection.  The American healthcare system,
advertised as the best in the world, is far from achieving the lowest
mortality rate.  Obamacare further cements a dysfunctional
healthcare system in place. 

A statistic
known as “mortality amenable to health care” measures
death from various causes before age 75 that are potentially preventable
with timely and effective health care. The U.S.
ranks in last place among 19 industrialized countries on this measure
of healthcare quality.

The culture
within the practice of medicine is not going to be changed with
a 2700-page document. But we have to ask, just where are the real
financial incentives to practice preventive medicine rather than
just give it lip service? So-called outcomes research is one thing,
but getting doctors to adhere to it is another.  For example,
doctors still perform PSA tests when there is no valid reason to
do so. 

While Title
IV, Section 4202 of the Affordable Care Act spells out the components
of a wellness program to include nutritional counseling, physical
activity plan, alcohol and smoking cessation counseling, stress
management, and dietary supplements that have health claims approved
by the Secretary of Health Education Welfare, doctors simply
aren’t trained to provide preventive services that they often consider
beneath their training. Furthermore, the fee for service system
that is now in place prioritizes services that produce the most
insurance reimbursement.

Is Less
Care A Bad Thing?

Because of
health rising healthcare costs and a weak economy one
Kaiser Health survey showed that 35% of respondents had to resort
to using home remedies or over-the-counter drugs instead of going
to see a doctor. But isn’t self-care a positive goal? Does more
doctoring promote the measureable endpoints of quality healthcare,
namely lower mortality rates? The low US ranking among national
mortality rates is shameful and suggests less doctoring may be more
desirable.

To back that
up, an analysis
of labor strikes over a period of nearly three decades where
doctors ceased providing everything except emergency services reveals
a strikingly consistent decline in death rates! Less doctoring saves
lives.

Among 1 billion
physicians’ office visits in 2008, many millions were deemed by
doctors to be avoidable or unnecessary if patients were oriented
towards self-management of their health using over-the-counter (OTC)
medicines and dietary supplements.

The survey
asked doctors and patients this question: When you experience
minor ailments such as headache, fever, colds or upset stomach,
what do they do? About eight in ten consumers said they relied upon
OTC medicines whereas only two-thirds of doctors utilized OTC remedies.
Just over six in ten consumers said they use dietary supplements
whereas only one in four physicians said the same. One in five consumers
said they use alternative treatments versus only five percent of
physicians. These are the same doctors that are supposed to be leading
the way in healthcare reform. It is no wonder healthcare costs so
much. This kind of common sense medicine is not included in the
language of the Affordable Health Care Act.

A difficulty
posed by embarking upon a road where less care equates with better
health is vulnerable to cries of rationing. Yet it is clear that
half of the US population spends little or nothing on health care
while 5 percent of the population spends almost half of all healthcare
dollars. Fifty percent of the US population accounts for only 3%
of overall US medical spending ($664 per person annually) versus
5 percent of the population that spends 17 times more per person
($11,487 per person). It is presumed most of these are less healthy
citizens smoke tobacco, have poor diets and over-imbibe alcohol
and are more likely to be found in low-income groups.

Obamacare addresses
preventive care in language spelled out in the Affordable Healthcare
Act document. But frankly, smoking
cessation programs have been a disappointment. One
study showed it costs $6204 to achieve one successful “quit”
among smokers. While health insurance premiums are higher for smokers,
it is cheaper
for employers to pay for the insurance than incur the cost of
smoking cessation programs.

Few patients
who have faced life-threatening cardiac events adhere
to dietary recommendations. That’s when life is threatened,
so you can imagine how many patients make lifestyle changes for
non-life threatening problems like diabetes.

While the Affordable
Care Act provides $200 million in grants to allow small businesses
to implement wellness programs, a report
issued by the National Institute For Healthcare Reform concludes
that “wellness programs are just too uncertain to justify broad
taxpayer-supported subsidies.” This is an agency of the US
government basically saying an aspect of Obamacare won’t work and
will be a waste of money.

It will
cost more, not less

Healthcare
insurance is the single strongest factor that determines whether
Americans access doctor’s offices or outpatient clinics. One
survey shows more than half (57%) of Americans age 18-64 without
health insurance never attended a doctor’s office or outpatient
clinic compared to 1 in 4 (23.7%) who were covered by public-only
health insurance, 1 in 10 (9.5%) who had Medicare and 1 in in 15
(6.5%) with private insurance coverage. Programs to increase insurance
coverage will surely increase utilization of healthcare services.

More Can
Be Accomplished Without Obamacare

It’s possible
more can be done outside of Obamacare to reduce healthcare expenditures
and improve the health status of Americans. For example, Marion
Nestle, a professor of nutrition, says America will not solve its
diabesity epidemic through promotion of self control. Nestle says
American
food companies must alter the food chain to offer more nutritious
foods, particularly to lower income groups that exhibit a greater
percentage of chronic disease. It is clear that something happened
to the American population at large in the 1980s, and that was when
high fructose corn syrup and iron-fortified, sugary breakfast cereals
became popular. Whatever did happen to the American food chain,
it disengaged the signal for satiation and Americans began eating
larger portions of food en masse.

A short treatise
entitled “Eight
Ways To Reform Health Care Without A Government Takeover”
is available online and worth a quick read.

Point Your
Finger At Congress

While some
Americans may want to throw tomatoes at the Supreme Court, it is
Congress that passed this legislation. As Supreme
Court Chief Justice John Roberts said: “We do not consider
whether the act embodies sound policies. That judgment is entrusted
to the nation’s elected leaders. It is not our job to protect the
people from the consequences of their political choices.”

When the underclasses
figure out Obamacare is a not what they anticipated, who knows what
follows?

July
2, 2012

Bill
Sardi [send
him mail] is a frequent writer on health and political
topics. His health writings can be found at www.naturalhealthlibrarian.com.
His
latest book is Downsizing
Your Body.

Copyright
© 2012 Bill Sardi Word of Knowledge Agency, San Dimas, California.
This article has been written exclusively for www.LewRockwell.com
and other parties who wish to refer to it should link rather than
post at other URLs. 

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