Archive for Barack Hippocrates Obama

Couple More Problems for ObamaCare

To get the moral of the story out of the way first, don’t lie and don’t bully. It’ll catch up with you eventually.

The lies:

The Department of Health and Human Services projected that between 9 and 9.9 million people would enroll in Obamacare plans next year, well short of the 13 million predicted by the independent Congressional Budget Office. Just a few days later, administration officials admitted they inflated sign-up figures for Obamacare in 2014, including dental plans, to pad the numbers by 400,000 — allowing the administration to meet its original goal of enrolling 7 million consumers.

Care to read that again? Last year, they cooked the books; now they admit it. And that fraud (a 5.7% shortfall) is nothing compared to the fraud already admitted for next year (a 25-30% shortfall). Did you know that? I didn’t.

No wonder, then:

The fallout from the November blunders was hard to ignore. When the administration trumpeted that roughly 460,000 people had signed up for 2015 Obamacare coverage in the first week of open enrollment, the announcement was immediately met with suspicion.

AFter the lies wear thin comes the bullying:

Leading U.S. CEOs, angered by the Obama administration’s challenge to certain “workplace wellness” programs, are threatening to side with anti-Obamacare forces unless the government backs off, according to people familiar with the matter.

Major U.S. corporations have broadly supported President Barack Obama’s healthcare reform despite concerns over several of its elements, largely because it included provisions encouraging the wellness programs.

The programs aim to control healthcare costs by reducing smoking, obesity, hypertension and other risk factors that can lead to expensive illnesses. A bipartisan provision in the 2010 healthcare reform law allows employers to reward workers who participate and penalize those who don’t.

Got that? “Penalize.” Harm someone for not marching in step like a good little foot soldier. Kind of like the individual mandate—an unconstitutional affront until it was transvestized into a tax.

But like it or not, it’s part of the law (of the land).

But recent lawsuits filed by the administration’s Equal Employment Opportunity Commission (EEOC), challenging the programs at Honeywell International and two smaller companies, have thrown the future of that part of Obamacare into doubt.

The lawsuits infuriated some large employers so much that they are considering aligning themselves with Obama’s opponents, according to people familiar with the executives’ thinking.

“The fact that the EEOC sued is shocking to our members,” said Maria Ghazal, vice-president and counsel at the Business Roundtable, a group of chief executives of more than 200 large U.S. corporations. “They don’t understand why a plan in compliance with the ACA (Affordable Care Act) is the target of a lawsuit,” she said. “This is a major issue to our members.”

Have your members never seen Goodfellas or The Sopranos? You don’t want these people as your partners. They’ll bleed you dry.

Obamacare allows financial incentives for workers taking part in workplace wellness programs of up to 50 percent of their monthly premiums, deductibles, and other costs. That translates into hundreds and sometimes thousands of dollars in extra annual costs for those who do not participate.

Typically, participation means filling out detailed health questionnaires, undergoing medical screenings, and in some cases attending weight-loss or smoking-cessation programs.

One of the arguments presented in the lawsuit against three employers is that requiring medical testing violates the Americans with Disabilities Act.

That 1990 law, according to employment-law attorney Joseph Lazzarotti of Jackson Lewis P.C. in Morristown, N.J., largely prohibits requiring medical tests as part of employment.

“You can’t make medical inquiries unless it’s consistent with job-necessity, or part of a voluntary wellness program,” he said.

The lawsuits are based on the view that it is no longer voluntary if employees face up to $4,000 in penalties for non-participation, loss of insurance or even their jobs.

Employers, however, see the lawsuits as reneging on the administration’s commitment to an important part of the healthcare reform.

If it violates ADA, what was it doing in the [bleeping] law? Did no one think to ask? Of course they did, but Nancy “The Bull” Pelosi gave away the game: we had to pass the “law” to find out what was in it.

The law itself is godawful enough. The process by which it passed was truly the work of Satan. No good could ever come of it. Just strife, chaos, mayhem, hellfire, brimstone, and Supreme Court appeals. All according to schedule.

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He Said What???

Our first post on Gruber-gate was a week ago this morning. Our source was a Daily Caller story from a day earlier.

But look who just found out:

ED HENRY, FOX NEWS: At your Burma townhall a couple of days ago, you tried to inspire young leaders by saying, “governments need to be held accountable, need to be responsive to the people.” I wonder how you square that with your former adviser, Jonathan Gruber claiming you were not transparent about the health law because in his words the American people, the voters are stupid. Did you mislead Americans about the taxes, about keeping your plan in order to get the bill passed?

PRESIDENT OBAMA: No, I did not. I just heard about this.

To be fair to the president, he’s been in Asia. It’s hard to get news over there. Wait’ll he finds out NBC canceled Bad Judge!

Let’s bring the most powerful man in the world up to date, shall we? The brains behind ObamaCare (if you’ll pardon the oxymoron) has been telling anyone who’ll listen (in six different videos so far) what a con the bill was—The Sting on one-sixth of the nation’s economy. Why, he even told you, sir, right in the Oval Office. (Though it came as no surprise, I’m sure.) Your pals in the MSM ignored the story for a couple of days, but even their wall of silence was not leakproof.

Of course, anyone not drinking the Kool-Aid already knew what Gruber said was true. Or is a liar:

The fact that some adviser who never worked on our staff expressed an opinion that I completely disagree with in terms of the voters, is no reflection on the actual process that was run. We had a year-long debate, Ed. I mean, go back and look at your stories. The one thing we can’t is that we did not have a lengthy debate about health care in the United States of America. Or that it was not adequately covered. I would just advise — every press outlet here, go back and pull up every clip, every story, and I think it will — it’s fair to say there was not a provision in the health care law that was not extensively debated and was fully transparent. Now, there were folks who disagreed with some of the various positions. It was a tough debate.

Eww…I feel dirty.

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Tell a Lie Often Enough…and No One Believes It

Of the myriad and manifest lies Obama told over and over (and over again), we probably agree that the most brazen and most damaging one was that “you can keep your doctor”.

Your doctor won’t even keep you:

As of May 2014, over 214,000 doctors wouldn’t participate in Obamacare plans, and that number may be growing, according to AAF, a free-market think tank in Washington. While some Obamacare kinks have been worked out over the past year, exchange plans remain as unfriendly to doctors as ever.

Obamacare puts physicians — especially the dwindling number of those in private practice — in an especially difficult financial situation, expecting doctors to eat the costs of patients who discontinue coverage and to simply take on more patients to make up for bottom-level reimbursements.

It’s no wonder that in such an unfriendly climate for physicians, many are staying out of Obamacare plans. At the beginning of Obamacare’s first enrollment period last year, over 70 percent of California’s physicians weren’t participating in Covered California plans, according to AAF — a big problem for the state with the largest Obamacare enrollment in the nation.

Obama is squeezing doctors in order to keep rates low.

How’s that working out?

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[M]ore employers are offering consumer-directed health plans, which usually come with high deductibles. In 2015, 81% of large employers will offer at least one of these plans, up from 63% five years earlier.

Consumer-directed plans typically carry deductibles of $1,500 for individual coverage, more than three times higher than traditional policies, according to the National Business Group on Health.

And these plans will be the only choice for a growing number of workers. The share of larger employers offering only consumer-directed policies is jumping to 32% for 2015, up from 22% this year.

Deductibles are soaring for traditional insurance policies, too.

Deductibles for individual coverage at all firms have jumped to $1,217, on average, up 47% over the past five years, according to the 2014 Kaiser Family Foundation/Health Research & Educational Trust report. In high-deductible plans, they have hit $2,215.

Employers say they want more accountability, and higher deductibles force workers to take a larger role in their own care while shifting more of the costs to them.

Hey, that sounds good to me: health care costs what it costs in part because no one feels the cost. Low premiums and a high deductible make people responsible consumers yet still protected from catastrophic illnesses. But I don’t think it sounds so good to President Obama. Another of his bald-faced lies was “bending” the cost curve. Instead, deductibles have rocketed by more than a third since ObamaCare passed.

Hardly droll, but never dull, ObamaCare is bending us.

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Whose Ass to Kick?

Uh-oh, first the Gulf oil spill, then the IRS (phony) scandal—Obama is angry again!

On the surface, even in his weekly address Saturday, President Barack Obama is urging calm when it comes to the Ebola crisis, but people behind the scenes say that he is becoming more frustrated and even angry with how his administration has been handling the United States’ response.

For example, during his cabinet meeting on Wednesday, people briefed on the event said he was angry about medical information that was turning out to be wrong, including how to categorize Ebola patients, reports The New York Times.

Obama reportedly complained that the response, particularly from the Centers for Disease Control, was “not tight.”

But being in command without stoking panic is a challenge, said David Axelrod, a former close adviser of Obama’s.

“It’s not enough to doggedly and persistently push for answers in meetings,” Axelrod told The Times. “You have to be seen doggedly and persistently pushing for answers.”

Again with the “optics”!

Obama is about nothing if he’s not about the optics:

President Obama is hitting the links on Saturday, joined by ESPN commentator Tony Kornheiser after a hectic week for the White House in response to the Ebola outbreak.

Kornheiser is a well-known expert in the field of infectious diseases. His monograph on beri-beri is still considered the last word on the subject.

One last point: isn’t “angry” one of those “dog whistle” words when applied to black men? I could have sworn it was. Shame on the New York Times for wallowing in racial stereotypes.

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Ebola Follies

Sow the wind, reap the whirlwind: [A few additional thoughts to Aggie’s similar post below]

A second Texas nurse who has contracted Ebola flew on a commercial flight from Ohio to Dallas with a slight temperature the day before she was diagnosed, health officials said on Wednesday, raising new concerns about U.S. efforts to control the disease.

Chances that other passengers on the plane were infected were very low, but the nurse should not have been traveling on the flight, U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Thomas Frieden told reporters.

The woman, Amber Vinson, 29, was isolated immediately after reporting a fever on Tuesday, Texas Department of State Health Services officials said. She had treated Liberian patient Thomas Eric Duncan, who died of Ebola and was the first patient diagnosed with the virus in the United States.

As Aggie reported earlier, Obama canceled a fundraising junket so as to appear to be involved (if not interested) in the effort to stave of an epidemic. No wonder stocks tanked (see below). If he cancels golf this weekend, move to New Zealand as soon as you can.

Frieden said Vinson had been monitoring herself for symptoms of Ebola and failed to report that her temperature had risen to 99.5 degrees before she departed for Dallas. Even so, Frieden said the risk to other passengers was “very low” because she did not vomit on the flight and was not bleeding.

He added that authorities had identified three people who had direct contact with her before she was isolated.

Dr. Mary DiOrio, interim chief of the Ohio Department of Health’s Division of Prevention and Health Promotion, told reporters Vinson visited family in Akron from Oct. 8 to Oct. 13 before she flew to Dallas on Frontier.

Lovely young woman, I’m sure. Doing God’s work. Of course she should not have taken the flight; of course she should have reported herself a week ago. But she did, and she didn’t. People do s**t like that all the time, sometimes with consequences, sometimes without.

I just love (as in hate) the fact that the CDC declares that an American citizen should not have taken a flight, yet recoils in horror at the suggestion that Liberian nationals from a Hot Zone be denied entry. We are so [bleeped]. Hello, Auckland!

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The “Good” News on ObamaCare

Never let it be said we don’t present both sides:

The ranks of the uninsured plummeted in early 2014, as millions gained health insurance coverage through Obamacare, new government data released Tuesday found.

There were 41 million Americans lacking coverage in early 2014, down from 44.8 million last year, according to the National Health Interview Survey, the first official government look at the uninsured after Obamacare policies kicked in on January 1. The uninsured rate fell to 13.1%, from 14.4%.

Wow…a whole 1.3%. I haven’t seen such a “plummet” since riding the Cyclone at Coney Island.

Take a look:

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Caught your breath yet?

Just a couple of questions. If ObamaCare was the savior of the uninsured, how come the rate of decline in the uninsured predates the (lewd) act by a year? And if Obama thinks he can legalize five million illegal aliens with the stroke of a pen, why, pray tell, did we have to go through the legislative and bureaucratic train wreck of ObamaCare just to extend insurance coverage to 3.7 million? Throwing millions more off their plans in the process?

President Obama had a Democrat majority in both houses of Congress. He could have expanded Medicaid in his first budget. His “soaring” rhetoric and adoring acolytes could have made anything happen. Heck, they passed ObamaCare.

Which tells you all you need to know. This wasn’t about the uninsured. It was about power. In that, the law (the Constitutional law, b*tches) is a success.

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Broken ObamaCare Promise No. LVXIII

Give or take a I or II:

More people newly insured by Medicaid under ObamaCare are seeking treatment in hospital emergency rooms — one of the most expensive medical settings, a study released Monday concludes.

The analysis by the Colorado Hospital Association found that the average number of ER visits in states that expanded Medicaid increased by 5.6 percent, when the second quarter of this year was compared with the same period in 2013.

The increase was more than three times larger than experienced by hospitals in states that did not expand.

The jump was also outside the range of normal year-to-year fluctuations.

“When this newly insured population is trying to understand the system, they are using the easiest access point, and that is the ER,” said Chris Tholen, a vice president of the hospital association.

You can’t keep your plan, let alone your doctor. It isn’t bending the “cost curve” down, but up. The system, which we were warned was under-secured, was recently hacked. It may (or may not) be Constitutional (bitches).

And the newly insured are still hitting the ER, as they always had. Otherwise, it’s aces.

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BTL Therapy Session

I hate to burden my subjects with my personal issues, but I had the worst dream last night. I need to share.

It started like this:

Sticker shock is around the corner for many Americans with government-brokered medical coverage, as insurance companies are beginning to apply their first-year costs to next year’s premiums.

In the case of Florida, some consumers will pay as much as 23 per cent more when their plans are renewed in the fall, according to the Florida Office of Insurance Regulation.

The numbers in virtually every state are all across the board, with the biggest rate hikes announced to date coming in states where the federal government runs the Obamacare marketplaces.

I woke up in a cold sweat. Once I had a glass of water, I tried to go back to sleep.

Until…

“The Obama administration on Friday appealed the ruling that some subsidies underObamaCare are illegal,” reports the Hill. “The Justice Department filed a petition with the full D.C. Circuit Court asking the judges to review the ruling in Halbig v. Burwell that overturned some of the subsidies distributed to help people pay for health insurance.”

A day earlier the plaintiffs in King v. Burwell filed an appeal petition directly with the Supreme Court, The Wall Street Journal reports. The cases raise the same question, but a three-judge panel of the Fourth U.S. Circuit Court of Appeals ruled in favor of the government. Both appeals were expected: The Obama administration has reason to expect a more favorable hearing from the D.C. Circuit, newly packed with Democratic appointees, than from the high court.

The Halbig court held that because the ObamaCare law expressly authorizes premium subsidies only for medical-insurance policies purchased on an exchange established by a state, it precludes a 2012 Internal Revenue Service regulation providing subsidies via the federal exchange, HealthCare.gov, as well. Administration supporters seem to have given up arguing that the IRS rule is consistent with what the law actually says, so instead they’ve rested their case on congressional intent.

No! NO!!

Forget dreams about falling or being naked in public, this was petrifying. Somehow, a law was passed that forced rises in medical costs, yet subsidized fewer people. When did our country get taken over by rich, greedy bastards?

Once I convinced myself this was twisted fantasy, I allowed myself to try sleep again.

Big mistake:

[F]ederal health officials are finding themselves swamped as they fact-check a flood of paperwork from applicants seeking taxpayer subsidies.

The Department of Health and Human Services seems to be caught between critics on both sides as it confronts the task.

The department, which oversees the implementation of the Affordable Care Act, has gotten hit by audits showing it hasn’t done enough to crack down on fraudsters trying to scam the system. At the same time, some frustrated applicants say they have played by the rules — signed up on time and submitted the necessary paperwork — only to be caught up in bureaucratic red tape.

The scramble to verify eligibility comes on the heels of a Government Accountability Office report that raised fresh doubt about the ability of the health care program to prevent or intercept costly fraud schemes.

Government investigators posing as fake applicants were able to go online, purchase health plans using fake documents and set themselves up to receive undeserved federal subsidies.

Eleven of the 12 fictitious applicants were able to dupe the system using invalid Social Security numbers as well as inaccurate citizenship information, according to the report. The 11 were given the go-ahead to receive $30,000-a-year in health care credits and subsidies.

STOP! The government caught barely 8% of fraudulent applications? Over 90% of con men and grifters could score an easy 30k without breaking a sweat?

Was I going mad?

I passed out again, feverish:

Vermont, a bellwether for healthcare reform, has fired the main technology contractor behind its bungled health insurance website, dealing the latest blow to CGI Federal, the company that was axed over its disastrous jobs in making the federal healthcare exchange website and a similarly troubled site for Massachusetts.

With Vermont still lacking a fully functioning health website more than 10 months after its glitch-plagued debut last October, Vermont officials said late Monday that they were pulling the plug on CGI’s CGI Technologies and Solutions’ contract. CGI’s Fairfax, Virg.-based subsidiary had stood to make at least $83 million from its work for Vermont but will now make just $66.7 million, a figure that incorporates a $5.1 million penalty levied by the state for shoddy work.

Despite the tangles, Vermont is pushing ahead with plans to become the nation’s first system in which the state foots all health-care bills for all residents — what conservatives call “socialized medicine,” and others call “single-payer” or “universal financing.” Miller told Newsweek that “development of the Vermont universal coverage system is proceeding” and that the Shumlin administration would provide cost estimates and an operational plan to the state legislature in January 2015.

The grand plan will require more federal dollars, in the form of grants, and federal approval to effectively bypass the Affordable Care Act, the very law that Vermont Health Connect was built to comply with. Vermont, Miller told Newsweek, is working with the Centers for Medicaid and Medicare Services, the federal agency overseeing the Affordable Care Act, “to submit requests for the waivers that will be needed.”

I am a changed man, a shell of myself. I went to bed thinking we had a health care system that worked for the vast majority of us. I woke up dizzy with the thought that we had passed some lurid gargoyle of a law that raised prices, cut subsidies, wasted hundreds of millions of dollars on botched websites, and was wide open to fraud.

Please tell me this isn’t so.

Please…?

Many of the eight million sign-ups in Obamacare exchanges nationwide already face more limited choices for physicians and hospitals than those in the private insurance market. But with low physician reimbursement rates, the problem could get even worse.

For a typical quick patient visit, Dr. Doug Gerard, a Connecticut internist, told NPR a private insurer would pay $100 while Medicare would pay around $80. But Obamacare plans are more likely to pay closer to $80, which Gerard says is unsustainable for his practice.

“I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,” Dr. Gerard told NPR. ”You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.”

[Whimper… shudder…sob…whimper…]

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ObamaCareless?

So, did the long-awaited, much-anticipated court ruling(s) on ObamaCare actually decide anything? Not yet.

But let’s dismiss the idea that the intent of Congress was plain:

Some argued that the text of the law clearly permitted subsidies to flow to those who purchased plans on the federal exchange—this was the argument offered by the government in court. Others argued that while the text didn’t technically permit those subsidies, that was clearly the intent of the the law, and any textual omission was surely due to a “drafting error.”

That’s right: a drafting error.

Let’s take a step back to see how plausible that explanation is. There are two types of exchanges: state-established, and federally established. The statutory authority for state-based exchanges comes in section 1311 of Obamacare. The statutory authority for a federal exchange in the event that a state chose not to establish one comes from section 1321(c) of Obamacare. Right off the bat, we have two discrete sections pertaining to two discrete types of health exchange. Was that a “drafting error”?

Then we have the specific construction of section 1321(c), which allows for the creation of a federal exchange. Nowhere does this section say that an exchange created under its authority will have the same treatment as a state-based exchange created under section 1311. At no point does it say that section 1321 plans are equivalent. Why, it’s almost as though the exchanges and the plans offered by them were not intended to receive the same treatment. Was that another “drafting error”?

Most important, we have the sections of the law providing for tax credits to help offset the cost of Obamacare’s health care plans: sections 1401, 1402, 1411, 1412, 1413, 1414, and 1415. And how do those sections establish authority to provide those tax credits? Why, they specifically state ten separate times that tax credits are available to offset the costs of state health exchange plans authorized by section 1311. And how many times are section 1321 federal exchange plans mentioned? Zero. Was that yet another “drafting error”?

The specific phrase “established by the State under section 1311? can be found twice in the tax credit title of Obamacare. The first instances relates to the size and the second to the scope of the tax credit subsidy. How many times is the phrase “established by the Federal government/Secretary under section 1321? found? Zero. Was that also a “drafting error”?

The deliberate creation of a separate section to authorize a separate federal entity is not a drafting error. The repeated and deliberate reference to one section but not another is not a drafting error. The refusal to grant equal authority to two programs authorized by two separate sections is not a drafting error. The decision to specifically reference section X but not section Y in a portion of a law that grants spending or tax authority is not a drafting error.

The clear text of the law repeatedly demonstrates that plans purchased via federal exchanges were never meant to be treated the same as plans purchased by state-based exchanges. Despite its assertions, the IRS was never granted the statutory authority to hand out tax credits related to plans purchased via a federal health exchange.

The law expressly and intentionally omits HealthCare.gov from handing out subsidies—yet the IRS decides that it can.

How?

Obamacare was signed into law in March of 2010. It wasn’t until August of 2011 that the IRS decided to make tax credit subsidies available to plans purchased on federal exchanges. That’s a span of 16 months—an awfully long time to recognize and address a “drafting error.” Furthermore, actual “drafting errors” have to be corrected by new laws, not by executive fiat. Even when they are plainly obvious to everyone who sees them, that 3015 that should’ve been 2015 still has to be amended via a new law: passed by both Houses, and signed by the president. Yet, that’s not what this administration did.

In its May 2012 announcement of its official new rule which suddenly allowed subsidies to flow to federal exchange plans, the IRS never claimed it was a drafting error. It claimed the opposite: that the text clearly endorsed the IRS interpretation.

So why did the IRS wait nearly 16 months to spring this new interpretation on the public? That’s also an easy one. As of August 17, 2011, when its rule was first proposed, only ten states had passed laws establishing their own exchanges. Seventeen had outright rejected the Obamacare exchanges. All told, 40 states had by that point failed to do the administration’s bidding and set up state-based Obamacare exchanges.

Without exchanges in every state, Obamacare would surely fail as a policy matter. And without massive subsidies to offset the costs of Obamacare’s health plans, Obamacare would fail as a political matter. The IRS maneuver was a last-ditch attempt to paper over the law’s serious structural flaws.

Big government at work. Give me a sausage.

PS: And then there’s this.

According to the findings of an investigation conducted by the Government Accountability Office which were presented to Congress on Wednesday, some of those taxpayer-funded subsidies are not merely legally problematic but are also subject to extensive fraud.

The GAO found that 11 of 12 applications for federal assistance while applying for insurance provided through the ACA using “fictitious identities” were accepted.

Who was the nimrod (fictitious nimrod) who didn’t get through? That guy wasn’t trying. Here’s a new slogan for EdselCare: 8.33% pure.

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The New Normal

OUT: You can keep your doctor, period.

IN: “Network restructuring is the new normal.”

National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials.

For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor.

UnitedHealthcare is the country’s largest provider of privately managed Medicare Advantage plans, and the ongoing cuts have prompted lawsuits by doctors, state investigations, and recent federal policy changes to better protect consumers. There is also pending legislation in Congress to prevent health plans from cutting physicians mid-year.

“This phenomenon is nationwide and needs to be addressed,” Senator Richard Blumenthal, a Connecticut Democrat, said in an interview. “I’m reviewing possible legislation that would prevent this kind of draconian discharge of providers from networks serving Medicare Advantage patients.”

The changes come amid a gradual reduction of reimbursements to private insurers that offer Medicare Advantage plans as a way to offset costs associated with President Obama’s health reform law.

Right. If we had an independent press, instead of a gang of cheerleaders, we would have known this was coming. It’s the law of the land—what’s more, it’s Constitutional, bitches.

UnitedHealthcare officials say they hope that streamlining the pool of doctors will not just save money but ultimately improve the quality of patient care — and thus improve its chances of receiving bonus payments under a new federal rating system.

Cost savings could translate into more affordable care for patients, the insurer said, with the potential for lower out-of-pocket costs for prescription and office visit co-pays.

“Network restructuring is the new normal. It’s not just UnitedHealthcare, but that’s the way health plans will be operating in the future,” said Dr. Sam Ho, UnitedHealthcare’s chief medical officer, in an interview. “Healthcare is going through so many significant changes that it’s no longer a matter of doctors providing services and health plans paying claims, but a focus on the quality and cost effectiveness of those services.”

I think that’s nonsense, too, but what did people expect when Obama tipped over the health insurance apple cart?

A better metaphor:

“We’re really opposed to their actions because it’s going to limit access to care,” said Dr. Richard Pieters, president of the Massachusetts Medical Society. “We think the decisions on how they are eliminating physicians may well be arbitrary and not based on quality. It’s very unsettling. Potentially, this is just another domino starting to fall.”

Another domino. That’s it exactly. And Obama toppled the first one.

“A government big enough to give you everything you want, is a government big enough to take away everything that you have.”

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One Nation, Underwhelmed

If opposition to ObamaCare is racist (what else could it be?), we’re all racists now.

Or 86% of us, anyway:

About one month after the new healthcare exchanges closed with over 8 million new enrollees, there has been little substantial change in Americans’ perception that the healthcare law has helped them. Most Americans say the law has had no impact on their healthcare situation, while those who do perceive an effect are more likely to say it has hurt them rather than helped them.

I include even those who claim no effect among the racists. How dare they dismiss the president’s signature achievement? And the 3% who had no answer: they were just hiding their blatant racism. Only 14% of you are truly enlightened. Shame on the rest of us.

If this display of cynicism leads me to early dementia… what was I saying?

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While Obama Putted

[NB: Hat Tip to Keith Koffler’s invaluable White House Dossier for most of these links.]

This was how the VA scandal broke:

At least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list.

The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources.

For six months, CNN has been reporting on extended delays in health care appointments suffered by veterans across the country and who died while waiting for appointments and care. But the new revelations about the Phoenix VA are perhaps the most disturbing and striking to come to light thus far.

Internal e-mails obtained by CNN show that top management at the VA hospital in Arizona knew about the practice and even defended it.

Dr. Sam Foote just retired after spending 24 years with the VA system in Phoenix. The veteran doctor told CNN in an exclusive interview that the Phoenix VA works off two lists for patient appointments.

That was on April 23, on CNN.

Dr. Foote explains himself in the New York Times today a day and a month later:

MY decision to become a whistle-blower after 24 years as a physician in a Veterans Affairs hospital was, at first, an easy one. I knew about patients who were dying while waiting for appointments on the V.A.’s secret schedules, and I couldn’t stay silent.

But there was no response to the two letters I sent to the Veterans Affairs inspector general, one in late October 2013 and one in early February. Going public would damage an institution I gave more than two decades of my life to, trying to make a better place for veterans to get their care. But I had to be able to sleep at night.

Any scandal that befalls the V.A. necessarily lands on the party that is in the White House. As this is an election year, we can expect that there will be significant pushback to delay and limit the discovery of negative information — which is why I expect my suggestions to be vehemently opposed by the White House and the V.A.’s upper management.

I am worried about the patients whose care is entrusted to the V.A., and I am skeptical about our chances of creating real, long-lasting reform — but I hope that this time we will. It is easy, especially on Memorial Day weekend, to pay lip service to the need to “support our troops” and our veterans. But it is much harder to actually do it.

Dr. Foote has little faith in President Obama’s leadership, a pretty cynical point of view when the president was described as “madder than hell”. But if we look at the intervening 31 days since the story broke, we may see the reason for the good doctor’s skepticism.

Obama was in Asia when the story broke (You remember, he told Malaysia that the US has “work to do” on human rights.) He returned to the White House on the evening of April 29th.

There was a lot of business to catch up on, as one might expect, but that’s what weekends are for—to work through the backlog of the nation’s business.

Eventually:

From the pool report:

POTUS motorcade departed WH at about 11:40 am and arrived at Fort Belvoir, Va. at 12:06 p.m., at which point motorcade pulled off from pool van. Pool did not see president.

Per White House, POTUS is playing golf with Marvin Nicholson, Joe Paulsen and Michael Brush.

Doubtless strategizing how to fix the VA. But he got busy the next week.

Fundraising:

Obama Schedule || Wednesday, May 7, 2014
by KEITH KOFFLER on MAY 6, 2014, 9:53 PM
10:00 am ET || Receives the Presidential Daily Briefing
11:05 am ET || Departs White House
12:35 pm CT || Arrives Arkansas
2:50 pm CT || Delivers a statement
3:35 pm CT || Departs Arkansas
5:00 pm PT || Arrives Los Angeles
6:55 pm PT || Delivers remarks and answers questions at a joint fundraiser for House and Senate Democrats; private residency, Los Angeles
8:10 pm PT || Attends USC Shoah Foundation dinner; Hyatt Regency Century Plaza, Los Angeles

The Shoah dinner as a cover for a fundraising junket—well played, sir!

And he wasn’t done yet!

Obama Schedule || Thursday, May 8, 2014
by KEITH KOFFLER on MAY 7, 2014, 8:26 PM
9:30 am || Participates in a DNC fundraiser; The Beverly Hilton
11:10 am || Departs Los Angeles
11:50 am || Arrives San Diego
1:15 pm || Delivers remarks at a fundraiser for congressional Democrats; private residence
2:30 pm || Departs San Diego
3:50 pm || Arrives San Jose
4:15 pm || Participates in a DNC fundraiser; private residence
6:30 pm || Speaks at a DNC fundraiser; Fairmont San Jose

A few more days pass—and it’s the weekend!

It’s the usual Saturday golf. President Obama and three White House aides – usual type players – arrived at the Joint Andrews course shortly after noon.

It’s the president’s 12th time out this year and the 169th round of his presidential golfing career.

Okay, he’s golfed enough, and fundraised enough—surely he’s over jet lag—it must be time to address the nation’s veterans.

But it’s not:

Obama Schedule || Wednesday, May 14, 2014
by KEITH KOFFLER on MAY 13, 2014, 10:26 PM
10:00 am || Receives the Presidential Daily Briefing
1:20 pm || With the first lady, departs the White House
2:30 pm || Arrives New York City
3:25 pm || Delivers remarks on infrastructure; Tarrytown, NY
5:00 pm || Attends a DNC fundraiser; InterContinental Hotel, New York City

It’s been three week, sir: surely time to display that legendary Obama temper and kick some ass, no?

Not exactly:

Rob Nabors, a White House deputy chief of staff, will work with the VA temporarily to help assess its practices and develop recommendations on how veterans’ hospitals can increase access to timely care, the White House announced Wednesday.

“While we get to the bottom of what happened in Phoenix, it’s clear the VA needs to do more to ensure quality care for our veterans. I’m grateful that Rob, one of my most trusted advisors, has agreed to work with Secretary Shinseki to help the team at this important moment.”

Maybe he hides his anger:

TAPPER How on earth, can the president still have full confidence in him. People died.

McDONOUGH You heard what Gen. Shinseki had to say about this. He’s mad as Hell about this. Nobody’s more mad than the president.

Grateful, angry, what’s the difference? Either way, he got his man:

Today, I accepted the resignation of Dr. Robert Petzel, Under Secretary for Health in the Department of Veterans Affairs.

I thank Dr. Petzel for his four decades of service to Veterans.

“Four decades” should have been a clue: it turns out the guy retired, a couple of weeks early.

That done, it was back to the golf course:

A reporter got stuck in less than stellar surroundings Saturday. As President Obama golfed at the fancy Robert Trent Jones Golf Club in Gainesville, Va., an exclusive course that has hosted four President’s cups, the reporter was put in a maintenance shed.

On the way to the shed, Houston Chronicle‘s Kevin Diaz first waited in the equipment shack cafeteria (whatever that means). Later, he was sent to a” maintenance shed” to wait out the President’s golf game.

As he noted in his White House Pool Report, “POTUS motorcade departed at 4:45 from the gated, lakefront campus of Robert Trent Jones’ signature golf course, which looked like a nice place to play golf, at least from the maintenance shed where pool spent the day.”

If the designated reporter is meek enough to sit on his ass in a maintenance shed, that’s probably where he belongs. What a useless lot the Washington press corps is.

FINALLY! Four weeks since the story broke:

Some of the problems with respect to how veterans are able to access the benefits that they’ve earned, that’s not a new issue. That’s an issue that I was working on when I was running for the United States Senate. Taking care of our veterans and their families has been one of the causes of my presidency.

And dummy lists, Mr. President? Have they been “one of the causes of [your] presidency”? Military “folks” died waiting for access to your “issue”.

What are you going to do about it?

President Obama headed out unusually early this morning for his customary Saturday round of golf, motorcading to the course at Joint Base Andrews.

From the pool reports:

The president left the White House in his motorcade at 9:25 am. He is wearing a well-tailored pair of khaki pants, a white polo shirt, a navy blue windbreaker and no hat.

At least, that’s how it looked from the maintenance shed.

In the month-plus since the story broke, Obama has “retired” one bureaucrat, raised hundreds of thousands of dollars for the Democrat Party, and golfed four times. Perhaps that explains Dr. Foote’s jaundiced view of affairs expressed above.

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