Obamacare - 2019

The Obamacare decision had a significant impact on America  - one on its political system, the other on its economy. Many on the left support it and continue to do so... that is until they get raked over the coals when they find out that the insurance they thought they had, they didn't. The horror stories are out there. Two key ones - People who are paying a lot more in premiums for a lot less in coverage and those who are paying for coverage and still wind up with bills into the tens of thousands of dollars after care.

The whole system in my and in many others opinion has become one big money making scam - instead of extracting tumors and gall stones, it extracts C-notes and thousand dollar bills. When 'Dr. Soprano' gets done with his wallet extraction surgery, you won't have so much as a bed pan to you-know-what in.

This is a massive system in this country

Data source: CMS.gov

Today's expenditures for the system is $3.4 Trillion per year. (original link)

You read that correctly, that is how much money flows through our system and don't think the unscrupulous and fraudsters are not busy trying to suck as much money from it as it can. They are very busy and don't think the DOJ is not busy trying to catch them.

The Department of Justice obtained more than $2.8 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. 30, 2018, Principal Deputy Associate Attorney General Jesse Panuccio and Assistant Attorney General Jody Hunt of the Department of Justice’s Civil Division announced today.  Recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, now total more than $59 billion.

“Every year, the submission of false claims to the government cheats the American taxpayer out of billions of dollars,” said Principal Deputy Associate Attorney General Panuccio. “In some cases, unscrupulous actors undermine federal healthcare programs or circumvent safeguards meant to protect the public health.  In other instances, deceitful contractors overcharge our military or sell faulty equipment to our law enforcement agencies.  Such fraud will not be tolerated by the Department of Justice.  The nearly three billion dollars recovered by the Civil Division represents the Department’s continued commitment to fighting fraudsters and cheats on behalf of the American taxpayer.”- DOJ

Look I am not going to give you a lot of links and horror stories today, they are out there and you don't have to go just to conservative sites to find them. Head on out to some of those senior blogs and sites; hit where young adults hang out on on the web, you'll find them.

The End Of Obamacare?

Let's us assume that Trump can end Obamacare, it will be very difficult as many in his own party are getting their 'palms greased' to keep the system as expensive and exploitative as possible. But lets say that he can do it. What then?

Chaos. Simple chaos will ensure for many as the whole system will lose a lot of money flowing into it from the Feds. Insurance companies will be in a quandary and many will be most confused and those on the political left will be angry -  even though they too have seen their premiums rise and rise significantly since Obamacare came into being.

But in my view a temporary period of chaos without a federal solution would not be a bad thing. I see Washington's interference in the Health Care system as being wholly unhealthy (PI). It has driven up costs costs and the money winds up in the pockets of key Washington firms that lobby Congress and the White house hard... very hard. This is why our system is so expensive and takes so much money out of the economy that could be put to much better use.

Amazon gets a lot of heat for the Retail Apocalypse, but I think that part of the problem is that ordinary people just don't have the disposable income to shop at your traditional bricks and mortar stores. I said this would be a result when Obamacare first was being debated. That folks would simply have less money to spend and that would hurt retailers. No, I don't blame all or even most retails woe's on the price of medical care, but I also cannot reasonably conclude it has not had an noticeable impact either. You take money out of someones take home pay and they simply have less to spend - period.

But dig below the employment numbers in this nation and we see a troubling tale. Tales of Americans who do not have full time work, but work part-time or as contractors. They have to, they are the only jobs available even and particularly for young people with college degrees and who have to pay back student loans. With these jobs, they are often only created so that the employer does not have to pay all manner of insurance and taxes that they would have to pay with a full time employee, These taxes, insurance and other costs are key drivers keeping people in low end, contracting and temp jobs. Obamacare in particular laid a heavy burden on employers, who because of the new requirement, cut the hours of part time employees. I say these things not to get into the Obamacare pro or con narrative, but to show you that policy decisions like this have a real effect on real people. Unemployment insurance, and other kinds of taxes that the federal government and states levy on businesses... that money comes from somewhere and often it just has to come out of the number of employee's hired or the number of hours they work. So when we hear this talk about low unemployment remember that many of those supposedly employed people are temps, contractors and part-timers who are not making that much money.

This is a trend we have been seeing for some time now, and Obamacare was just one factor in a trend of bad economic policy decisions that are keeping people in low paying jobs. The result. As we saw recently in a study done by Deutche Bank, economic mobility in the country is near to non-existant. This leads to income inequality. One of the solutions being proposed around the country is raising the mandatory minimum wage. It sounds great on the surface, but one must always remember that many small and medium sized businesses, they don't make a lot of money. They are not 'raking in the millions'. They have a modest profit in some months and may lose money in other months. An employer who has to pay his employees more and who is not doing well, he simply is not going to have any choice, he is going to have to let someone go in order to pay the higher wages, or hire them back as a part timer.  Perhaps he will hire two and then not have to pay all those insurance premiums on those new employees. We have seen many papers and studies on this, the rise of the temp or 'gig' economy. One key factor cited in professional journals is the desire  by employers to avoid those taxes and fee's insurance premiums that go with hiring a full time employee.

In my view the trillions annually our  system sucks our of our economy would be perhaps somewhat justifiable, if our mortality rates were really so very much better than the rest of the world, justifying our massive health costs, but they aren't - look at infant mortality. Our system is not the best, it's just the most corrupt and expensive. They have merely found a way to monetize our personal and national health. The American health care system more and more in my view, has become a national wealth transference system.

This view is probably not shared by most of you and that is fine. Get socked with $20,000 bill for a medical procedure you thought you were covered for and I can assure you, your opinion will shift immediately into agreement... and these things really do happen. The system is expensive and in my view, rotten.

So if Obamacare went and there was nothing put in its place what could be done? How? How can the nation provide affordable - I mean really affordable care to its citizens? Now let me make this clear when I say affordable, I am not so much talking about a system where the actual cost of care is merely shifted onto government. That simply is not working. That costs a lot of money and as the Baby Boomers retire, it is going to cost even more as they go on Medicare.

Source CBO

Many Americans think there is a magic potion to pay for all of this. They really think that somehow 'they' can fix this without 'them' having to pay for it - that somehow some magic wand can be waved, some star chart can be cast, some magic lamp can be rubbed and the money to pay for all of this will appear. Like the fool at the Carnival who gets taken in by some professional trickster... there is a sucker born every minute and those who believe such side-show antics can solve this problem, fall clearly into this category. We have heard many Presidential hopefuls talk about Medicare for all, and a Single Payer system. It sounds great until you do that forbidden act, the secret sin that no politicians in American should ever do in public. What is that? Count how much what you just proposed will cost.

How do I know this is where Americans are at that they are being suckered? One look at the political debate, the blogs, the sites of those who scream to protect Obamacare but don't look at the costs, the numbers and how the country or even ordinary working people will be able to pay for all of this 10- 20 years from now. They get whipped up into a partisan emotional furor and fail to do one simple thing - count. Those costs just have to come down, no two ways about it.

That is how Americans are when they think they can have their cake and get someone else to pay for it - they are the sucker at the carnival; and this brings us to the crux of the matter.

The system itself is too expensive, I am not talking about premiums but the actual cost of all those services and procedures that get charged to the insurance company and to the patient. The nation needs to focus in on those costs and a serious Obamacare crisis could address this. How?

Again, get as much of the Medical system out of District of Corruption as possible. One solution would be to block grant 'X' amount of dollars to each individual state and let each state handle medical care and insurance in the way that it see's fit and best. Different regions have different needs and different economic means, different demographics and a different political make up. If the States were given significantly more leeway to administer their own systems, with significantly relaxed regulatory frameworks we could see a major change for the better. If we could allow states to use more generics, create new low cost hostels (but clean and safe) for in patient care, roaming medical vans for certain medical services in poorer communities, a cap on premiums doctors have to pay for Malpractice insurance - These are things that will put us on firmer economic footing. Folks there are ways to fix this, but the first step in fixing a problem is identifying some of its causes and one of the biggest causes of our medical expense problem is Washington and the money that gets poured into it.
AMA Lobbying Money

Medical Supplies Lobbying

Health Overall Lobbing
So yes, I am not just making thus up or reciting some Facebook or Twitter rumor or conspiracy theory hatched out of some atrophied mind. These are the facts - the dollars and cents and political facts and these are the reasons why Medical care in this country is so very, very expensive -  those paying the campaign bills are going to make sure it stays that way because all that money is heading their way... to the tune of 3.4 Trillion dollars a year. 

If state governments could get considerably more control over their own respective health care systems, different states could try different methodologies to make sure that (truly) affordable care can be had by all. Yes, it will be trial and error, yes there will be mistakes, but in 10 years time, we could indeed have a less expensive and more effective health care system that serves all Americans at a price point they can reasonably afford.

Well that's enough for this morning... I hope I have not bored any of you...

God bless and keep each and everyone of you in Christ!

Brother Mark

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