Pipe dream? Obamacare

[isobars]

Not when fiscal conflict of interest is involved.

[isobars]

[nw30]

For those who don't want to hear any news about anything that involves FOX News, this is your heads up so you can run around the block with your fingers in your ears, screaming na-na-na-na-na, it's all lies, na-na-na-na-na!!!!
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ObamaCare in Trouble?
Exchange provision delayed, as lawmakers push to repeal another
By Jim Angle

Published April 03, 2013
FoxNews.com


Parts of ObamaCare are starting to fray, even before full implementation.

The Obama administration now says a special system of exchanges designed to make it easier for small businesses to provide insurance will be delayed an entire year -- to 2015.

"Lots of small businesses struggle with providing insurance for their workers so this was supposed to facilitate it and make it easier for small business to do this," said Jim Capretta of the Ethics and Public Policy Center. "It was a huge portion of the sale job. When they passed the law in 2010 there were many senators and members of Congress who were saying 'I am doing this because it's going to help small businesses.'"

The exchanges were designed to give workers a range of choices supported by dollars from their employers. But now they will have only one choice until 2015, which could mean they can't shop for insurance that includes their current providers. Capretta said the administration is "way" behind schedule.

Since insurance is more expensive for small businesses, many of which have no obligation under the law to provide coverage, analysts now fear many might just stop trying and let workers go on the soon-to-be-launched state exchanges.

Sara Teppema of the Society of Actuaries -- which did an exhaustive study of ObamaCare -- said that "even if it's just a small change of people who are leaving the employment-based insurance and coming into the individual insurance market, their costs and their numbers will overwhelm those who are currently uninsured."

That means costs would increase.

Meanwhile, 79 senators including several liberal lawmakers recently voted to repeal a new tax on medical devices contained in the health care law following a similar vote in the House.

"The House and the Senate agreeing? This is a harmonic convergence, it doesn't happen," said former Democratic Sen. Evan Bayh. "But on this it's happened because the adverse consequences to our economy and the quality of health care are so apparent."

The two separate votes have not become law but show widespread opposition to the 2.3 percent sales tax on medical devices. Critics say the law is unfair to the industry since it's a tax on gross sales -- meaning it adds up to a much bigger percentage of a company's profits.

But supporters such as Paul Van de Water of the Center for American Progress oppose any repeal.

"I think that repealing the device tax would be irresponsible. We need the revenue and it's not going to be a job killer," he said.

The theory was that ObamaCare would insure 30 million more people and that device makers, like pharmaceutical companies, would get lots of new customers and a steady stream of new revenue to make up for the tax. Van de Water predicted that would still happen.

"These device manufacturers are for the most part going to be getting a large increase in business thanks to health reform, thanks to ObamaCare," he said.

But the CEO of one company said that's not true for the 7,000 small companies with 400,000 employees who make a wide range of devices.

Christine Jacobs of Theragenics said: "We make widgets -- hips, knees, stents, pacemakers, and implants, even, for prostate cancer. Those widgets tend to be used by people that are elderly. As the body parts wear out, we're needed."

But Jacobs notes that most people whose body parts wear out are already on Medicare, so ObamaCare does not provide a new revenue stream for her company -- only financial pain.

"In the case of a small company, that medical device tax is equal to our R-and-D budget for this year," Jacobs said.

Bayh said in his own state of Indiana, one company planned to open up to five facilities over the next five years but had to scrap those plans because of the "uncertainty created by this tax."

Jacobs said the huge multinational device makers might be able to handle the burden but not the small companies.

"It's just such a disproportionate burden for little guys," she said. "Because we're all being told that it's the little companies that create the jobs. And that's not message that we're getting."

The tax will even be applied to sutures used on pets that Theragenics developed for the veterinary market.

She sought FDA approval to demonstrate the quality of her products. But now she said "it's hard for me not to get frosted on this one" -- she explained that whoever wrote the regulations said "if you have FDA approval, you will be taxed."

President Obama has vowed to veto any repeal of the tax, but Bayh notes that 79 votes in the Senate would be more than enough to override any veto.

Read more: http://www.foxnews.com/politics/2013/04/03/obamacare-in-trouble-exchange-provision-delayed-as-lawmakers-push-to-repeal/#ixzz2PRjv3u38
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It's too big, and too complicated, they can't handle it, they can't even deliver the mail w/o loosing money.
I predict a total redo, as it should be.

[mac]

The partisan part of me is highly amused as the Birchers resume bashing Obama about health care reform. The rest of me, that thinks we need a credible Republican party, shakes my head about what fools we mortals be.

For Iso and the rest that argued that health care reform was unconstitutional, unaffordable, and had your party lose the Presidential election by 5 million votes when you made it a campaign issue--you lost! Every step of the way! Obama and Pelosi outsmarted your ops, and your refusal to play nice was part of the reason. Much of the objections of those who ended up voting for Obama anyway was because the bill didn't go far enough. Many in this country want a single payer system.

Few ideas came from the Republican Party after the outline of the bill, largely a Republican concept, was first suggested by the Heritage "think" tank. The Republicans made it clear that no amendments would result in a single vote. The only idea that I remember was competition in cooperatives across State lines--which I think ended up in the bill. Correct me if I'm wrong--but there was very little in substantive criticisms on this forum--but lots of name calling. Socialist was the most polite. Again, you bet the farm and lost and the mortgage is new.

Capetonian wants to present profit taking as a divine right in what is a highly caretelized system. It is essentially a non-market. The history of the Republicans in creating this system is particularly unsavory, and reasonably well known to the voters. Take, for the most egregious example, the expansion of the Medicare drug benefit under Bush. The funding problems of the system were apparent to actuaries at the time--yet the drug benefit was expanded without a means test, and with an express prohibition against using the purchasing power of Medicare to limit the cost of drugs. So Bush assured that the US Government was the anti-Walmart, and inflated the cost of drugs with their great purchasing power. As a result, Big Pharma enjoyed a 37% profit margin if memory serves. Republican policies, including government efforts to try to prevent generics from being used even overseas, assured that there was no market forces to drive prices down. Were there any objections from Republicans as Bush socialized the risks of new drugs and privatized the profits? Nary a peep. By the way, Bush did the same thing with most of his efforts, most notably AIDS assistance. Bush receives good grades from many for increasing funding for AIDS treatment in poor countries. (Of course religious conservatives prevented AIDS prevention because it involves contraception. It's because they care, and are compassionate conservatives.) So the increased AIDS funding actually bought 1/3 of the treatment that it could have with generics used instead of the more expensive Big Pharma products. Tell me again about how Republicans foster strong markets and avoid crony capitalism.

The list goes on. Bard--any Republican willing to cross the line and offer substantive modifications to the health care bill will be a hero, and will find support on the other side of the aisle. Obama achieved a bill that was possible by making a deal with Big Pharma, just as I feared Hillary would. He had to do that because the Republicans refused to cooperate at all, and that's what it took to deliver the troglodytes in his own party. But the billl has hundreds of pages that fund pilot projects for cost control, looking for ideas such as Kaiser uses, and seeing if it is possible to scale those ideas. It is certain that the bill is flawed in many ways--but it reflects a fundamental fact of politics, and of reform. Don't let perfect be the enemy of good.

The Republicans, now seeing that they couldn't beat Obama out of the White House with this cudgel, are free to suggest ideas to improve it. What have they done? Tried to undo it and defund it. About 40 times so far? What is Einstein's definition of insanity? Doing the same think over and over again and expecting a better result?

[nw30]

mac, what took you so long to reply?

[mac]

Training for a century. There are some here who actually are interested in a conversation, not talking points.

[swchandler]

NW30, do you think that all those Republican governors, hoping that the ACA would be struck down by the Supreme Court, had anything to do with the problems of setting up insurance exchanges? Of course, in the Fox News article, there was no mention of that important issue. Go figure.

[pueno]

[coboardhead]

Mac...very good points.

I think it is somewhat amusing to see articles posted here that highlight the difficulties in implementing a plan that affects nearly 20% of our GDP in an attempt to prove that the plan is failing. Every poster on this forum, that has supported the ACA, has expressed concern that the legislation is not perfect and that the details of the implementation would be where the real work is.

I do not believe that voters will give up the popular parts of the plan; so repeal is a dead end street for the Repubs. The plan will survive, mostly intact. I really would like to see these guys spend their (our) time constructively working on solutions to the implementation difficulties and costs.

"Training for a century?" Road biking? I am training for a half century (mile vertical)!

[nw30]

Talk about the republican governors, the GOP, and big pharma all you want, but it doesn't change the fact, Obamacare could be in serious trouble. Take it from Joe Kline himself, from Time magazine, or has he been written off as well.
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Obamacare Incompetence
By Joe Klein
April 02, 2013

Let me try to understand this: the key incentive for small businesses to support Obamacare was that they would be able to shop for the best deals in health care superstores — called exchanges. The Administration has had three years to set up these exchanges. It has failed to do so.
This is a really bad sign. There will be those who argue that it’s not the Administration’s fault. It’s the fault of the 33 states that have refused to set up their own exchanges. Nonsense. Where was the contingency planning? There certainly are models, after all — the federal government’s own health-benefits plan (FEHBP) operates markets that exist in all 50 states. So does Medicare Advantage. But now, the Obama Administration has announced that it won’t have the exchanges ready in time, that small businesses will be offered one choice for the time being — for a year, at least. No doubt, small-business owners will be skeptical of the Obama Administration’s belief in the efficacy of the market system to produce lower prices through competition. That was supposed to be the point of this plan.

Certainly, the Republicans who have stood in the way of these exchanges — their own idea, by the way, born in the conservative Heritage Foundation — deserve a great deal of “credit” for the debacle. But we are now seeing weekly examples of this Administration’s inability to govern. Just a few weeks ago, I reported on the failure of the Department of Defense and Veterans Affairs to come up with a unified electronic health care records system. There has also been the studied inattention to the myriad ineffective job-training programs scattered through the bureaucracy. There have been the oblique and belated efforts to reform Head Start, a $7 billion program that a study conducted by its own bureaucracy — the Department of Health and Human Services — has found nearly worthless. The list is endless.

Yes, the President has faced a terrible economic crisis — and he has done well to limit the damage. He has also succeeded in avoiding disasters overseas. But, as a Democrat — as someone who believes in activist government — he has a vested interest in seeing that federal programs actually work efficiently. I don’t see much evidence that this is anywhere near the top of his priorities.

One thing is clear: Obamacare will fail if he doesn’t start paying more attention to the details of implementation, if he doesn’t start demanding action. And, in a larger sense, the notion of activist government will be in peril — despite the demographics flowing the Democrats’ way — if institutions like the VA and Obamacare don’t deliver the goods. Sooner or later, the Republican Party may come to understand that its best argument isn’t about tearing down the government we have, but making it run more efficiently.

Sooner or later, the Democrats may come to understand that making it run efficiently is the prerequisite for maintaining power.

Read more: http://swampland.time.com/2013/04/02/obamacare-incompetence/#ixzz2PSy2mIwk