Obama’s Titanic

Posted on March 30, 2012

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The political hacks, including the Los Angeles Times, the Washington Post and notably, Jeffrey Toobin, CNN’s ‘Senior Legal Expert’ are now in panic mode, seeing the writing on the wall for the Affordable Patient Care Act aka ‘Obamacare’.  Toobin, even on the very eve before the first day of deliberations was putting his mark down firmly on SCOTUS affirming Obamacare.

After the very first day of hearings, he takes a 360 and now is talking about what if any ‘plan B’, Obama might have.  “I think the individual mandate is gone, based on the questioning,” Toobin said after the morning session. “It sure looks like there are at least five votes to get rid of … the individual mandate.”

Jeffrey my man, you wrote a check on TV – I think it might turn out to be a rubber one.  I’m going to be at least as bold as Mr. Toobin.  I’m going to put down my marker that the Supremes are going to sing to President Obama, ‘Nothing But Heartaches’.

Most of the discussion has centered around the ‘Individual Mandate’ and the constitutionality thereof.  I think what was remarkable about the whole process that led up to that provision was the sweetheart deal that Obama and the Democrats made with the major healthcare insurers.  No one but an idiot would believe that the insurers would simply roll over and play dead for any such piece of legislation unless the net effect of it was to create a government sponsored monopoly for the big boys, while freezing out the any competition that might come down the pike.

If there wasn’t a juicy bargain for them to be had, they would have spent enough money on lawyers to put a fairly good sized dent in the deficit.  It’s obvious that the reason that Obama flipped over from strongly opposing the Individual Mandate when Hillary was running against him, was that there was no huge campaign donations from Big Health until he awakened to the advantages of a colossal crony capital cartel involving Big Pharma and Big Insurance.  A match made in Heaven.

I look at the mandate with a particularly personal set of eyes.  I’m one of the ones that is ‘participating in commerce’ by not purchasing health insurance.  Yes, there it is – I confess, whether you care to believe it or not – neither I nor my family have had a healthcare plan for over 30 years.  I’m not boasting about this or in particular recommending it to anyone else – it’s simply a choice that we made and for us, it has been successful.  Have we ever had need for doctors or medical facilities during that span of time?  Rarely.  But when we did, we paid as we went on an as needed, uninsured basis.

The premise that is continually referred to with regard to the mandate, is that there is just a slew of people out there using medical services and not paying for them – called ‘free riders’.  I have not been able to uncover any reliable statistics that confirm that assertion.  The Wall Street Journal reports:

“Where did Congress go wrong [in calculating the cost of the “free rider” problem as $43 billion per year]? We traced its estimates of the magnitude of the hidden tax of $43 billion per year, or an increase in family premiums by an average of $1,000 per year, to two sources—the aforementioned Health Affairs study, and a non-peer-reviewed study commissioned by FamiliesUSA, a Washington, D.C., group long known for its advocacy of greater government involvement in health care. Yet Congress simply ignored the evidence in the Health Affairs study and failed to recognize the serious flaws in the FamiliesUSA analysis.”

You’ve heard quoted ad nauseum, that there are 44 million uninsured people in the United States.  That, first of all, is a number made up out of whole cloth – a complete fabrication.   Setting that aside for a moment, even assuming a number even in the ballpark, there is a large component of the uninsured that never is mentioned in the liberal media – Illegal aliens, 11 to 15 million.  That issue cannot be addressed because it is ‘hateful’, ‘xenophobic’, ‘racist’ and …true.

Healthcare professionals will tell you that aside from the calamities that befall illegals because they get drunk and into accidents and have work related injuries stemming from unsafe working conditions and illiteracy – the baby mamas show up to the ER with the ninos and ninas even when they have nothing more than a case of the sniffles.  The reason for that is the Emergency Medical Treatment and Active Labor Act, or EMTALA.

Congress enacted this legislation that tethers Medicare and Medicaid payments to Hospitals taking on all comers – legal citizens or not.  Now, I’m not saying that an illegal with a serious, immediate medical crisis should not receive treatment – that would be inhumane.  But what I am saying is there are around 12 million or so White Elephants in the room that no one can talk about because the solution to much of this ‘uncompensated care’ is to rigorously enforce immigration law.  We’re told we can’t do that, but as I demonstrate in a recent post, we absolutely can.

There is a tragic unintended consequence with this EMTALA mandate.  Since Hospitals and Medical Centers have to honor the terms of EMTALA or forfeit the fed funding, the nation’s ER’s are often crowded with people whose conditions do not warrant emergency attention.  That means that people who need triage stat, are not having their more dire needs properly managed.  That’s not a subjective conclusion, that’s reality.

Listening to the White House’s Solicitor General, Donald Verilli Jr. and all the other advocates, including the President, one would think that ‘Free Riders’ are an enormous factor in healthcare costs in America and are driving the cost of insurance for all other policy holders.  Is this really the case?  So how much uncompensated care is received by the uninsured?

The Urban Institute study puts the number at about $35 billion a year in 2001, or only 2.8 percent of total health care expenditures for that year. In other words, even if the individual mandate works exactly as planned, it will affect at best a mere 3 percent of health care expenditures.

As others have said, that is a relatively miniscule problem to necessitate shredding not only the Constitution, but as George Will has so eloquently pointed out, 200 years of Contract Law and centuries more of Common Law upon which our contract laws are based upon.  Mr. Will correctly observes that one of the bedrock concepts of contract law is that no one can be compelled, coerced or mandated to become a party to or enter into a contract.  That’s precisely what the individual mandate does.

Interestingly enough, a handful of studies on healthcare usage demonstrate that ‘under-compensated’ care, rather than the ‘un-compensated’ care that the individual mandate purports to solve, is the real driver of increased costs in America.  People with coverage – whether it’s on the basis of EMTALA or a private policy use considerably more services than do the uninsured.

The bottom line?  In reality, as the Congressional Budget Office has confirmed, the national cost of Obamacare is going to be at least twice what Obama and his Administration have told us it would cost.  What a surprise?  You mean Obama has been caught in another lie?

Another basic issue that has largely escaped attention from pundits.  The idea that healthcare is something that the government ‘owes’ individuals.  Privileges and personal responsibilities have been and are radically being redefined as ‘rights’.  Did the framers of the Constitution guarantee the citizen (or non-citizen as well) happiness – or did they guarantee your ability to pursue happiness?

That’s at the core of  much of the ideological struggle between progressives and conservatives and their supposed proxies Democrats and Republicans.  I chose the picture for this post because it struck me that many that are militating in favor of Obamacare, really do believe that government is no longer their ‘Uncle’, but is instead, their ‘pimp daddy’ and their ‘baby momma’.

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