No Runny Eggs

The repository of one hard-boiled egg from the south suburbs of Milwaukee, Wisconsin (and the occassional guest-blogger). The ramblings within may or may not offend, shock and awe you, but they are what I (or my guest-bloggers) think.

Archive for March 1st, 2012

Thank you, Thank you very much!

It’s been a couple of interesting weeks on the Obamacare front.

First, Obama Inc. told the Catholic Church that they had to offer contraceptive coverage in their insurance plans. I covered that little episode here.

Obama Inc. made a poorly camouflaged attempt to acquiesce without actually changing anything. Their proposal was to not require the Catholic Church, but to require their insurers to provide the contraception at no cost.

After 22.5 seconds of consideration, the Church came back with their response..NYET! In fact, not only NYET but if you force us, we’ll close our hospitals and other institutions.

Also recently, a study was released that showed some interesting early information on the reality of costs associated with Obamacare. You may remember President Obama telling us time and again how Obamacare would bend the cost curve on health care. Well, it turns out he was probably right. The problem is that the cost curve appears to be bent up not down, and at a very steep angle. According to this analysis and report, the first year costs for the high risk pool that covers people with preexisting conditions are running at a rate that is twice what was planned!

Finally, some had theorized that Obama may use the Blunt amendment as a way to let the Catholic Church off the hook while saving face on his administrations earlier edict. Unfortunately, the Blunt amendment was defeated on a mostly partly line vote today so the Catholic Church’s reason to close it’s facilities remains intact.

What are we to make of all this?

Some pundits, including the esteemed Ed Morrissey believe this is a high stakes game of chicken and that in the end, Obama will blink. I don’t buy it. Let’s look at the implications of the various actions I’ve previously noted.

When I looked at the premiums being charge for the high cost fund I noted that my family of 4 would be covered for about $800 per month. That may seem like a lot. However, for similar coverage from the high cost fund when we lived in Minnesota, we were paying nearly $1,500/month and that was two years ago. My point is that not only is the Obamacare high cost fund costing a lot more than it’s counterparts, it is also charging a lot less than its state counterparts. Last I looked, high costs and low revenue didn’t make a successful business. The outcome, if this is allowed to continue, is that insurance companies will be saddled with higher costs and lower revenues. This, over time, will force weaker insurance companies out of the business. Fewer insurance companies will lead to fewer choices which in turn, will lead to higher insurance costs.

I don’t think Obama will blink for the Catholic Church. As I noted earlier, he had the perfect opportunity to get a way out via the Blunt amendment. The amendment would have allowed church organizations to object and not provide certain coverages but would have required all other businesses to continue to provide whatever mandate Obama Inc. came up with. The tell for me is that this was voted down on nearly a party line vote. There are numerous Democrats in “swing” states who are up for election this year. There’s no way this is going to work in their favor. Had Obama wanted an out for the Catholic Church, there is no doubt in my mind that Harry Reid would have allowed just enough Democrats to vote for the amendment and “grudgingly” allowed it to pass. The fact that it didn’t means Obama is playing for keeps.

Finally, the Catholic Church threat. According to Morrissey, nearly 16% of admissions are served by Catholic hospitals. Nearly a third of those hospitals are in lesser served rural areas. If the Church does indeed pull their hospitals and other organizations, it will create a health care shortage of significant proportions in many areas of the U.S..

Contrary to the notion that Obama will blink, I think Obama is setting up exactly what he wants in health care.

If insurance costs skyrocket due to fewer providers and higher costs and access to care becomes scarcer due to a boycott by the Catholic Church, Obama, should he win a second election, will have the perfect pretense to declare a crisis and push, declare, impose or legislate for a national health care, single payer system…which is what he has wanted all along.

I will admit that it is possible that I’m wrong but I haven’t been wrong about much with this President. If I’m wrong, look for one of the following things to occur:

1. The Blunt amendment is brought back (it was tabled) and narrowly passes.
2. The Supreme Court rules that the health care mandate is unconstitutional before the election.

Any of these things could indicate that Obama won’t or isn’t able to eat the entire loaf. However, I don’t think either of these will happen. Rather, I think that Obama has planned this approach and as the Catholic Church threatened, if you listen closely you will hear Obama saying, “Thank you, Thank you very much!”

Four years of a Medicare Funding Warning, zero years of Obama action

by @ 12:04. Filed under Health Care Reform, Politics - National.

Rep. Paul Ryan (R-WI), chairman of the House Budget Committee, and Sen. Jeff Sessions (R-AL), ranking member of the Senate Budget Committee, fired off a letter to the White House in the wake of the fourth consecutive year of the Obama Administration’s decision to not address the now-current funding crisis of Medicare in violation of law. From the press release announcing the letter:

“Within fifteen days of presenting his budget plan, the President is required by law to send a legislative proposal to Congress to address Medicare’s looming insolvency. For four straight years, this ‘Medicare trigger’ has been issued. And for four straight years, President Obama has ignored the alarm and fled his post. America’s debt, as measured by the International Monetary Fund, is now worse than Greece on a per-capita basis. The course President Obama has laid out leads to fiscal ruin. His budget plan raises taxes by $2 trillion, increases the debt by $11 trillion, and increases spending by $1.6 trillion.

“The President’s unserious approach to Medicare will have serious consequences for seniors. President Obama continues to ignore his legal and moral obligations to protect the health security of America’s seniors. While he refuses to advance credible solutions to strengthen Medicare, the President’s health-care law does great harm to this critical program – raiding Medicare by over $500 billion to fund a new open-ended entitlement, while leaving the fate of seniors’ care to a board of 15 unelected bureaucrats in Washington. There is a growing bipartisan consensus on how best to preserve the Medicare guarantee, but the President won’t join this discussion. The President is required by law to respond to the Medicare Trustees’ annual warning, and – as a matter of fundamental leadership – is duty-bound to do so.

“Meanwhile, the Democratic leaders in the Senate refuse to bring a budget plan to the floor for the third straight year. The livelihoods, savings and futures of millions of hardworking Americans are at stake, but the President and his party’s leaders can’t even be bothered to fulfill their most basic obligations in a time of crisis.”

A bit of background is in order – as part of the creation of the Medicare Part D prescription drug benefit, a reqirement was put into place requriring, if the Medicare trustees find in two consecutive years that general funds, be they interest on the Treasury securities held by three “Trust Fund” accounts held by Medicare, redemptions of same, or other “general fund” revenues, do, or will within 6 fiscal years, comprise more than 45% of total Medicare outlays (or once the Hospital Insurance Fund was depleted, the “dedicated” funds are less than 55% of total obligations whether fulfilled or unfulfilled), the President to submit to Congress legislation to deal with said excessive general funding within 15 days of submitting the following year’s budget.

The first year the trustees found that situation becoming a probability based on the “intermediate-case” scenario was 2006, with FY2012 projected to require more than 45% of Medicare’s outlays come from the general fund. This imbalance was projected to arrive despite a pending reduction of physician reimbursement fees that had been called for since the prior decade and postponed every time since because of fears doctors would flee the Medicare program if the reductions were to happen (the postponement is known as the “doc fix”). Each time the “doc fix” was extended, the pain that would be caused if it was not extended yet again grew.

The 2007 Trustees’ Report, while it pushed off the year of reckoning to FY2013, triggered the “Medicare funding warning” as it was still within the 7-year scope of the trigger and the second consecutive finding. Accordingly, President Bush had Health and Human Services Secretary Mike Leavitt submit in February 2008, just after he submitted the FY2009 budget, what became H.R. 5480 and S. 2662. Those two bills were promptly buried in committee by the Democrats running both Houses of Congress.

The 2008 Trustees’ Report once again pushed off the year of reckoning to FY2014, which was once again at the very end of the 7-year scope of the trigger. President Obama chose not to submit any legislation despite his party controlling both Houses. Instead, we got PlaceboCare at the beginning of 2010, while the 2009 Trustees’ Report, breaking with the postponement history, once again put the year of reckoning as FY2014.

Fresh from his victory on PlaceboCare, Obama failed to address the immediate problem, and much like the “unanticipated” rapid decline of the Social Security “Trust Funds”, the state of the Medicare “Trust Funds” also declined very rapidly. The 2010 Trustees’ Report found that the year of reckoning had come that fiscal year, as general revenues were set to comprise more than 45% of the total Medicare expenditures in FY2010, with a projected temporary return to general funds needing to cover less than 45% of expenditures in FY2012. Instead of addressing this in early 2011, Obama and Congress once again extended the “doc fix” a bunch of times, which by that point represented a significant “overrun” versus budget.

Tired of waiting for any sign of leadership from the White House out of a very-predictable fiscal crisis, the House Budget Committee included a version of Medicare reform first outlined in Paul Ryan’s Roadmap for America. While it would not have stopped the warning in the 2011 Trustees’ Report as FY2011 was more than half over, it would have put the program on the path to no longer triggering said warnings and ultimately long-term solvency while permanently implementing the “doc fix”. Unfortunately, just as the 2008 legislation designed to address what was then a future funding problem in Medicare, that budget was buried by the Democrats in the Senate as part of their three-year-long refusal to pass any budget, and because the only action on Medicare was continued extensions of the “doc fix”, general revenues comprised more than 45% of expenditures in FY2011 and FY2012.

Speaking of that 2011 Trustees’ Report, it pushed back the return to temporary overall Medicare stability to FY2013. Once again, instead of addressing the problem, Obama and Congress extended the “doc fix”, making it all but certain that for the fourth consecutive year and probably a fifth with no corrective action, general revenues will comprise more than 45% of Medicare expenditures.

The House Budget Committee will once again attempt to reform Medicare along the lines of a premium-support program. This time, there is some support from the other side of the aisle, even if that support won’t be too public until after November and then only if there is a change in the White House, Senate, or both.

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