● Grrr. . . Seriously, W.T.F.?: How can HHS put an ad on my television pimping Obama’s “signature” achievement, i.e. the one he won’t mention on a bet? Well, disturbingly, this is legal. Federal agencies are not allowed to engage in partisan politics. This goes back to the 1930s when the Republicans tried to suck the politics out of the federal bureaucracy. Up to that point, the agencies were considered spoils of the process and the parties used them to hand out jobs and favors and to extract favors in return. Laws like the Hatch Act put an end to that.
So how can HHS run an ad that is essentially a pro-Obama campaign ad? Believe it or not, federal agencies are allowed to advertise the kinds of benefits they offer the public. That’s right. They are actually allowed to put out ads telling people to come get “free” stuff, i.e. things paid for by the taxpayers. This falls under the category of performing their mission because their mission requires advising the public about the benefits available to them.
What HHS technically was doing was telling the public about the new benefits being offered so that those of us who qualify could sign up for them. It just so happens that in so doing, they were basically campaigning for Obama by telling everyone about the great new law offering all the free healthcare you can sponge. Grrr.
As an aside, this isn’t the only instance of this during this election cycle. The Department of Agriculture has actually teamed with the government of Mexico to advertise American food stamps to any eligible Mexicans. Grrrrrr.
● Is There A Doctor In The House?: Anyway, HHS left out one key point in their expositions on the “virtues" of Obamacare: there aren’t enough doctors. The Association of American Medical Colleges estimates that without Obamacare, the nation will be short 62,900 doctors by 2015 and 100,000 by 2025. With Obamacare, the number will exceed 125,000 by 2025. That’s an interesting admission. Why would a law that was meant to make everything perfect make the doctor shortage worse? There’s even a part of Obamacare which was supposed to address this! So how can this be? Well, the law only authorizes 3,000 new doctors, not the 125,000+ needed. Moreover, the law itself is driving doctors from the profession.
Further, I think these numbers are vastly understated. According to official estimates, 30 million people are about to get health coverage in 2014. If the system already has a shortage of doctors, how much worse will it get when that happens? The government recommends 60-80 primary care physicians and 85-105 specialists for every 100,000 people. This means, 30 million “new” people will need an additional 21,000 primary physicians and 28,500 specialists by next year. It apparently takes ten years to train a doctor. So unless someone expected Obamacare in 2004 and started cranking up the med schools, we’re going to be 49,500 additional doctors short starting next year because of Obamacare. And all of this is before another 25 million people join the ranks of Medicare, meaning they will need a lot more care than they presently receive, and they will need it on the taxpayer’s dime.
The result of this doctor shortage will be felt in two ways. Some people won’t be able to find care. A good example of this can be seen in Medicaid. In 2008, less than half of primary care physicians were willing to take new Medicaid patients. Why? Because they lose money on each. Obamacare expands Medicaid. In fact, one-third of the 30 million people who will be “covered” will be covered through an expansion of Medicaid. Few of those people will be able to find doctors.
The other way this will be felt will be as “an invisible problem.” This means that patients will still be able to see their doctors and get care, but the process will become slow and difficult because of overcrowding. Some people will need to drive long distances. Many will languish on waiting lists for care. And a lot of people will end up using the emergency rooms as a substitute. In effect, Obamacare will make the very problems it was supposed to cure worse. Imagine that.
99 comments:
There's nothing wrong with vertically challenged medical personnel.
Andrew: They're busy telling us all how we can get food stamps (SNAP cards), Section 8 housing, earned income credits, welfare, etc. etc. ad nauseam. Obamacare is just the frosting on the cake. Never mind that we've run out of real money to fund these "free gifts from the government" and we're quickly running out of doctors who are stupid enough to put up with the treatment that mimics the British National Health Service. It's all outweighed by the fact that it just feels so damned good to get all this free stuff.
Arrgh. It's one of those days. I had to listen to TOTUS talking in one of his insipid campaign ads, the stupid media is talking about how Romney's overseas trip was a PR disaster for....some reason, and now the government's running propaganda ads with our tax dollars. Grrrr. I want multiple Cabinet departments eliminated next year. I know it won't happen, but that's what I want.
Lawhawk, It's amazing how hard the government works to give away money it doesn't have, isn't it?
On the number of doctors, this just proves that you can't repeal the laws of economics. The lousier you make it for people to do something fewer people who are willing to do it.
Dear Short Doctors, Sorry, I missed your comment down there. ;)
T-Rav, Well, his overseas trip was a disaster... for Obama. But if we all keep pretending it wasn't, and then make the issue about how Romney's staff treated those poor reporters who were harassing him, maybe the public will see it differently?!
Forget the elimination of cabinet departments, that won't happen.
As for the propaganda, yeah, that sucks.
Well, this is good news. I guess it's time to make sure I never get sick again.
Ellen, That's probably your best plan. ;)
Also, did anybody see Dick Morris say that Clinton would vote for Romney. I had to laugh at that.
Ellen, I saw that. I could see that. Morris was saying that Clinton would publicly support Obama, but plans to undermine him behind the scenes. There is a lot of reason to think that might happen.
Dear Short Doctors:
You are correct, there is nothing wrong with you that platform shoes cannot correct.
Sincerely,
The General Public
Dear General Public, Let's not mock the doctors. We will need them more than ever after all, now that Obamacare is driving out all the non-short doctors.
This is just another example of how goverment does not ever correct problems, it just creates more problems and the bureaucracy to go with it...
Bev, Absolutely correct. And they'll try to solve this crisis they've created in some new way which will only make the problem worse and create a whole new set of problems.... because that's what government does, it causes problems.
Bev, I should also point out that the fact there is a shortage already is evidence that the medical system is not controlled by the laws of supply and demand, it's run by government regulation which has resulted in a misallocation of resources.
Leviathan is a powerful opponent when it is lined up against you.
What do we have to fight it? The internets....fox news.....bloggers......?!
Saw that drudge posted that the feds are preparing for massive unrest at the election.... why do you think that would be?
Patriot, You can't fight city hall. Seriously, when the feds decide to control something, there is nothing you can do to stop them. Stand in the way and you will get crushed.
All we can really do in this case is to keep pushing back by speaking up and applying pressure to the Republicans to act.
The problem is that the best they will do is erase ObamaCare, they won't free the rest of the system.
I saw that about the feds preparing for unrest. My guess is that it's nothing. But you never know. Leftists do like to riot, don't they?
Patriot, probably all those people who'll realize Obama won't be there to pay for their bills or gas money anymore.
Patriot, I saw that and it strikes me it's just one of those things that doesn't have any real meaning.
T-Rav, I still remember that woman: "he's gonna pay for my gas!" Unbelievable.
T-Rav, That's exactly who will riot, the people who've been expecting Obama to pay for everything they want and who've been told that the reason Obama hasn't delivered is because the evil Republicans stopped him. This is going to be an ugly election.
Ellen, I remember her too. That was stunning. Who can think like that? How out of touch with reality do you need to be?
Beyond the most basic stupidity of this whole thing - which is a long way to go since the basic stupidity is pretty frickin big - Andrew, you said "Well, the law only authorizes 3,000 new doctors": Whiskey Tango? The law actually says how many doctors we can have? Is that what you are saying?
T-Rav, your lips to God's ears "Obama won't be there"!!!!!!!!!!!!!!!!
This --
" The Department of Agriculture has actually teamed with the government of Mexico to advertise American food stamps to any eligible Mexicans."
has backfired, though. It's been the talk of talk radio in some circles and has people up in arms. It's something most folks didn't know about and we're now wondering WTH?? It's just another thing that's kept people irate and motivated and ready to vote you-know-who out.
rlaWTX, The bill includes a provision to train and "incentivize" new doctors. But it's only 3,000 doctors. And they're supposed to work in rural areas.
As for the basic stupidity being pretty frickin big, isn't that the truth! This whole thing is stunningly stupid. How many times have governments tried to control supply and demand? When has it EVER worked?
Crispy, That's the great thing about the "new media." In the past, they could do this and no one would know because no member of the MSM would ever report on the program. But now there are hundreds of talk radio hosts, magazines, blogs, and Fox News to point out this insane program to the public. And the public is not happy.
OK - "incentivizing" is better than "authorizing".
But the bar for "better" is so low that "throwing dirt clods at the side of the barn" is better!
Anyone else have a bruise in the middle of their forehead from hitting the wall repeatedly???
Silly Andrew
Healthcare is for the enlightened members of the party that care for people.....
for the rest well.... the citizenry need glue....
rlaWTX, I used to get that, then I learned to tape a pillow to my forehead before I read the news each day. :)
Yeah, the bar is pretty darn low, that's for sure.
Dear Pelosian,
Apparently, that's how your party thinks. I can't help but notice that health care companies in Nancy's district keep getting waivers from the harsher provisions of the law.
Andrew
We like this system an awful lot....
Lots of Forms and boxes to check
My doctor told me he's planning on retiring in the next couple years unless it gets repealed.
Yeah, You've got to figure the Vogons would like it. And I guess if we complain you're going to refer us to the planning office, where the plans for ObamaCare have been on file for five million years, right?
Ed, My doc sold his practice to the hospital because he said he couldn't afford to continue because of some changes in the law.
Excellent article as always. I saw the headline on this on Rush, but didn't read the article. You really put your finger on it above when yous said that you can't repeal the laws of economics, no matter how much Obama thinks you can.
Andrew, I'm not surprised. My doctor said that some of the rules they passed have made it impossible for him to do certain things. He didn't go into detail, but it sounds like a real mess.
rlaWTX, Incentivizing is a better word, but the bar is low. The government shouldn't be out there trying to manipulate how man doctors of patients there should be. This has disaster written all over it.
Thanks DUQ. I figured Rush would talk about this. The story seems to be spreading. And you're right, you can't repeal the laws of economics. The left thinks you can, but you just can't.
Ed, My doc said the same thing. I didn't go into with him, but he said that all the doctors in his specialty sold out to the local hospital in the past year because it just became impossible for them to stay independent. He's pretty angry about it.
DUQ, I agree. It's one thing to give people something like a tax incentive, though I would argue we shouldn't even be doing that because it distorts the market, but this idea of basically dictating numbers is ridiculous and is destined to create massive problems.
Andrew and Ed: None of my doctors in San Francisco would accept new Medicare patients as early as 2005. I was fortunate in that I joined up with them when I still had plenty of private insurance. Today, in retirement, I have a good Medicare supplemental plan, but the number of doctors available to accept even both of those by themselves as payment in full has decreased dramatically. Cash reserves, sometimes hefty cash reserves, have become necessary.
By attrition, many of the best doctors who don't just quit now will retire and there won't be enough replacements for them. At which point, medical certification will be dumbed-down, and we'll have the National Health Service with an American twist.
We must repeal as much of Obamacare as is possible, and reform Social Security and Medicare as quickly as possible thereafter.
I can imagine he would be angry. Imagine of Uncle Sam came to you and said, "what you do is important to the nation, so from now on we're going to tell you how to do it." How happy would you be about staying in that job, especially once they started giving bogus instructions?
Have you been reading about these "flash mobs" that have been springing up all over the country? Not once.......not once, has the fact that these have been majority black mobs that target certain stores. The most recent one was they went into the store and new exactly where the designer jeans they wanted to steal were.
It will not take much to start another race riot once a store owner ... Of any race... Starts protecting their property and someone gets shot.
Could this be what the Feds are planning for as an "October surprise?" we have been detailing all the lawlessness that this administration has been undertaking recently, what would stop him/them from doing an FDR or Lincoln and making sure that votes in certain cities are invalidated due to social unrest?
Scary times.......scary times
Lawhawk, I agree, it needs to be repealed fast and Medicare/Medicaid reformed before the system implodes, which it will at the present rate.
My father's doctor was the same way, by the way. He refuses to take new Medicare patients, but he takes me father because he was a patient long before he got onto Medicare. Otherwise, he wouldn't see my father.
Ed, The answer is that I wouldn't like it at all, but people don't stop to think. They see things in the abstract without ever thinking about how it will affect people or how they will respond. That's the great failing of liberalism, that it lacks the ability to see a dynamic world rather than a static world.
Patriot, For one thing, the administration doesn't have that power. Congress is the arbiter of elections and the Executive has no power at all in that regard.
For another, the feds don't have the right or power to shut down a city. They would need state law enforcement to do it unless they called out the military, but the military is prohibited from conducting civilian law enforcement. And regarding state law enforcement, they aren't strong enough to control a city of any size. Not to mention, the backlash would be intense.
There's nothing to gain from even trying this and everything to lose.
Also, flash mobs are a gang thing and a thug thing. They aren't really political, except in the sense that they thrive on envy and spite.
My guess is that if the feds really are concerned about civil unrest during the election, what they are talking about is either (1) terrorism related or (2) a concern that some of Obama's supporters will try to burn down places like Detroit when he loses -- like they do when they lose sports championships.
And don't forget, the feds are HORRIBLE at keeping secrets. If there was something planned, we'd know already.
Andrew.....the opening in your last comment requires further review. "The Feds are HORRiBLE at keeping secrets" ?
I submit that if it serves this administration, then the usual watchdogs and leakers will not divulge it. I ask you, what was Obamas GPA while at Columbia? What passport was he using when he visited Pahkistan in the early 80's? What is Echelon/Carnivore? Enquiring minds want to know! Can you think of any other "secrets" that the Feds have sat on for years until the info finally came to light?
rla, I'm trying to be optimistic. Let's hope I'm proved right.
T-Rav, Optimism is your middle name... that or Elmer. ;)
Patriot, Harvard is a private school and passports are maintained under privacy law -- they are supposed to be beyond politics.
As for the rest, there really is very little the government has ever managed to keep secret and when they do it's almost never anything politically controversial, it's typically something like a military operation where there is no incentive for anyone to speak and the people who know all have a direct interest in the outcome.
I think the fact there is already a doctor shortage tells us that the government already interferes too much. Obviously, Obamacare will make it worse.
Doc, I agree with that.
I don't buy any conspiracy theory about Obama trying to stop the elections. Both sides say this stuff before every election and it just doesn't make any sense. There is too much that needs to happen before something like that could happen and it's just not possible. This isn't Mexico.
Doc, I give it no credence either. I remember rumors about the military being trained to take over, to go house to house and seize guns, to just suspend elections, to create a crisis which would allow the imposition of martial law, etc. It's all bunk.
Do you think they'll import doctors from places like India to fill in the gap?
this makes my "fricking" head hurt. What really pisses me off is that Obama and friends lied about this. Medicare premiums will more than double, and if you read the report of medicare's senior actuary to congress in 2011, you see that it is being used to pay for the new insureds. Supposedly, the federal government will wring costs out of the season by gradually lowering payments to providers. This allegedly will reward more efficient providers, but in smaller towns, the vast bulk of expenses are jobs. So, they will cut jobs and drive people out of business. The government acts like a 1970's era corporation. Flowery language about all this newfound efficiency (We won't have to work harder, just smarter, blah, blah, blah.) Probably what will actually happen is that politically they will have to retract the payout cuts or face the wrath of the electorate. But, they won't raise taxes to pay for it, and voila another trillion or two in unfunded liabilities. These guys are so bad . . . . sorry just ranting. :)
wring costs out of the system--sorry
Nightcrawler, I think that will be the inevitable result. That's what the European countries did. And once the shortage becomes pronounced enough, I suspect they will do the same here.
Jed, I agree entirely. This is 1970's style conglomerate thinking. This is missing the forest for the trees stuff. This is going to involve slash and burn to cut costs without any thought about the effects on the product.
And of course Obama lied. He's a leftist and they believe that their ideas will ultimately work once everyone is forced into the system. So while there may be initial problems, he has no qualms about lying about those if it protects the "big idea."
I wonder if the number of people applying to medical school has gone up or down now that ObamaCare is the law?
My pop's a doc. He has said that if this thing does not get repealed he will be out of business. He has already stopped taking Medicare due to the major bureaucratic nonsense involved in completing simple forms. My buddy who's a dentist has said the same thing though he will take direct payments instead of obamacare insurance. By the way, is it not funny that Obama and company will not take this healthcare and have exempted themselves from this law? If it were so good why would they do that? Also, just to make a point, he said "You didn't build that, somebody else made that happen." No amount of crowd control or Southpark like "I'm Sorry" Ads will change it. He's a Marxist and he needs to be booted. Good day.
Terry, That's a good question. I don't have data on that, but it would tell us what the public thinks will happen to the profession under Obamacare.
Just make sure to look at applications, not admissions. Admissions will always be stable or go up. It's the size of the pool who are interested that matter.
ACG, I think it's very telling that our political class exempted themselves from this law. If it's so great, why not be forced into it like the rest of us?
From what I've heard from doctors and from Medicare patients, the system is on the verge of falling apart. It sounds like no one wants to take new Medicare patients, which means people aren't getting treated. And when they do get treatment, they end up cutting corners so badly that it calls into question if the treatment is worthwhile?
Plus, at the same time, I hear about amazingly stupid decisions by Medicare where they won't pay for some cheap and effective treatment, but will pay for some obscenely expensive treatment. It's a crazy system, like only a top-down bureaucratic system can be.
On an interesting related note, here's an article about 16 states that are now rationing drugs under Medicaid because they can't afford them: LINK.
No doubt this problem will magically go away when 10 million more people get added to the Medicaid system.
Exactly! Wave the magic socialism wand and big brother will make it all go away.
ACG, It really is an amazing way of "thinking." All you have to do is force everyone into the system and then it will all work out once you tinker a bit at the edges to achieve the perfect balance. That's honestly lunatic thinking. Yet, that's how the left thinks.
They do and they despise us for our individualism. I cannot tell you how many of my friends have told me flat out "You know that what Obama said was taken out of context so why do you persist on spreading the Republican agenda?" I respond with I know what he said and he said what he meant. In fact, it is probably the only time he has been honest with us. Remember him waffling over the gay marriage issue or bowing to the Muslim dictators?
That's because we ruin their fantasy. Their fantasy requires EVERYONE to get on the same page and then it will magically work once we all agree to clap for Tinkerbell because they think that once everyone agrees, then everything else will follow. So long as you and I and others refuse to join the hive, they believe that their dream is out of reach because we will sabotage it.
I absolutely remember him waffling over gay marriage. He's still doing it.
Yep. He's a gay waffle.
LOL! That he is. And if he was a superhero, he'd be "The Gay Waffler".
Andrew
Nope not fiv e million years....
Just since Woodrow Wilson was in office although the plans were not formally introdduced until the FDR administration.
Which in the Fast Food NEA schooling Eighties Generation understanding of History might as well be five million years.
Dear Vogons, In any event, you think we bare the blame for not checking the planning office sooner, right?
I can't help but think that we need to do our own version of the NBPP.
NBPP?
The first word is 'new'
New Barack Party Poopers?
That would work.
What we really need to worry about is something like "The Militant Cardiologists Front!" or the "The Al-Doctor Brotherhood."
Oh boy, that would be a problem.
How about "Nimrod and Broke Political Party"?
Yeah, I think the Militant Cardiologists would be a particular problem. LOL!
T-Elmer-Rav, LOL! You mean "The Democrats"?
Is there a 'Fudd' in there somewhere? What have you done with T-Rav?
You just don't get it, do you?
Be vewy quiet, Jen. I'm hunting wittle kittens.
T-Rav, kittens are very useful critters. They also take care of those wascally wabbits, which then leaves you free to pursue bigger, and better prizes.
Jen, There should be a Fudd in there someone if this was real life and not a blog-toon.
T-Rav, Put down the cat!
Andrew, A blog-toon? Works for me.
I still think my suggestion is doable. I'll guard the entrances with...pitchforks! I can think of others too, but not here, not now ;)
Great. I can see it now. Member of an obscure blog were arrested today after trying to block voting booths with pitchforks. LOL!
More doctor shortages, rationing, Amtrak efficiency, more rationing, USPS profitability (okay, sustainability
?) (okay, we may have a problem) (oh crap! We definitely have a problem!) (ha ha! Remember when they said they would pay for Obamascare with medicare savings? What? You don't think it's funny?) (remember that movie Coma? It's an analogy of Obamacare).
My doc is retiring in 3 years so if you don't hear from me after that you'll have a pretty good idea what happened to me and it won't be nice.
Obamacare will make everything worse for everyone (except for the politicians who summoned this Leviathon).
VA and Military healthcare will be among the first to be rationed and affected badly (it's already socialized, inefficient and a bureaucratic mess, so naturally it will only get worse).
I really do hope Mitt n' company repeal this evil bill quickly because it's unhealthy. Obamacare is the ebola of healhcare plans.
Not that medicare is much better.
Good post, Andrew!
Man, I really hate the idiots who think screwing up the best healthcare system in the world is a good thing.
I've come late and skipped the comments, so my apologies if I'm repeating anything.
Immediately, the first thing that irritates me about the HHS announcement of all the great new freebies is that they are not for me! I say that with a fair dose of sarcasm, but in all seriousness, having a special-needs daughter, I've looked into this stuff. Guess what? Based on my (much less than $250,000) income, I'm too stinkin' rich to qualify.
Now, I never expected any handouts, but according to 0bama's soaring rhetoric of four years ago, this program was designed for people just like me and my daughter. I have insurance, but not enough in the areas where I need it. More to the point, such insurance is unavailable to me. In my daughter's case, it has less to do with a pre-existing condition and more to do with a condition that nobody truly covers--autism.
Autism falls under the broad and nebulous heading of "behavioral health" which include addicts and criminals and which insurance companies don't like to pay for because they can't construct meaningful tables for. The thing that scares me about 0bamaCare is--once we are all on gov't insurance, guess what area is going to get cut first?
Thanks Ben. I hate it too that they're messing with the best healthcare system in the world. It drives me even more nuts that they will never do the handful of reforms that would make it even better.
Yeah, I had to laugh when they said they would pay for ObamaCare with Medicare savings. What a joke. There won't be any savings.
tryanmax, That's true. Once we're all on the government's dime, the cuts will need to begin and the government will very much act like an insurance company... an irrational one, but still like one. So they will end up covering things like sex changes, but they won't cover the cost of hips for old people. And the waiting lists will be huge.
Andrew
Of course not .....
when have you ever met a bureaucrat to take blame for anything...
No, No, no we passed a law ensuring all blame would go to the Marketing Department of the Sirius Cybernetics Corporation. They are kind of like out version of George Bush or emmanuel Goldstein.
That's very wise of you, Vogons.
Andrew
the savings will come when they stop treating people....
Indi, That seems to be the plan.
T-Optimism-Rav: walk away from the kittens. the kittens are your friends.
We already have lots of Indian docs here. Not complaining.
The way the govt and insurance companies limit mental and behavioral health is the reason most counselors I know are going private pay only. As an LPC, I would not be allowed to diagnose. However, if I filed with insurance I would be required to do something I am not allowed to do. [Kinda like the EPA and the unicorn juice that's supposed to be in fuel...] Anyway, luckily many of the therapists I know do a sliding scale fee...
But we have very few that work with children at all...
rlaWTX, T-Optimism-Rav, LOL! I like that!
There are a lot of Indian doctors in the US already. A doctor friend of mine came from India actually.
That's one of the problems with the current system, people are required to follow certain rules that either don't make sense or a are bad practice, or which even conflict sometimes.
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