Thread: U.S. Issues ObamaCare: Rotten to the core
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Old 02-10-2013, 05:30 PM   #86
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Originally Posted by GoWalrus View Post
It's because Obama wants Insurance companies to quadruple their profits at the expense of quality of health being provided to honest hard working Americans.
I don't agree with this statement at all, and I know far more about Obamacare than this doctor.

Obama is much more clever.

Obama is in fact, trying to create a health care system that will cause the electorate to demand nationalized health care. Its the only thing that makes sense, unless we are to presume the crafters of this legislation are complete morons.

Obama thinks we should have nationalized health care, probably due to the left wing arguments about how France spends about 8% of their GDP on health care while we spend 18% and the french have better longevity expectations and lower infant mortality rates.

The american public has resounding rejected nationalized health at every opportunity. Consequently, Obama crafted a system which is admirably we'll crafted to achieve its purpose, but that purpose is NOT to provide health care. The purpose is to shift public opinion in favor of nationlized health.

Quadrupling insurance company profits in the short term is the carrot he dangled in front of insurance executives (who only think short term) to quell their opposition. Go directly after national health, and insurance companies will spend a mountain of money to fight you, because that will disenfranchise them overnight (and, more importantly, unemploy their decision-making executives).

Yet, Obamacare creates incentives for companies to DROP employee health coverage, by setting the penalty an order of magnitude lower than providing health care. Think about this, Obama has created a situation where companies stop providing health care while CHOOSING to pay more taxes (in forms of penalties) to the government. In one fell swoop he's created a situation where individuals will now be seeking iindividual plans, and will now cry out for government to "defend" them against the big bad insurance copmanies. All of this while INCREASING government revenue so that he has more govt sugar with which to pay off voters and corporations.

He's also required individuals to get health care. This is a hidden tax increase, under the guise of giving you health care. The supreme court, btw, calls it what it is: a tax. Forget about Obama and Pelosi's lies. Now, those individuals will be out seeking individual policies without group bargaining power. Insurance companies will make hay bargaining against the untried and inexperienced organizations known as government established co-ops, which, as government entities, they will be able to influence through lobbying.

As the op establishes, Obamacare pretty much makes it impossible for an insurance company to lose money, while shifting all the risk to health care providers.

We can see the real intent of Obamacare in the taxation of medical devices, including things like BRACES in orthodontics which are hardly high tech. How, exactly, does increasing the cost of using medical devices improve access to health care? Not at all. In fact, it creates a government-mandated disincentive to provide health care, while increasing government revenue. Obama has, again, increased his capability to buy off voters and corporations on the back of sick Americans.

As for why hospitals are going bankrupt, its going to get worse. This fall, we are still scheduled to change the coding method for health care claims, going from what is known as ICD-9 to ICD-10. Numerous analysts have reported that changing the coding method will cause a bigger financial hit to the health care system than the losses that destroyed the real estate industry in 2007-08. While most do not expect the same kind of economic meltdown since home-mortgages were built into financial instruments well-beyond the immediate losses to the home real estate industry, this is a crisis for hospital CFO's. Estimates suggest that hospitals will lose more than 4%-5% of revenue on the inefficiency of the new claims system during the adjustment period (of around a year). Now, when you consider that the majority of hospitals run at a 1-1.5% profit margin (2% is HIGH for a hospital) that means that the CFO will have to finance a year of losses. If they maintain their typical profit margins, they are looking at 4 (or more years if you look at finance costs) years operating in the red if you include the financing costs.

Btw, the conversion to ICD-10 is not exactly part of Obamacare, but is instead a separate piece of legislation.

Gee, is it any wonder that they aren't hiring or wanting to buy new equipment? I can't imagine how this harms the economic recovery, with health care being the single largest sector of the US economy. Btw, hospitals and doctors are also required to digitize their medical records (as part of the 2009 stimulus package and is tehcnically not part of OBamacare). Beginning in 2014, providers will face medicare and medicaid reimbursement penalties (of around 4%) for failure to comply to a requirement that only causes them losses and yields no benefit with most EMR systems.

Now, for most EMR systems, digitization does NOT help the provider's bottom line, but does help the government. In fact, many new EMR systems will force the physician to spend MORE time dealing with new data requirements, increasing the time admin duties will take during patient visits. (Btw, as a matter of full disclosure---I work for a small health care IT company which is trying to get in on this market. I hold a sliver of founder stock and the CEO is my first cousin---he was also one of the key designers of Java.) Btw, the new regs for EMR systems are (surprise, surprise) behind schedule. And, industry data indicates that 30% of providers are so unhappy with their new EMR systems, that they are already looking for replacements. This is another whole area of revenue hits due to compliance inefficiency in the wake of a new regulatory system.

While I do not expect anyone to "cry" for poor health care providers, I do hope to make you understand why providers are so unhappy.

Physicians are now selling their private practices to join hospital owned groups, seeking more institutional expertise in dealing with these regulatory concerns. In fact, now more than %50 of providers operate in a hospital-owned practice rather than physician owned (1st time in history). My dad (a retired physician who used to be staff president of a KC area hospital) tells me this is a cyclical thing, that usually swings back when profits tend to gravitate toward hospital executives and the admin personnel develop proficiency under the new regs. Notice, however, that doctors under regulatory siege become more likely to embrace a european-style one-payer system.

Yet, when paired with the incentives for employers and hordes of new patients put in a weak bargaining position vis a vis insurers, and hospital losses, you can see that Obamacare has undermined every source of opposition to national health. Obama is creating a political moment where national health can win at the polls by delivering something that is much worse. I think its intentional.

P.S. (note that under the hospital-owned physician practice problems, I did not even mention the inherent conflict of interest created by hospital-owned practices and hits to quality of care).

Last edited by JohnnyV13; 02-10-2013 at 05:53 PM..
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