Tuesday, March 27, 2012

The Supreme Court Health Care Review

The Supreme Court is now going to take on the issue of Obamacare. It’s anybody’s guess as to how it will come out. But there is a mindset problem creeping into our thinking. Congress passed Social Security and Medicare. And now we are about to receive health care. Notice that whenever someone threatens to reduce any of these benefits, they change from entitlements to fundamentally God given guaranteed rights.

Social Security is pretty straight forward; you receive 7 times what you contributed into the plan. There is a definite cap on what will be paid out. When it was first passed, 50% of the population survived to collect it. Since then, 20 percent more of the population live to collect it and live 5 years longer than they did when the program first started. The fact that Congress has looted the Social Security piggy bank to the tune of two trillion dollars shows what government can do with creative financing.


Then there is Medicare and Medicaid. In Abraham Lincoln’s time, total lifetime Medicare costs wouldn’t have exceeded $100 per person; medicine was in its infancy. In today’s world, the ability of the government to pay all health care costs (considering the technological advances in medicine) could bankrupt any country. Today, even without Obamacare, there is no bottom line cost per patient with Medicare.

To put it in perspective, imagine that your pet dog got very sick. At the animal hospital, the costs are all laid out in front of you before any treatment. Say the bill comes to $3,000 with no guarantees of survival, what do you do? You have to make a decision. Can I afford to pay it? This is where you hear the words “death panels” when it comes to state run health insurance. It’s an admission by government that there is a limit on their resources.

The total benefits each taxpayer is entitled to over their lifetime needs to be defined and it isn't. The concept of “government insurance” in a Democracy is nothing more than a free ride. The reason being, governments don’t have to make a profit, insurance companies need to, in order to survive (if you're not making a profit, you're giving away the store). Government health care is kind of like telling a hooker what rates she can charge and advise her, no one can be denied service. The neat thing about that, the price is right---grab a number and wait. And just like Obamacare, you'll have a long wait before she gets to your number.

The Supreme Court will be looking at three questions. Can the government force everyone to purchase a product that they don’t really feel they need? Should the government be able to force arbitrary rules on an insurance company that would limit their profitability or drive it out of business (forced to cover preexisting conditions). And third, does the Congress have the constitutional authority to nationalize the health industry?

Obama and the Congress passed this 2074 page bill without reading it. The Supreme Court will read it looking for errors and omissions. Will they give this unread "Work of Art," a good review? We won't have to wait long to find out.



Copyright 2012 by Jim Brubaker

18 comments:

Anonymous said...

Jim,
Obama has trashed the Bill of Rights with the recent signing of NDAA. He's been working on the Constitution too and making great headway. If the Supreme Court doesn't declare this mandatory aspect of Obamacare unconstitutional it will further erosion of our Constitution and a big win for totalitarianism or fascism, whatever you want to call it.

I'm just amazed as to where our country is heading. It has been happening gradually through the past 100 years, but it really seems to be picking up pace now.

I guess we just need to scratch out the "1984" off of George Orwell's book and rename it "2020". The Central Planners/Power Elite should have everything pretty much wrapped up by then.

Orwell got it right, he just missed the date.

Drewbert said...

1. The individual mandate comes down to this: Does the federal government require me to buy a house? No. But if I do, they give me a discount on my taxes. Does the federal government require me to buy an electric vehicle? No, but if I do, they give me a discount on my taxes. Is the federal government requiring me to buy health insurance? No, but if I do, I get a discount on my taxes.

2. Can the federal government force "arbitrary" rules on automobile companies that force the cars to get a certain level of fuel economy or survive a certain level of impact? GM (Government Motors, so I've been told) would be far more profitable if they didn't have to bother with all that R&D investment into airbags (they pioneered them, first to offer in the 1970s), crash test dummies (invented them), and direct injection engines (made them available to mainstream consumers). If the Feds can't set rules that certain industries have to live by if it makes the company unprofitable, a whole bunch of stuff just got made unconstitutional.

3. Is that one actually a question being considered by the SCOTUS? The healthcare/health insurance industry hasn't been nationalized. Blue Cross Blue Shield is still a network of private companies.....

Your statement of "The reason being, governments don’t have to make a profit, insurance companies need to, in order to survive (if you're not making a profit, you're giving away the store). Government health care is kind of like telling a hooker what rates she can charge and advise her, no one can be denied service. The neat thing about that, the price is right---grab a number and wait. And just like Obamacare, you'll have a long wait before she gets to your number." shows that you apparently have no idea how the system works, how it is set up, and you're simply getting your talking points from Fox News.

Jim in San Marcos said...

Hi Drewbert

It looks like you are going to save on your taxes at all costs. If Obamacare is constitutional, you will no longer have the option to buy health insurance and save on your taxes. Figure on paying an extra $8,000 per year in taxes to pay for the premiums (of course your employer pays half- ha-ha).

The way Congress gets better gas mileage, is in the mix of vehicles. Increasing the number of compacts in relation to gas guzzlers, is how the mileage quotas are met. Government regulation never made better American cars, competition from Japan was what did it.

If Obamacare is upheld, it spells the end of private health care insurance. What would happen if Obamacare decided to raise rates? You can't drop out of it if you don't like the cost, now can you?

I'm not really taking a position on the issue, the quote you cite more or less discusses how a "for profit entity" cannot compete against a government agency that doesn't have to show a profit.

As for the hooker analogy, it was an allusion to the government health care in Canada (four month wait for heart bypass surgery)and Great Britain (18 month wait for cancer surgery). I know how the system works and it sucks.

And as for Fox news, its kind of like watching a cat and dog fight it out in a burlap bag. You can't see much and nobody is there to listen to the other party's views. Its a little like listening Rush Limbaugh, your upset the rest of the day and not really quite sure why.

I guess between you and Obama Detroit will sell at least two electric cars.

Hope you like your new Volt.

New Oregonian said...

An uninsured relative died on Medicaid's nickel. Cost about a quarter million dollars. She made money at tax time through EIC. I doubt she paid $25k in taxes her whole life.

It's no fun putting a dollar value on a life (us pet owners have to, sometimes), but it's unsustainable pay out millions per person when taking in mere thousands or tens of thousands per person.

Either way, the government provides the ultimate insurance. If you're too sick to work, you get Medicare. If you're too rich for Medicare, you won't be after paying big medical bills out of pocket. What the government doesn't pay, private insurance does through cost-shifting from the uninsured.

Some amount of healthcare is a luxury good. It's only affordable and sustainable as a discretionary purchase by the very rich. Canada and Britain figured that out - the rationing kills off the poor and very sick; the rich buy private supplemental insurance or travel to free-market countries for care.

I think Obama could have done more good by addressing the shortage of PCPs. Until there are enough doctors/NPs/PAs to go around, increasing the number of insureds is just adding to the disaster.

PS to Drewbert - Obamacare doesn't give a discount on taxes, it penalizes consumers through tax penalties. It's subtle, but there is a difference.

AIM said...

The government should have nothing to do with healthcare (as is the case for so many other aspects of our lives, businesses and society).

There is absolutely no reason for medical treatment and medicine to cost what they do. The costs have been manufactured and manipulated by special interests out of greed. The government hasn't done anything but make the area of health more expensive.

Healing and medicine are not things that should be major profit makers. It's inhuman. As a sane society progresses health treatment and medicine should cost less and less... and there should also be less and less illness as time goes by.

Leave it to the people and the free market. The people will bring the cost of medical treatment and medicine down by voting with their dollars.

Jim in San Marcos said...

Hi New Oregonian

I'm in complete agreement.

I think at some point we need to set limits on what health care will pay. I find half million dollar tabs for premature babies as an obscene a waste of resources. But yet the bill gets paid.

The thing we need to realize is that most people believe government insurance is "other peoples" money, when it isn't. Basically they are gaming the system, paying in less than they get out.

The Democrats and Republicans want to hold down health care costs, but they fail to address what is making them rise--the printing of dollars to finance our grand dream of "We can have it all now."

The failure of the government to properly fund the future liability's of Medicare shouldn't have to be predicated on a health care tax on the young.

My only problem, I don't see a solution that everyone can live with.

Jim in San Marcos said...

Hi AIM

I agree with you. Given time, most health care issues will solve themselves without government intervention.

Medicare is one of those blank checks that gets abused to death and as you suggest, government payments keep on paying and they keep on printing dollars. Why am I not surprised that gas prices aren't the only thing rising?

Drewbert said...

Germany figured out the healthcare issue 150 years ago, it's about time we catch up to them. They have a blended public/private system where most employed folks "buy-up" through their employer to a better plan. Their healthcare is inexpensive, extremely portable employer to employer, and very efficient. Doctors there are no more special than a convenience store in consumers' minds. If the consumer doesn't like the wait, there is another doctor down the street. That mindset is prevalent there, so that the market handles wait times and consumers aren't captive to a specific doctor like here in the states. Their care is also superior to ours in quality.

Everyone but the most destitute are required have have coverage. The ultra poor are covered by minimalistic plans paid for by the state. This creates a desire for private health insurance because no one wants to be on the minimalist plan. Your claim that Obamacare would "do away" with private health insurance bares no resemblance to reality. Germany, Massachusetts and Hawaii all have health insurance mandates, and in a whopping ZERO cases, has private health insurance disappeared.

You're going to have to point out this Obamacare agency you keep citing. There is no such entity that provides insurance (unless you're counting expanded Medicaid). It doesn't set rates, "the market" does via the insurance exchanges that are being set up. Obamacare mandating health insurance doesn't set rates any more than state mandated auto insurance sets car insurance rates. Last time I looked, Progressive, and not State of Pennsylvania, is printed on my big American V8's insurance card. again, THERE IS NO GOVERNMENT ENTITY PROVIDING INSURANCE unless you are somehow including medicare/medicaid... which have already existed for years have have thus far failed to drive the private insurance companies out of business.

We didn't get Canadian/British style government healthcare with Obamacare. Not even close... so the comparisons to it aren't valid. We are closer to the German system... which as I described above doesn't have the waiting line issues the English and Canadians have. WE have waiting lists here in the U.S. as well. I was 32 years old and was having chest pain, but even with my big, expensive, private health insurance, was told I had a 3 month wait to see one of the approved Cardiologists.

The Volt is a great entry from GM the same way the iPhone is a great phone. Will it suit everyone's needs? Not even close. But it is a technology game changer for the industry just like the iPhone was. And you know what? As much as I love my V8, the Volt was a blast to drive. 80mph, absolutely silent, all electric, with my driving patterns, I could probably go months between filling up yet drive every day. My electricity costs would go up by $30 a month but my gasoline costs would drop by $200. Yes, I did the math behind that one. I'm not buying one anytime soon, but I can certainly see why someone would. Get ready for the electric car onslaught, there are five more due to be released in the next 12 months.

"Government regulation never made a better American car"

Say what? Government regulation required cleaner emissions. Government regulation required the ability to run without lead in gasoline. Government regulations required stronger safety standards (the original Japanese cars were absolute death traps right up till the mid-90s). Government regulations required stability control (all manufacturers have it, for 2012 it is required to be standard on all cars)

Stop being such a knee-jerk, anti-government, reactionary and actually look at facts.

Jim in San Marcos said...

Hi Drewbert

You were doing OK until you got to the last sentence.

Jim in San Marcos said...

Hi All

Here is a rather long link on German Health Care

There are many different reports out there, that you can pick and choose from to illustrate just about any view. In the link above, the remarks section are what I consider most telling-- and no,I didn't write them.

Another thing to remember about Germany, they lost all of their savings in the currency debacle in 1923 and then again when Germany fell at the end of WWII. Retirement benefits were what you scraped out of a trash can, so socialized medicine was better than nothing, which is what a lot of Germans had a lot of.

From what I can glean, US health care is rated below most other countries because the ones we are compared to, cover everyone. That gives us an automatic 3 strikes.

Congress says 40 million people are without health insurance. I would suggest that probably 130 million people are young enough that they don't even need it.

Health insurance companies could all together disappear. Usually a group of investors gets together to form a plan. They expect a reasonable return on their investment of around 12%. Congress says the consumer is being ripped off if a health care provider is making more than 5%. Interpreted from the investor point of view, "Its now against the law to make a reasonable profit." The solution, invest in something else that will give a better return.Most business have a return of about 18%.

As for Obamacare,is it something we really need? Put it another way, if your 55 and uninsured with a heart condition, its a good thing. If your 20, why not spend the money on a wide screen TV and a real nice vacation?

Media Mentions said...

The debate is hot! for those who aren’t quite following, here’s a fairly good overview (http://www.pressdisplay.com/pressdisplay/showlink.aspx?bookmarkid=4DRVLAYF4ZE1&preview=article&linkid=78be1f15-de2d-4d08-80ea-037760782518&pdaffid=ZVFwBG5jk4Kvl9OaBJc5%2bg%3d%3d) but I’d suggest twitter/streams as an ideal source for this one. Cheers!

Jim in San Marcos said...

Hi Media Mentions

Thank you for the link. I hope the source will be considered unbiased ;>)

I was just mentally thinking how much I've spent from the age of 17 to age 65 on actual medical costs, probably less than $2,000. The actual amount I have paid in health insurance is hard to calculate, but I would guess it would be in the neighborhood of $40,000.

I'm now at an age where things are supposed to go wrong. Of Course, I have arrived to where Medicare takes over.

There is one expense that I have had the last 20 years that sneaks up on you. Dental care. Its surprising to know that 50 percent of the people in this country have never visited a dentist. I have dental insurance, and basically you pay the full shot if you have a lot of work to be done. Even with insurance, my out of pocket costs for root canals and crowns is somewhere around $15000. I'm also including the braces I had when I was a teenager.

If you have a bad tooth, you get presented the option, free extraction or $600-800 for a full crown.

Dentistry is a special case. While in college I went to get my dental retainer for braces modified. There was a Hippie in the waiting room. The doctor came out and asked him to open his mouth. The dentist took one look and said, "I don't work for free, can you pay for the service in advance?" The kid said no and left. Imagine trying to do that in the Emergency Room.

When you examine dental insurance, there is no free ride. Silver filings are free, porcelain cost $85. You are presented with cost consideration decisions.

Going to the dentist is still a real nightmare for me. My mom use to save $5 on filling my teeth by having the dentist skip the Novocaine (those water cooled drills were not as painless as billed).

The funny thing is dental insurance coverage isn't really a part of the Obamacare plan. I can see why, nobody really wants to go to the dentist, I can think of a hundred other places I'd rather be.

Anonymous said...

What age is it when Medicare takes over Jim? I'm 60.

Anonymous said...

ITS AT AGE 65 FOR MOST. SOME CAN QUALIFY AT AN EARLIER AGE FOR SPECIAL REASONS. CAN GO ONLINE TO THE GOVMT WEBSITE AND GET ALL YOUR QUESTIONS ANSWERED.

Jim in San Marcos said...

Hi Anon 10:15

I'm 65 and still working and get employer health care and am not really yet concerned about Medicare.

Anon 10:21's suggestions are where you need to go. Just google Medicare and choose the .org web sites.

Looks like you need to file for Medicare A at age 65 and from there, b-d are supplementals that you pay out of pocket for.

I do know that kidney failure patients qualify for Medicare at any age.

Retirement is a goal for a lot of people, but I enjoy what I'm doing and I get paid for it. So I guess I'll keep working. Plus my son's going to Berkeley and that cuts into the budget a tad--no student loans, our son is not going to be a slave to a bank.

Anonymous said...

Who knows what the Supreme Court verdict will be on Obamacare. It could go either way. The whole thing could be scrapped or it could just be the mandatory section that is scrapped. Or the whole program could be passed as constitutional. Add it to the Iran conflict as another nail biter for the American public.

Personally I hope the whole of Obamacare is thrown out; that Obama does not get a second term; and that all of these big tax hikes coming in 2013 are cancelled as well.

I don't want to live in a high income tax-unsustainable welfare-war monger-debtor-police state.

New Oregonian said...

Interesting comparison to Germany. It's one of hubby's favorite countries for medical care, because he got a sinus infection while visiting and was able to get meds recommended and filled by a pharmacist, no doctor monopoly involved. Now, we live in a state that requires a prescription for sudafed.

I know a fellow who uses fish stores for meds; no doctor's visit and the cost doesn't have liability insurance baked in. Cheaper than copays. If you've got a lick of common sense, a lot of simple medical problems are easy, but the meds/supplies are restricted to either maintain the AMA monopoly or protect the idiots from themselves. Yet restricting the supply of IV needles hasn't licked the heroin problem and boomers who haven't saved enough for retirement may welcome an arrest for buying from Canadian pharmacies; free room and board courtesy of the prison system can really stretch your retirement dollars.

Anonymous said...

Why doesn't Drewbert go to one of the insurance rich European countries he so admires? Oh yeah-they are going BROKE!! The reason Germany, England, Greece, ad nauseam can afford "the government dole" is because we, the good ol' USA citizens have paid for their military defense for 67 years!! Not only do we provide it for free, we pay them to have bases, hospitals, etc. Get off the decaf and get some real coffee!! Why are people in this country now so afraid of being free citizens in a free republic? Personally, I have never had as my goal, a government check every month. What a pitiful citizenry we have become.