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ObamaCare Won't Work as Promised

By Doug O'Brien, Big Government - November 29, 2009

The controversy surrounding the recent mammography guidelines issued by the U.S. Preventive Services Task Force is a recommendation for swift and decisive defeat of efforts to expand federal oversight of health care.  It almost seems as if this was designed as a laboratory experiment to learn exactly what will happen under Obamacare.  The results validate some of the most compelling arguments that opponents have made over the past few months.

When opponents claim that Obamacare will lead to rationing of medical services, defenders counter with an irrelevant but true retort that care is already rationed by insurance companies.  By this logic, everything is rationed by economics.  Housing is rationed by the availability of capital to invest in housing which is a collective market choice.  Cars are rationed in that you can't just walk into a dealer and drive off the lot.  So, yes, currently the health care market, mostly in the form of third-party payers (insurers and public programs), rations care in that there are finite resources to pay for treatments and everyone cannot have everything any time they wish.

The reason that argument is irrelevant is that the debate here is about government rationing of care, which represents an entire new level of restrictions on individuals.  When the government sets up panels of "experts" to make recommendations of what kind of care is appropriate under what circumstances and those recommendations are implemented in the form of regulations over what care will and will not be paid for by both private and public insurance, it limits the rights of patients to control their care in consultation with their physicians.  It also destroys the market for those excluded treatments which then become either prohibitively expensive or entirely unavailable.

Under Obamacare, new cost effectiveness panels will join the advisory panels like the Preventive Services Task Force.  Instead of just making clinical recommendations primarily intended to improve the quality of patient care, they will make recommendations intended to also contain the cost of care.  So when the cost effectiveness folks decide that mammograms are only indicated every two years and only for women over 50, that will become the reimbursement policy for Medicare and Medicaid, and the mandate for private insurance that must comport with coverage standards.  Sure, you could pay higher premiums for more coverage or pay out of pocket if your and your doctor think it wise to have annual mammograms at age 40, but wait, we were told Obamacare would save us money and wouldn't decrease our coverage.

So we have a federal panel of "experts" setting policies for medical treatment.  That will hopefully prevent people from consuming unnecessary care that drives up the total cost of health care.  (Never mind that defensive medicine caused by liability concerns are strictly off the table.)  But we have just seen the knee jerk reaction of Congress and the White House to what is only a non-binding recommendation, where they instantly caved to public opinion and special interests (in the form of radiologists and the American Cancer Society) and disavowed the recommendations and assured American women that they could go right ahead and keep getting all the mammograms they want.

What will Congress do when the cost effectiveness folks decide that expensive colonoscopies should be denied to all but a limited group of patients?  Is it possible that when voters start calling their offices that Congress will step in to protect access to limitless colonoscopies?  Every time Congress or future administrations bow to pressure cost containment becomes more and more impossible.

Health and Human Services Secretary Sibelius made the farcical excuse that the Preventive Services Task Force doesn't make policy or coverage decisions so all the controversy is a political ploy.  But that is not the point.  The entire purpose of the various new panels created under Obamacare (and already created in the stimulus bill) is precisely to make policy and coverage decisions.  In fact, the Preventive Services Task Force will play just such a role in the new world order.  So if everyone is reacting this way to a mere recommendation, how will they react to an actual policy dictate that meets opposition from some constituencies?  And when they create political pressure and the politicians give in, what happens to cost containment?

Health care professionals who agree with the Task Force recommendations to reduce the use of mammograms recognize this for exactly what it is"”politicization of health care.  Under Obamacare, the most effective lobbying efforts will have more impact on the care you can get than the opinion of your physician.

The White House has launched its usual ad hominem attacks against those who have pointed to this instance as a taste of things to come.  They accuse opponents of lying and being disingenuous. They even try to imply some sinister motive to the Task Force by pointing out that its members were appointed by the Bush administration.  Since they have reduced this debate to the level of a playground back-and-forth, the "rubber and glue" principle applies and these charges are beginning to bounce right back on to the administration.

GA_googleFillSlot("bh_post_before_comments"); 3393823 Commentshttp://biggovernment.com/2009/11/29/obamacare-wont-work-as-promised-heres-the-proof/ObamaCare+Won%27t+Work+as+Promised%3A+Here%27s+the+Proof2009-11-29+14%3A31%3A47Doug+O%26%2339%3BBrien Liberty666 - November 29th, 2009 at 2:40 pm

the servants better stop trying to force the masters to do things

Cowboy Logic - November 29th, 2009 at 2:43 pm

WE should all face the simple Inconvienent Truth. WE can no longer trust our Government in any capacity, be it for Health Care, Cap and Trade or Protection from all Enemies, Domesti or Foreign. Our enemies have breached the walls and entered the palace grounds, as easily as the White House Party Crashers entered the inner sanctum sanctorum.

Their numbers lie, and are skewed, to promote "Agenda's". The agenda's are not those of the people.

Charles_Kirtley - November 29th, 2009 at 2:57 pm

In Obamaland everyone will be healthy and will need less medical attention. Thus no rationing will be necessary.

We will have a water czar to insure we have pure water. A food czar to make sure we eat right. An air czar to make sure we breathe correctly. We will have an exercize czar to make sure everyone exercises enought. Our new electric cars will not run over 20 mph, thus eliminating hospital stays caused by accidents. Etc., etc., etc. Everything will be wonderful.

LazyJack - November 29th, 2009 at 3:04 pm

Carl Sagan often said, “It strains credulity.” He said it whenever he encountered a popular concept that millions believed in with little or no proof. His implication was that many of our belief systems were without reason, little more than faith, and unsupportable by facts or observations. For example, space aliens abducting millions of humans and breeding with us is a concept that strains credulity, but one that is taken on faith by a large portion of humanity.

The federal government is now clamoring to create a healthcare mandate plagiarized from the Massachusetts work of fiction. At time when even the Boston Globe is forced to report that costs are increasing at annual rates well into the double digits, that a couple of hundred thousand remain uninsured, and that the long term viability of the program is in doubt without, surprise, tax increases, it is hardly surprising that congress is ready to clone the program. For your benefit, of course. And none of the bad stuff evident in Massachusetts is going to happen nationally. And Frankenstein’s experiment was a complete success too. Strains credulity, indeed.

For more see:

http://www.cato.org/pubs/bp/bp112.pdf http://thanksforthelaughs.wordpress.com/2009/11/0...

Lazy Jack

Rt_Thinker - November 29th, 2009 at 3:16 pm

Good article Doug, but I don't think you go far enough. The Task Force recommendations will impact reimbursements, but, at least as I understand it, not level of care criteria for malpractice. Without malpractice reform, providers will still be expected to provide a "reasonable" standard of care. And the Task Force recommendations, while perhaps evidence of a prevailing standard, would not be determinative of it. Indeed, the controversy shows how much disagreement there is in the medical community. I am confident that the malpractice liability insurers would still want the tests performed.

This then places us in the situation where providers will be expected (at least from a future liability perspective) to provide a service for which they would not be reimbursed. Those who do will figure out a way to charge for the service, and some will be able to pay for it. Those who do pay will eventually also be paying for those who don't. This will, of course drive the cost of the service up faster than inflation. Thus, fewer people able to afford it, and those who are subsidizing those who can't. Eventually you get back to where we are now; a system where people are "denied" care because of "means".

As bad as this is now, watch out for the next "solution" when this one doesn't do what they promise.

Erotic Music - November 29th, 2009 at 8:38 am

Seems like the government is incapable of managing anything. They need to take care of the citizens.

Rita Sowders - November 29th, 2009 at 4:01 pm

This Obamacare is the same as not only MA, but Canada and the UK as well.

arekayone - November 29th, 2009 at 4:07 pm

Never in a million years could I possibly imagine this thought would cross my mind, but has anyone opined about how the rationing could play out across party lines? When I look at the obvious strong arm tactics this administration uses to ensure their massive power grab, I have to wonder if a republican will have the same access to a colonoscopy as a democrat has.

It is completely sick and deranged that I even imagined this scenario, but I am at a point now that I don't trust anything these corrupt liberals do or say. Their lust for power and control is frightening.

Tweets that mention Big Government » Blog Archive » ObamaCare Won't Work as Promised: Here's the Proof -- Topsy.com - November 29th, 2009 at 9:11 am

[...] This post was mentioned on Twitter by The Noble Patriot, Naum Lavnevich. Naum Lavnevich said: RT @TheNoblePatriot: ObamaCare Won't Work as Promised: Here's the Proof http://j.mp/8cflZ5 #tcot #tlot #killbill [...]

Valora - November 29th, 2009 at 4:35 pm

The culture war is at hand. Expect the government to fix all problems, give them all your money so they can, or expect the governement stick to security, policy, and matters which they can do, and leave the social programs and our money alone! There is no middle ground anymore, we are at the tipping point!

kooz - November 29th, 2009 at 4:39 pm

Like say maybe the people in Louisiana would get better care for instance?? No I'm sure that would never happen.

PotterJones - November 29th, 2009 at 4:43 pm

Are you sick of Obama yet, especially with this horrendous health care bill hanging over our heads? Would you like to see him legally ousted? Do you know anyone who qualifies as an "interested" or "third" person as described in the graphics that illustrate the process to remove Obama? Yes, it can be done by legal statute, 16-3503 because Obama has dual citizenship with Britain. These graphics explain everything you need to know.

3 Graphics: Quo Warranto Process to Remove Obama http://jeffersonsrebels.blogspot.com/2009/11/quo-...

PotterJones - November 29th, 2009 at 4:43 pm

Are you sick of Obama yet, especially with this horrendous health care bill hanging over our heads? Would you like to see him legally ousted? Do you know anyone who qualifies as an "interested" or "third" person as described in the graphics that illustrate the process to remove Obama? Yes, it can be done by legal statute, 16-3503 because Obama has dual citizenship with Britain. These graphics explain everything you need to know.

3 Graphics: Quo Warranto Process to Remove Obama http://jeffersonsrebels.blogspot.com/2009/11/quo-...

JoeCollins - November 29th, 2009 at 4:44 pm

Obamacare test case failed.

libertyshrugged - November 29th, 2009 at 4:51 pm

Healthcare is not only expensive because of the lack of Tort Reform, but also because of the extreme cost and delay of getting FDA approval for devices and drugs and the stifling OSHA regulations. When one needs a script for any effective drug even though it may be reasonably safe, costs are further propelled through the roof. As a contrast, drugs are so much cheaper in Hong Kong or Africa where the rules are far more relaxed.

kooz - November 29th, 2009 at 4:52 pm

The thing that concerns me the most is what happens to the uninsured after this is implemented? While it is true now that anybody can walk into a hospital and get care, will that be the case with Obomacare? I think we will then see truly disenfranchised people then.

Liberty666 - November 29th, 2009 at 4:58 pm

yeah the 300 mil. to LA for their medicare is part of the "savings" in Medicare that they are going to use to fund Obamacare, the Liberal's logic is amazing, almost magical

Dave Rooney - November 29th, 2009 at 4:58 pm

"So we have a federal panel of “experts” setting policies for medical treatment."

So.

We had mortgage experts at Fannie and Freddie in Franklin Raines and Jamie Gorelick. Oh wait!!! They were lobbyists, liars and a POTUS lawyer.

We had climate experts at the UN's Intergovernmental Panel on Climate Change (IPCC) in Kevin Trenberth, Gavin Schmidt, Ben Santer and Michael Mann. Oh WAIT!!! They were lobbyists and liars.

Wait Doug. Why won't the expert panel on health care work?

copperpeony - November 29th, 2009 at 5:00 pm

There is a two year waiting period to get a family physician in Canada (Ontario) even if you have government healthcare. While you are waiting, you have to go to a clinic and sit for hours on a first come basis with hundreds of other people no matter what your situation is.

It takes months to get a simple test done. Thats where we are headed because doctor's will have a cap on their earnings and what is the motivation to go through years of med school if the governement will run your life? You can easily become a blue collar laborer installing elevators and get payed over $80,000/year.

syvyn11 - November 29th, 2009 at 5:01 pm

This administration counts on a certian amount of the population being 'stupid' to the facts. The problem with that is that there will only be so many who will remain willingly 'stupid'. And that number is getting smaller and smaller every day.

I think you can cross off two groups of women. Those with breast cancer and those who are scared to death of getting breast cancer.

Dave Rooney - November 29th, 2009 at 5:02 pm

We are way past the tipping point. We are cap-sizing. But every day someone new in America gets it is another day we move closer to impact.

America. Brace yourself. They are ready for battle.

copperpeony - November 29th, 2009 at 5:04 pm

PLUS, I just went to Wallyworld to get my mom's meds. The same med she's been paying 10.95 for years now has skyrocketed to 79.95. The pharmacist said the Pharma companies are raising prices on all the meds. That is outrageous and part of this healthcare debacle.

@ccwasabi - November 29th, 2009 at 5:06 pm

I thought reform was supposed to make things cheaper and available to everyone. This does neither.

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the servants better stop trying to force the masters to do things

WE should all face the simple Inconvienent Truth. WE can no longer trust our Government in any capacity, be it for Health Care, Cap and Trade or Protection from all Enemies, Domesti or Foreign. Our enemies have breached the walls and entered the palace grounds, as easily as the White House Party Crashers entered the inner sanctum sanctorum.

Their numbers lie, and are skewed, to promote "Agenda's". The agenda's are not those of the people.

In Obamaland everyone will be healthy and will need less medical attention. Thus no rationing will be necessary.

We will have a water czar to insure we have pure water. A food czar to make sure we eat right. An air czar to make sure we breathe correctly. We will have an exercize czar to make sure everyone exercises enought. Our new electric cars will not run over 20 mph, thus eliminating hospital stays caused by accidents. Etc., etc., etc. Everything will be wonderful.

Carl Sagan often said, “It strains credulity.” He said it whenever he encountered a popular concept that millions believed in with little or no proof. His implication was that many of our belief systems were without reason, little more than faith, and unsupportable by facts or observations. For example, space aliens abducting millions of humans and breeding with us is a concept that strains credulity, but one that is taken on faith by a large portion of humanity.

The federal government is now clamoring to create a healthcare mandate plagiarized from the Massachusetts work of fiction. At time when even the Boston Globe is forced to report that costs are increasing at annual rates well into the double digits, that a couple of hundred thousand remain uninsured, and that the long term viability of the program is in doubt without, surprise, tax increases, it is hardly surprising that congress is ready to clone the program. For your benefit, of course. And none of the bad stuff evident in Massachusetts is going to happen nationally. And Frankenstein’s experiment was a complete success too. Strains credulity, indeed.

For more see:

http://www.cato.org/pubs/bp/bp112.pdf http://thanksforthelaughs.wordpress.com/2009/11/0...

Lazy Jack

Good article Doug, but I don't think you go far enough. The Task Force recommendations will impact reimbursements, but, at least as I understand it, not level of care criteria for malpractice. Without malpractice reform, providers will still be expected to provide a "reasonable" standard of care. And the Task Force recommendations, while perhaps evidence of a prevailing standard, would not be determinative of it. Indeed, the controversy shows how much disagreement there is in the medical community. I am confident that the malpractice liability insurers would still want the tests performed.

This then places us in the situation where providers will be expected (at least from a future liability perspective) to provide a service for which they would not be reimbursed. Those who do will figure out a way to charge for the service, and some will be able to pay for it. Those who do pay will eventually also be paying for those who don't. This will, of course drive the cost of the service up faster than inflation. Thus, fewer people able to afford it, and those who are subsidizing those who can't. Eventually you get back to where we are now; a system where people are "denied" care because of "means".

As bad as this is now, watch out for the next "solution" when this one doesn't do what they promise.

Seems like the government is incapable of managing anything. They need to take care of the citizens.

This Obamacare is the same as not only MA, but Canada and the UK as well.

Never in a million years could I possibly imagine this thought would cross my mind, but has anyone opined about how the rationing could play out across party lines? When I look at the obvious strong arm tactics this administration uses to ensure their massive power grab, I have to wonder if a republican will have the same access to a colonoscopy as a democrat has.

It is completely sick and deranged that I even imagined this scenario, but I am at a point now that I don't trust anything these corrupt liberals do or say. Their lust for power and control is frightening.

[...] This post was mentioned on Twitter by The Noble Patriot, Naum Lavnevich. Naum Lavnevich said: RT @TheNoblePatriot: ObamaCare Won't Work as Promised: Here's the Proof http://j.mp/8cflZ5 #tcot #tlot #killbill [...]

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