UPDATE The Real Obamacare Death Spiral

Tonight, I want to tell you about the real Obamacare death spiral, give you more reasons why hospitals are not our friends, and clear up some confusion about Medicaid payments to hospitals. I’ll finish with a brief announcement.

The news about Obamacare insurance just keeps getting worse – insurers are leaving the exchanges, and huge rate increases are coming again next year – 45 percent expected in New Hampshire alone.  Talk of an insurance death spiral is back.  But here’s the REAL Obamacare death spiral – tax credits go up with premiums. Every time premiums go up, Obamacare subsidies go up.  This is crazy. The national debt is already $19.2 trillion. Federal healthcare spending is now bigger than Social Security, a story said this week.  Every cent for Obamacare subsidies has to be borrowed. Who’s going to pay for all this – the health insurance fairy?  That’s what one commentator wanted to know this week.  Obamacare takes us further and further away from a debt-free future, and that’s another reason to fight it, as if we needed any more.  How can we keep doing this? Like the economists say, if something can’t continue, it won’t.  We have a choice – we can keep throwing more and more money at the death spiral of Big Government, Big Insurance, and Big Healthcare, or change course and move in the direction of simplicity, catastrophic insurance, and patient-centered reform. We’re headed in the wrong direction.  Stop this train wreck – I wanna get off!

I’ve focused on hospitals before on these webinars, because hospitals lobby furiously for Medicaid expansion – they just want more money, they don’t care where they get it, or whether it’s good public policy. And the way they are buying up each other and independent providers is leading to single-payer. There were a number of reminders in the news in the last couple of weeks about how hospitals are not our friends.  I call them ‘hospitrosses’.  In West Virginia, two hospitals settled antitrust claims that they conspired to stay out of each other’s territory and not compete with each other.  In Chicago, city residents will pay $45 million more for healthcare next year, and every year thereafter, if the two biggest hospitals are allowed to merge.  Hospital monopolies are forcing independent doctors out of Vermont. I’ve spoken before about mission creep in healthcare.  Hospitals are a prime example.  Some hospitals are now business incubators.  I don’t know about you, but I don’t want to pay for new company start-ups on my hospital bill.  And I don’t want to pay for community gardens either, which is also happening.  Other hospitals are double-booking surgeries and not telling patients that their surgeon will have to leave in the middle of an operation.  The practice has been criticized as unsafe. Ya think? And now, my favorite: A hospital in New York has been fined $2.2 million for allowing a TV reality show to film patients without prior consent.  Allowing reality shows to roam your halls – does it get any greedier than that?  We should go on offense and agitate for hospitals to be stripped of their tax exemptions.  If community gardens are their idea of community benefit justifying a tax exemption, there’s something wrong with tax exemptions.

Now I want to clear up some confusion about Medicaid payments to hospitals.  They’re called Disproportionate Share payments, or ‘dish’ for short.  These payments were supposed to be cut under Obamacare because, it was assumed – incorrectly as it turned out – that Medicaid expansion would be mandatory in all 50 states, and hospitals would no longer need DSH payments.  The reporting on this has been very confused.  Stories in the news are not careful to distinguish between Medicaid DSH payments and Medicare DSH payments.  More importantly, lots of stories make it sound like the Medicaid DSH cuts have already occurred but, in fact, they have been delayed.  I talked to some congressional staffers last week and they confirmed what I thought:  the Medicaid DSH cuts have in fact been delayed and no hospital has lost a single penny from a Medicaid DSH cut yet.  So, when you hear hospitals squealing about DSH cuts, demand proof.  They just might be postponed forever, like the notorious Medicare ‘doc fix’.  You can assume that reporters don’t know what they’re talking about on this subject, as is so often the case with stories that are important to folks on our side of the ledger.

If I may be permitted a brief aside, my Anticommunism Action Team is holding a twitter rally this coming Friday, April 29th at 1 p.m. Eastern to push back against communist May Day celebrations taking place around the world around May 1st.  We invite you to join us.  The hashtag is #MayDayMadness and I’ll send a link in for the wrap-up.  Jenny Beth is writing an op-ed in the Washington Times and you can see all the other pushback efforts at my website Spider & the Fly dot com.

Links

New Hampshire looking at 45% increase next year RIGHT BETWEEN THE EYES!
http://www.unionleader.com/Unaffordable-Care-Act-NH-customers-facing-increase

Federal spending on major health programs (Medicaid, Medicare, #ACA) now bigger than Social Security
http://dailysignal.com/2016/04/01/4-facts-that-prove-obamacare-isnt-aging-well/?utm_source=TDS_Email&utm_medium=email&utm_campaign=CapitolBell&mkt_tok=eyJpIjoiWWpsbU5URmhNMlptTnpJMSIsInQiOiI3SmFKUnptaE8xSkRQUGxxUkRLM0RpMXArUjlHUWxKTjk1ZUtESkNMZFMrZTc0OG1TdnJIam5talZFYVpXSll2dTk2VklMdU9OS2dLNmQwQVZWQzdHWXMwcG5SUVZCMGVpOXUreElNKzJnVT0ifQ%3D%3D

#ACA #crony Tavenner says #Obamacare market not stabilizing, rates will go up more next year than last
https://morningconsult.com/2016/04/marilyn-tavenner-predicts-exchange-premium-increases-2017/

#ACA ‘stability’ can only be purchased at price of repeated rate hikes, narrower networks and higher out-of-pocket.
http://healthpolicyandmarket.blogspot.com/2016/04/united-healthcare-leaving-obamacare.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+HealthCarePolicyAndMarketplaceBlog+%28Health+Care+Policy+and+Marketplace+Blog%29

UnitedHealth is 1 of 2 insurers in 536 counties; pull-out will cause rates to go up
https://morningconsult.com/2016/04/study-finds-local-impact-unitedhealth-aca-withdrawal/

“Who is going to pay these ever higher full costs for the consumers who get subsidies? The health insurance fairy?”
http://healthpolicyandmarket.blogspot.com/2016/04/united-healthcare-leaving-obamacare.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+HealthCarePolicyAndMarketplaceBlog+%28Health+Care+Policy+and+Marketplace+Blog%29

“only one solution to the nasty mess of government-run health care and entitlements: get the government out of it.”
http://www.deseretnews.com/article/865652379/Get-the-government-out-of-it.html?pg=all

Healthcare costs were rising 2.6% faster than inflation, but now it’s 3.3%. Masterminds? Master con artists is more like it.

The money for Medicaid expansion is all borrowed. What do we think we’re doing?

#Obamacare – Because the Best Way to Handle Overpriced Medical Bills is to Overpay Them, with Borrowed Money!

Two West Virginia hospitals settle antitrust claims they divided territory, didn’t compete. #Hospitrosses
http://www.modernhealthcare.com/article/20160414/NEWS/160419945/justice-department-alleges-two-west-virginia-hospitals-illegally

FTC: Chicagoans to pay $45M/yr more if 2 biggest hospitals merge. #RevokeHospitalTaxExemptions
http://www.chicagobusiness.com/article/20160414/NEWS07/160419908/ftc-expert-warns-of-higher-costs-from-northshore-advocate-merger

Public medicine, hospital monopolies squeezing independent private practice docs out of Vermont
http://watchdog.org/261960/vermont-health-care-professionals-dissatisfied/

Hospitals becoming business incubators. Do u want to pay on your hospital bill for giving money to start-ups?
http://www.modernhealthcare.com/article/20160409/MAGAZINE/304099982

I don’t know about you, but I object to paying for community gardens on my hospital bill. #MissionCreep
http://healthaffairs.org/blog/2016/04/05/hospitals-engagement-in-population-health-moving-past-the-medicine-and-into-the-community/

Hospitals flout rules, routinely double-book unsafe concurrent surgeries. #RapaciousHospitals
http://www.bostonglobe.com/metro/2016/04/13/surgery/Jn7Lb0Hq3VUGeZGBgjiw0M/story.html

Greedy NY hospital to pay $2.2M fine over TV reality show filming patients without prior consent
http://www.nytimes.com/2016/04/22/nyregion/new-york-hospital-to-pay-fine-over-unauthorized-filming-of-2-patients.html?ref=health&_r=0

Per congressional staff – Medicaid DSH cuts haven’t happened yet. Not one hospital has lost a single penny. Another delay is possible.

 O/T

Push back on communism! Join the Anticommunism Action Team’s twitter rally @WeSowDiscontent Friday April 29th 1 p.m. ET. #MayDayMadness

MayDay Pushback from the Anticommunism Action Team
http://www.spider-and-the-fly.com/may-day-2016.html

Liberal Fascists Out in Force During Supreme Court Immigration Case (On-The-Scene Tweets from The Discontenterati)
http://www.liberato.us/the-discontenterati.html

 

 

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