Monday, November 12, 2012

Obamacare: Just give us a bill to hype; we don’t care what it is

Dees Illustration
Paul Craig Roberts, Contributor
Activist Post

In the article below, Dr. Dotson provides more information about Obamacare. The program is not what its supporters or its critics imagine. In my opinion, with Republicans blocking a single-payer national health system, the Obama White House went to the insurance lobby and said, “give us a health care bill that you can get Congress to pass.” The result is a complex system of taxes, penalties, and government subsidized private health insurance policies with a layer of profits added to the costs of new levels of bureaucracy.

Nomi Prins reports that the claim is laughable that Obamacare will lower costs by creating competitive insurance premiums, because of consolidations and mergers of insurance companies in preparation for the “insurance exchanges.” Wall Street is already making money off the mergers. What Obamacare really does is to allow concentration and control of health care by large corporations that will sacrifice health care to private profits.

Dr. Dotson believes that Obamacare will result in Medicare being blended into some type of corporatist insurance product bringing higher costs and fewer benefits to patients. It will be a “health system” that funnels federal revenues into insurance company profits instead of into health care.

The unexpected consequences of Obamacare are likely to require endless amendments to the legislation. The complexity will result in mistakes by doctors and hospitals that will be prosecuted as crimes. Health care for patients and adequate payment to health care providers will become back burner concerns.

Once Obamacare is up and running, the private and bureaucratic interests that benefit from the monstrosity will protect it regardless of its failure. It would have been so much better, so much cheaper, and so much simpler to have created a single-payer national health service like every other developed country. Instead, “superpower americans” are to be deprived of good and inexpensive health care for the sole sake of corporate profits.

Obamacare – The Tax Man Cometh ~ Robert S. Dotson, M.D.

I think you should send us the biggest transport plane you have, and take this thing to the Arctic or somewhere and drop it where it will never thaw. - Lieutenant Dave in the Sci-Fi Classic, The Blob

With the confusion accompanying the passage of the Patient Protection and Affordable Care Act (PPACA, aka Obamacare) and its on-going implementation, it has not been easy to discern its real meaning for those covered by it. Presidential and Vice-Presidential candidates alike have kicked the disinformation machines into high gear. In what follows I will try to identify some of its ramifications.

The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) have continued to periodically release estimates of the costs of PPACA.

Their most recent cost estimates for current provisions in the legislation (July 2012) indicate that the insurance coverage provisions of Obamacare will have a net cost of $1.168 trillion from 2012-2022.

Government projections usually underestimate costs. We were told that the war in Iraq would be essentially self-financing and that the banks only needed a few hundred billion to protect them from collapse.

Many thousands of billions of dollars have been shoveled at both to date and the end is not in sight.

The CBO says that the new health care law raises taxes by more than $1 trillion. The individual mandate (which the CBO refers to as a “penalty tax”) will produce $55 billion in “penalty payments for uninsured individuals”. The “additional hospital insurance tax” is the largest tax increase in Obamacare and is projected to bring in $318 billion in new revenues. Supposedly, this tax mainly hits “high-income taxpayers” (individuals making over $125,000/year and households over $250,000/year). Other money comes from: “associated effects of coverage provisions on tax revenues” ($216 billion); “reinsurance and risk adjustment collections” ($184 billion); fees on certain manufacturers and insurers ($165 billion); “penalty payments by employers” ($106 billion); “other revenue provisions” ($87 billion); and, an excise tax (40%!) on high-premium insurance plans ($111 billion).

Americans are holding on to the fairy tale that someone else will be paying these taxes – those rich pharmaceutical and insurance companies, for instance. In fact, all costs will be passed along to consumers/patients in the form of higher premiums and higher costs for drugs and medical devices. According to the Cato Institute, the top 1% of income earners can expect tax hikes of up to $52,000/year, but the bottom 99% will also feel the pain – and lack the discretionary income to absorb the taxes.

There are at least twenty new taxes included in PPACA. Seven of them will directly impact the people whose taxes Obama promised not to raise: those making less than $250,000 per household. Below is a summary of the new taxes on the middle class:

1. The Individual Mandate Tax – In 2014 this penalty will hit all Americans who are not covered by a private health insurance policy, Medicaid, Medicare, of other public insurance program. The penalty requires a couple to pay the higher of a base tax of $1,360/year, or 2.5% of adjusted growth income (AGI). In 2016 the cost of not being part of Obamacare is $695 for individuals and $2,085 for families.

2. The Medicine Cabinet Tax – This tax (begun in 2011) prohibits reimbursement of expenses for over-the-counter (OTC) medicines, with the exception of insulin, from an employee’s Health Saving Account (HSA), Flexible Spending Account (FSA), or Health Reimbursement Account (HRA). This impacts the shrinking middle class hard, since they earn enough to actually pay federal taxes, but not enough to make this a negligible restriction. This is also another backdoor attempt to block access to alternative medicines (vitamins and nutritional supplements).

3. The FSA Cap – This tax scheduled to begin in 2013 is potentially one of the most harmful to middle class people, as it imposes a cap of $2,500/year (it’s now unlimited) on the amount of pre-tax dollars that can be deposited in these accounts. Why so harmful? It is because funds in these accounts can be used for special needs education for special needs children. Tuition rates for such special education can readily exceed $14,000/year and the use of pre-tax dollars has helped many families over the years.

4. The Medical Itemized Deduction Hurdle – Presently, one must have medical itemized deductions of greater than 7.5% to deduct them on federal income taxes. Obamacare raises the bar to 10% of AGI beginning in 2013.

5. The HSA Withdrawal Tax – This tax increases the additional tax on early non-medical withdrawals from these types of accounts from 10% to 20% in 2013.

6. The Indoor Tanning Services Tax – Begun in 2010, this provision added a 10% excise tax on people using tanning salons. Some may consider this minor, but it is another attempt by the Ruling Elite to control the behavior of the peasants and, I believe, to put a road block to accessing beneficial light therapy for many people. Space does not permit exploring this much further here, but suffice it to say that there are many potential health benefits from the use of tanning beds when properly used. A variety of conditions, from depression (Seasonal Affective Disorder or SAD) and related mood disorders to psoriasis, are improved by the judicious use of tanning type beds. I can hear my Dermatology colleagues groaning now, but the over-reaction to increases in skin cancers by banning tanning beds and slathering often-toxic sunscreen on everyone has led to an even worse epidemic of Vitamin D deficiency, in my opinion. The latter problem, of course, can be directly linked to explosions in the numbers of Type II diabetics, cancers of many types, and respiratory infections (such as, influenza).

7. The Excise Tax on Comprehensive Health Insurance Plans or the “Cadillac” Health Insurance Plan Tax – So-called Cadillac plans are generally fully paid for by employers. This tax, delayed until 2018 to protect Obama’s union supporters, will impose a 40% excise tax on the recipients when fully enacted.

There are at least 13 other significant taxes imposed on all businesses, employers, and “high income” individuals (>$125,000/year) and families (>$250,000/year) within PPACA. A summary of these other taxes and the history behind Obamneycare can be found at Wikipedia:

It is worth taking time to review this entry, so that one can understand how invasive and costly this legislation really is.

For “low income” individuals and families, subsidies for insurance obtained from “insurance exchanges” will be provided for those between 100% and 400% of the Federal Poverty Level (FPL). For example, the 2016 FPL is projected to be $11,800/year for an individual and $24,000/year for a family of four. DHHS and CBO estimate that the average annual premium cost for a family of four without PPACA would be $11,328/year. With PPACA in place as presently enacted, the same family at 200% of FPL would be paying $2,778/year out of pocket and at 400% of FPL, $8,379/year. In participating states, Medicaid eligibility will be expanded to all individuals and families earning up to 133% of the FPL. The Wikipedia entry referenced above contains several tables that explain this in more detail.

The Internal Revenue Service will be the implementer and enforcer of PPACA (up to 16,000 new agents). The Act will be partially paid for by taking $716 billion from Medicare and Medicaid; AARP claims that the money is taken from doctors and hospitals, but the lower payments to health care providers will reduce the services that Medicare patients receive.

The Congressional Budget Office reports that costs will rise for all Americans; and, more than 30 million will remain uninsured when Obamneycare is fully implemented. The CBO further predicts that the average family’s insurance premiums will rise at least $2500/year, in spite of candidate Obama’s repeated promises that they would go down that same amount. Be of good cheer, however, as all illegal immigrants will be exempt from the health insurance mandate and, yet, will remain eligible for emergency services under the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA).

As a kid (and, I confess, as an adult) I always loved the 1950s science fiction thrillers. One of the classics from that era is The Blob (1958). Though silly in many ways, it remains metaphorically appropriate today. Starring a young Steve McQueen, the story revolves around an extraterrestrial bit of alien protoplasm that arrives on Earth via a meteorite. This goo proceeds to engulf every living thing that comes in contact with it until it fills the town’s cinema and engulfs the local diner. In this thriller, the Blob is finally defeated by freezing it with CO2 bottles and the U.S Air force airlifts the blob to the arctic. Problem solved – at least, until global warming kicks in.

In reflecting on Obamneycare over the past few months, I have been unable to discover any such easy solution for eliminating PPACA.

This article first appeared at Paul Craig Roberts' new website Institute For Political Economy.  Paul Craig Roberts was Assistant Secretary of the Treasury for Economic Policy and associate editor of the Wall Street Journal. He was columnist for Business Week, Scripps Howard News Service, and Creators Syndicate. He has had many university appointments. His Internet columns have attracted a worldwide following.


This article may be re-posted in full with attribution.


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Anonymous said...

"I have been unable to discover any such easy solution for eliminating PPACA" = stand down everyone.

They dont care what the bill is? Total bull crap.

Don't you love these guys that have no answers when there are many?

Paul Craig Robert is a shill for the NWO. Just look at his 9/11 positions.

Anonymous said...

Definitely worth a view, documentary titled "Doctored" on additional ActPo article posted today. It's a vampiric takeover. Hollywood movies were just to make it seem like fiction.

Dr. Robert's home state of Georgia prides itself on initiating model "welllness incentives" in 2011 for state employees/ retirees. They have sharply escalated for '13. Huge inflationary costs unless you agree to intrusive evaluations and targets which must be reached to incur milder jacked-up rates/ co-pays. Many HMO services no longer flat fee but subject to deductibles - even labs. Of two mega-corp programs offered, United Health Care and Cigna, one was $6 cheaper. Reminds me of another illusion of choice we were offered recently. As of 1/1/13, local school system is no longer subsidizing health insurance - huge hit in take-home pay after years w/o increase.

Time to get off the merry-go-round of BigPharma drugs and their medical pill-pushers; live and eat in healthier ways.

Time to take back control of our human experience.

Anonymous said...

Shills like Paul Craig Roberts will tell you it's all about profits when it's all about genocide. He blames it on insurance companies and forgets to point a finger at our NWO controlled government. He does this every time.

Anonymous said...

PPACA is just a replay of Medicare partD. Fabricated by and for big pharma and the insurance companies. At least partD is not mandatory; YET. When they decide to further exploit retirees, it will be taken directly from our SS checks. RobW

Anonymous said...

Exactly this: the Obama White House went to the insurance lobby and said, “give us a health care bill that you can get Congress to pass.”

You have to pass it to see what is in it, hard because it is an ongoing process of making sure lobbyists get adequate return on their investment. It is not a bill that becomes a law, it is a blob of special interests each carving out its bribery payout - the folks that were at the table. The table was a disgrace. We were not even the dogs begging at it. We were on it. Our nation's wealth is what is and was for dinner.

Unaddressed, this issue is destroying our economy, our country. Washington fiddles and parties and collects the checks while the people are destroyed.

Anonymous said...

This crap you call Obamacare will ome day come back to bite all that are for it, what the hell is wrong with you people, have you been bite by a snake oil salesman, I would say so! OBC will bankrupt the States!

Anonymous said...

Last month I read a comment by an ER physician blogger who tells us that Obamacare is now denying hospitals reimbursement for the treatment of Medicare care patients if they are admitted to the hospital within 30 days of a prior admission even if the new admission is for a different health problem or the admitting hospital is not the same one that previously hospitalized the patient. This policy will result in denial of care and premature death in many instances as doctors are pressured to deny admission to patients in need of professional care and close observation. The blog commentary is in the link below.

Death Panels are HERE

Funny, in youtube videoclips we can see both Romney and Obama describing the ultimate goal of a single payer system. This is not a panacea by any stretch of the imagination. The problem with modern medicine is centralization of power, lack of transparency and competition, and lack of consumer education - all of which have combined to generate astronomical medical inflation costs that force us at gunpoint to fork over our hard earned money to the various mafias, esp. the insurance mafia.

I also agree that Craig Roberts doesn't really get to the heart of the problem. He seems to run a lot of limited hangouts and always projects defeatism and learned helplessness.

BTW, we have already been informed by the MSM that the national organ transplant program will no longer operate on a priority system of need and waiting times for all eligible candidates, instead, the youngest applicants will get top priority. We are also told by govt spokespersons that this model is expected to extend on some level to the eventual rationing of cancer treatments. These are national policy level decisions and reflect the "social utility" measurements of individual worth we can expect in U.S. mandated sickcare where only the very wealthy will have options.

Anonymous said...

Sadly, this is a tax on your existence. It means you are owned property. If you pay the tax you are better off than if you don’t. Either way, you are property of the state. They determine what medications you can have or not have. They determine if you live or die and they determine how you live.

It’s the Golden Rule. Those who have the gold make the rules. The tax puts the IRS in command of your body. They have color of seizure as they do with bank accounts. But this time, it’s you. You can be seized for not paying the tax.

The 13th Amendment has an exception. If you are imprisoned, you can be enslaved and forced to work. If you fail to pay your medical tax. You go to jail.

They can use you for medical experiments or anything else they want. Don’t think they can’t. The Supreme Court has already said they can. See Buck v State of Virginia, May, 1927. You can be forcibly sterilized for being an "incompetent person". It already happened to 600,000 people in the 1920's and 30's. All were non white.

Welcome to Camp FEMA. You are already living in it.

Anonymous said...

I for one am getting tired of "Anonymous" and his boring "Paul Craig Roberts is a shill" routine. I might point out that posting comments such as this on every article PCR writes is exactly the type of thing that shills and trolls are known for. We just want to read the articles in peace, so please, Anonymous, take your problems elsewhere. Mr. Roberts writes intelligent, thoughtful articles with no apparent agenda. You, on the other hand, definitely have an agenda and none of us cares about yours. And if you ever find a writer without some kind of bias, please let us know. I've never run across one in my life. But a bias is not an agenda.

Anonymous said...

Amen, anony 1032. I'm tired of it, too.

Anonymous said...

I agree that PCR is not a shill. I disagree with some of what he says, but that's our perogative, to measure the words of others with skepticism. He has insider credentials, and much of what he writes reneges the insider agenda. It must be difficult, and he's probably bound by non-disclosure directives. I just enjoy the good stuff he posts. RobW

Anonymous said...

All you that are tired of me, too bad. Why don't you ban me then. I am tired of you govbots promoting the shills and their false solutions. It's sickening.

And it's interesting how some of you know which comments are mine. Apparently you are insiders at Activist Post. Tells me a lot about this place and explains why so many articles are NWO propaganda.

Any regular alt. media mouthpiece that is not a 9/11 truther and doesn't call for arrests is a fraud.

I see you think everyone must agree and think as one. I don't.

Anonymous said...

For the record, my agenda is to put the NWO criminals in prison. If you want to call that a "bias", then something is wrong with you. It is obvious you propagandists don't want justice.

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