Category: Health Care

This piece first ran in Investor’s Business Daily.

The Affordable Care Act may not yet be fully implemented, but its negative effects and exorbitant price tag are already being felt in statehouses, hospitals, and homes across the country.

Yet in the face of the President’s and the Senate’s unwillingness to address the law’s many issues, some states—including my home state of Pennsylvania—are taking proactive steps to help protect taxpayers and families from the ACA’s burdensome costs by refusing to expand Medicaid programs that fail to serve the poor.

Fifteen states have so far announced their intention not to participate in the ACA’s Medicaid expansion program.

The President may not like this development, but it’s a decision that makes sense—both fiscally and morally.

Consider Medicaid’s current bill of health. Medicaid has a poor record of serving the people who need it the most. The program’s broken system of doctor reimbursements and its reams of red tape mean that many doctors have to choose between accepting Medicaid patients and staying in business. As a result, Medicaid recipients have fewer options, spend more time in the waiting room, and ultimately don’t get the care they need.

The 48-year old program is bleeding red ink. It is already the single largest item in most state budgets, accounting for roughly 23 percent of state spending on average. Pennsylvania alone expects to spend more than $9 billion in state funds on Medicaid over the next year.

The national numbers are even more enormous. Medicaid spending ballooned from $73.7 billion in 1990 to an estimated $450 billion last year. And the GAO predicts Medicaid costs will continue to grow faster than taxpayers’ ability to pay and consume a larger share of state and federal spending.

These numbers—already at mind-boggling levels—are expected to accelerate under the Affordable Care Act. Rather than rein in the runaway cost of Medicaid, the ACA urges states to expand the program using an unfortunate “carrot and stick” approach.

The “carrot” is that the federal government has promised to shoulder the additional costs at first, but its payments will trickle off after three years. The “stick” is 20 new federal taxes that residents will still pay for Medicaid expansion in other states, even if their state refuses to participate. It’s nothing more than financial extortion by another name.

Pennsylvania has seen through this ruse, as have 14 other states, with ten more still weighing the offer. Past experience has taught these governors that Washington politicians will renege on their promises—President Obama has already suggested cutting the federal matching rate. Even if the federal government keeps its end of the deal, states will be forced raise taxes to pay for a program they have little control over.

That’s why Governor Corbett should also be praised for requesting an “innovation waiver” for the program. Unlike the fake flexibility pursued by Arkansas, these waivers offer states wider latitude and have a good track record in the states where they exist.

With flexibility to fix Medicaid, states have saved money, improved patient care, and produced more satisfied participants. In the face of the ACA’s crippling uniformity, such waivers are the best means for states to improve the health care of their neediest citizens while balancing their budgets.

The ACA’s problems are obvious, whether you’re sitting in Washington, Harrisburg, or anywhere in between. That’s why leaders in statehouses across the country should do the right thing and follow Pennsylvania’s lead. Instead of waiting for dollars and dictates from D.C. to expand a broken program, our states can save our ailing health care system by fixing Medicaid themselves.

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Thomas J. Smith was Pennsylvania’s 2012 Republican candidate for U.S. Senate and is a member of the Board of Directors for the Commonwealth Foundation for Public Policy Alternatives, (www.CommonwealthFoundation.org) Pennsylvania’s free-market think tank.

States Fixing Medicaid When President, Congress Won’t

In its 2012 decision on Obamacare, the U.S. Supreme Court based its ruling on a convoluted interpretation of law. In a 5-4 decision, Chief Justice John Roberts voted alongside liberal justices to clear the way for the implementation of Obamacare. Roberts’ overriding concern was if the individual mandate to force Americans to buy medical insurance should be labeled a tax or a fine. Human loss and suffering were inconsequential. The human toll could not be factored in based on legal constricts placed on the court.
Decisions are to be based on law and not emotion. Regardless and
predictably, the leftist jurists’ ideology of applying social justice, a
primary tenet of socialism, infused their decisions. Conservatives on
the bench voted against the individual mandate, which would force
Americans to purchase medical insurance under coercion whether by a tax
or fine, as unconstitutional.

Soon after its passage, Obamacare began claiming casualties.
Front-line victims became early warnings of the pain and suffering — the
desperation — to come. Few in seats of power took heed. Obama and
Congress had, after all, exempted themselves from the medical nightmare
they created along with a swath of their political cronies and
supporters. Supreme Court justices remain exempt as well. Question: Why
exempt themselves? What is it that they are afraid of?

Mid-2010, Americans were beginning to experience the creeping effects
of socialized medicine. During a radio interview, a caller who
identified himself as a life-long Democrat told me of the particular
form of hell that he and his young paraplegic wife were going through
due to Obamacare. The caller wanted to warn fellow Americans. His wife
was already being abandoned by her doctors who feared cuts in
reimbursements. Doctors pointed to mandated cuts in Medicare monies
being shifted to fund Obamacare. What follows is a limited transcript of
my on-air interview with the caller about his wife’s ordeal.

Husband/Caller: “Our doctors have told us
to be prepared for the worst because right now we can hardly find a
doctor. We’re not in a small town, and when we go to find a new doctor
for a new problem, a podiatrist or specialty doctor of any kind, we go
through many, many, many, many names before one finally decides to take
us. They tell us upfront that you are going to probably end-up being
billed the 20% because we [the doctors] know that we don’t get
reimbursed for that and they’ve changed their paperwork. You used to be
able to pick up the phone and call any doctor and they say come on in,
we take Medicare, we take QMB – now I spend two and three days trying to
find one doctor with other doctors helping me to find a doctor that
would accept the program. Through the Bush time, we thought GW was the
worst thing that had ever happened to America. But, we were able to keep
everything we had. Nothing was affected, our health plan was not
affected, the doctors were not affected, nothing happened to us badly.
Well, now since Obama has taken over we can no longer . . .” (Voice
cracks.)

The caller explained further, that in desperation, he took his wife
to a clinic. Clinic doctors informed him that they were not qualified to
treat his wife, nor could they admit patients to a hospital. Frantic,
he recruited the help of others in his continued search to find a
qualified doctor who would accept their Medicare/Qualified Medicare
Beneficiary program. Eventually, he said, a 74-year-old doctor, in
semi-retirement, finally agreed to treat his wife.

As a result of that call, I have investigated first-hand accounts and
concerns of those who provide medical care to our mentally and
physically disabled and to our seniors. Medical care providers expect
the human toll, from warehousing patients to loss of life, to be
extensive. Obamacare results in fewer doctors available to middle and
lower income patients. Corruption is embedded in Obama’s Affordable Care
Act as it fosters breeding grounds for less skilled and less ethical
doctors and clinics to run Obamacare mills based on quantity of patients
and not quality of care.

A recent interview I did with an emergency room doctor disclosed
traumatizing choices that doctors are already being forced to make. An
experienced emergency room doctor found himself trapped
between admitting two critically ill patients or adhering to newly
applied government regulations. His hospital’s funding was under new
government-imposed financial guidelines. Costs were to be lowered by
turning away short-term, repeat Medicare patients. The doctor explains
that he is now caught in a regulatory vice:

“As more and more are added to the
Obamacare rolls, there will be less and less access. People will get
sicker and yes, people will die because of it. I had a sick and sinking
feeling in the pit of my stomach today after both of these incidents.”

Facing the prospects of turning away dying patients or facing a
hospital reprimand for admitting them, this doctor chose patient care
over job security. The doctor expects to retire in a few years.

Former top aide to Obama, Jeffrey Crowley, helped design how
Obamacare is being implemented. Crowley openly admits that there are
serious flaws, saying, “We know it’s going to be messy.” “Messy?”  Is
that what President Obama, liberal Democrats and socialists on the
Supreme Court call the heartache, suffering and sorrow that is already
being faced by Americans and their families? Chief Justice Roberts and
his liberal jurists on the high court have torpedoed the American
economy along with the American health care system making the pain not
just medical, but financial. Workers nationwide complain that their
paychecks have been hit with the first-round of Obamacare taxes
resulting in less take-home pay. It is just the beginning.

The latest Rasmussen Reports survey reveals that a 54 percent
majority of Americans expect the U.S. healthcare system to get worse
over the next four years. Benjamin Domenech of Health Care News reports
that the latest Kaiser/Harvard survey found, “Obamacare’s Unpopularity
Grows in New Poll.” The survey reports that the disapproval of Obamacare
“was mostly driven by an increase in opposition from the politically
significant independent voters — the survey found 57% of independents
opposed the law, up from 41 percent last month.” The
House of Representatives currently has the authority to defund the
administrative arm of the Affordable Care Act and effectively nullify
Obamacare. Having been given that authority by the American people, the
latest polls indicate that they should use it — and then expand sales of
personal medical insurance into the free-market to be sold at
competitive rates across state lines.

Sharon Sebastian’s work can be found at  AmericanDailyHerald.Com

Chief Justice Roberts Meet ObamaCare