A4 Sunday, October 27, 2013
OPINION
Obama in Affordable Care Act Wonderland
“Why, sometimes I’ve believed as many as six impossible things before breakfast.” — The White Queen, “Alice in Wonderland” The more President Obama talks about the supposed joys of his Affordable Health Care law, the more he resembles a political Mad Hatter, devoid of reason, absent logic and ignorant of facts. At a Rose Garden event Monday, the president’s theatrics were on full display. With a chorus of supporters behind him, Obama blamed the “slow, wonky” rollout of health insurance enrollment on too many people trying to log on to the government’s new marketplace website at the same time. He labeled the false start “glitches.” This isn’t a glitch; it’s a disaster. The administration is asking for a lifeline from the private sector to offer technical help. Ponder this for a moment: The very people who claim they are sufficiently competent to run health care, which constitutes about one-
EDITORIAL
CAL
THOMAS SYNDICATED COLUMNIST
sixth of the nation’s economy, can’t manage to launch a workable website, even though they had at least three years to set it up. Keep in mind this is also the same government that is having trouble making Medicare and Social Security permanently solvent. The Obama administration has spent $200 million on its flawed marketplace system to sign up (so far) untold “thousands” — the president said thousands — not the seven million, out of 40 million uninsured, he and other top officials predicted. He now wants to spend even more to hire people who
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actually know what they are doing. Why didn’t the administration consult Silicon Valley first? Let’s put it in a way everyone can understand. You buy a can of sardines at the supermarket only to discover when you get home that the tin has been recalled because its contents are tainted and may make you sick. You return the sardines to the store, but instead of simply exchanging the tainted ones for untainted ones, the manager wants to charge you again for an untainted tin. Would that be fair? Would it be legal? Don’t think so. From the beginning, Obamacare was a tainted tin of sardines. It can’t live up to its promises. It can’t deliver health insurance we are used to at affordable prices. People are being laid off, not hired, reduced to part-time employment. They cannot shoulder the burden of purchasing overpriced, mismanaged health care. They’d like to exchange Obamacare for something that works, but the administration
won’t take back the tainted fish. And now we all will have to pay, and pay... The British have tried to centralize health care. They quickly saw health care costs rise as the quality and availability of qualified medical treatment declined. Obamacare and the single-payer system that will likely follow (perhaps along with rationing) might eventually be available for all, but at a personal and monetary price most Americans will be unwilling to pay. Take for example the Canadian Supreme Court. Adam Goldenberg of Slate.com reports that the court recently ruled that in Ontario a panel of “adjudicators” appointed by the government may overrule a family’s wishes when it comes to keeping a patient on life support. Death panels, anyone? All inhumanities begin at the extremes, but when a precedent has been established it is difficult to reverse it. Remember the many promises the president made to sell the
Affordable Care Act to the public, including “if you like your current policy you can keep it” and “premiums will actually go down.” People are now opening letters from their insurance companies that tell a different story. Many companies are telling them they can’t keep the policy they have and in some cases their policies are being canceled. Others have been jolted with the news that their premiums are going up beyond their ability to pay. Talk radio shows are hearing from listeners, including disappointed and outraged Obama voters, who realize now they fell for a lie. Conservatives warned them, but they were caught up in wishful thinking and blinded by Obama’s charm. “I can’t go back to yesterday,” said Alice. “I was a different person then.” Weren’t we all, Alice; weren’t we all. (Readers may e-mail Cal Thomas at tcaeditors@tribune.com.)
Doctor shortage snarls Obamacare
In 2009, President Obama, touting his proposed health care legislation to the American Medical Association, said, “No matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.” The promise you could keep your insurance plan is already broken, as insurers raise rates, reduce coverage or even pull out of certain markets altogether. Now, broken as well is the president’s promise that you can keep your doctor “no matter what.” Buried in one of many stories about the hobbling debut of the Obamacare insurance exchanges is distressing confirmation that, even if you manage to surmount the website glitches and crashes to successfully register, you will face significant restrictions on which doctors you are allowed to select. Blue Shield of California confirmed to the San Jose Mercury News that half its network of physicians will be available to those who sign up for Obamacare. Anthem Blue Cross of California will allow access to 60 percent of its doctors. Welcome to rationing. Even more worrisome than if you will be able to keep your doctor, is the prospect that it will be harder to see a doctor at all. Americans are a growing population with a shrinking number of doctors to care for us, and, as the boomer generation ages, they will need more frequent and intensive care. Yet, nearly half the nation’s physicians are at least age 50, with many approaching retirement. Medical schools are producing more specialists than primary-care doctors at a rate of 4-1, and increasing numbers of doctors in primary care are choosing “concierge” practices, where patients pay extra for access. How will the health care system cope with the new demands of millions of formerly uninsured people with subsidized coverage, aging people requiring more-frequent care and fewer doctors to see them? It can’t. For those who can afford it, health care will become an expensive exercise in privilege, with private physicians and hospitals. For the majority, shortages will lead to long waits, a decline in quality of care, and higher costs. But the federal government has taken on itself all these problems to solve. And that government can’t seem to build an insurance enrollment website that works. Enrolling people should be the easiest part. However, when run through the Washington mill of favors, waste and plain old bureaucratic incompetence, it becomes a nightmare. According to the Washington Examiner, the administration hired a Canadian company, CGI Federal, (whose contract was previously terminated by the Montreal government for failing to deliver an online medical registry for that Canadian city) to work with another contractor, Booz Allen Hamilton, (which employed NSA leaker Edward Snowden). Overseeing both was the agency in charge of Medicare and Medicaid, whose administrator, Donald Berwick, when asked about the dysfunctional system, was quoted by the New York Times as saying, “We did not have enough money.” They had $400 million. Our government is, partly by design, both unwieldy and slow. The founders bequeathed to us a system intended more to protect us from despotism than to facilitate minute control over our everyday lives. Even if we accept the premise that a forced purchase of health insurance, with some people paying to subsidize others, is a great idea, the federal government has simply not demonstrated yet the competence to manage it. The Orange County Register
Broke America resumes its spending trend What would you think of a person who earned $24,000 a year but spent $35,000? Suppose on top of that, he was already $170,000 in debt. You’d tell him to get his act together — stop spending so much or he’d destroy his family, impoverish his kids and wreck their future. Of course, no individual could live so irresponsibly for long. But tack on eight more zeroes to that budget and you have the checkbook for our out-of-control, big-spending federal government. Yet when Congress and President Obama agreed on a deal last week to raise the
Doonesbury
DEAR DOCTOR K: I’m the primary caregiver for my ill, elderly father. I’m exhausted and upset all the time. What can I do to lighten my load without costing us much? Neither of us is well off. DEAR READER: You’re not alone. Approximately one in five American adults helps an elderly or disabled family member with the daily tasks of life. This caregiving runs the gamut from grocery shopping, cooking and cleaning house, to helping with baths and personal hygiene or providing hands-on medical care. That’s often in addition to caring for other family members and holding down a paid job. Caregiving may be one of the most worthwhile jobs
JOHN
STOSSEL SYNDICATED COLUMNIST
debt ceiling and resume gover nment spending, people reacted as if a disaster was averted — instead of reacting as if a disaster had resumed. It has. And it continues. Congratulating ourselves for raising the debt ceiling once again, the way we do every time this drama plays out, is
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you’ll ever undertake, but it can be exhausting. It can cause immense strain, which may lead to depression and health problems. Here are some budget-conscious tips to help you take care of yourself: — Always accept help when it's offered. Create a list of very specific things that you would love to have help with,
like congratulating an alcoholic for talking the bartender out of cutting him off. As with alcoholics, there’s a deeper problem here. It’s not just that America is addicted to debt. Everyone agrees we should pay our bills, just not when or how. The deeper addiction is to government. For most of the history of America, federal spending never took up more than 5 percent of the economy. Spending increased during wars, but after World Wars I and II, spending dropped back to prewar levels. Then came Presidents Johnson and Nixon and the “great
society.” From then on, spending rose even in peacetime. Now, if you include local government, government spending makes up more than 40 percent of the economy. “Government has exploded in size,” warned economist Dan Mitchell of the Cato Institute. It happens because of “politicians promising things they cannot deliver and imposing tax burdens that are crippling private sectors.” Politicians from both parties criticize spending when they’re out of power. But then they increase spending once
so you can request something specific when help is offered. — Tap into religious communities. A religious or spiritual community can be a strong source of assistance if you or the person you are caring for belongs to one. — Support groups are a good place to share ideas and experiences with other caregivers. There are quite a number of support groups for caregivers on the Internet. Just type “caregiving support groups” into a search engine. — Look for gover nmentsupported services. You might be surprised by how many services your father may be eligible for. These are services provided by local or state governments, or by the federal
government. Ask your doctor for the name of a social worker who can work with the two of you. Particularly if your father is on Medicare, he may be eligible for help in cleaning the home, personal hygiene, and even “Meals on Wheels” delivered to the home. — Stay connected. Catch up with friends regularly. Establish a weekly walk with a friend or an occasional lunch or movie. — Clear your schedule. Set aside a regular time to spend with your partner or family, away from home. — Stay active. Try to get 30 minutes of moderate exercise a day, most days of the week.
See STOSSEL, Page A5
See DR. K, Page A5