Thursday, September 2, 2010

5: Obama Accounting: Why Pay Mandated Obamacare Insurance Premiums for Rationed Medical Care?

Barack Obama has selected Harvard Medical School Professor, Dr. Donald Berwick, as Director of the Centers for Medicare and Medicaid Services, the federal agency which manages Medicare and Medicaid. Dr. Berwick is an unconfirmed "recess" appointee, appointed without the usual Senate confirmation.

Dr. Berwick, also CEO of Institute for Healthcare Improvement, is a very aggressive opponent of free-market medicine. He advocated rationed care in Great Britain. Berwick praises the socialized British government-run health care system for spending only 9% of GDP (Gross Domestic Product) on rationed health care, rather than the current 17% of GDP spent in the United States.

Kathleen Sebelius, Cabinet Secretary, Department of Health and Human Services (HHS), gave full support to Dr. Berwick as the "right leader at this time" for the Centers for Medicare and Medicaid in a videotaped question and answer session at the National Press Club posted May 26, 2010.

ObamaCare (Patient Protection and Affordable Care Act, March, 2010), mandates insurance premiums to be paid by taxpayers earning above the poverty level. Americans below the poverty level must register for Welfare medical care, Medicaid. Americans will be required to provide "proof of insurance" or pay IRS fees, fines, and penalties for "non-compliance".

Why mandate insurance premiums for anyone in a proposed rationed health care system? Who will receive the mandated insurance premiums or the services paid for by these premiums in a rationed health care system? What care will be available under a rationed health care system? Was rationing covered in the over 2,000 page Obamacare Act voted on by Congress? Is this a late, but very significant Obama Administration modification?

Medicare is a "pay-in" plan for workers deducted from payroll checks by employers for payment to the federal "Medicare" account for that employee, to be available to that employee when eligible as a "senior citizen". Over 40 million Americans now participate in Medicare.

Medicaid is the welfare medical card, providing over 30 million welfare recipients with free medical care. Medicaid is referred to as "insurance", a Federal Guaranty Insurance Corporation-type plan, the stated purpose of which is to repay medical centers and providers for caring for welfare patients. Medicaid in the past made projected payment plans of only 10-11% of health care expenses incurred at "usual, reasonable" rates. This creates enormous losses for welfare medical centers and providers.

This is another Democratic Party "redistribution of wealth" plan, a socialist term as startling in American politics now, as when first uttered by former President William J. Clinton. Who is the wealth to be redistributed to?

The obvious possible answer is to the welfare population, currently covered under Medicaid. The "pay-in" Medicare premiums, because of the combination of "pay-in" health insurance with "free Medicaid", are used to subsidize welfare health care. This obscures an accounting of the actual cost of providing Medicaid welfare health care. How much does the Medicaid welfare card health care cost? (Total current Health and Human Services cost $414.9 Billion.)

The less obvious possible answer is the premiums will be used to subsidize other government budget items proposed by the Obama Administration. Despite his spoken commitment to "transparency" in government, Obama has begun a process of moving funds from one department to another or involving multiple departments in a single, complex piece of legislation, obscuring the source and location of the money. Obama already has set record budget deficits, $458.6 Million in 2008 and 1.8 Trillion in 2009, doubling the national debt under Bush in 2002 from $6 Trillion to $12.9 Trillion or more.

Obama are planning to subsidize hiring a large number of IRS agents to investigate and collect penalties, fees, fines, and needed tax refunds from Americans who do not chose to buy health care insurance or become insolvent, risking loss of home and assets, by signing up for welfare.

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Photograph: Higggins Eye Pearlymussel, Unionidae, an endangered species of freshwater mussel since 1976, in IL, IA, MN, MO, WI, from Beacham's Guide to the Engangered Species of North America, 2001.

References: NYT Almanac 2008, 2009, 2010.