OBAMACARE & A FEW OTHER THINGS

I'm really, really surprised that Obmacare passed. I guess you have to chalk another one up to the comeback kid. The funny thing is that it is largely a Republican bill. Most things that are in it have been proposed in the past by some Republican. This was underlined in an article by the Secretary of Health and Human Services and someone else who told of a number of issues which Republican had proposed what item. I have trouble figuring out why Republicans are so enraged about it.

And why are Right To Lifers so enraged by the bill, especially when the President has issued an edict that no Federal money will be used for abortions (I guess they think an executive order is not binding.). It all seems irrational to me. Beside outlawing Federal money for abortions only applies to the poor and probably the lower middle class, The more wealthy can pay for their daughters abortions or even send them to some country where abortion is legal if abortion of any kind was outlawed in this country. Bring back the coat-hanger abortions? But ruling that no Federal money can go to abortion is made several different ways: now by the executive order and also the Hyde amendment. I would feel better about it if so many right to lifers weren't also for the death penalty. If life is sacred, how can you justify the death penalty. Apparently right to life only applies to the unborn.

The bill is 2,404 pages, I believe, including 900 pages of amendments of which 170 of the amendments are by Republicans. Of course it is hard to believe that anyone can keep in their mind all the things in such a bill. I guess we will just have to let things develop and see. But the big thing as I see it is the inclusion of the 32 million new uninsured. If we can't do this, maybe we don't deserve to be a country? Well, I have heard the problem is that people with health insurance say, "What's in it for me?" There are 14 items that will begin this year: http://majorityleader.gov/docUploads/Top14FINAL.pdf

Adding 32 million people to health care presumably will put a strain on our stock of primary care physicians. We are told that the poor now are covered by going to emergency rooms. So the thought occurs to me that if this is true, there will be less need for physicians in emergency rooms so they can have private practices to see new patients at less than one-third the cost of an emergency room visit. Hm, maybe not that many of the poor go to emergency rooms for their primary care. I took my wife once, and her visit lasted seven hours (this in northern Virginia). A lady we know went to an emergency room here in North Carolina because of a bad fall, and it took her six hours. After you do this once, you maybe try to avoid emergency rooms? So maybe there will be a shortage of primary care physicians. One of the things that will begin soon with the passage of Obamacare is support for the training of more primary care physicians. I know not how many.

Well, I think there is some legitimate concern that the budget balancing in the health plan bill will actually be sustained by future congresses. As to financial reform, it is certainly necessary. We cannot allow so many "too big to fail" organizations affect out country. The first big thing was repeal of the glass Steagal Act which Clinton signed; I believe it was his biggest mistake. It may be that the SEC has been lax in its enforcement, but we have had 20 years of deregulation of the financial industry in this country, and there is no regulation of hedge funds. And Bush idid things that have ruined the economy for the rest of my life (unfunded wars accompaying tax cuts, an unfunded prescription drug paln, among others.). Even closing down Lehman Brothers has almost done in the country. I suggest you read a book called The Big Short which has come out recently. I have not read the book, but I've heard the author on many occasions on radio and TV.

Of course we need to overhaul the income tax code, but everything that is in it is in it because some interest group wants it (We are a country of push and shove and anything goes.) so the reform is never done, and I doubt it ever will be, just made more and more complicated with time. I spend a large amount of time for about a month on our income tax.

In this blog, I have noted that you cannot balance the budget by eliminating the discretionary spending (which includes DoD,. by the way) of the Federal government. Total budget for discretionary spending is $1.4 trillion whereas the Federal deficit this fiscal year is currently estimated to be $1.55 trillion. So you could close down the entire Federal government as we think of it and not balance the budget. Actually the deficit would rise a lot because of the 2 million (about) Federal workers put out of work and discontinuation of all their contracts with industry.

So if we are to balance the budget, then we have to address entitlements (e.g. Social Security and Medicare) plus raise taxes. Any kind of even modest Federal budget decreases raises alarm. Obama proposed ending a program for manned missions to the Moon and a number of Republicans objected. Can you think of anything we need LESS than to send men to the Moon? It certainly is not essential. Yet, there are loud squeals.

The latest thing is about companies, that provided health care for prescription drugs, will have this benefit taxed. What is interesting about this is that the tax will be on a Federal SUBSIDY (!) given to such companies to continue drug coverage to their employees and retirees. In other words, it is a decrease in a Federal SUBSIDY. The Wall Street Journal loves to tell which company is taking what kind of hit. ATT, for example, is taking a billion dollar write down, and they have a hard time decreasing their prescription drug coverage because of all sorts of union agreements. Disclosure: We own some ATT stock. I still have trouble getting excited about this small decrease in a subsidy.

Personally, I feel companies shouldn't be providing heath care to employees anyway. It started as an accident in WW-II when salaries were frozen and Henry J. Kaiser decided to offer health care as an inducement to get more of the limited pool of workers. Among other things, it put a terrible onus on workers who will lose their health care if they quit, but companies are free to fire them any time they feel like it, costing them their health care. Labor is the main elastic component of business. I think that, at the very least, the health care insurance should be owned by the employee and a company could make donations towards it if they like. At least the employee can take the health care with them if they quit or are fired.

It would be even better to have a government operated health insurance system such a Medicare now (Ah, the Public Option which is not in the bill?). There is no restriction in Medicare as to which physician you go to. The doctor bills Medicare which pays some part of the bill (usually), and our backup plan pays the rest. If Medicare refuses payment, then our backup plan can too. Not every physician will accept Medicare, but there are a large pool that do. And Medicare doesn't pay everything. For example, they won't pay for anything they judge to be cosmetic surgery. And there are some tests they will only pay for once a year (I think some tests have even a longer time frame.). But overall, I think it works well for the patient.