The American Dilemma and How We Can Fix It

Posts tagged ‘Obamacare’


Once again HHS Secretary Kathleen Sebelius made an appearance on Capitol Hill at a Congressional hearing.  I’ve seen her so frequently that I feel that I should be allowed to call her Kathy or, perhaps, Kit Kat.  She looked very stressed as she explained that she has asked her agency’s Inspector General to conduct an investigation into the outside IT vendors to determine if there was malfeasance in the way they performed their duties.

Hmmm.  Good timing.  Due diligence would suggest that the time to perform an investigation into a contractor’s background is before rather than after you’ve committed to spend $600 million with them.  But then due diligence would also suggest that you put a major contract out for competitive bidding and avoid giving business to a college chum who happens to have gone to school with the First Lady.  It’s called propriety.   Notwithstanding, government via the DOD has still figured out that $650 for a toilet seat is a reasonable price, competitive bidding notwithstanding.

If you’re one of the unlucky “small number” of people whose insurance contracts were cancelled by your insurer – 5.9 million policies and approximately 15 million people nationwide – you’re probably nervous about what you’re going to do come January 1st.  You had a perfectly nice policy which suddenly went away and now you’re having some difficulty finding a replacement.  Fortunately, the website is now working better than it did ten weeks ago – so there’s actually a chance you might be able to see what Obamacare has to offer.

And now you’re sitting there saying to yourself, “Self – my choices are getting a new policy with all sorts of provisions which I don’t want or need, paying a higher premium and having a huge deductible before I get any benefits.  Or paying a $95 penalty or 1% of my income as a penalty by the IRS – which can only be collected if I get a refund.  What do I do?  Should I just take my chances and hope I don’t get sick and disregard the law, choosing to pay the penalty and pocketing the difference to self-fund my own healthcare?  Oh, and if I do get sick, then I can sign up for Obamacare and since pre-existing conditions must be covered I am guaranteed the right to buy insurance?”  Well, that seems like a plan to me.  But wait, there’s a way to avoid the penalty entirely.

On page 1427 of the legislation which gave us Obamacare is an exemption from the law for two religious groups – Old Order Amish and Old Order Mennonites.  (They are also exempt from being subject to paying Social Security and Medicare taxes).  So all you have to do is convert to one of these two groups, start replacing your clothes with black homespun and you guys need to start letting your beards grow out.

I expect that as we get more details on all the “benefits” in store for us with Obamacare, we will see the populations of Ohio, Pennsylvania and Indiana swell as more of us convert and become either Old Order Amish or Mennonites.  Yes, you’ll have to give up your cell phone and toss out your television (no great loss there), but on a positive note, you’ll learn how to build a barn and deep down, admit it, haven’t you always wanted to learn how to whittle?


Today the president cranked up the road show which we are warned will continue daily for the next three weeks to tout the virtues of Obamacare.  He used a tried and true formula that direct mail marketeers have employed for decades.  Perhaps you’ve received some literature from them in the past.

If you have you’ll recognize the shtick.  On very inexpensive paper you will be solicited to explore the wonderful new system that the mailer has discovered which is guaranteed to turn your humble financial life into that of an affluent nabob.  The “system” is guaranteed and fool-proof.  If you only remit the modest sum of $8.95 which includes the shipping charge, you will soon have delivered to you the secret of how to become wealthy almost overnight.

Naturally, in order to convince you to part with this modest sum of money, not only does the discoverer of this remarkable system share with you the story of his personal success, he includes the testimonials of a variety of earlier subscribers who attest to their own new found wealth as they employed the system they received.  These testimonials bear their abbreviated names, such as Sharon L. – Daytona, FL or Larry C. – Indianapolis, IN.

If you are still doubtful, thinking to yourself, “Why would anyone give away this key to riches for such a modest price,?” the author has an answer.  You see he has already made more money than he can ever spend, now has four houses on both coasts with a Rolls Royce in the driveway of each and two chateaux overseas and it is because he is so grateful for his good fortune that he wants to share his wealth creating system with other, less fortunate souls.  Of course, that begs the question, “Why didn’t you just send me the book for free instead of sending me an ad for it?”

Once again, there is an answer in the material.  You see the author does not want to “Cast his pearls before swine,” and your modest “investment” is merely an expression of both your commitment and your good faith, proving that you are the kind of person who will actually utilize and deserves to be blessed by this remarkable discovery.

I couldn’t help but think of these many mail solicitations that I have received over the years as I listened to the president today.  The presentation, replete with testimonials about people who have benefitted from Obamacare lacked as much credibility as any of the “get-rich-quick” schemes that I have been offered.  Which is not to say that there are not people who will indeed benefit from the law – and that is a good thing.  But the honest question which everyone, irrespective of party affiliation should be asking is, “At what price?”

Anytime a law is enacted it affects people.  That is, in fact, the reason for creating it in the first place.  And the more sweeping the law, naturally the more people who are affected by it.  Obamacare is as sweeping a law as has been passed for perhaps close to a century.  Therefore, we should not be surprised that millions are being affected – and at this point in time, it is fair to say that those effects have predominantly been perverse.

The stated goal of this program is to “insure every American” – yet we know that by the administration’s own admission, they still expect that 30 million will remain uninsured.  So if that is the fundamental premise and reason for implementation, it is flawed from the beginning.

In part because of the inadequacy of the website, fewer enrollees have signed up than are necessary for this plan to work (hence today’s dog and pony show – to tout the “improvements” and get the gullible to sign on).  What the president omitted from his presentation is that for every person signing up for Obamacare, fifty have already lost their coverage due to Obamacare – and more of those cancellations, far more, can be expected next year.

But this attempt to sell America on Obamacare focuses only on one side of a multi-faceted issue.  It emphasizes the importance of getting insurance but it fails to address the question of “What do you do with it once you have it?”

More and more we are hearing from the medical community that they simply will not honor or participate in this program.  So, in essence, you now have a wonderful magic card and a plan booklet that is unusable.  Most of us would not consider that to be a benefit – especially when you realize that you were forced to buy this product of dubious value.

The president likes to make comparisons between Obamacare and its problems and the glitches that Apple has had with various product releases.  It seems to me that there is a fundamental flaw in that argument – or maybe two.

The first is that within a short period of time and at minimal cost, Apple fixed its problems.  The same cannot be said of Obamacare the law or Obamacare the website.

The second is that by simply letting the public know when the latest iPhone is going to be released, people in the droves queue up at their local Apple store to be one of the first to buy it.  Obamacare – not so much.

It is, in a world of “change” and “moving on” perhaps arcane to mention an old adage which I first heard from my Grandmother.  And though it may be old-fashioned and trite, it’s still true.

“You can’t make a silk purse out of a sow’s ear.”


So in case you survived Black Friday and missed it, today is Cyber Monday.  This morning bright and early I logged into my Amazon account.  Alas, there were no special deals on either the Brita water filter replacements or Gracie’s Greenies Canine Dental Chews that I was prepared to purchase.  Nevertheless, I needed both items and within five minutes I had completed my purchase and received an email confirmation for my order.  Now that’s efficiency at its finest.

Fresh from this experience I decided to try to see how “new and improved” the site was.  One of the issues which I had not seen and hoped to find in the latest iteration of the site was to be able to look at specific plans and find out whether my doctor was a participating physician.  I was, in essence, planning on doing some comparative shopping.  But I found that when I was referred to the Nevada Health Link, that information was still not available.

There was, however, a reassuring message on that web page that suggested that if I wanted to speak with a person and “have all my questions answered” I could call the toll free number and get the information I wanted.  As speaking with a person was my preference anyway, I decided to pursue that avenue.

So I called the toll free number, listened to the prompts and looked forward to hearing a friendly, helpful voice on the other end.  When I hit the third prompt, “If you have any other questions,” I immediately was thanked by the robotic voice and told that “my call would be answered in the order in which it was received and that my expected wait time was 43 minutes.”  As that was more time than I hoped to spend on hold I decided to try again later.

I made some oatmeal, went in the backyard and gave Gracie her morning treats while I ate my breakfast.  Charlie the mockingbird stopped by and I set out some food for him and watched him enjoy his meal and then entertain us with his singing.

About an hour had passed and I decided to try my call again.  On this second attempt I was informed that my wait time had increased to an hour and forty-seven minutes.  Years ago I had surgery to correct a bunion.  That entire procedure took less time than my prospective wait time just to get information.  And I sincerely wonder whether the person I might finally reach could actually answer my questions.

Being a persistent sort I will try again.  Perhaps midnight will be a time that offers a shorter wait period.  But I’m not certain that the phones are manned 24/7 so I might find that I’m asked to call back during normal business hours – which will put me right back where I was this morning.  Only time will tell.  But if I want to get the information it seems to me that with only three weeks to enroll in a plan or face a penalty, the wait times are likely to get worse as we approach that deadline.

But I couldn’t help thinking that instead of shopping for health insurance I might consider looking into prepaid funeral arrangements.  With all the difficulty facing the consumer who is mandated to buy health insurance, I’ll bet those who offer those services are probably ramping up their phone banks to accommodate those prospects who are tired of being put on terminal hold in their effort to comply with Obamacare.

WEBSITE DESIGN 101(01010101)

Health and Human Services Secretary Kathleen Sebelius might have been more gracious recently when a local council member handed her a copy of “Websites for Dummies,” while she was pitching the virtues of Obamacare at a community meeting.   Perhaps his gesture was too little too late – as the “enrollment numbers” for have been released for its first month of operation.  Even to the supporters of this legislation they were “bad.”

Let me be the first to say that I am not a computer programmer.  But I do have a solid educational background in logic and an affinity for math – which are the bases for any program.  As an end user, I have commissioned and paid to have two separate programs written.  And while I believe that I might have, with the aid of “Websites for Dummies” and other reference guides, been able to write those programs myself, I recognized that contracting this work out to people who made a living doing just that would be both time and cost effective.

In my case, unlike the government website administrator, I had accountability – to the bank that held my mortgage, to my dry cleaner, to my dogs to provide food for them and to myself.  In the second of these efforts I made a terrible mistake.

I hired a programmer who talked a great game and delivered virtually nothing.  After looking at what he had developed after three weeks (the whole project was only supposed to require six), I realized that I had spent five thousand dollars on a retainer on which I would see no return.  (The fact that he accepted the retainer and immediately took off for ten days in Tahiti – where he could “think about the project” was my first clue).  So I fired him and replaced him with someone who was able to accomplish the task.

You would think that if a person were in charge of a major project such as the Obamacare website rollout, that individual would be getting very little sleep and spend all her time checking to make sure that the project was on schedule and was working properly.  Apparently, that is not the tack that HHS Secretary Sebelius employed.  There is no other reason to believe that it has been such a dismal failure.  And that despite the fact that hundreds of millions of dollars have been spent.

What should be disturbing to anyone who is being pressed into the Obamacare system is that developing a website is by far the most simple of the tasks that government will be expected to perform regarding the nation’s healthcare system.  If this is such a disaster, what are we to expect down the road when we might actually need to use the much touted “superior health insurance” for which they want us to sign on the dotted line?

One of the issues that I think was missed in the website development but which is borne out by the initial low enrollment numbers, notwithstanding the federal website’s problems, is the fact that “selling insurance” is not the same as “selling a tangible product.”

If you go to Amazon you can look at that beautiful four piece toaster or the warm and snuggly down comforter.  These are items that you can touch, feel and envision in your home.  Insurance, whether it is for your house, auto, health or life are intangibles – and they are products, while they have a potential value, are ones that you hope never to use.

Most consumers view paying for any kind of insurance as a monetary outlay and paying the premiums does not provide the psychic reward that purchasing a tangible product offers.  They view this as an expense rather than a benefit.  Therefore, this is a hard sell – and one that is best effected with the interaction of another person.

A website, even the best designed one, does not provide that personal dialogue and discussion.  And when you have a website that simply does not function in a user-friendly manner, that provides a discouragement that the already unwilling potential buyer might find to be the final reason not to bother with it.

With only slightly more than 100,000 people “enrolled” in Obamacare during the first month of operation, the administration is only twenty per cent to the goal they have set for the law to work.  By “enrolled” we do not know how many of those people are purchasers – and how many are merely browsers who are considering making a purchase.  And it is significant that three quarters of the people who have so enrolled came through websites that the states, rather than the Federal government constructed.  So apparently, building a working website is not  all that tough as 36 states have accomplished it.

But imperative in Obamacare’s succeeding is the demographics of who is actually signing up for health insurance.  It is imperative if this law is to work that 2.4 Million people who are 18-34 years old participate because they will be overcharged for the insurance that they receive in order to make up for the deficits that older and sicker people will drain from the insurance companies.  We have no word as to the makeup of those enrollees although that is promised for next month.

As I write this I am listening to President Obama give a press conference in which he is offering a “fix” for those whose health insurance contracts have been cancelled by their carriers.  His solution is to “allow” those insurance companies who cancelled their contracts which did not comply with Obamacare’s mandated coverage to extend those through 2014.  There is only one problem with this solution – as well intended as it might be.

The states regulate insurance companies who offer product within their boundaries and the Federal government does not have the power nor the authority to issue this “fix.”  And therein lies the fundamental flawed premise which underpins Obamacare and every other over-reaching intrusion that those of “the Federal government can do it best and should do it” mindset subscribe.

Not surprisingly, even if we accept the statement that 100,000 have actually enrolled and will confirm that with premium payments to Obamacare in the first month, almost four times as many people have signed up for Medicaid – which is free to them and will result in increasing medical costs paid by all American taxpayers.  The explosion in Medicaid in and of itself will certainly sabotage the financial assumptions that President Obama made and touted that this law would actually provide savings to our skyrocketing healthcare costs.

But if the President wants to attract those 18-34 year olds who under the most rosy scenario have to enroll in order for this scheme to work, I would like to offer a suggestion that may attract them.  Simply offer them a new free iPhone every time one is released.  Giving away “free stuff” is something that this administration does very well.


Perhaps one of the most famous quotes in history, “Let them eat cake,” has been attributed to Marie Antoinette.  Purportedly that was her response when told that the peasants had no bread to eat.  Although there is debate over who actually uttered this and the suspicion is that it was not the Queen of France, we now know the author with certainty, President Obama.

When he spoke in Boston the other day to his groveling throng of admirers and referred to the millions whose health insurance policies have been cancelled, he arrogantly offered advice to them.  “Let them go to the website and go shoppin’ – that’s what’s it’s there for.”  The arrogance of that statement and the way that it was delivered speaks volumes about Obama’s attitude towards the American people.

The premise on which “universal healthcare” via Obamacare was sold is that it was a matter of social justice that everyone have access to health insurance.  That is not an unreasonable goal – although I would again remind my readers that having comprehensive health insurance and having excellent healthcare are two separate and distinct issues.  And from the onset, non-partisan estimates suggested that there would still be thirty million who would remain uninsured even if Obamacare were fully implemented.

But if we accept the purported lofty ideals with which the bill was sold, it is incumbent that we ask ourselves, why then does the administration appear so unfeeling toward those who, because of the way HHS wrote the regulations, are being prevented from keeping the insurance that they freely chose and liked?

In many reported cases, these were not the “shoddy” policies which the omniscient in Washington deemed unworthy.  In many cases there are people who are losing decades long relationships with their physicians and their insurers.  And all of those are now faced with having to replace health insurance through a website that simply doesn’t work – and usually at greater cost than what they already had.

If we listen to Obama, he preaches a gospel of compassion, but he delivers the reality of indifference while working to the ultimate goal which is control – total and complete control of every aspect of every American’s life.  Obamacare is nothing more or less than a tool to bring about the total enslavement of a nation – no longer under God but under the heel of those who consider themselves the anointed ones.

What is worse, this President is so filled with hubris that today he re-wrote history – his own history.  He no longer claims that he committed to Americans’ being able to keep their old insurance policies if they were in place before Obamacare was passed.  The new line is that he promised that “if” no changes were made to those plans.  Thanks to the wonderful world of video tape we know that is an outright untruth (my polite way for saying that was a bald-faced lie).

Perhaps the President is as oblivious to his former remarks as he is to his promise to bring those who were responsible for the Benghazi massacre to justice.  Perhaps he was unaware that someone in his administration purposely barricaded the WW II Memorial to make the opposition party look bad during the partial government shutdown.

Perhaps, returning to the original thought that prompted this post, if the President wants to attempt to leave behind him a reputation as other than the worst president we have ever elected, he should call down to the White House kitchen and ask for a double helping of humble pie.  That would be a just dessert.


Perhaps too many of us have fallen prey to the syndrome of not being able to see the forest for the trees when it comes to Obamacare.  I believe that I am guilty of that.

Sure, Republicans are hoping that this grand scheme falls on its face because they envision billion dollar increases in taxpayers’ expense to fund subsidies and millions of new patients enrolling in Medicaid costing even more billions; if successful in meeting its enrollment goals, they expect that there will be rationing of services; they wonder who will treat  the American public as more and more medical practitioners voluntarily choose not to accept the new order; and, most frightening, how will this be administered by a regime that cannot develop a website.

The Democrats on the other hand, are praying to any god who will listen that the website will be repaired and that zillions of the uninsured will enroll; that the President didn’t really say what millions heard on dozens of occasions – obviously the result of a mass delusion; that the cause of cancer will ultimately be proven to be the fault of George W. Bush; and that right thinking people don’t really have to get sick if only they sing Kumbaya loudly enough.

Well, if I say so myself, I have come up with a way to solve all these problems.  If Obama could get a Nobel Peace prize, I expect to be awarded with something at least ten times grander.  And the answer is RoboDoc.

Think about all the advantages of having an Artificial Intelligence robot taking care of your medical needs.  I am going to offer a list which I believe sets forth some of the primary benefits but is anything but all-inclusive.

First, RoboDoc will never misdiagnose your condition.  He/She/It will always have the most current medical knowledge automatically downloaded to His/Her/Its  processor.  No longer will a patient have to worry about getting the wrong prescription for a particular illness.

Second, RoboDoc will be available 24/7.  Those of us who remember house calls will certainly look back with fondness at having RoboDoc available whenever we need Him/Her/It.

Third, there will no longer be a need to get an appointment with RoboDoc just so that you can get a referral for another appointment with a specialist.  RoboDoc will be able to do it all, from Internal Medicine to Surgery to Psychiatry.

Fourth, with so many medical practitioners in this country whose origin and accents are foreign, we will no longer mistake the doctor’s telling us “You’re going to die,” with “Have a nice day.”

Fifth, since RoboDoc will always know the right thing to do and do it according to the most recent protocols, there will be no left over sponges or scalpels left in patients who require surgery, nor will anyone who is in to have a mole removed have his right hip replaced.

Sixth, since RoboDoc will always do His/Her/Its job absolutely perfectly, there will be no further need for medical malpractice insurance or plaintiffs’ lawyers – thus saving the taxpayers countless billions.

Seventh, once assembled, RoboDoc will be fully operational.  This will eliminate countless wasted years in medical school and interning in hospitals, not to mention those nasty expensive student loans that hang so cumbersomely around the necks of those who are studying to become doctors.

Eighth, the savings to the healthcare system from not needing to pay the RoboDocs will more than cover the cost of developing this AI miracle of modern medicine.  The only cost associated after the initial outlay will be finding an appropriate green energy power source to recharge His/Her/Its batteries.

Well, as I said, I could go on and on extolling the virtues of RoboDoc.  No doubt you have some excellent ideas of your own.  There are only a few minor drawbacks which come to mind.

The corps of RoboDocs will have thousands of patient records in memory and might be the target for cyber-terrorists who seek to profit from this information.  So we build in a self-destruct protocol should any unauthorized person attempt to access it.  While this will destroy the RoboDoc unit, it will also take out one of the terrorists, thus saving us time and money by avoiding a lengthy trial.  And this would make patient information more secure than on a poorly designed government website.

But the one that gives me goose bumps is the thought of those cold digits, poking and probing during the course of a proctology exam.  That sends shivers up and down my spine.


A century ago, New York City had a thriving industry which centered in an area of Manhattan known as the Garment District.  This was, of course, long before we exported the manufacture of clothing to Sri Lanka and Pakistan, Mexico and the Far East Asia.

There were two men, Abe and Irving who had grown up together in Brooklyn and had gone to work in the business as button salesmen.   They worked for competitors.  But Abe was the toast of his company and his reputation as a top notch salesman was well known throughout the district.  Irving struggled to meet his quotas and worked twice as hard as his childhood friend now turned competitor.  This went on for years – and poor Irving became so frustrated with his situation that one day, when he encountered Abe on the street he asked him for some advice.

“Abe, we’ve known each other since we played stick ball.  You’re a success – no one can deny that.  But I don’t understand how you can sell your A307P button for only two cents.  It has to cost your company at least five cents to make it.  So how do you do it?”

To this Abe responded, “I’ll tell you Irving it’s very simple.  What I lose on each button, I make up for in volume.”

A few years later, Abe left his button company and accepted a nice desk job in government.

Let’s look at one claim that is intended to justify the President’s mis-statement, “If you like your health care plan, you’ll be able to keep your plan.”  In this particular ploy, the defenders of the President claim that it is not Obamacare which is causing insurance companies to cancel existing policies (which they characterize as sub-standard), but this is a volitional and conscious choice made by the insurance companies themselves.  Estimates suggest that as many as 14 million people who pay for their own insurance will be affected by these cancellations.

Let’s assume that the administration is correct, that is to say that these policies are sub-standard (the term “crappy” has also been used to describe them).  Well, what makes them sub-standard?  The fact that they charge more for coverage than is actuarially required and they pay only limited amounts in the way of benefits.  Let’s set aside the fact that might actually be what the consumer realized he or she was buying and was satisfied with these limited policies.

So now let’s put ourselves in the place of the insurers.  If these policies overcharge and in fact under-deliver, that suggests that these would be highly profitable.  Why would any rational executive at an insurance company voluntarily cancel this highly profitable piece of business?  Unlike Abe who claimed to make up the loss on each button by selling more of them, these insurance companies make more money by selling more of these “sub-standard” policies.

But let’s look at the financial model which those who support Obamacare realize must be achieved in order for the law to work economically.  One of the goals is to allow those who have serious health issues (pre-existing conditions) to have access to coverage.  These people will pay less in premium than the amount of benefits they will receive from their insurance.  In order to “make up” this deficit, the system is designed to overcharge younger, healthier people who will pay more for insurance than the benefits they are likely to receive.  Some might describe this as a “crappy deal” for the young.

It seems likely that those who have serious health issues will be eager to sign up for Obamacare.  As for the young who overwhelmingly supported the president in his two election campaigns, it remains to be seen how many will choose to participate.  Perhaps it will depend on how hard and successfully the administration can push their buttons.

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