More of the Same

Please, sir, I want some more.

Charles Dickens (1812-1870),  Oliver Twist

Americans always want more.

Anonymous foreign observer

November 7, 2012 -  As a member of the loyal opposition,  the election results disappoint me.  But in America, the majority rules.  My congratulations to the winner, and my condolences to the loser.

Now Americans will have:

1.    More national debt, estimated to rise to $20 trillion in Obama’s second term 

2.      More taxes on personal income, capital gains,  dividends, and estates, which translates to more taxes on “the rich,” those making over $250,000, a disproportionate number of whom are small businessmen. 

 

3. More political gridlock with a Democrat President and Senate, a Republican House and 32 State Governorships

 

4.  More economic stagnation and a still possible financial cliff

5. More taxes secondary to Obamacare, estimated at $500 billion

6.   More  health care for 30 million more Medicaid recipients

7. More government subsidized health care for families with incomes less than 4 times poverty

8.    More money devoted to health care,  $2.6 trillion over the next ten years according to the Congressional Budget Office

9.   More closures of hospitals and physicians leaving or not entering the profession,  with physician shortages and lack of access to care, particularly for seniors

10.  A more robust fast-growing  underground and under- the -radar health economy, with more retail clinics, cash-only practices and concierge practices

According to Christopher DeMuth, a distinguished fellow at the Hudson Institute, the choice of Barack Obama in health care matters “is singular not only for its importance but for its certainty’

“If President Obama is re-elected, ObamaCare’s controls over doctors, hospitals, pharmaceutical firms and providers of medical care will be tightened, and the operations of private insurance companies will be progressively restricted.  Everyone involved will know where  the process  is going – to a single-payer system or one with a few chosen insurers subject to national public-utility controls – and negotiated the best possible accommodations to it.  Within a few years, a new political  equilibrium will be in place, making the system irreversible and subject to only marginal adjustment.(“A Referendum on ObamaCare and Liberty"WSJ, November 5, 2012).”

The few chosen insurers will be Medicare, Medicaid,  and possibly UnitedHealth, which supplies most of the Medicare supplements for AARP.   The tightening of controls will come through data-driven restrictions, monitored through electronic health records,  enforced through protocols and algorithms, and backed by lowering or raising of fees to  favored  providers and cuts for those not in favor who fit the Adminstration’s agenda of how things ought to be.

Fee adjustments, is already underway.  CMS has just issued a final  1362 page report covering 57 specialties announcing what specialists and providers will be raised and who will be cut starting in January 2013.

Medicare pay will be raised  for:

·         Family physicians,  +7%

·         Geriatricians,  +5%

·         Nurse practitioners, + 4%

·         General internists,  +4% 

·         Physician assistants,  +3%

·         Pediatricians, +3%

·         Allergists/immunologists,  +3%

Medicare pay will be cut for:

·         Radiation therapists,  -9%

·         Radiation oncologists, - 7%

·         Pathologists, - 6%

·         Physical medicine specialists, - 4% 

·         Radiologists,  -3%

·         Interventional radiologists, - 3%

·         Nuclear medicine specialists,  -3%

·         Ophthalmologists,  -3% 

The government, in short, will pick the winners and losers among medical specialists, deeming  what their services are worth in their  political  eyes and in  federal spread sheets of federal bureaucrats.   This process will be heavily political, as it is with picking winners and losers among green energy suppliers and fossil fuel providers.

Tweet:   With the re-election of President Obama,  we shall have more government, more taxes, and more intervention into health care.