Tuesday, November 16, 2010

Doctoring the Books

On December 1st of this year, government payments to doctors performing Medicare services are scheduled to be cut by 23%...and predictably, neither doctors nor patients are happy about it.

Many doctors are saying they can no longer afford to take new Medicare patients (just when baby boomers are reaching Medicare age)...and other doctors are dropping Medicare patients entirely.

The cost-savings provided by slashing payments to doctors are, in part, what was supposed to make Obamacare into a "money saver" that would "bend the cost curve downward," back when the Democrats were still making those claims.

Of course, the other factor that was supposed to bring down costs was to make sure that everyone was required by law to participate in the new healthcare plans. In the words of Barack Obama, no one could opt out because "we're not going to have other people carrying your burdens for you" which would raise costs for everyone else.

But that's exactly what's happening, now that the Obama administration has quietly (very quietly) issued waivers to 111 companies and unions to allow them to dodge the Obamacare bullet, which will affect the prices that everyone not in political favor will have to pay.

Of course, to issue all of those waivers in such a short time, the government obviously has the power to act quickly when it needs to. Meaning if nothing happens by December 1st, we can assume that potential destruction of the Medicare system is exactly what Obama administration wants.



Angry Hoosier Dad said...

My mother turns 85 this week and has a laundry list of serious ailments associated with age and a lifetime of smoking, etc. She needs Medicare coverage and we can only hope she will continue to receive it. She is also one of those easily-duped Americans who voted for Obama because, in her words, "he seems like a wonderful person". Jug-ears would probably call her a typical white woman....you know, guilty of being white. I want her to stick around as long as God will let her, but I don't want her to suffer the indignity of some death panel telling her to go home and wait for the reaper cause she's not productive or useful enough anymore to warrant medical care. Even as her surviving children step up to help, it has to be bitter to know that this is what your value as a human being is reduced to: A lifetime of giving, sacrificing and caring rendered meaningless by the tin gods of What-have-you-done-for-me-lately. To our everlasting shame we did this to ourselves. With God's help or the blood of tyrants we will undo it.

Anonymous said...

You ignorant, self-righteous prick!

Did you even read the article you posted in connection to this strip?

"The cuts have nothing to do with President Barack Obama's health care overhaul. They're the consequence of a 1990s budget-balancing law whose requirements Congress has routinely postponed."

It's disgusting that you would take a situation that has the potential to hurt so many people and twist it to serve your own political opinions. It has nothing to do with Obama's healthcare plan. It has to do with political mismanagement from every person in the legislature that has passed the buck, and from what I can recall, the "Party of No" has been the primary group running that circus in Washington. So, if you're looking for someone to blame, why don't you take some time and write a strongly written letter to the people you just elected.

Philip said...

Shock Poll : Only 26% Of Public Thinks Obama Will Be Reelected...

CNN Poll: 70% Say Republican Mid-Term Victories Were a Rejection of Democratic Policies

Stilton Jarlsberg said...

Anonymous (immediately above)- Not only did I read the article connected to this strip but (surprise!) I've read a lot of other articles as well.

When the article cited here says "The cuts have nothing to do with President Barack Obama's health care overhaul," they're being technically accurate...but deliberately misleading. The cuts have nothing to do with Obamacare, but the actual payment to doctors (or reduction in payment), has everything to do with Obamacare.

Yes, the cuts in Medicare payments for doctors have been a bad joke perpetuated by both parties for a long time (there's no particular love for the GOP here); every year they say they'll make the cuts, and then every year - facing the consequences - they don't. This game has become known as the "Doc Fix."

But indeed, there is a wrinkle that ties the current situation to Obamacare. As I noted above, the president and Democrats, wanting to make Obamacare have the illusion of fiscal solvency, made a point of breaking the "Doc Fix" out of the necessary funding for Medicare, proposing instead that the money would appear by magic. So on the one hand, Obamacare's books balance...but the payment for doctors went onto another set of books which had no funding whatsoever.

It was a trick which only needed to work long enough to ram Obamacare up the American peoples' collective rectum...giving Obama a CYA position as he made speeches about the tremendous "cost savings" his medical power-grab would provide.

But on December 1st, the bills actually need to get paid... or the doctors are walking away from Medicare. If the existing payment rates are maintained, then all of the fictitious "savings" claims associated with Obamacare go out the window.

Which I assume that regular readers of this blog would have figured out based on today's commentary, and their own recollections of the tortured lies told by Obama and the Dems over the past year.

But we don't mind taking the time to walk you through this step-by-step. And we're glad to see that you realize that the Democrats' actions have "the potential to hurt so many people."

By the way, since you're obviously either new to this site, or new to the whole concept of "reading and understanding the news," we invite you to look up our blog entry from June 23 of this year (in the blog archive on the left side of this page)...in which we said, very clearly, that this was going to happen. And why.

John the Econ said...

My Dr. stopped taking Medicare years ago. I do love my Dr., and wonder what I'll have to do when I get to be 65. Hopefully I'll be invited to "Galt's Gulch by then.

As I've said soooo many times before, it's all part of the grand Progressive plan to take down what is left of the private system to the degree that the desperate masses will eventually cry "uncle!" and submit to the grand takeover and a "single payer" solution. Once they have absolute control over our health care, they'll have absolute control over us.

Stilton Jarlsberg said...

John the Econ- You've summarized this very nicely. As we've said before, Obamacare has never been about either medicine or economics. It's about control.

Pete(Detroit) said...

John - exactly.
they will have the ability to tell you where to go, what/not to eat / drink, make sure that you exercise enough, get your shots whether you want them or not... good by tobacco, alcohol, firearms, motorcycles, skydiving, scuba, surfing.
So long FUN!!!
We won't REALLY live forever, it will just seem like it.

Anonymous said...


So, I'm still not clear. What is it exactly you want to be done with the Doc Fix? As is so often the case with your strip, your criticisms are loud and clear, but lack any substantial recommendations for a solution.

Also, why is it that you refer to yourself in plural? I mean, don't get me wrong, I love it when someone speaks loudly about their opinions and humbly refers to themselves in the royal "we", it totally gets their point across with the perfect amount of wit and approachability, but I was just curious.

And to think, this is the first time since I began reading your site nearly a year ago that I thought to even look at the comments section, let alone post. *Facepalm*

Pete(Detroit) said...

Can't speak for anyone else, but honest accounting would be a good start.
"Paying for it" with further tax cuts on "the rich" (tax cuts generate revenue, you know, right?) might not be a bad idea.
A case could be made for 'doc in a box' clinics for the indigent who need routine care.
Finding out what's WRONG w/ people as opposed to putting them on 46 scrips, many of which only counter the side effects of others.
Let people save in a medical 401 so they can pay their own frikkin' bills...
Lotsa options.

Stilton Jarlsberg said...

Anonymous (two above)- I'm assuming you must not be the same anonymous who posted earlier, since I'm not being described as an ignorant, self-righteous prick (grin).

Regarding criticisms and recommendations, the main (but not exclusive) thrust of this site is to point out the many hypocrisies and failings of this so called "Hope and Change" administration, and reflect on what its doing to our country and our culture.

But even accurately-targeted bitching is pointless unless there's something different that could've been done. Otherwise it's just noise.

So what do I want done with the "Doc Fix?" For starters, I want all the lying to stop. If doctors' fees are really, finally going to be slashed by 23%, then politicians shouldn't pretend this will have no impact on Medicare patients.

Alternately, if the politicians know that they're going to cough up the dough (as has been the case every year since the "cuts" were introduced), then they need to truthfully include those costs in the Medicare budget instead of simply erasing them and attributing them to an unfunded mandate.

All of that would at least get us to the point where we're talking about real numbers, real services, and real patient care.

The step after that, of course, is then to examine whether those "real numbers" can be paid without bankrupting the country and, if not, making real cuts in services. Which would be vastly unpopular, but "reality" must always trump "popularity."

On a different topic, I (yes, I!) frequently will use the royal "we" when writing here because "Hope n' Change" is intended to be a broader concept than just one person; it's intended to be a mindset and an attitude, and forever putting it in the first person diminishes that.

That being said, in the comments section (and I'm delighted you finally discovered it!), things are less formal and I'm just as likely to just be my own humble self. Well, reasonably humble. (grin)

Stilton Jarlsberg said...

Pete (Detroit)- Great post, and both broader and more succinct than mine (which got posted at the same time).

There are actually plenty of ways to enact genuine healthcare reform. Because Obamacare addresses no reforms whatsoever.

Anonymous said...


How are tax cuts on "the rich" going to generate the kind of revenue that needed to pay for the gap in funding for medicare? Are we talking income taxes? Well that would mean that "the rich" would have more spending money, and then that would be taxed for medicare? Problem is, medicare funding comes from income tax. If we want to get rid of that, do we need to establish a portion of sales tax as the medicare tax?

What would be the point of trading one tax for another?

Anonymous said...

Don't worry. Once we see what's in it, we'll like it. Pelosi hasn't steered us wrong before, right?

Anonymous said...

as 1 anonymous to another (yes, I intend to get my name on here proper as soon as I figure out how), the tax breaks to the "rich" work like this. since the "rich" are more likely to own a business (I mean, really, when has a poor guy given anybody a paycheck), by giving them a tax break, they are more likely to expand their business. an expanded business is able to hire more people AND is more likely to pay more in taxes. ya see, with low enough tax rates, people & business are less likely to conceal their income. thus making it MORE likely that they will pay taxes. the Dems say it won't work, but it HAS worked every time it has been tried.

Stilton Jarlsberg said...

Anonymous (immediately above)- Wow, we need to start passing out Hope n' Change official name tags around here!

Aside from that, you're exactly right. Lowering taxes on those who hire others helps energize the economy, as well as keeping up the incentive for achievement. It's "growing the pie."

And as you say, it's worked every time - but when Obama was confronted with that information, he said he'd still rather raise taxes to be "more fair" even though it would decrease revenues for the social programs he claims to cherish.

Obama cares more about punishing the successful then helping the needy. Which ensures that everyone will be needlessly punished.

moronpolitics said...

Well, John the Econ, I didn't get my second major in Eco like I wanted due to the "business" I started at SMU being extremely illegal at the time. Now... scatter shooting whilst wondering what ever happened to Paul Grudzien... I read enough Econ along the way to know that even Mr Laffer knows that his curve is just that... a curve. It's Laffer, btw, not knee-slapping Guffaw. The point of his work was that SOMETIMES.... SOMETIMES....a decreased rate can cause increased revenue. Never wrote my book "The Ice Cream Diet" either because I was writing it long before I heard of our buddy Artie. People have changed it into something so silly that it is -- to quote one of string theory's funerary attendees -- "not even wrong". That's how you get paperback economists like Rush demanding broad lowering of his property tax rates because "We need the money that a lower rate will generate."

Lowering very high rates on capital gains can cause really great revenue increases for a year or two. Trying it again and again can be like taking LSD a 2nd, 3rd and 4th day in a row. I promise. They both stop working. Try explaining exactly HOW that lowered tax rate on private homes was going to work.

If YOU wanna drop me an Email, SJ, I would love a chance to elucidate without clogging your blogging.

Anonymous said...

Stilton, (and everyone else who saw it) it's the Editorial "we", not the Royal "we" here in American Blogsville. Right?

And apparently, Baracky Fife doesn't seem to realize that what he's doing with Obamacare is going to cause a huge number of doctors to just quit practicing medicine. Or perhaps he doesn't care. Or that's the plan... It's also interesting to note that some liberals are now using Sarah Palin's term "Death Panels", too. Which they swore weren't going to exist, right?


Stilton Jarlsberg said...

JustaJeepGuy- Waitaminnit, if I have to use the editorial "we" instead of the royal "we," does that mean I need to stop wearing my crown?

Anonymous said...

When you get together with the other royalty, you can wear the crown. At least, according to the Crown Protocol manual I found in the costume shop.