I define “entitlementism” as a political process by which voters in a democracy, motivated by greed, need, fear, or a desire to promote the comfort and well-being of others, elect presidents, governors and legislators who favor the retention or expansion of welfare benefits and other economic entitlements mainly for the poor and the elderly. Entitlementists are people who promote entitlementism. Entitlementists generally believe that wealthy and high income individuals and the entities that they control should pay higher taxes, fees and other payments to pay for the entitlements.
The grave danger that entitlementism poses to American democracy is that voters will vote for candidates who support and maximize entitlements and that political candidates who seek to control excessive entitlement spending may become un-electable in many areas of the country. If entitlementists get control of the presidency and both houses of Congress, they may, though a combination of taxes, mandates and penalties on individuals and businesses, turn American free market capitalism into an undesirable form of socialism that may over time erode into communism.
Entitlementists adopted Obamacare to offer new types of welfare benefits, including premium subsidies to many millions of individuals with incomes up to $46,000 and families of four with incomes up to $94,000 expecting them to become entitlements. It mandates the purchase, by businesses and individuals, of over-priced insurance that many of them do not want or need, to pay for new entitlements for others.
Although President Obama and his Democrat supporters refuse to acknowledge it, healthy young people with middle class tax-paying jobs are targeted victims selected to pay for the increased healthcare costs mandated by Obamacare. They are being asked to pay excessive premiums, deductibles and co-pays to (i) finance the expanded Obamacare mandated benefits, (ii) to substantially reduce the premiums payable by people with pre-existing conditions and (iii) to limit the premium increases of the elderly. They will also have to bear the brunt of tax increases that will be required to pay for the multi-billion dollar subsidies for the poor and lower middle class and for the expansion of Medicaid coverage. President Obama and other Obamacare supporters are also concealing the fact that most of the elderly, unless they qualify for premium subsidies, are subject to increased premium rates (even though their premiums are unrealistically limited under Obamacare rules (in disregard of actuarial statistics) to no more than 3 times the premium rates of young people). Most of them do not need the mandated Obamacare benefits.
Right wing conservatives, many of whom claim to be Tea Party members, are taking a political stance that enabled Democrat entitlementists to win a number of contested Congressional elections in 2012. They assess the voting record and statements of Republican candidates and, if they fail to meet pre-determined standards, they call them RINOS (Republicans in name only) and oppose their nomination. As a result Republicans often nominate a right-wing candidate who loses an election the Republicans would in all likelihood have won. Alternately, if a moderate Republican they oppose wins the nomination, they refuse financial support or to vote for him or her and he or she often loses a close election to a Democrat entitlementist. Such actions have been instrumental in enabling Democrats to retain control of the Senate. All Republicans, even moderates, opposed the passage of Obamacare. If Republicans are going to stop the march toward entitlementism, that will gain momentum if entitlements are not brought under control, they must harness their idealism and recognize the importance of winning control of both the House and the Senate in the 2014 elections.
An economic entitlement is a financial benefit that large numbers of people believe they are entitled to receive, generally from the government. Entitlements were adopted in the US over time for various commendable purposes to improve the lives of Americans. They have evolved into a broad range of benefits to provide safety net payments. They are designed to prevent hunger, provide shelter and basic needs, including medical care. Entitlements include Social Security, Medicare, Medicaid, food stamps, housing supplements and other welfare benefits, negative income taxes, unemployment and disability insurance, flood insurance, financial relief following national disasters and now Obamacare. All of these programs are financed in large part by the US government. The costs of providing each of the entitlements are growing rapidly and are out of control. Entitlement costs are increased significantly by payments to beneficiaries and others cheating the system based on fraudulent claims under entitlement programs that now exceed hundreds of billions of dollars annually. Yet, we do almost nothing to prevent or punish the wrongdoers. Entitlementists don’t seem to care.
When adopting legislation authorizing various of the entitlement programs Congress chose different ways to determine eligibility for benefits and to fund the costs. Unfortunately our Congressmen ignored or misjudged the costs of providing certain of the entitlements and we are now facing $60 to $90 trillion of estimated unfunded entitlement liabilities that we cannot afford even if we achieve an annual two or three percent rate of growth of the GDP. We might be able to manage the unfunded entitlement problem if we grow the GDP at 7 to 10% annually for the next ten years, but because our leadership is inept, that is unlikely to be achieved. Therefore, we must find a way to scale back a significant portion of the unfunded entitlement liabilities. As a result of the Great Recession and skyrocketing entitlement payments the National Debt is approaching $17 trillion. It doesn’t seem to be currently affecting anyone. Most people seem to think that the rising National Debt will present a burden for our children and grandchildren, but few people think that our wealthy country can’t handle a National Debt of $20 trillion, $25 trillion or more. Low interest rates have masked the problem. Entitlementists like President Obama have for years been stonewalling any attempts to modify entitlements to reduce rising current entitlement costs or the unfunded liabilities in the out years. To the contrary they have magnified the entitlement problem by adopting Obamacare. In all likelihood, we will not know that the National Debt is too high until interest rates rise and we discover that we are no longer the world’s most powerful country financially or militarily. We will then be faced with a choice of reducing entitlements or other government spending, raising taxes, or printing money and enduring inflation. Moreover, if entitlementists are in control of the presidency and both houses of Congress, it may ultimately lead to confiscation of property from the wealthy.
Most of the entitlement underfunding comes from Social Security, Medicare and Medicaid obligations. Social Security is a fabulous mandated retirement program. The amount a retiree can expect to collect is calculated by taking into account the withholding tax payments made into the system over a life-time. Social Security payments are the principal source of income for a large percentage of elderly Americans. Most people over age 65 in reasonably good health, who are entitled to Social Security and Medicare, can be financially self-reliant.
Although Social Security benefits vary based on the amount of one’s contributions, benefit levels offer a favorable return to our senior citizens. Years ago we recognized the under-funding of Social Security resulting from increased life expectancy and raised the age of eligibility to begin receiving benefits. We have known throughout the Obama presidency that we should again raise the age for commencement of Social Security benefits or change the manner in which inflation adjustments are calculated. Yet, despite the soaring National Debt, because entitlementists are in control of the presidency and the Senate, no action has been taken to make Social Security payments more affordable. Social Security cash flow needs present an additional problem as the number of workers contributing into the system per retiree declines. No trust fund was set aside out of the funds withheld from employee salaries to pay retiree benefits. Our government became obligated for future benefits, but spent the withholding taxes it received.
The other entitlements consist mostly of welfare payments. By design low-income individuals pay little or nothing for their entitlement benefits other than Social Security. Half of our population pays no income tax. They pay sales taxes and withholding taxes (often offset by negative income taxes) in amounts that are insignificant when compared to the benefits they receive. Democrat entitlementists have learned that they can buy votes by expanding entitlements.
Medicare was designed to ensure that healthcare would be available for the elderly. We have Medicare withholding taxes, annual premium payments and co-pays that can be covered in large part by the purchase of supplemental insurance, but the Medicare benefits dwarf the amounts collected. Low income people pay little into the system, yet they are eligible for full benefits. We have known for years that Medicare was an ill-conceived program which our government will not be able to afford as our population ages. Entitlementists rave about the success of Medicare but ignore its funding problem. The elderly and their children, who are relieved of a potential burden, love the benefits. It would be politically suicidal to try to reduce any Medicare benefits currently payable for the elderly. They vote in large numbers and feel entitled to Medicare benefits regardless of the cost. We have known for years that we must raise the age of eligibility for future Medicare beneficiaries (as we did for Social Security) and take other steps to control Medicare costs. President Obama knows this, but, except to state, every once in a while, that he knows we must deal with controlling future entitlements and that he will consider the way in which inflationary increases are calculated, he has not made any meaningful proposal to deal with the problem. The problem becomes greater with each passing year. Congressmen who propose ways to control Medicare payments in the out years are taking a political risk. Anyone who even brings up the subject of reducing entitlement benefits is immediately bashed by the liberal press and entitlementists seeking to gain political advantage.
Various individuals have proposed alternatives to the current form of Medicare. One way to reign in future Medicare liabilities is to modify the system for people currently under a designated age, such as 55, to a voucher system with co-pays and annual or lifetime limits. Each person would be entitled to an amount available to be spent during the remainder of their lifetime after becoming eligible for Medicare. By introducing aggregate spending limits (with higher limits for designated catastrophic injuries and illnesses) we can get the beneficiaries involved in controlling costs. We can even provide a death benefit for unused life-time benefits. Unfortunately, some people might spend their allocated benefits and be unable to afford all of their additional healthcare needs for various reasons. They might include their own negligence, and might be forced into bankruptcy. Our government will have to offer supplemental healthcare coverage, like Medicaid, and welfare assistance for such individuals. As we are learning from the harm being caused by Obamacare, that alternative is preferential to the destruction of the healthcare system and the middle class and the slowing of economic growth.
The SNAP (food-stamps) welfare program evolved to provide food for the poor in a dignified and efficient manner (though subject to abuse) through the use of a debit card. Welfare has been expanded to include housing and transportation subsidies, Medicaid, cell phones, baby sitters, home care and negative income taxes. A growing number of individuals, single mothers (often teenagers and sometimes with the unidentified father of their children moving in and out of the home to avoid the mother losing her welfare eligibility) and two parent families are relying on food stamps and other welfare benefits as their primary source of income. Some of them live comfortably by working part-time at low-paying jobs (which entitle them to negative income taxes) or off the books to supplement their welfare payments. Encouraged to apply for welfare benefits by navigators under programs initiated by entitlementists, more than 45 million people are now receiving food stamps. Most of them of working age are not attempting to further their education or job skills or looking for a job that would improve their standard of living and reduce or eliminate their welfare benefits. Instead they concentrate their efforts on maximizing welfare benefits. They lack the motivation and drive that has made American capitalism revered throughout the world. The increase in the number of welfare recipients has been fueled by an executive order issued by President Obama in violation of the 1996 welfare law, that makes it easier to satisfy the work requirement and gives states the authority to ignore such requirement.
Flood insurance is sold by the US Government at a fraction of its market cost. When flood insurance payments are added to disaster relief it encourages beneficiaries to rebuild in flood zones leading to large government payments when the next flood occurs in the same area.
It is becoming clear that Obamacare was rushed through Congress by President Obama and entitlementist Democrat Congressmen not only to give government control of all aspects of healthcare from birth to grave, but also to create a number of new entitlements for millions of individuals.
Many of the benefits of Obamacare became effective immediately, while most of the funding provisions were delayed for years until January 1, 2014. This was done so that President Obama could claim credit during the 2012 election campaign for all the benefits of Obamacare while concealing the disastrous aspects of Obamacare from the voters. The public heard repeatedly that 30 million people without insurance were going to be covered, pre-existing conditions were being eliminated from consideration, children under age 26 could remain on their parents coverage and a variety of benefits would be required to be covered, including preventive care, birth control, abortion and other women’s healthcare services.
Until recently, few people understood the funding or other provisions and regulations of Obamacare (many of which had not been written) or the secondary effects they would have on jobs, the healthcare industry or previously existing insurance policies. Since the adverse consequences of Obamacare were relatively unknown President Obama was able during the 2012 re-election campaign to time and again repeat a list of deliberately untrue promises (the now infamous President Obama lies), namely, (i) insurance premiums would decline for everyone, (ii) if you liked your insurance you could keep it and (iii) if you liked your doctor or hospital you could keep them. President Obama and the Democrat entitlementists didn’t tell anyone that the Obamacare insurance policies would provide for increased premiums in most states and large deductibles and co-pays which might make the insurance worthless. Nor did they tell voters they might lose their coverage, their doctor or their full-time job. They didn’t tell college students that Obamacare might harm the economy and prevent them from finding a job. They wanted President Obama and other Democrats to be elected and anticipated that the liberal press, most of whom are entitlementists, would let them outrageously stonewall the lies when they were exposed.
The 2012 election debates over Obamacare focused on birth control, abortion and other women’s rights issues that proved harmful to the Romney campaign and would have been of lesser importance had voters known the truth about how Obamacare would affect their jobs, the loss of their existing insurance coverage, their increased premium costs and the large deductibles and co-pays that were being imposed to enable insurance companies to provide expanded Obamacare mandated benefits and to offer health insurance policies at below free market rates for the sick, the disabled and the elderly. Postponing the harm of the employer mandate until 2015 was clearly intended to and may have a similar effect of deceiving the voters in the 2014 elections except to the extent that voters learn that many employers are taking steps to protect themselves against Obamacare mandates in advance of its effectiveness. To attempt to keep control of the Senate in the 2014 elections, President Obama will do everything possible to focus on women’s rights issues and criticize the stance of the Tea Party on such issues to divert attention from the harm to the middle class being caused by Obamacare.
Few people understand the enormous amount by which eliminating pre-existing conditions will increase insurance premiums. The healthcare costs of people born with special needs, or who become ill or injured may be 10 or 20 or more times more costly than those of a person in good health. Prior to the adoption of Obamacare, individual insurance policies generally had a one year term. Coverage for catastrophic injuries and illness were covered during the term. However, insurance companies would renew the policies of people who became ill or injured during the term only at greatly increased rates. People with pre-existing conditions were generally unable to purchase health insurance at affordable rates. They became cost conscious and limited their demands for treatments and procedures or spent their personal funds. Now, individuals and families burdened with the costs of pre-existing conditions will, if they haven’t already done so, purchase Obamacare qualified policies as soon as HHS gets its Obamacare website to function. We can expect them to make substantially increased demands for healthcare services. Some are rich and getting an undeserved windfall being paid for by the increases in the premiums, deductibles and co-pays of Obamacare mandated policies. Some of them who had lost their job and their coverage have sympathetic arguments for assistance and we should have found ways to help them independently of the adoption of Obamacare using high risk pools that were available in some states.
Healthcare needs for people of all ages are in large part based on discretionary decisions made by a patient and his or her doctor. Elective treatments or procedures can be delayed or avoided. Some people are willing to endure physical difficulties or high thresholds of pain rather than face the risk or cost of surgery. The high deductibles and co-pays under Obamacare will encourage more people to avoid elective procedures.
Unlike Medicare and Medicaid, under Obamacare, federal and state governments are not paying for all of the benefits. The entitlementists, who designed it, believe that they have found a way for insurance companies to (i) provide healthcare benefits mandated by Obamacare, (ii) cover the enormous costs of disregarding pre-existing conditions when determining premiums and (iii) limiting insurance premium increases for the elderly, by overcharging businesses and healthy young and middle-class workers.
In addition, the US government is subsidizing premium costs for low-income people and some small businesses, and expanding free Medicaid coverage for the poor. Almost all part-time workers will receive substantial premium subsidies. As a result, millions of voters will benefit from the new entitlements moving our country closer to entitlementism. Despite the myriad of new taxes imposed by Obamacare, if not modified or repealed the Obamacare premium subsidies will add hundreds of billions each year to federal spending that will have to be paid for by tax increases (to be paid in large part by the same middle class workers who are being overcharged for their health insurance) or by increasing the National Debt. President Obama and the Democratic entitlementists apparently believe that the Obamacare subsidies will gain Democrats more votes than they lose.
Most of the low-income people who purchase highly subsidized insurance policies on the Obamacare exchanges will still be faced with substantial deductibles and co-pays. As a result they receive will have little or no value to them. They will continue to satisfy a significant portion of their families’ medical care needs at hospital emergency rooms. Existing laws provide that they must be treated even if they do not pay the amount due. In all likelihood doctors, hospitals and other providers will be unable to collect a substantial portion of the deductibles and co-pays from such people. Hospitals, facing revenue shortages, will whenever possible increase the rates they charge for patients not covered by Obamacare, Medicare or Medicaid. The insurance companies will pay and, in turn, raise their premium rates on policies not being offered on an exchange. In the event that a patient shows up at a hospital or other healthcare provider without any insurance coverage, the healthcare provider may, if permitted by law, offer to pay the patient’s Obamacare insurance premium in excess of the subsidy, in an attempt to limit is losses to the amount of such premium payments plus the uncollectible deductibles and co-pays.
Over time, an increasing number of doctors, hospitals and other healthcare providers are likely to refuse to treat Obamacare, Medicare and Medicaid patients unless they receive adequate fees from the Obamacare exchange insurers or the US Government. Unless we adequately compensate healthcare providers we can expect the quality and availability of healthcare to decline.
President Obama has made it clear that despite its faults he will veto any attempt to repeal Obamacare. He will continue to use his executive powers to grant exemptions principally for groups that favor Democrats. It is difficult to predict what other steps President Obama may take to try to prevent Obamacare from failing regardless of the cost to the middle class or the US government. Since deductibles and co-pays are already causing serious problems for both insurance policy purchasers and healthcare providers, we can expect that President Obama will propose further additional government subsidies, regardless of cost, to cover the deductibles and co-pays payable by the poor and lower-income people. If Republicans refuse to approve his proposed changes because of costs, he will brand them as unfair obstructionists.
One of the favorable features of Obamacare is that it will create significant healthcare cost savings by creating clinics and expanding nursing care, but that could have been accomplished independently of Obamacare. Hospitals should be given the choice of treating patients unable or unwilling to pay either at emergency rooms or at clinics created at or near the hospital.
Employer provided health insurance has been a major source of funding for employee healthcare and has represented a significant portion of employee compensation for years. Many businesses have been offsetting healthcare cost increases by increasing deductibles and co-pays and reducing middle-class cash compensation. Some are reacting to Obamacare by reducing full-time head count and hiring part-time employees to limit healthcare costs. Some businesses have delayed expansion plans. Other businesses are going to use Obamacare mandated requirements as an excuse to cease providing healthcare benefits to employees in order to reduce costs. Instead many of them will pay the applicable penalty and offer a taxable salary increase and advise employees how to purchase insurance on Obamacare exchanges. Many of the employees will be unable to purchase an exchange offered policy with the after-tax dollars received or will decline to purchase insurance when they realize that it is of little value because of the high premiums (even if reduced by a subsidy), deductibles and co-pays. They will pay the penalty and take the risk of living without insurance. If they later need catastrophic coverage they will acquire it during the following eligibility period. The result will be that the poor and those with pre-existing conditions will have insurance or Medicaid and millions of people who had jobs and insurance coverage will lose their job or their coverage. We are learning that Obamacare is not promoting the common good as claimed by the entitlementists. Instead it is destroying the American way of life. We can nevertheless expect that President Obama and the Democrats will ignore the detrimental affects of the dropped employer coverage and claim credit for pre-tax amount of the cash compensation increases. They will also claim that Obamacare enrollment is improving as anticipated by including individuals who lose their employer coverage and purchase insurance on the exchanges. A portion of the cost of providing health insurance for low-income workers will pass from the employer to the US Government which will subsidize the premiums for such workers’ policies purchased on the Obamacare exchanges.
Congress should take immediate steps to modify Obamacare to encourage employers to continue to provide health insurance for their employees. This might entail elimination of the employer mandate or limiting the required benefits to be offered under employer plans. President Obama may, in an attempt to help Democrat candidates in the 2014 elections, again postpone the employer mandate by fiat, even if he does not have authority to do so.
Giving free Medicaid or health insurance with greatly expanded mandated coverage to 30 million additional people and eliminating pre-existing conditions had to substantially increase the cost of healthcare insurance for everyone except for those who were going to receive underpriced or highly subsidized policies. The designers of Obamacare didn’t tell voters that their plan was to reduce healthcare costs for the sick, the poor and low-income workers by sticking a large part of the new entitlement costs on businesses, the rich, the healthy middle-class and young people. They also relied on unjustifiable expectations that fees to providers for treatments and procedures could be reduced, without harming the quality and availability of healthcare, because providers would be treating large numbers of additional patients.
They also created the fiction, that if enough healthy people were forced to over-pay for health insurance, it would pay for the enhanced benefits of a Obamacare policy and the extra costs for reducing the premium costs for those with pre-existing conditions and the elderly. They knew or should have known that they significantly underestimated the costs to be incurred by the exchange qualified insurance companies in paying for the mandated Obamacare benefits and the requirement that they provide coverage for people with pre-existing conditions and the elderly at below actuarially calculated rates and that not enough young or healthy people existed even if all of them bought the overpriced Obamacare qualified policies. Although the facts relating to the percentage of healthy young people buying Obamacare exchange policies are being concealed for political reasons and ignored by the liberal press, the truth will eventually be learned. President Obama and the Democrats also deliberately underestimated the government costs of providing the premium subsidies by underestimating the number of employees who would lose their full-time jobs or their employer coverage.
Obamacare was adopted at the depth of the Great Recession. President Obama and the Democrats ignored the risk of further damaging the economy or slowing the hoped for recovery. It’s adoption coincided with the adoption of what turned out to be a failed stimulus plan that led to an unprecedented expansion of welfare benefits and squandered funds on other liberal causes (that included excessive payments to Obama supporters) and pork spending while creating few tax-paying jobs. However, they anticipated that Obamacare would be disruptive to business and the healthcare industry and therefore postponed the effectiveness of many of the provisions of Obamacare until after the 2012 presidential elections. They wrote the law and regulations so that almost all individual insurance policies would be cancelled and the individuals would have to purchase replacement policies on the exchanges. They also knew that, despite the employer mandate and the penalties they imposed, millions of employees would ultimately lose their existing employer paid coverage because businesses would do everything possible to increase short-term profits and would attempt to avoid increases in or reduce healthcare costs. They were relying on the better health status of the individuals who were losing their employer paid coverage to improve the quality of the pool of exchange policy purchasers to help pay for the extra costs the insurance companies would have to pay to meet Obamacare requirements.
Obamacare mandates are leading to the loss of full-time jobs, the increase in part-time jobs, the loss of existing healthcare coverages and the continuance of an upward spiral of insurance costs in most states. These factors have caused a slowdown in the economic recovery that was predictable when Obamacare was passed. President Obama was fortunate that events he had nothing to do with, like actions taken by the Fed, amazing oil and gas fracking successes, the rapidly expanding use of social media and new internet devices and software and business and growth in the developing world, helped the US economy make a modest recovery from the Great Recession.
President Obama and the Democrats are changing their tune. They ignore the lies about being able to keep your insurance and claim that Obamacare requires better benefits. They now argue that requiring young and healthy people and businesses to purchase insurance policies, subject to high deductibles and co-pays, they don’t want or need, or pay a penalty, to pay to help the poor and those people with pre-existing conditions, serves the common good. They are claiming that more people will be helped that hurt by Obamacare. Even if it turns out to be true because of the enormous government subsidies, that claim does not justify the great harm it is causing. The outrageous taking of property and damage being inflicted by entitlementists on the quality and availability of healthcare, businesses, millions of individuals and the US economy, is unjustifiable. They are trying to trick young and healthy people into purchasing insurance policies on the exchanges using government paid advertising and navigators to convince them it is their patriotic duty to do so while misleading them as to the aggregate costs.
Obamacare is furthering the destruction of the middle class. An individual or family whose income slightly exceeds the maximum amount that qualifies for a Obamacare subsidy will find that the portion of their income remaining after paying taxes and excessive healthcare costs may be negligibly higher (or in some case lower) than the disposable funds available to those who work part-time, collect negative income taxes and maximize their welfare benefits including healthcare subsidies. What incentive will young people have to incur college loans in a country that is more interested in expanding entitlements for the poor and low-income workers than in creating full-time high-quality job opportunities?
Like all entitlements, once people are getting the benefits of Obamacare, it will be difficult or impossible to take them away. We will never know the extent of middle-class job or wage losses or the negative impact on the US GDP caused by Obamacare. President Obama and other Democrats will try to shift the blame for Obamacare failures to the Republicans. They will resurrect outrageous claims for political purposes that Republicans who have criticized Obamacare and President Obama’s lies about it are extortionists and obstructionists. It is all but forgotten that President Obama refused to negotiate with Republicans relating to their concerns about Obamacare or unfunded entitlement obligations. Ted Cruz, Mike Lee and other conservative Republicans may have made tactical mistakes by failing to anticipate that they would be fiercely attacked by President Obama and the liberal press and that the American public would blame them for the government shutdown. They were not trying to harm the US economy. They were trying to prevent the upcoming Obamacare disaster that they anticipated. Although President Obama acts like he has dictatorial powers, the US Constitution gives Congress control over government spending.
The actions and statements of President Obama and his appointees during the partial government shutdown, like causing barricades to be placed at monuments and parks, were obviously intended to inflict as much pain as possible on the American people that he could blame on the Republicans. They are indicative of the fact that President Obama wanted a much publicized short, but painful, government shutdown for his own political gain. His obvious goal was to shift the blame for his economic failures to the Republicans to enable entitlementists to retain a majority in the Senate and gain control of the House in the 2014 elections. Although it was ignored by the liberal press, President Obama and his cabinet appointees, seeking to maximize the criticism against Tea Party conservatives, shamefully played politics by exaggerating the risk of default and failing to assure financial markets around the world that President Obama would use his Presidential powers to ensure that the US would not default on its debts. They knew that more than adequate monthly incoming tax receipts would be available to be used to meet the interest and principal payments on US debt as they became due. President Obama’s political gamesmanship, and not the short-term partial government shutdown, is responsible for any long-term damage to our credit in world financial markets.
Entitlements do not care if the entitlements they propose promote the common-good as long as they result in additional voters becoming dependent upon them. Obamacare is reducing the quality and availability of healthcare. Encouraging insurance companies to limit their extra costs by reducing payments to doctors, hospitals and other healthcare providers is going to backfire. Healthcare providers are going to suffer great financial harm with the result that they will refuse to participate in Obamacare exchange insurance provider networks. Doctors are leaving private practice in large part because of reduced Medicare, Medicaid and Obamacare fees, excessive record keeping requirements, difficulties in getting paid and excessive malpractice insurance costs. Low-income people with newly issued insurance policies can be expected to greatly increase the number of malpractice claims that will speed the doctor exodus.
Some doctors will perform services only for individuals and families willing to pay them directly. Concierge healthcare plans with limited benefit are being offered by groups of doctors, outside of Medicare, Medicaid and Obamacare. They will become more popular as the quality and availability of healthcare provided under government programs further declines.
The initial failure of the federal government’s Obamacare website is a “red-herring”. It is merely a sign of the HHS’ incompetence in running a business. They will eventually get it to work. The website failure is merely delaying the distress which is going to be suffered by millions of Americans when they discover they are facing job and insurance coverage losses, large premium cost increases and large deductibles and co-pays. We can expect that the government will investigate and fail to disclose how the contractor to build the website was selected, how the website requirements were determined and who failed in monitoring the installation.
Look for President Obama to use the website failure as an excuse to postpone the penalties for failing to comply with the individual mandate so that people will not have to pay or leave themselves subject to the penalty if they decide not to purchase insurance. He will claim that registration is growing each month and that it will take a few years to get the kinks out and reach satisfactory enrollment levels. We know that if they do not get a large percentage of healthy people to pay for coverage (and even 100% may be insufficient), the insurance companies will lose money and will raise the premiums as soon as they can unless they are subsidized by the government. Obamacare anticipated the problem and provides for declining subsidies for the insurance companies over the next few years. We can anticipate that if premiums go up or the quality and availability of healthcare decline the entitlementists will then blame the insurance companies for operating inefficiently and demand single payer healthcare.
Make no mistake, the principal purposes of Obamacare is to give a new welfare entitlement to the poor and low-income individuals and to give the government control of healthcare. It promotes entitlementism and enlarges the Democrat base, by offering a new complex welfare entitlement benefit to a very large group of low-income people. It furthers the plan of liberal Democrats to take from those who have and give to those who have not. It also enables Democrats to demonize Republicans who want to control the costs of entitlements and preserve American capitalism. Entitlementists will seek to make Obamacare a pillar of entitlementism.
Even if Republicans gain control of both the Senate and the House in the 2014 elections it will be extremely difficult to reverse the damage already caused by Obamacare. However, it will give them the opportunity to seek changes in Obamacare, to limit future damage and reduce unfunded entitlement obligations.
They are talking about the unfair increase in insurance premiums, deductibles and co-pays to finance the costs of eliminating pre-existing conditions from consideration and reinstating high risk pools to help alleviate the healthcare costs for those with pre-existing conditions. They also propose the sale of health insurance beyond state lines to create competition among providers.
As always, an incisive exposition from a writer who has a good grasp on why America is on a downward slope.