ER Visits Up with the Advent of Obamacare

Stephanie Armour and Louise Radnofsky pointed this out earlier in the week in The Wall Street Journal.

Among other things, they mentioned

The median ER charge was more than $1,200 for the most frequent outpatient diagnoses in a study of over 8,000 ER visits in 2006-08….

This is right before Obamacare was enacted.

Notice that ER charge. A significant fraction of the deductibles on Obamacare health coverage plans is larger than that—ranging from $2,000 to above $10,000, depending on family size, the specific plan selected, and so on.

Since the ER charge is less than the deductible, even if these ER patients had an Obamacare plan, where is their incentive to see a doctor in his office? He’s still paying those $1,200 out of his pocket. The proud possession of a health plan is irrelevant to that.

It’s Time

…to bring the Veterans Administration within the Department of Defense, to be run by active duty military personnel from mid-level management on up.

I’ve written about the Veterans Administration’s apparently routine failure to perform a number of times.

Now it seems to be killing our veterans through neglect.

Last week, Jeff Miller (R, FL) Chairman of the House Committee on Veterans Affairs, said the panel’s investigators concluded as many as 40 Arizona veteran deaths could be related to VA delays in providing them medical care.

Some veterans say wait times now average 55 days.

It gets worse.

Miller also said panel investigators had evidence that officials at the Phoenix VA Health Care System kept two sets of records to hide lengthy wait times for patients seeking doctor appointments and treatment, the Arizona Republic reported.

Dr Sam Foote, a former VA doctor in the Phoenix system, told Megyn Kelly on “The Kelly File” Thursday night “we believe senior management obviously had knowledge of this.”

Earlier, he told CNN that the alleged secret waiting list was used by senior management to conceal the fact that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor.

It gets even worse. Apparently, the VA also just moves its mismanagers around, rather than terminating them.

Sharon Helman, Director of the Phoenix Veterans Affairs Health Care system [a member of the “senior management” about which Foote talked above], is accused with other management officials of keeping a fake waiting list that made it appear sick veterans were being treated in a timely manner—while hiding the real list that showed up to 1,600 sick veterans were waiting months to see a physician.

And

From July 2007 through the first week of July 2008, at least 22 veterans in the Spokane VA service area committed suicide. During that same time period, however, Spokane VA reported nine suicides and 34 attempted suicides, according to Military.com and other media outlets.

Helman was director of the Spokane facility at the time the number of suicides were being misreported.

Or maybe it’s time to utterly disband the VA altogether, returning all VA personnel other than the doctors and nurses to the private sector. Then build, from the ground up, an entirely different facility whose function would be to take care of our wounded, the families of our fallen, and to help those who separate or retire get on with their lives in their new environment.

This VA is an insult to our soldiers. It’s an insult to our nation.

Income Inequality and Blinders

The impact of Obamacare, still being denied in some circles:

In January, nearly half of small-business owners with at least five employees, or 45% of those polled, said they had had to curb their hiring plans because of the health law, and almost a third—29%—said they had been forced to make staff cuts, according to a U.S. Bancorp survey of 3,173 owners with less than $10 million….

And

Given how much the President talks about income inequality, it is perhaps ironic that his signature achievement is preventing people from earning incomes.

ObamaCare-induced phenomenon of “29ers”—employees held below 30 hours of work per week to avoid counting as full-time workers eligible for employer-provided health insurance. As a Journal editorial explained last year, “The savings from restricting hours worked can be enormous. If a company with 50 employees hires a new worker for $12 an hour for 29 hours a week, there is no health insurance requirement. But suppose that worker moves to 30 hours a week. This triggers the $2,000 federal penalty. So to get 50 more hours of work a year from that employee, the extra cost to the employer rises to about $52 an hour—the $12 salary and the ObamaCare tax of what works out to be $40 an hour.

Hmm….

Obamacare Rates

So much (to pound the dead horse) for rates going down $2,500 per, courtesy of Obamacare.

The research team at investment bank Morgan Stanley surveyed 131 brokers, finding that December 2013 rates are rising in excess of 6% in the small group market, and 9% in the individual market.

But that’s just chump change, so far (except for the victims of the rise).

More:

[H]ealth plans are also predicting higher cost trends in 2014, after years of stabilization (much of it attributable to the economic downturn [and its long-term non-recovery, say I], which reduced medical utilization rates).

And:

Among the states seeing the highest annualized rate hikes (for the full 2013 year) in the individual market are Connecticut, which is averaging a 37% increase; Florida (42%); Illinois (33%); Michigan (39%); and Minnesota (35%).

Among the states with the biggest annualized spike in the small group rates are Delaware, which is averaging a 35% increase; Michigan (30%); and Minnesota (50%).

It’s interesting, too, to note that these are some of the most tightly regulated states; their regulations (now superseded by Obamacare regulations) greatly suppressed health “insurance” rates.

Birth Control “Mandate”

In the Twitter to-do surrounding the Supreme Court’s hearing two cases related to this, Planned Parenthood linked to one of their favorite posters, reproduced just below.  The poster is so mendacious, it cries out for a post in point-by-point response.

1. 99% still can—and 99% already were, long before Obamacare came up.  Neither case before the Court has anything to do with women’s access, only whether employers, or insurers, must cover birth control in every plan offered.  And it’s always been cheap, too, including for guys (why aren’t condoms mandated, by the way?  Whatever happened to equality of the sexes?).  WalMart, for instance sells birth control pills for as little as $4/mo.  The doctor’s appointment to get the prescription still is extra.  WalMart sells condoms for as little as $15 for three dozen.  No doctor’s appointment required.

2. Birth control for health reasons isn’t birth control; it’s medicinal use for treating an illness or other condition unrelated to pregnancy.  As a medicine, it’s already covered in other aspects of a health plan.  If it isn’t, that would be a legitimate gripe, but it would be legitimate only between customers and plan purveyors.  It would remain no business of government.

3. 27 million women still can; this is wholly unrelated to any question of the legitimacy of a contraceptive coverage mandate.  See #1 above.

4. 70%?  That depends on who’s polling.  Of course there’s a bias involved: who doesn’t like free stuff?  Especially when they’re not the ones paying to make it “free.”

5. Who, indeed, are the plaintiffs?  Two families with deeply held religious beliefs who live their religion in their business operations, too—like charity toward all, family nurturing practices vis-à-vis their employees, and so on.  What products they offer to sell matters to this debate how, exactly?

6. Slippery Slope?  This is a cynically offered straw man.  No one is regulating women’s access to birth control here except the government.  No one is looking to regulate access to vaccines, transfusion, etc—except, perhaps government as it attempts to start down this slope.  The only thing the plaintiffs in these two cases want to do is to not be regulated in this arena.  As to access itself, see #1 and #3 above.

7. First time for whom, actually?  Businesses always before have had the choice to offer health coverage plans (back when they actually resembled insurance policies and not Obamacare’s mandated health welfare plans).  Now it’s government that wants, for the first time, to eliminate that right to choose.  And, of course, with this point, Planned Parenthood ignores the fact that in opposing the plaintiffs, they’re seeking nakedly to impose their own personal beliefs on others.  This whole argument also cynically elides the fact that it’s a market choice, not business’ or government’s, that determines what gets included in a health coverage plan.  At least in a free country.

As to the Twitter hashtag #Notmybossbusiness, indeed it’s not.  The employer has no business providing birth control to his employees, “free,” or otherwise.  The use of birth control is a personal choice, not an employer’s.