Thanks (for nothing) Obama!

I read an article by Peggy Noonan in the WSJ recently about how despite his ‘accomplishments,’ our boy-president’s number just keep falling.  Every sane American knows the reason why, and Noonan explained the reason for the others– obama has done things for himself, for his own vision of the world, but they are at odds with the wellbeing of the United States.  The health care fiasco?  Obama’s lies were not exposed by the complicit media, so it is only now that the truth leaks out, when it is too late to do anything about it– that the costs were grossly under-reported, that there are NOT savings to be made in Medicare and Medicaid without draconian program cuts, and that you CAN”T keep your doctor.  Oops!  Sorry!

Over the weekend the silly AJ, Holder, said that the reason he hasn’t gotten around to deciding on where to try the mastermind of the WTC attacks was ‘politics.’   Never mind that it is his call;  that he can simply decide and act– he is being held back by ‘politics.’  So what does he expect US to do about it?  Um, Eric, you are in a politically-appointed government job. Politics sort of go with Washington DC!   This from the guy who couldn’t bring himself to say that ‘radical Islam’ motivates people against the US during Congressional hearings about the bang-up job he has been doing. 

Other obama accomplishments this week– we learned that obama was able to prevent the case against the black panther party from going forward– those guys who ‘hate white crackers’ who blocked Philly polling places.  According to obama’s world, you can’t accuse a black man of racism.

Dump Obama, keep Arizona!

Also this week obama and Holder, freed up from prosecuting black racists, announced their intention to sue Arizona for passing a law that says ‘we are enforcing the law.’  In fact, obama announced intent to sue Arizona twice.  If you asked Americans who we should get rid of, I bet more would favor dumping obama than dumping Arizona.

Obama announced another moratorium on drilling in the Gulf.  We had one accident in 40 years of drilling, but he wants to keep his boot on the neck of residents of the gulf.  Don’t let any crisis go unused– and this crisis allows him to try to destroy the country’s energy supply.  Thanks obama.

The bipartisan debt commision that obama appointed a couple months ago was supposed to keep quiet until after November, but someone talked– and admitted that after looking at the real amount that obama is running up in debt, some of the commision members up-chucked.  If someone wanted to destroy the country from within, could they do a better job than obama has one in 18 months?

Now that the slowing of the economy is clear for all to see, someone should point out the obvious– that the stimulus package sucked.  We know that economic growth is stimulated by less government, less regulation, more certainty, and lower taxes.  In the stimulus obama gave us more government, more regulation, more uncertainty, and higher taxes.  Half of the stimulus has not been spent– and much that was spent went to projects that did NOTHING to increase jobs.  Obama still blames Bush 18 mos into his presidency– never mind that Bush also inherited a recession, and also inherited the WTC attacks that could have crippled our economy if poorly handled.  We bounced back from that devastating blow on top of a recession, thanks to good policy.  This one drags on because of poor policy.

We still have cap and tax to look forward to… and obama’s cronies floated balloons about increasing taxes far beyond the expiring Bush tax cuts, including eliminating the mortgage deduction and means-testing Medicare.  And he is still just getting started.

Thanks– for nothing– obama!

Other news–

By SCOTT GOTTLIEB

President Obama guaranteed Americans that after health reform became law they could keep their insurance plans and their doctors. It’s clear that this promise cannot be kept. Insurers and physicians are already reshaping their businesses as a result of Mr. Obama’s plan.

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The health-reform law caps how much insurers can spend on expenses and take for profits. Starting next year, health plans will have a regulated “floor” on their medical-loss ratios, which is the amount of revenue they spend on medical claims. Insurers can only spend 20% of their premiums on running their plans if they offer policies directly to consumers or to small employers. The spending cap is 15% for policies sold to large employers.

This regulation is going to have its biggest impact on insurance sold directly to consumers—what’s referred to as the “individual market.” These policies cost more to market. They also have higher medical costs, owing partly to selection by less healthy consumers.

Finally, individual policies have high start-up costs. If insurers cannot spend more of their revenue getting plans on track, fewer new policies will be offered.

This will hit Wellpoint, one of the biggest players in the individual market, particularly hard. The insurance company already has a strained relationship with the White House: Earlier this month Mr. Obama accused Wellpoint of systemically denying coverage to breast cancer patients, though the facts don’t bear that out.

Restrictions on how insurers can spend money are compounded by simultaneous constraints on how they can manage their costs. Beginning in 2014, a new federal agency will standardize insurance benefits, placing minimum actuarial values on medical policies. There are also mandates forcing insurers to cover a lot of expensive primary-care services in full. At the same time, insurers are being blocked from raising premiums—for now by political jawboning, but the threat of legislative restrictions looms.

One of the few remaining ways to manage expenses is to reduce the actual cost of the products. In health care, this means pushing providers to accept lower fees and reduce their use of costly services like radiology or other diagnostic testing.

To implement this strategy, companies need to be able to exert more control over doctors. So insurers are trying to buy up medical clinics and doctor practices. Where they can’t own providers outright, they’ll maintain smaller “networks” of physicians that they will contract with so they can manage doctors more closely. That means even fewer choices for beneficiaries. Insurers hope that owning providers will enable health policies to offset the cost of the new regulations.

Doctors, meanwhile, are selling their practices to local hospitals. In 2005, doctors owned more than two-thirds of all medical practices. By next year, more than 60% of physicians will be salaried employees. About a third of those will be working for hospitals, according to the American Medical Association. A review of the open job searches held by one of the country’s largest physician-recruiting firms shows that nearly 50% are for jobs in hospitals, up from about 25% five years ago.

Last month, a hospital I’m affiliated with outside of Manhattan sent a note to its physicians announcing a new subsidiary it’s forming to buy up local medical practices. Nearby physicians are lining up to sell—and not just primary-care doctors, but highly paid specialists like orthopedic surgeons and neurologists. Similar developments are unfolding nationwide.

Consolidated practices and salaried doctors will leave fewer options for patients and longer waiting times for routine appointments. Like the insurers, physicians are responding to the economic burdens of the president’s plan in one of the few ways they’re permitted to.

For physicians, the strains include higher operating costs. The Obama health plan puts expensive new mandates on doctors, such as a requirement to purchase IT systems and keep more records. Overhead costs already consume more than 60% of the revenue generated by an average medical practice, according to a 2007 survey by the Medical Group Management Association. At the same time, reimbursement under Medicare is falling. Some specialists, such as radiologists and cardiologists, will see their Medicare payments fall by more than 10% next year. Then there’s the fact that medical malpractice premiums have risen by 10%-20% annually for specialists like surgeons, particularly in states that haven’t passed liability reform.

The bottom line: Defensive business arrangements designed to blunt ObamaCare’s economic impacts will mean less patient choice.

Dr. Gottlieb, a former official at the Centers for Medicare and Medicaid Services, is a fellow at the American Enterprise Institute and a practicing internist. He’s partner to a firm that invests in health-care companies.