Well buddy when I die throw my body in the back
And drive me to the junkyard in my Cadillac

— Bruce Springsteen, “Cadillac Ranch”

Say goodbye to that $500 deductible insurance plan and the $20 co-payment for a doctor’s office visit. They are likely to become luxuries of the past. . . .

Then blame — or credit — the so-called Cadillac tax, which penalizes companies that offer high-end health care plans to their employees.

— High-End Health Plans Scale Back to Avoid ‘Cadillac Tax’ – NYTimes.com

You’re probably thinking: “So what? I don’t have a high-end health care plan. I’m a working stiff. Let the Wall Street fat cats pay their Cadillac tax.”

Actually, because the plan cost that triggers the Cadillac tax is not indexed for inflation, Bradley Herring, a health economist at Johns Hopkins Bloomberg School of Public Health, estimates that as many as 75 percent of plans could be affected by the tax over the next decade.

The hospital where Abbey Bruce, a nursing assistant in Olympia, Wash., worked, for example, stopped offering the traditional plan that she and her husband, Casey, who has cystic fibrosis, had chosen. . . .

She has had to drop out of school and take on additional jobs to pay for her husband’s medicine.

“My husband didn’t choose to be born this way,” Ms. Bruce said. The union representing her, a chapter of the Service Employees International Union, has objected to the changes. Her employer, Providence Health & Services, says it designed the plans to avoid having employees shoulder too much in medical bills and has reduced how much workers pay in premiums.

Abbey Bruce, a nursing assistant who works a second job cleaning, will pay a sharply higher deductible.

ObamaCare proponents say the Cadillac tax is bringing down employer (not patient) costs as planned.

Cynthia Weidner, an executive at the benefits consultant HighRoads, [said] that the tax appeared to be having the intended effect. “The premise it’s built upon is happening,” she said, adding, “the consumer should continue to expect that their plan is going to be more expensive, and they will have less benefits.”

Key takeaway: Pay more. Get less.

I hate to say I told you so, so instead I’ll say say an insincere thank you to Obama and all the delusional fuckers who voted for this goddamn law.

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

— Despite New Health Law, Some See Sharp Rise in Premiums – NYTimes.com

That headline should not read “DESPITE new health law,” it should read “BECAUSE OF new health law.”

But we were going to get things for free! We were promised better things at a lower cost!

In my day, most of the citizens were farmers or merchants or tradesmen. They lived by their hands and their wits. They had horse sense and they knew when they were being sold a bill of goods.

Of course, that was before television.

Americans today are unfortunately rather stupid. Most of them don’t know anything about economics, science, history, government . . . as George Carlin says, “Think of how stupid the average person is, and realize half of them are stupider than that.” George is here in heaven now. He breaks me up, he really does.

Your president and Congress have decreed that every American will have health insurance whether they want it or not. They have further decreed that a lot of Americans will not have to pay for their own health insurance, which means that the cost of their health insurance has to be paid by the rest of you. That’s one reason why your health insurance premium is going up.

Another reason your premium is going up is the “guaranteed issue” provision. “Guaranteed issue” means that no one can be denied health insurance because of pre-existing conditions.

Funny story: My friend Paul Epps, his wife has an insurance agency in Southern California. It’s an area that’s susceptible to wildfires in the summer months. When a fire breaks out, people who live near the fire actually call this woman wanting to buy a homeowners policy.

Of course, she doesn’t sell it to them. Insurance companies are a little bit smarter than that.

Buying a homeowners policy when your house is already on fire is analogous to “guaranteed issue” health insurance: Hello, I’d like to buy some health insurance. Oh by the way, I have cancer, but the doctors think that with lengthy and expensive treatment, I have a chance to pull through.

This is not even insurance anymore. Insurance is something you pay for now to protect against the risk of having to pay a lot more later. In these cases, there IS no risk. The bad news has already happened. It’s a dead loss for the insurance company and they have to spread the cost of that loss to other policyholders. That’s another reason your premium is going up.

This isn’t even economics, folks, it’s just common sense.

A slight minority of Democrats (48%) say the government should be extremely or very involved compared to 13 percent of Republicans. Non-whites (47%) are more likely than whites (25%) to say the government should be very or extremely involved in finding solutions to the country’s obesity problem.

— Obesity in the United States: Public Perceptions

My fellow Americans –

The country doesn’t have an obesity problem. If you’re obese, that’s your problem, not the country’s problem, and you bear the costs of it, financial and otherwise.

Some people might argue that obesity causes an increase in public health costs. That is untrue.

Think about it. If you die in your 40s because you’re too fat, you have saved us all a lot of money, to the extent that your healthcare costs are borne by the public.  If you’d maintained a normal weight and lived to be 80, you’d still have end-of-life medical expenses, plus an additional 30 years of expenditures in between.

For those who want a solution to the “obesity problem,” I offer two:

1. Eat less.
2. Exercise more.

Got that, fatso?

If [Affordable Care Act] implementation goes as intended and widespread utilization and automation are achieved, providers could save about $11 billion per year.

— Reducing Administrative Costs and Improving the Health Care System — New England Journal of Medicine (NEJM)

You really can’t dispute something as vague as that but it does raise a number of questions:

1. What does it mean for thousands of pages of legislation affecting the entire healthcare industry as well as every man, woman and child in America to go “as intended”? It’s a circular argument. If it goes as intended, we save $11 billion. If we don’t save $11 billion, it didn’t go as intended.
2. Is “widespread utilization and automation” part of going “as intended” or is that a separate thing?
3. Assuming that implementation does go as intended and widespread utilization and automation are achieved, the best we can say is that providers “could” save “about” $11 billion per year? Could they save more? Less? Break even? Could they lose $11 billion? It’s meaningless speculation.
4. Can anyone remind me of a large-scale government program that went “as intended” and saved everyone a lot of money?
5. Why, despite all evidence to the contrary, do people continue to believe that government can successfully engineer social aspirations?

In other news, if my plan to grow wings on pigs goes as intended, it could revolutionize the way we export bacon.

These things never go as intended. They can’t possibly go as intended. There are always unintended consequences. I can’t implement a policy in my own house and have it go as intended and there’s just two people and a dog.

I asked the friend who called the NEJM article to my attention what going “as intended” means in the context of the ACA and he said, “I think it means legislators don’t muck with it too much.” What does “muck” mean? What does “too much” mean? We could go on and on . . .

David Henderson says — accurately, I think — that Mitt Romney’s “47 percent” remarks can be paraphrased as “People who are dependent on government will vote for the candidate who credibly (to them, at least) promises to keep the programs that have created that dependence.”

Do you think President Obama disagrees with that? He doesn’t.

If you think he does, please see The Life of Julia on the president’s web site. It lays out a “typical” woman’s cradle-to-grave dependence on government assistance and describes how Obama will keep those programs going while Mitt Romney won’t.

The most insulting thing about it is that as you read about Obama funding this and Obama funding that, it sounds like he’s doing it all out of his own goddamn pocket. What a prince!

There’s no acknowledgement that Obama is taking from some and giving to others, and that all of Julia’s “free” stuff is paid for by me and people like me out of money earned by our own labor.

And we are struggling. We’re putting a kid through college, my wife has had an expensive medical condition, our home equity has plummeted, the roof leaks, my car is long overdue for new tires . . . there are unplanned expenses . . . next month, something else will break. That’s life.

As part of our middle-class existence, we pay a five-figure annual federal income tax bill. We pay for Julia’s babysitters, education, health care, etc., and Obama takes the credit. Not even a “thank you.” If we could keep even a fraction of that money, maybe we could afford to pay our own education and health care costs.

How about acknowledging that for every Life of Julia there’s a Life of Paul and presenting their stories in juxtaposition to show how, as with any policy, some people are better off and some people worse.

You see the idea? Let’s try another one . . .

The money being used to buy the votes of millions of Julias out there is not coming exclusively or even primarily from unnamed “millionaires” on “Wall Street” . . . it’s coming from “middle class” “hard-working Americans” on “Main Street” who are struggling.

• Progressive = Liberal
• Investing = Spending
• Choice = Abortion
• Bodies = Abortion
• Healthcare = Abortion
• Who they love = Gay marriage

Remember, we’re supposed to be worrying about skyrocketing health-care expenses. Doubling the number of wellness visits and free pills sounds great, but who’s going to pay for it? There is a liberal dream that by mandating coverage the government can make something free.

Here’s a good mandate: Let’s mandate that every time a government official says that the government is going to “help” some category of voter, he or she has to say who they are going to hurt in the same sentence. Because it has to be someone.

— John Cochrane, “The Real Trouble With the Birth-Control Mandate”

I work for a healthcare organization. In the lunch room today was one of those cylinders full of caramel corn and cheese corn that turn up everywhere around the holidays.

This one had a note attached: Compliments of your colleagues at the American College of Chest Physicians.

Are caramel corn and cheese corn good for cardiac health? They’ve gotta be terrible, right?

Beware of chest physicians bearing gifts!

CARDIOLOGIST: Who referred you to our office?
PATIENT: I saw your name on a container of cheese corn.
CARDIOLOGIST: Ha ha, yeah, those things pay for themselves a million times over in stents and angioplasties.

I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.

— Barack Obama, Sept. 12, 2008

There must be some mistake then because I just got an email from our accounting department stating that effective January 1, 2011, over-the-counter drugs will require a doctor’s prescription when an FSA claim for reimbursement is submitted.

That doesn’t even make sense. Of course I don’t have a prescription for OTC drugs. Why would I pay a doctor to write me a prescription for something that I can just walk into Walgreen’s and buy it?

Hi Doc, I’ve got a terrible cold so I just stopped by to drop a $30 co-pay and get a prescription for some Nyquil.

And if I can no longer pay for ibuprofen, aspirin, cough/cold medication, etc., with pre-tax dollars through my FSA, that makes my taxes go up. Did I mention that I earn less than $250,000 a year?

They came first for the smokers with last April’s increase in the cigarette tax from 39 cents a pack to $1.01 (even for smokers making less than $250,000), and I didn’t speak up because I wasn’t a smoker.

Then they came for the tanners with the 10 percent tanning bed tax (no exemption for tanners making less than $250,000), and I didn’t speak up because I wasn’t a tanner.

Then they came for me and by that time no one was left to speak up . . .

WASHINGTON — President Barack Obama told voters repeatedly during the health care debate that the overhaul legislation would bring down fast-rising health care costs and save them money. Now, he’s hemming and hawing on that.

— Health care politics run into economic reality – msnbc.com

Could not have seen that coming!

Many large companies are examining a course that was heretofore unthinkable, dumping the health care coverage they provide to their workers in exchange for paying penalty fees to the government.

That would dismantle the employer-based system that has reigned since World War II. It would also seem to contradict President Obama’s statements that Americans who like their current plans could keep them. And as we’ll see, it would hugely magnify the projected costs for the bill, which controls deficits only by assuming that America’s employers would remain the backbone of the nation’s health care system.

Hence, health-care reform risks becoming a victim of unintended consequences.

— Fortune, May 5, 2010

We have to pass the bill so that you can find out what is in it.

— Nancy Pelosi, March 9, 2010

Experience hath shewn, that even under the best forms of government those entrusted with power have, in time, and by slow operations, perverted it into tyranny.

— TJ

My fellow Americans –

This is a glorious day in our great nation! No, I’m not referring to that tragedy of a health care bill, which I’ll get to in a moment. I’m talking about Free Pastry Day at Starbucks! Who doesn’t enjoy a tasty scone with his morning coffee?

Now, on a more somber note . . .

Goodbye, representative democracy! Farewell, consent of the governed!

President Obama today signed into law a far-reaching measure that will affect everyone living in these United States, now and in the future. It is opposed by most of the country and it is now law.

I would never have believed that the government I helped to establish would one day engage in this kind of forced sodomy against its own people.

We know what is right and we will do it, regardless of whether you want it done to you or not.

If Karl Marx were here, he would no doubt make a case for trading off liberty in favor of whatever it’s called when a centralized authority redistributes your income in the interest of “equality.” If you know even a little bit about American history, I guess you know which side of that fence old Tom Jefferson is on.

Switching from politics to economics: People with insurance use more health care resources than people without. Put another stitch in my head, doc! I’ve got insurance!

If more people have insurance, it will increase the demand for health care, which in turn will increase the price.

Now imagine that everyone has insurance. I got your health care reform right here: We’re going to drive the price of health care through the roof, then spend a titanic amount of money helping poor people afford it.

I have no (proven) living descendants and for that I say — Thank God! The next generation of Americans is going to be crushed under the burden of paying for this misguided vision of government.

Yours in sadness and in hope,

Tom

Rep. John Murtha of Pennsylvania, a longtime fixture on the House subcommittee that oversees Pentagon spending, died after complications from gallbladder surgery, according to his office. He was 77.

The Democratic congressman recently underwent scheduled laparoscopic surgery at National Naval Medical Center in Bethesda, Maryland, to remove his gallbladder. The procedure was “routine minimally invasive surgery,” but doctors “hit his intestines,” a source close to the late congressman told CNN.

— CNN.com

OMG I HAD THAT SAME OPERATION I COULD HAVE DIED!!!

On a lighter note, how ironic is it that the president loses a pro-ObamaCare vote due to medical error in a government-run hospital?

David Brooks declares “we spend too much on health care” (on NPR) then demands “innovation” and “new technologies.” What if they cost money?

— @kausmickey (Mickey Kaus)

• RT @capricecrane: "Twitter" was the most used word of 2009. Numbers two and three were "I'm" and "broke." #
• RT @Aimee_B_Loved: Sometimes I drive between lanes and pretend my car is Pacman gobbling up the dashed lines. #
• RT @FakeAPStylebook: Use "can of whup-ass" only, as whup-ass is not sold in jars, squeeze tubes or resealable bags. #
• RT @RogervonOech: Never state a problem to yourself in the same terms as it was brought to you. [More at:]
  http://j.mp/cthirsh #
• RT @HarvardBiz: Government Health Care: Like the Postal Service? http://bit.ly/4IzozI #
• RT @capricecrane: I don't know how your car got dented. Maybe it's God saying you shouldn't have cut me off for that parking space. Or me. #
• RT @diablocody: Eating a gingerbread house for breakfast. A new low. #
• RT @capricecrane: According to Billboard: "Nickelback: 'Band of the decade.'" That's all. Enjoy the apocalypse. #
• RT @TheOnion: "Why do all the girls I like think of me as just a friend? And why isn't there a term to describe that relationship?" -Plato #

From TheCoreProtocols Yahoo group:

This one is pretty good:

IMPROVE THE HEALTH OF THOSE WE SERVE.

Compare that to the previous one:

Our mission is to make a significant, positive impact on the healthcare system by changing behaviors and improving outcomes.

And before that:

APS is dedicated to providing user-friendly, accessible, comprehensive and innovative behavioral healthcare systems that promote teamwork, relationships, and provider partnerships; add value to our client’s services; and improve upon members’ quality of care and outcomes. APS believes that quality is achieved by providing access to the most appropriate care and in the least restrictive setting.

And originally:

The mission is to be a premier care management company that can flexibly, yet cost effectively, deliver the full continuum of care management services needed to improve total health outcomes; and, more specifically, to assure quality care is provided in the most appropriate and cost-effective setting based on individual patient needs and within the guidelines of the particular insurance contract.

I will actually give you a speech made up entirely–almost at the spur of the moment, of what a candidate for president would say if that candidate did not care about becoming president. . . .

“Thank you so much for coming this afternoon. I’m so glad to see you, and I would like to be president. Let me tell you a few things on health care. Look, we have the only health-care system in the world that is designed to avoid sick people. [laughter] That’s true, and what I’m going to do is I am going to try to reorganize it to be more amenable to treating sick people. But that means you–particularly you young people, particularly you young, healthy people–you’re going to have to pay more. [applause] Thank you.

“And by the way, we are going to have to–if you’re very old, we’re not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It’s too expensive, so we’re going to let you die. [applause]

“Also, I’m going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid–we already have a lot of bargaining leverage–to force drug companies and insurance companies and medical suppliers to reduce their costs. But that means less innovation, and that means less new products and less new drugs on the market, which means you are probably not going to live that much longer than your parents. [applause] Thank you.”

— Robert Reich

When the government runs healthcare . . .

Liver cancer sufferers are being condemned to an early death by being denied a new drug on the Health Service, campaigners warn. They criticised draft guidance that will effectively ban the drug sorafenib — which is routinely used in every other country where it is licensed. Trials show the drug, which costs £36,000 [$60,000] a year, can increase survival by around six months for patients who have run out of options.

The Government’s rationing body, the National Institute for Health and Clinical Excellence (Nice) said the overall cost was “simply too high” to justify the “benefit to patients.”

— Mail Online

In an interview with Popular Mechanics, Dean Kamen, one of the world’s most prolific inventors of healthcare technologies, challenges the notion that the U.S. has a healthcare crisis. Rather than slowing the pace of medical progress in order to cut healthcare costs, he argues, America should be encouraging more innovation in life-saving drugs and technologies . . .