HealthCare Redistribution: Rationing By Any Other Name Would Be Rationing!
 
Essay by Brian Kelly

Finally, there is a real explanation of the new form of health care rationing that is eventually coming as a result of the2700 page Obamacare bill that passed over a year ago. To explain this monster 2700 page bill in laymen’s terms with regard to its effect on rationing took me about thirteen pages single spaced in MS Word format. Click here to get a PDF version that you can print easily if you choose to do so.  

Consider this section the preamble of the essay. Before I begin the actual work in explaining rationing and redistribution, please permit me a few paragraphs for some set up time.  There are some prerequisite notions that will help us all understand this giant bill. The pattern I use in the essay is to explain new terms in line, rather than ask you to take a link. Unfortunately, as you read, it is possible to lose the train of the main essay as a side issue is explained. To help avoid this, I use an italic font to cover the side issues.

Places in which you may see this include, for example, Medicaid and EMTALA which have been in place for years. In a side discussion I point out that there was no pressing need for Obamacare per se because these two programs were an adequate safety net for the legal and illegal population and I take you through that. I also take you through the fact that Obamacare does provide some benefit over what has been the system for years, though at far too great a cost than need be.

For example, Obamacare contains a preexisting condition stipulation as well as policy dollar limits. These two notions could have been implemented with a several page bill. None of the changes to the existing system required 2700 pages of freedom-stealing regulations and special favors written into the law for Obama campaign supporters. . So, already you can see we have been off-track and on-track because this is a complicated topic. Now let us begin. 

The main essay goes like this:

 

  • Healthcare Rationing Exists Today
  • Market-Based Healthcare Rationing
  • Medicaid and EMTALA
  • Government Control
  • Government Redistribution of Healthcare
  • Government-Based Healthcare Rationing 
  • Trusting the Government

 
Healthcare rationing is already here. It is called Obamacare

Don't let all this talk about health care rationing disturb you. It is already happening.  Whenever there is less available than what is needed, there is rationing. So, if 20,000 or 50,000 new people -- those who reportedly do not have healthcare today, are added to an already overextended system, what will be the necessary result? The result is more rationing, of course.  By the way the number of new “patients,” whatever it is that you hear, is wrong. Government has this really clever technique that they have begun to use to keep the public duped. Perhaps you have heard of the technique.  Many of us used it in grade school but our parents corrected us as we got older. It is a simple technique. It is called lying.   
 
Healthcare Rationing Exists Today

There is a notion that I would like to call "natural rationing." If you do not have healthcare today, and by the way, with EMTALA, and Medicaid, that should be nobody, that would mean that you have been rationed out by the marketplace.

EMTALA is a bill passed in 1986 called the Emergency Medical Treatment Active Labor Act.  This act requires any hospital that accepts payments from Medicare to provide care to any patient who arrives in its emergency department for treatment, regardless of the patient's citizenship, legal status in the United States or ability to pay for the services. EMTALA applies to ambulance and hospital care. EMTALA is why the ERs are filled with patients looking for primary care. Though patients are expected to pay, the provider cannot ask for payment before treatment. Therefore, after treatment, many who know how to get free healthcare, simply walk out of the emergency room, or if they were admitted, they walk out after being discharged and most never pay their bill. Some don’t even take the bill since they know they will never pay it.

If you have no healthcare in the years before Obamacare fully takes effect besides EMTALA, you have been thereby excluded by the natural occurrence of people making choices and there is none left for you -- with no government intervention. But, alas, with Obamacare, you are one of the few who may be happy since you will get some healthcare.   
 
That none left for you part in the current rationing scheme means that you are not helpless. If you were helpless, you would be covered by Medicaid.  It means that you are deemed (at least in Pennsylvania) of making 33% more than the poverty level and so Pennsylvania thinks you should be able to afford your own health insurance.  It means that in PA, you have decided to use your money for things other than healthcare.

Therefore, you are making at least 33% more money than the poverty level. The bad news is that Medicaid has decided that because of your "high" income, and the fact that you are not disabled, you do not qualify.  We can call that rationing since available healthcare is being rationed by the marketplace. If you can afford it, you get it. If you can’t pay for it; you don’t get it. I have been told by doctors who work in ERs in New York or in New Jersey that in almost all cases, social workers in the hospitals sign the patients up for Medicaid regardless of their situation. In this way, the hospital has a source to bill that gives them a chance to collect. So, in many states, there is no market exclusion for any patient.
 
I forgot one other thing about Medicaid in Pennsylvania.  If you are single, and you are not helpless it is different. No matter how much you scream and yell, Pennsylvania thinks you should go get a job and not be a burden on the taxpayers.  You are not covered under PA Medicaid. Many of us think that PA law ought to be changed so that while you are on unemployment, you can have some level of healthcare coverage, such as Medicaid but this has not happened yet.

Despite people not being eligible for Medicaid, many are still able through various waivers granted by many states, and because they can be proven to be temporarily disabled, or sometimes, they simply fall through eligibility cracks and have the good fortune of gaining Medicaid assistance. In fact, there are so many people on Medicaid that it is difficult to believe that any other healthcare safety net is required at all.

The only group left out of the “served” it seems are able bodied unmarried individuals and those earning over 133% of the federal poverty level, who are between 20 years old and 64 years old. These are the only ones that I can see who are not covered by Medicaid. Thus, there are a huge number of people on Medicaid. I ask myself, how is it that huge numbers do not have any type of healthcare. Who is it among us that have no healthcare? Perhaps if we knew who you were, we would pay to charities to help you in your plight. Who are you?

In this next section, to demonstrate the pervasiveness of Medicaid in US society, we outline the provisions by which a person from Pennsylvania qualifies for Medicaid. In Pennsylvania, the Medicaid program is called Medical Assistance, and it is managed by the Department of Public Welfare (DPW). Some states are more liberal than Pennsylvania in granting Medicaid benefits and some are less liberal. All states deliver the amount of care that they think those deemed helpless in their state need to be OK.

Medicaid in Pennsylvania

How many individuals are covered by Medicaid?

In 2008, the most recent data for which national data are available, 43.5 million individuals, or about 14 percent of the population, were covered by Medicaid in the United States. In the state fiscal year 2009 (July 1, 2008-June 31, 2009), there were 2,019,888 Medical Assistance recipients in Pennsylvania on the average month. This represented 16.6 percent of the Commonwealth's population. The current enrollment is higher than it has been in the past because of the recession: as people lose their jobs (and corresponding income and health insurance), they become eligible for Medicaid coverage to help meet their health needs.

Who is eligible for Medicaid in Pennsylvania?

In state fiscal year 2009, over 16 percent of Pennsylvania's population was eligible for Medicaid. In most cases, to be eligible for Medicaid in Pennsylvania, an individual must: (1) fit into a specified coverage group; (2) meet the income requirements for that group (calculated as a percentage of the Federal Poverty Level); (3) meet the resource/asset requirement for that group; (4) be a United States citizen or lawful alien; and (5) be a Pennsylvania resident.

Under federal law, Pennsylvania is only required to cover certain individuals under Medicaid. These individuals are known as "mandatory categorically needy." However, federal law also permits Pennsylvania to expand Medicaid coverage to optional individuals and still receive federal matching payments. Pennsylvania has opted to cover many optional individuals.

What are the mandatory federal eligibility categories?

  • Individuals that meet the requirements of the Aid to Families with Dependent Children program (AFDC) in 1996 when the AFDC program was terminated and replaced by Temporary Assistance for Needy Families (TANF). The people who are currently covered under this category are low-income adults with children.
  • Children under age six whose family income is at or below 133 percent of the Federal Poverty Level (FPL);
  • Children over the age of 6 and under the age of 19, in families with incomes at or below the FPL;
  • Pregnant women whose family income is below 133 percent of the FPL;
  • Supplemental Security Income (SSI) recipients - these are individuals who meet the SSI disability criteria or who are 65 and over. They must also meet certain income and asset requirements. For individuals, their income must be less than 76 percent of the FPL and their assets cannot exceed $2,000.
  • Recipients of adoption or foster care assistance under Title IV of the Social Security Act;
  • Special protected groups - typically individuals on SSI who lose their cash assistance due to earnings from work or from increased social security benefits, but who may keep Medicaid for a period of time.
  • Certain Medicare beneficiaries - Medicaid must pay Medicare premiums and/or cost sharing for Medicare beneficiaries who fall within certain income and asset levels.

Does Pennsylvania Medicaid cover any special populations?

While the states must cover individuals who fall into the groups specified above, they may extend Medicaid coverage to optional categorically related groups and still receive federal matching funds. These optional groups broaden the scope of eligibility by increasing income limits, resource limits and medical conditions. Pennsylvania has extended eligibility to a number of optional populations, such as: (1) individuals who are in an institution, such as a nursing home, and whose income is under 300 percent of the FPL; (2) individuals who would be eligible if institutionalized, but who are receiving care and home and community-based services (HCBS) waivers; (3) children with disabilities, regardless of their family's income and assets; (4) certain individuals with disabilities that work and have a family income of less than 250 percent of the FPL, who would qualify for SSI if they did not work; and (5) certain uninsured or low-income women who are screened for breast or cervical cancer through a program administered by the Centers for Disease Control and Prevention (CDC).

Pennsylvania also covers "medically needy" individuals. Medically needy individuals would be eligible for Medicaid under one of the mandatory or optional groups, except that their income and/or resources are above the eligibility level. However, if their medical spending is very high and reduces their available income to within the prescribed limits, they can receive care through Medicaid. Single individuals are also covered by Pennsylvania Medicaid through the "General Assistance" program. These individuals qualify for coverage under the General Assistance program because they are unable to work due to a temporary or permanent disability, are a pending SSI recipient, are blind or fit into other General Assistance related categories, such as domestic violence victims.

Some Comments on Pennsylvania

It would be nice if there were some rich guy whose title was the “Earl of Pennsylvania,” who covered all of the fine people in our state when they have major health issues or better yet, before. The best we can get out of the pre-Obamacare scenario is that all Americans and illegals have health coverage in the US.

All Americans, in PA or otherwise can always go to the ER, and as noted, with EMTALA, the ER personnel are not permitted to ask for payment until after you are treated.  Then, when they ask, if you have no means of payment, and you choose to leave, they have no power to stop you.  They do put it on your bill and they do expect you to pay it when life is treating you better.  So do I.
 
The essence is that in a system, which takes care of the helpless, if you are not taken care of, then perhaps, and I use the terms lightly, perhaps, you are not helpless.

Why would your state consider you to not be helpless?  States are pretty clear on their directives.  You either make too much money or you are not helpless or both. 

One would expect the population to call out a big cheer for EMTALA since it is available for all -- legal and illegal.  If you have no insurance card, or you have an insurance card but choose not to use it, you can get health care anywhere in the US because of EMTALA. So, why are we Americans trying to help the able bodied to get insurance when all of the helpless people are already covered?
 

EMTALA is abused by many including illegal aliens

 
Mexican mothers who are eight + months pregnant love EMTALA.  Ninety percent of the births in the Southern Border States are from women of Mexican / South of the border (SOB) origin who made the run successfully.  These women can tell any American how wonderful the health care prospects in the US are for Americans because they have made themselves available for one or several trips to super hospitals under "ALA" and after the birth process, there is an added bonus; their children are automatically citizens of the US. 
 
The derogatory term for this notion is “Anchor Babies” as they are the anchor that permits a whole Mexican or SOB family to take up residence in the US, regardless of whether they are working or not. The mom first must give birth for free under EMTALA in an American hospital. Jackie Mason would say: "such a deal."  That may have been OK (though I suggest not) when America had money but now, America is flat broke.  Americans are now lining up for charity and as tough as it is for globalists to hear these words, I am for American first.  

 

The bottom line is that Mexican and SOB women are some of the biggest users of EMTALA in the southern US states. Close to the border, the Active Labor Act (ALA) part of EMTALA encourages Mexican expectant mothers to do what is best for their future newborn. Who can blame them?  Unwittingly, this act encourages expectant Mexican and SOB mothers to jump the border so they can have their babies born in the US. Some observers suggest they are very brave for doing so. Others say they are stealing from the Americans who fund healthcare for Americans.

EMTALA takes care of all -- legal and illegal. So, I find myself asking, what is it that Obamacare does?  Oh, it does take over healthcare and it does give bureaucrats jobs in positions between the patient and the doctor that most Americans do not want filled.  So, maybe Obamacare is a jobs bill of the worst kind. Who wants it when we have all this? Will healthcare get better for any of us?

Obamacare does a few other things. It steals your insurance policy and gives it to somebody who is not helpless but who makes too much money for Medicaid.  So, now, you will know what it is like to have healthcare rationing. Obamacare is merely a different method of rationing that does not take into account that somebody might have been foolish enough to work for a living. The policy they once could afford, with Obamacare it is now up for grabs in the Obama rationing system. Try to get it back!
 
Under the government plan, there is different rationing that is not based upon who can and who cannot afford health insurance.  So what is it based upon?  It is based upon the good will of the bureaucrat you will get to visit when you are sick. Healthcare in the new system therefore is also rationed but it is redistributed so that those who may never have qualified for free insurance will get it and, as noted previously, those who have always had insurance will have to give it up. The notion that what you have you will keep is merely an inconvenient government lie.

Obama and the 111th Congress thought you would be OK not having your own top level care, which you regularly pay for. They think you will give it up as long as you know it is going to help a new friend who, though not helpless, is in need.

And, yes, Virginia, it may very well be you who is excluded from the benefits of your former policy because former insurance policies must be surrendered and they will be forgotten as Obamacare becomes the implemented healthcare law of the land.  
 
I think you can see that under both systems there is still rationing but in the new plan government bureaucrats will be the ones in charge of choosing what is fair and who gets care.  It may not be you who is excluded; it may be me, the person next door or the guy down the street.  The point is we the working people in the government plan have already lost our ability and our freedom to be included if the government chooses that someone else, legal or illegal is more worthy.  Ask your doctor.  There is only so much care to go around. It's that simple.  If you trust that the government will give you back your healthcare once you give it to Obama then, this is a good plan for you.
 
Before I move on further with this, I would like you to know that I have written two books that go more deeply into this matter of government controlling healthcare, and who is accountable for medical bills, and a number of other healthcare related topics.  I teach a course in Health Information Technology in the Healthcare Administration program at King's College every year so I try to keep up on such issues.  The book references are included at the bottom of this essay. My conclusion is that the Obama administration wants those who have had healthcare to no longer have it, and those that never had good healthcare to be able to afford their healthcare from dollars extracted from your wallet via the government.
 
Government Will Make All Healthcare Decisions
 
Rather than you having a say in how the care gets rationed, the government will take that burden from you. Even if you once had insurance, when most of your friends had insurance, your insurance will only get you a policy in the "Obama exchange" and this may not and probably will not be good enough anymore.  That's what happens when rationing is artificially enforced by a third party agent, such as the government, rather than by market forces. 

 

You once had control of your own healthcare. Under Obamacare, Obama is in charge.  If you like the man, sweat no more. Give him a call if that is not what you are looking for. In the meantime, while waiting for the Obama return call, be nice to the government bureaucrats that Obama places in charge of your healthcare. Exercising freedom or liberty or freedom of speech regarding healthcare may very well cost you your next several appointments. 
 
Why do some think this is implausible?  If you are not in control and somebody else is in control, how is it that you might think you will have the same advantages as when you were in control?  As of March 21, 2010, Obama is in control.  Nobody refutes that. But the Obamanites believe that this is the penultimate of fairness. It may not be freedom, but having Obama at the helm is better than freedom some think. Is it not?  

What is Healthcare Redistribution?
 
I think that about explains Obamacare. All Obamacare wants to do is redistribute the rationing to make it more fair for friends of Obama.  For your part, your job is to trust the government and all will be as well as things always are when you trust the government. 
 
When government by policy takes from one and gives to another, it is called redistribution. When the item that is taken is your right to healthcare, which you have paid for, and that right is given to somebody else, who has not paid for it, this is known as healthcare redistribution. It is destined to be far more intrusive in your life than simple wealth redistribution. In this plan, it may be your friendly government bureaucrat who actually decides whether you live or die. 
 
With the US so far in debt, which way do you think the bureaucrats will go -- life and more costs, or death, and the costs are lower costs? In fact, when you die, the costs are not only lower, the costs are over.  You may recall that some time in 2010, the "free" press slipped and told the story of the limit on Mammograms in the Obama regulations to those women over 50.  This had to be a leak.  The essence is that one of the first regulations that we will see that purposely permits people to die to save costs is this mammogram notion. There will be many more such regulations from the government as healthcare costs are substantially reduced when the patient is dead. And, yes, this is the same Democratic controlled government that in March, 2012 could not cut the budget and claimed that Republicans wanted to kill women. It is time for Democrats to look in the mirror.

 

Forget about death panels and yes, they exist too. That, ladies and gentlemen, as described above, is the essence of healthcare rationing.  Let me say it differently; that ladies and gentlemen is Obamacare.  It is a clever method to permit somebody else to get your healthcare insurance, while Obama and the Congress keep theirs, no matter what their press releases say.  So, when you are explaining what this is all about to your kids, you can laugh and recall those days when you had control over your own health, your family's health, and the family's health insurance and it did not matter what Obama thought.  Now, with Obama-directed healthcare redistribution, which Robert P. Casey happily voted for, you know who is in control of your life -- Uncle Sam. But, on the weekends, you may call him Uncle Obama.
 
But, the government says it will be fair.  Who can argue with fair?--fair for society and fair for the country as a whole--fair for those who never had insurance because they had other things to do with their time other than work--fair for those who one day would like to be citizens and take your job.  The country, after all, according to Obama-thought is far more important than the individual.  
 
Trust the Government and All Will Be Well!
 
To do your part in this new people friendly government you must trust your elected representatives that they will surely do the right thing. Just let it happen. Stop complaining! Vote for the incumbent if you like what you see. You will continue to like it.  
 
The intent of Obamacare is to give Obama full control of healthcare. By controlling whether you are sick or well, or whether you can get better or not, Obama controls the most important part of your life. You may get something out of it but don’t count on it. It is a lot like income tax.  Obama is now in charge of another one sixth of the economy and all the wonderful patronage jobs that will come from that.  Obama will be fair in giving out the jobs, but wouldn’t it be better if the people ran the government and had their own healthcare instead of Obama being in charge of everything?


 
For a moment, let's pretend that it is not as I have described. Let's say Obamacare is necessary because the disadvantaged (as shown in letters F to H in the chart below) need the healthcare insurance that you already happen to have.  Unfortunately, it is a zero sum game, and if you have your insurance, they cannot get your insurance.  So, if you read it carefully, or you read any of the synopses that are available, or you pay attention to the right news outlets, you'll see that regardless of what Obama has said, with Obamacare you first give up your healthcare insurance.  This is step 1.  This permits you to be a candidate for the more perfect government health insurance version or the modified, more expensive version of your own insurance. More than likely however, according to the experts you will never get your policy back, and anything close to it will cost you lots more than what you now pay. 
 
The simple fact is Obama has decreed that those who have no insurance need your healthcare insurance more than you need it. If you needed it and did not have it, you too would need health insurance.  Right now for this to work there is a big problem.   The big problem is that you still have your insurance. If you keep your insurance and it costs you no more, then the Obamacare system cannot work.

Obama wants your insurance and your lawmakers want you to give it to those who need your policy.  They have promised you that your insurance will not change but this is a big lie.  They cannot get your healthcare without either (1) a full government takeover (Obamacare) or (2) enough regulations that it is a de facto takeover. In either scenario, you must give up your healthcare to the government for redistribution. That is how government healthcare works.  
 
Will 25% More Doctors Appear Overnight?
 
Fear not, if 25% more skilled doctors and nurses than exist today, out of nowhere, show up to practice in the U.S. immediately, and the number of hospital beds goes up by 25% overnight, and all costs go down substantially, and China forgives our debt, and the moon is in the seventh house, and Jupiter is aligned with Mars, your healthcare insurance may not have to be redistributed to a more deserving person.
 
Right now, however, all systems are “go.” The 111th Congress, many of whom are still in the Senate, knew it and they voted for it. They gave your healthcare away to somebody you do not know. But, perhaps peace will guide the planets and love will steer the stars. And, then again, perhaps your own healthcare, along with Alice Cramdon, will arrive on the moon some time in 2013, right after Obama gets reelected. In other words, unless you are an Astronaut, kiss your Health Insurance good-bye.
 
As you can see, I have tried to use some humor to paint the direness of the times in which we live.  So, that we understand the notion of rationing regarding healthcare and health insurance, let's discuss specifically how healthcare is already rationed today, in even more succinct terms than above, though many of us may not at first see it that way.  In the chart below, we introduce the current rationing system. Following this, with a little hyperbole, I will show you how this will change when the already passed rationing is redistributed. 
 
Market Based Rationing Formula for Patients with "Health Insurance."

Try each of these market based healthcare rationing scenarios using the word, "Patient" as the subject of the sentences below:

A.  Has lotsa money, no insurance, and uses own wealth to pay own healthcare bills.
B. Has lotsa money and buys health insurance.
C. Has an employer who provides some or all health insurance.
D. Is a retiree and former employer provides some or all health insurance.
E. Is on Medicare --- buys affordable supplemental programs.
F. Is on welfare or disability and gets health insurance from Medicaid.

 
Market Based Rationing Formula for Patients without "Health Insurance."

 

G. Figures he or she won't get sick; keeps the $$ for lifestyle & vacations.
H. Can’t afford insurance – uses ER (EMTALA) for all healthcare
I. Illegal Alien-- uses ER (EMTALA) for emergencies and routine care.
 
(EMTALA -- In 1986, Congress enacted the Emergency Medical Treatment & Labor Act to ensure public access to emergency services regardless of ability to pay. Thus, nobody is without the ability to get health treatment, regardless of citizen status or ability to pay the bill. )
 
Natural Rationing

Right now, the scenario above depicts how natural rationing works. The hand of government does not direct the “who’s, what’s, and where’s” of healthcare. Rationing occurs naturally and fairly because there just isn't enough to go around.   It is based on the haves / have not scenario.  If you can afford a higher bracket, it is your choice as to whether you engage that bracket. Everybody has the right to work hard to afford health care.  

If there were enough healthcare to go around then both parts of the above list would be served equally.  There is not enough, however, and therefore, in the above scenarios somebody does not get the insurance per se, or the healthcare from the doctor's office, or preventive medicine.  When there is not unlimited supply, some rationing scheme is always used. Most often in the US, the scheme suggests that those that can afford get care, and those that cannot afford or choose not to afford, do not get care. It is the same scheme used for who gets ice cream.

When Obamacare comes in, there still won't be enough to go around so there still will be rationing but it will be a CHANGE as the President has said -- a "change that you can believe in."  The government, instead of the marketplace will re-distribute your old insurance policy to a more deserving person than you.

Those who have worked in the current system above (A to F) are still reaping their just rewards, at least for the time being.  If all of your life you worked and are still working, more than likely, you have health insurance. If you retired, you have insurance etc.  Obamacare takes your insurance that you worked for and gives it to somebody else who you do not know, who has not worked for it or contributed towards it. From the people who have worked and have vested interests in their health insurance policies, government will claim the dollars to fund items G through I above.  Ironically, the people losing the most may very well be those who wanted Obamacare the most.

Can't There Be Something for the Non-Workers?

 

Some people who have worked a little but have not achieved much in life may not have received much in life and they may not have a great healthcare plan. In some cases this is because they did not prepare for employment or they chose not to work hard or perhaps they could not find work all the time.  These people are not the helpless. They should not be included in a system which is designed to help the helpless. Instead, if they receive help, it will make them helpless.

As we look at the scenarios A-F above, in the marketplace system, there is always the possibility that even without government intervention, somebody who cannot affords health insurance today, one day may get a job and be able to afford it. That is how most of US, before Obama took over, have looked upon healthcare, and in fact having a job.

When somebody received a job interview and then got a job twenty years ago, they would immediately move to the upper area of the healthcare marketplace rationing system described as A-F above. They had earned it. The Obama system has a label for such people who work for a living – “dirty capitalist pigs.”  Those who can afford insurance but choose not to buy it, often do not buy insurance until they become older and are more likely to need it. Once they begin to pay for insurance, they can move to a number of different categories in the upper area (A-F). Or perhaps they may move into a lower area as time goes by.
 
Illegal foreign nationals of course can become legitimate citizens by working through the process and then they may get better jobs. With the better jobs the employees would get better health insurance? Of course, theoretically they can go back to their home countries and pick up the health insurance they left behind.
 
The point is the rationing scenario is very dynamic. People are not in these categories all their lives. But, once they get placed on the dole by Obama, they are less likely to ever rise out of their dependency status.  Life goes on. The jobless get jobs and those with jobs lose them every now and then. Sure a system should preserve health insurance and help Americans but the current system did not have to be disassembled to do that.  The marketplace rationing described above is natural and it is dynamic and no bureaucrat gets to decide who goes to the head of the line or who has to die for the system to work. 

 

People's life choices and in some poor circumstances, fate, make the decisions today -- much better than a government bureaucrat would.  Some might suggest that individual determination and tenacity and hard work along with luck and help from God have some say in how well one does in life. Would it be better to give up this method and turn your fate over to government bureaucrats?  Maybe for a few, it would be better -- but for many, especially the elderly it would not. 
 
Please remember there are losers today and there are winners today and this fact will not change with Obamacare. The faces will change.  Many of today's winning faces, who worked hard all their lives, will become losers, by government decree. Likewise, many whose fate or poor choices were made losers will become winners by government decree and take the insurance once held by a "winning" face. Perhaps that is your face.  That's how the government rationed system will play out.  The underserved will have won the healthcare distribution lottery while a hard-working American whose biggest mistake was having a job, must pay for their winnings.
 
It really is like a healthcare lottery except the government rules say that all players must participate in the lottery.  As much as Congress and the President deny it, the fact is that those with healthcare insurance will have to give it up to get their healthcare lottery ticket.  They will no longer be in control of their health. All citizens must play and your ticket is your insurance policy or a note that you have none.   For those with insurance, the stakes are high. For those without insurance it is a winning scenario. 
 
Even in full communism, it always helps if you "know somebody."  So, perhaps the schmoozer's in society have another option.
 
Government Based Healthcare Redistribution

Now, let's talk about the pattern of the government rationing since the monster bill passed the House and the Senate in 2010 and the President has signed it into law. At this point, the government is fully in control of all health insurance from infants to seniors whether there is the full banana government controlled health care insurance option or not. The hoopla is muted because those in office, such as Robert P. Casey, Jr., who went for the bad deal, think if they say nothing for months, we will forget.

 

Obama and company do not have to press for the public option, which is the penultimate in progressive socialism. They actually engineered it into the bill that passed March 21, 2010.    It will be the natural happening and then government will be the only permitted payer. Insurance companies will be phased out.  While capitalism is paid lip service, insurance companies will be the servants of the government, and they will be paid well. Then, one day, poof, they will be gone, and so will any protections we have against a government gone wild.

For the hard working American, life in America will no longer be something that is easily understood.  It doesn't matter if you worked all your life to earn your health insurance. It doesn't matter if you went to graduate school and invested a lot of time and money and debt into your education.  All insurance will be the same -- unless you run for Congress and make it. Then, you and I can change it and hopefully we will get our chance.

Casey voted for Obamacare.  He knows that Obmacare is anti-American and must be replaced. Yet, when he had his chance again in 2011 to repeal it, he voted nay!  Therefore, the people must vote “nay” against Bob Casey Jr.
 
Government Based Rationing Formula for Patients Regardless of Insurance

Government healthcare rationing is about to materialize this way.  If you need a procedure, depending on where you are in the selection table below, you may or may not receive government permission for the procedure.  First, of course before you see your doctor, your friendly bureaucrat will make the determination. Let's look at the probable pecking order for Obamacare
 
A. Filthy Rich who pay their own -- see the doctor immediately
B. Senators and Congressman and ex senators and ex congressman -- all of their wives, friends, campaign donors, concubines,  etc.  See the doctor almost immediately
C. The filthy rich not included in A or B.   See the doctor as quickly as those included in item B above.
D. Young illegal aliens ages 15 to 45. See Doctor next in line after C
E. Medicaid patients who 15 to 45.  See Doctor next

F. Underprivileged ages 15 to 45, See Doctor next in line
G. Formerly Covered by Insurance -- Ages 15 to 45. See Doctor next in line
H.  Formerly used $$$ for fun -- ages 15 and 45 See Doctor next in line
I.  All other groups, illegals 2 to 14, other 46 to 64, See Doctor next in line
J. Medicare or not in a prior group ages 65 to 79, See Doctor next in line
K. Medicare or not in a prior group ages 80 to 99,  See doctor next in line,
L. All patients 100 or older -- See doctor next in line. These folks get to view the Sarah Palin Death Panel Video and a Dr. Kevorkian video before being scheduled.

M. One to two year olds -- not yet productive according to govt. -- small societal loss. No healthcare – do not get to see doctor ever.
 
The charts and the text probably need some work but this is a continual work in progress.  Yes, though incomplete, it is scary enough to take some action. Though government may build the cafeterias, those with the highest survival rates will be those that believe there is no free lunch. 
 
As you can see, as long as you know your place in line and you are patient, you will eventually be served unless you are from womb to two years old. Check the rules.  Additionally, the new czars in the administration have made it known that they find little redeeming value in senior citizens.  This is good to know if you are a senior. Seniors take away care that others might get, and if they would only see Dr. Kevorkian, and his clones, the costs to society would be substantially lower.

For example, the Czars like using number of years left to live for the good of society as an important gauge. Thus, it would be far better to prioritize for rationing a 15 year old with 30 more years until they reach 45 than five or ten sixty-five year olds.  Considering that the old coots consume lots of healthcare, his eminence, Barack Obama, supreme commander of the allied health services, might be called upon to request a quick death to save society the expense of caring for somebody who only has five or ten years left anyway.   

The moral of the story is no health expenses, no death panel.  Health expenses, no medicine. No medicine, no life. No life, no health expenses.  There you go-- finally a final solution. Was that term ever used before?
 
Healthcare Will Be Restricted

 

Rationing is just rationing. The definition of rationing is "To restrict to limited allotments."
 
So, what's the big deal?
 
Some simple equations follow:
 
2 split two ways == 1 + 1 = 2
2 split three ways ==  2/3 + 2/3 + 2/3 = 2
2 split four ways == 1/2 + 1/2 + 1/2 + 1/2 = 2

 

If 2 are all there are then 2 is all that can be given.

You can get to 3 only if you can first find another 1.  The point is since there are no more doctors, and many doctors plan to retire if Obamacare is passed, all we are doing is splitting up how much we can get and that is the definition of rationing. The more to whom we give, the smaller is everybody's allotment.  
 
Rationing Is Rationing Is Rationing

 Do you like the natural system to determine who gets health care or should the government bureaucrats make that determination?

Hint: the government bureaucrats may be fine people in your neighborhood.

Either way there is only so much to go around.
 
In the natural system, remember that you are not powerless unless you do not work and cannot come up with -- money.  If you can find a few dollars, you would not be at the whim of a government bureaucrat standing between you and your doctor.
 
If you would like to read more about my perspective on Obamacare, I have written two books that have lots of information on the subject.
 
Obama's Seven Deadly Sins
Healthcare Accountability

 
Both are available at www.itjungle.com/store.html

I  am 100% against the Obamacare plan as it is not a reform of healthcare but a means of giving everybody less care than was formerly available and making everybody dependent on the good will of a bureaucrat rather than rugged individualism and survival of the fittest.

If you like being the best that you can be, rest assured that in the world of Obamacare, somebody who has no concern for what you want or do not want, like or do not like, will make the decisions for you.  It is a major loss of freedom for all, forever.  I promise to work for its repeal if I am elected.

It is simply a government takeover of healthcare

Big government does not work!