Watching our lawmakers is the moral of Obamacare. Take daylight saving time, an artificial construct created by government dictating the very time of day citizens experience. Today, clocks moved forward one hour in the US.
Many can recall when the government’s dictate of time was on different dates during the year, the old, “Spring ahead, fall back.” Now, it’s a Sunday rule, Second Sunday in March and First Sunday in November. The change in law was motivated by an intent to reduce energy consumption, in 2007 as provided in the Energy Policy Act of 2005.
I’m sure somewhere there is some study that “proves” the change in daylight saving was worth it in terms of its goal to reduce energy consumption, but, you’ll have to do your own research to discover why daylight saving time was a Congress-worthy issue.
In a March 2009 article entitled, “Does Daylight Saving Time Conserve Energy?” (Charles Q. Choi, 2/16/2009) there is also reference to studies indicating that “…heart attacks rose about five percent during the first week of daylight saving time,” (http://www.scientificamerican.com/article/does-daylight-saving-times-save-energy/?page=2), (arguably shouldn't we have gotten rid of it altogether?).
The time/money balance is not new to government, but when it comes to health, oftentimes aside from patient stakeholders, other stakeholders opt for saving money or earning more money over lives. I’ll stop right here while everyone who wants to disagree rambles on.
It is this brutal truth that much of Obamacare and other laws that make the choice of money over health look to justify and benignly explain. Health insurers whether public or private always emphasize that they don’t prescribe whether or not you can get treatment, only whether their product will help pay for that treatment. As most know, in the US, this is the same thing because if you can’t pay for treatment you won’t get it.
But Obamacare goes further, codifying a priority to study and determine whether a treatment is “worth it,” in other words whether the patient is "worth it," it being the expense of trying to get that patient well. It’s brutal and that’s why there is so much verbiage attempting to disguise this truth.
Obamacare also incentivizes (with money) physicians who not only treat healthier patients, but those who achieve these “better” outcomes in accordance with research indicating who should or should not get certain treatment. Physicians will be paid for going along with government guidance.
Obamacare, through its changes and judgments, often representing at least arguably illogical reasoning, has money-focused stakeholders more involved than ever before in deciding whether a certain patient is “worth it.”
When Medicare doctors decided they weren’t getting enough money from the federal government, many decided it was not “worth it,” to treat Medicare patients. During the sickest part of their lives in old age, the government and stakeholders have and will have new standards for deciding whether it is “worth it,” to preserve life. This is one of the dangers of Obamacare.
Consider some of the provisions of the law that are choosing money over patient treatment:
In section 6301, Patient-centered outcomes research, the obvious result of applying research that essentially decides whether a treatment or procedure is “worth it,” carefully includes language to make sure that such decisions are reached neutrally, that the initial decision weighing the worthiness of a person of receiving treatment based on “research,” not be susceptible to individual opinions about who is barred from coverage for specific conditions and who is not based on more personal preferences of decision makers.
Therefore, you find: ‘(e) The Patient-Centered Outcomes Research Institute established under section 1181(b)(1) shall not develop or employ a dollars per- quality adjusted life year (or similar measure that discounts the value of a life because of an individual’s disability) as a threshold to establish what type of health care is cost effective or recommended. The Secretary shall not utilize such an adjusted life year (or such a similar measure) as a threshold to determine coverage, reimbursement, or incentive programs under title XVIII.’
We again find the money motivation in Section 1311, “Affordable Choices of Health Benefit Plans,” that rewards providers who improve health outcomes, which essentially rewards providers financially for taking healthier patients and provides for, “(g) REWARDING QUALITY THROUGH MARKET-BASED INCENTIVES.—
(1) STRATEGY DESCRIBED.—A strategy described in this paragraph is a payment structure that provides increased reimbursement or other incentives for—
(A) improving health outcomes through the implementation of activities that shall include quality reporting, effective case management, care coordination, chronic disease management, medication and care compliance initiatives, including through the use of the medical home model, for treatment or services under the plan or coverage;”
Under Section 2701, “Fair Health Insurance Premiums,” we find that such premium levels are anything but fair. The traditional discriminatory category of age is one of only TWO reasons for charging more in premiums (other than smoking). (1) IN GENERAL.—With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market—
‘‘(A) such rate shall vary with respect to the particular plan or coverage involved only by—
‘‘(i) whether such plan or coverage covers an individual or family;
‘‘(ii) rating area, as established in accordance with paragraph (2);
‘‘(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
‘‘(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1.”
I’ll leave the smoking increased rate alone until people realize that charging more for tobacco use ALONE is arbitrary when one considers the world of human beings who make a variety of choices including marijuana smokers, prescription drug abusers, alcoholics, illegal drug users, overweight people, sedentary people all of whom CANNOT be charged greater premiums under the law. However, the age discrimination affects young and old because younger people can now be charged a greater percentage of whatever is charged to older people and naturally, older people will be charged more in premiums.
The point of focusing on daylight saving time and Obamacare is that both represent lawmakers choosing to prioritize certain interests for our population and imposing their verdict about what reality is on citizens.
It’s important to remember that these choices are supposed to reflect the American public they represent.
To date, under the new "reality" spelled out and made into law by Obamacare, (http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/) on 9/26/2013, “Key Fact about the Uninsured,” the Kaiser Family Foundation concluded that, “Over 47 million nonelderly individuals were uninsured in 2012. This represents a decrease of almost 2 million uninsured people since 2010. This change resulted from small gains in public coverage and stability in private coverage. However, the number of uninsured is still more than 4 million higher than when the recession began in 2007.”
