$20,000 for a Minimal Health Plan Under ObamaCare

Wait, What????  How the frak is that gonna work?

In a final regulation issued Wednesday, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year. 

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS. 

The IRS's assumption that the cheapest plan for a family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.

Lest anyone thing that the IRS's numbers are totally without merit, take a look at this report by the Commonwealth Fund shows that average health insurance premiums for a family of four rose from $9,249 in 2003 to $15,022 in 2011.  That is an increase of $5,773 or 62% in just 8 years. (Ironically, the Commonwealth Fund believes that Obamacare will "moderate" costs--apparently they are not reading their own research).

Bear in mind that announcements are already rolling in of double digit premium increases for this year alone.  Do you really think that Obamacare is actually going to lower costs with all those extra mandates?  Think about that.

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Remember When the President Said We Could Keep the Health Insurance We Have?

Yeah, well, in addition to unemployment problems (which impacts whether or not I can keep the coverage I had--which I can't since I lost my job), what the President didn't say was that his health care plan would drive up the cost of my health insurance.  Forbes magazine has some suggestions for dual income earners in particular to look at how to reduce as much as possible the cost of health insurance:  

Many families put everyone on one spouse’s plan for simplicity and don’t “shop” the other spouse’s plan, says Jeanne Wyand, a senior consultant with Towers Watson in Boston. That’s always been a mistake, but it will be even more so as employers respond to rising healthcare costs and Obamacare mandates by making changes like adding spousal surcharges and reducing subsidies for spouses and dependents. “What’s really driving this from the employer side is that the incremental costs that are being assessed onto their plans are starting to get unmanageable,” Wyand says.

Where do those "incremental costs" come from--yeah Affordable Care Act and piggy back state mandates.  

What Are the Limits of a Court's Power to Order Medical Treatment?

Eugene Volokh has an interesting post on the question of whether a court may order treatment on a woman on the basis of "delusional" religious beliefs.

“During a hearing conducted on March 1, 2011, the District Court determined that L.K. is not competent to make her own medical decisions and directed that she undergo a radical hysterectomy on March 3, 2011, against her desires. L.K. objects to the surgery on religious grounds, and expert testimony admitted at the hearing indicated that her religious objections are delusional.” So states an order of the Montana Supreme Court, in Office of State Public Defender on Behalf of L.K. v. Montana Fourth Judicial District Court; the Montana Supreme Court stayed the district court’s order, and ordered an expedited appeal.

So an expert testified that L.K.'s religious beliefs are delusional, but by whose standard?  One of the most commonly held religious beliefs, spanning almost the entire breadth of world religion is the belief in an afterlife or reincarnation or something similar, that is a belief that the soul will live beyond the corporal existence of the body.  We accept that religious tenant despite having almost no empirical proof of its existence.  One could argue that after millennia of a dearth of proof of an afterlife, that maintaining such a belief is delusional.

The trial court, presumably based on expert testimony as to the delusional nature of L.K., ordered her to undergo an hysterectomy, despite L.K.'s own testimony that she wants to have children, that her husband is agreeable AND that she might change her mind about undergoing the recommended procedure.  Since, informed consent is the hallmark of medical treatment, and this woman has, in an apparently rational basis, considered the advice, consulted with her husband and remains open to the notion that she might changer her mind and have the procedure, I am wondering how the trial court came to the conclusion to force her to undergo the procedure? From the portion quoted above, it does not say that L.K. is completely incompetent or otherwise insane, only that the religious beliefs underlying her objection are delusional.   How far can the courts go to require otherwise competent, religiously zealous, person to undergo medical treatment against their will?

This case has some serious implications beyond this single dispute. Is religious zeal now a "condition" by which someone can be determined to be legally incompetent to make their own medical decisions?  It seems to me that there is a case for arguing that the court has infringed upon someone's right to the free exercise of their religion.

What if we are talking about other medical treatments, other than a radical hysterectomy?  Could a court order a heart surgery?  Could a court order a kidney transplant?  What about other life-saving treatments that are not so radical?  Could a court order a morbidly obese person into treatment involving exercise and diet changes?  What if the person is objects on the grounds that "God made me fat and who am I to disagree with God?  It's his plan and I am but a part of that plan."  There might be no question that the person will likely die if they don't exercise and alter their diet, but I find it to be perfectly normal to believe that God's plan might include morbidly obese people.  That is not delusional or at least, I don't see how it is delusional.

Since we are talking, in L.K.'s case, about reproductive health, could a court order an abortion?  Could the court order an abortion even when doctors are certain that either the baby or the mother or both will die as a result of carrying the child to term?  What if the mother AND the father, both competent, agnostic or atheist adults believe that it is wrong to terminate a pregnancy and that view is not based on any religious doctrine?  What if those agnostics or atheists want to, in light of all the advice to the contrary, carry the child to term despite the risks?  How can a court order a procedure when a sane person has made an informed choice?  Where does the court draw the line as far as whose life is more important?

Is this not the opposite of the question of "death panels" wherein governmental bureaucracy might ration health care in cases where they deem it to be unlikely to succeed?  IN other words, are we going to have a health and legal system that can at once deny care in some cases and require and enforce care in others?  How is that freedom or liberty?

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Health Insurance Mandates versus Subsidies

Arnold Kling talks about the differences from a monetary policy perspective and leaves unasked the social cost of either plan.

One Wal-Mart Clinic Testimonial

From Freeman Hunt in Arkansas. My comments included this bit.

Wal-Mart is the master of standardization and if they are accepting insurances (which it appears they are), then over time, through their bargaining power, they will likely force insurance companies to standardize their claims forms, making the paper costs of insurance less and easing the pain and effort for other medical providers, including your own local doctor.

Hat Tip: the Instapundit.

First Aid Training--In Effect

A great story of military first aid training and initiative. Look not only did the military give me first aid training, but I have expanded training as Emergency Medical Technician. Too often as an EMT we would come to an accident scene where the medics were called quickly which resulted in more serious injuries than necessary had someone just taken the initiative to do something.

Under most state laws, you cannot be sued for helping (contrary to what some people would have you believe). Keep everyone as still as possible consistent with their overall safety (that is, if the car is burning or sinking and you can help-do so). That is not to say you should take unnecessary risks when trying to help someone, but even the simply act of applying pressure to a bleeding wound can do wonders. I once had someone tell me at a scene that they didn't want to use a dirty blanket to stop the bleeding for fear of giving the victim an infection. The patient lost enough blood that we had to re-start her heart on the road the hospital. The patient survived thanks to three units of plasma and short trip to the local hospital, but simply putting that dirty blanket on her leg would have done wonders for her health and recovery.

Look, unless your blanket is dirty by way of some fast acting poison, any infection someone gets from a dirty blanket is a far lesser concern than actually stopping the bleeding. An infection can be treated with aggressive anti-biotics. A loss of blood can lead to a loss of life.

Here is a funny story for you. In EMT training, I could not eat before class. The pictures of injuries made me squeamish (almost to the point of dropping out). But once I was onsight at my first car accident, I was never squeamish, there is too much to do.

So, if you come upon an accident, by all means call 911 and get the professionals rolling. Next, make sure bystanders are safe and if necessary stop or reroute traffic to make sure the victims are not hurt more. Then at least start taking an "inventory" of who is there and what injuries you can ascertain. Serious injuries should be brought to the professional's attention as soon as they arrive. Any information you can give is a help.

Smoke for the Children

Satire, alive and well on YouTube.

Paging Dr. Moore, Paging "Dr." Michael Moore--Your Theory Needs Reworking

Britons Flee National Health System

Not Your Typical Reaction to the Middle School Birth Control Mess

From Fordham Fellow Cait Farrell:

It's completely fascinating to me the differences in state culture and politics. In Maine, the discussion focused on providing birth control prescriptions to middle-schoolers while other states are fighting to keep their socially conservative abstinence-only-until- marriage sexual education programs. For example, as reported by the ACLU, materials from an abstinence-only-until-marriage program used recently in Alabama state, “[S]ame sex ‘unions' cannot provide an adequate means of achieving a genuine physical relationship with another human being because this type of ‘union' is contrary to the laws of nature.”

3. Then there are the interesting federal politics at play, as states are choosing to accept (or avoid) federal funds for the Community-Based Abstinence Education Program.

My favorite part of the CBAE requirements:
D. Teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity.

So we can have a federal standard for human sexual activity but not for math or science?

Ouch.

Michael Graham on Middle School Birth Control

Michael Graham writes:

I have a daughter in a public middle school. I know how hard it is to get a school-sanctioned Tylenol on campus. I’ve fought the “no cupcakes, they might have peanuts!” fight. Some schools are getting rid of the snack machines out of fear of giving our children access to high-fructose corn syrup.

But these same liberal educators are going to let the school nurse my 11-year-old full of progesterone so she can “get her groove on” without fear of pregnancy?

Please. Just give her the cupcake.

Maine runs a series of school health clinics like the one at King Middle, most commonly treating things like sore throats and giving physicals. But King, which already hands out condoms to 12-year-olds regardless of whether mom likes it, wants to expand its mission to include aiding and abetting sexual assault.

Because in Maine, the age of consent is 16, too.

Liberal activists supporting the King Middle proposal claim it’s necessary because some of their students are sexually active. Of course they are - you’re giving them sex aids! What are they supposed to do with birth control? Use it to control weight gain? Trade it for Oxy?

The only reason to give 12-year-olds the pill is because they’re having sex. But sex with a 12-year-old is a felony in Maine, so who are they supposed to have this sex with? Other 12-year-olds?

Makes you wonder, doesn't it.

A Truly Lost Generataion

Philip Mella on the Portland Maine birth control pill controversy:

This decision has achieved what most of us would have found impossible, which is a rare combination of a collective abdication of moral responsibility and a cynical endorsement of the presupposition that children are immune from ethical imprinting. We don't need psychologists to tell us that eleven year old children are emotionally unformed and fragile souls whose moral immaturity and compromised judgment can conspire to cause them indelible pain and suffering. Yet this decision puts them in the wholly untenable position of encouraging an act for which many adults are emotionally unfit.

We must wonder why the liberals, who are champions of this kind of stupidity, suppose that those 'victimized' by the sub-prime housing debacle aren't truly capable of making an informed decision, but insist that children have the maturity to decide whether or not it's wise to engage in sexual intercourse.

Hmmm! Good point.

Maryland Law Allows Pre-Teens Confidential Access to Birth Control

Yesterday, I stood in shock of a recent decision by a Portland, Maine school board to allow a middle school to give out birth control pills to girls as young as 11. Apparently, I should have looked in my own back yard, as the Baltimore Sun reports:

While much of the nation debates a Maine school board's vote to let school-based clinics give young teens contraceptives without parental consent, Baltimore girls as young as 12 have had access to birth-control pills from such clinics for more than 20 years.

Advocates say making contraceptives available has played a large role in the city's declining teen birth rate - especially in the past decade, when it has been cut in half for girls younger than 15.

It's not just in Baltimore. A Maryland law that dates to the 1970s allows a minor confidential access to contraception, meaning any adolescent girl can ask her doctor for birth control - knowing that information will not be shared with her mother or father.

Most girls will tell their parents, health officials said, but the girls have a right to privacy here, as in 20 other states and the District of Columbia.

"We promote abstinence as the best choice for teenagers," said Bonnie S. Birkel, director of Maryland's Center for Maternal and Child Health, "but we don't deny services to anyone."

When it comes to reproductive health care, it is apparent that this country as a real problem with hypocrisy.

Under the laws of 20 states and the District of Columbia a pre-teen can walk into a school administered health clinic (not the school nurse apparently, but if there is a clinic staffed by a nurse practitioner) she can ask and receive birth control pills WITHOUT NOTIFYING HER PARENTS OR GUARDIAN!!!!.

This kind of a law, while it may have lead to a reduction in the teen pregnancy rate, completely undermines the role of parents in the healthcare decisions related to their children. In Maine, the rationale for providing the birth control is that some girls will not want to discuss the matter with their parents. In Maryland, officials believe that the most girls will tell their parents. Unless the girls in Maine are of a completely different sub-species of girls than those in Maryland, the chances are that no girl tells their parents because to do so will indicate to the parents that they are sexually active.

There are so many health risks associated with not telling the parents that it is hard to fathom how this was even made law. First, there is the hormonal content of a birth control pill and the effect on younger girls, even those who have reached menses. This is no a simple matter of giving a child a Tylenol, which washes out of the system in relatively short order, but a pill that alters and regulates the hormones in a body, a body that is still growing and changing on practically a daily basis.

Second, the hormones in a birth control pill can interact with other drugs that may need to be prescribed. Unless the young girl informs the health care worker giving out the pill, there is a risk of interaction. If a girl gets another prescription from her regular doctor and the parents don't know of the birth control pills, there is a risk of an interaction. There is a reason why doctors ask questions about whether you are taking any medications before prescribing a new medication--it is to prevent dangerous interactions.

But aside from the medical/physical side of things, there is a conflict with other laws. For example, under most state laws, including Maryland, a doctor may not treat a child for say a broken leg without parental approval. Absent a life-threatening injury, doctors are supposed to wait for parental approval to do much of anything to any minor, even those as old as 17. Yet, girls as young as 11 can get birth control. How are we to reconcile those two policies? A girl with a broken arm can't authorize treatment of her arm because the law has deemed her incapable of making that choice, but she is capable of making a decision to get birth control?

Either she is old to enough to authorize all medical treatment or she is not old enough to authorize any medical treatment. Choose one policy because the conflict is too great.

The argument that a child is "entitled" to a right of privacy is ludicrous. A girl as young as 11 or 12 is not entitled to the same rights as an 18, 19 or 20 year old. There are so many other reductions in her rights that to say she enjoys a full right of privacy on this matter is ridiculous and flies in the face of logic. For example, in the schools in Frederick County, a high school girl or boy for that matter, cannot take a prescription drug for allergies without oversight by the school nurse. So the right to take a doctor prescribed antibiotic is circumscribed, but not the right to OBTAIN birth control. Is there anything else so ludicrous as that particular dichotomy?

One by-product of this debate is that there will be a fair number of state legislatures put on the defensive about this particular law, not that I expect that Democratically controlled Maryland General Assembly to change the law (that would make sense), but at least there will be some questioning.

Maine Middle School to Offer the Pill

Portland, Maine school officials voted to permit a middle school to dispense contraceptives. Yes, a middle school--and we are not talking about condoms, we are also talking about birth control pills.

Pupils at a city middle school will be able to get birth control pills and patches at their student health center after the local school board approved the proposal Wednesday evening.

The plan, offered by city health officials, makes King Middle School the first middle school in Maine to make a full range of contraception available to students in grades 6 through 8, according to the state Department of Health and Human Services....

The Portland School Committee voted 5-2 for the measure.

Chairman John Coynie voted against it, saying he felt providing the birth control was a parental responsibility. The other no vote came from Ben Meiklejohn, who said the consent form does not clearly define the services being offered.

Opponents cited religious and health objections.

Diane Miller said she felt the plan was against religion and against God. Another opponent, Peter Doyle, said he felt it violated the rights of parents and puts students at risk of cancer because of hormones in the pill.

A supporter, Richard Verrier, said it's not enough to depend on parents to protect their children because there may be students who can't discuss things with their parents.

Condoms have been available since 2002 to King students who have parental permission to be treated at its student health center.

I hope it is not just me that feels quesy about this step. I certainly hope that the school health center must obtain specific consent to dispense contraceptives rather than just a generalized consent to dispense drugs, but I would not be surprised if it were not required.

The sexualization of our youngsters is bad enough when talking about consumer products such as dolls (the Bratz line in particular) or clothes (do 10-year-old girls really need thong underwear marketed to them?) because parents can exercise reasonable control over the purchases of their children. But when contraception in the form of condoms has been available to 11, 12 and 13 year olds in a middle school for five years and now contraceptive drugs are now available, we have strayed into an utterly surreal world. We need to be teaching our 11-13 year olds about responsible sexual behavior and at 13, that should include a warning that they don't need contraceptives because they shouldn't be engaging in any activity that would require such drugs.

The hypersexualization of American kids needs to stop.

Only one member of the school board in Portland got this right. Contraception is a duty of the parents and there is no reason for a school health center to be providing these services. I can envision a reasonalbe argument for high schools (I don't like it but I can see the rationale), but not for middle schools.

I don't brook the argument that "kids are going to do it whether we counsel against it or not." Such an argument is a surrender to the notion that kids run the world and the schools. I also don't brook the argument that some kids don't feel comfortable talking about sex with their parents. No kid does, but that doesn't detract from the parental responsiblity to do so. It is not a fun conversation for either side, but it is one that is just as important as "Don't do drugs."

Political leaders and school officials issue a regular hew and cry about the lack of parental involvement in our children's schooling and lives. Yet then we have steps like this one which not offers a mechanism for parents to abdicate their role, but practically begs the parent to not be involved in this aspect of their kids lives because the school makes these services available.

SCHIP and the Consequences of Choice

Another flaming idiot in Maryland.

Andrew Kujan has turned into the bane of our existence at Red Maryland. Brian Griffiths has already taken on Kujan on this post, but I think I have to throw in a couple of cents.

I have no issue with private schooling, if parents choose that route. I have no issue with parents who choose not to have health care for them or their children (as insane as that decision may be). I have house envy of the Frosts, but they have their home and I have mine. They have made their choices and they should suffer the consequences of their choices.

My problem is that I, as a taxpayer, should not have to subsidize their choices. Maybe the kids are on a scholarship to that private school, I don't know. But you have to question the prioritization of spending in a family of six, with four kids in private school, a huge house in a tony Baltimore neighborhood and no health insurance.

The political issue of SCHIP is that the Democrats and Kujan by extension, want to expand it beyond its original scope. The program was designed from the start to cover poor children, those living at or below the federal poverty line. It was not intended to cover their parents, it was not intended to cover a family of six with apparently considerable resources (as evidenced by a large house and private education). It was for poor people who had no other means of obtaining health care for their kids.

The real issue is that people make choices and those choices carry consequences. The government should not be in the business of cushioning those people who make choices and then desire protection from the consequences.

Health Care Competition

John Stossel:

Health-care costs overall have been rising faster than inflation, but not all medical costs are skyrocketing. In a few pockets of medicine, costs are down while quality is up.

What are those few pockets?

The areas of medical care and services that are not covered by insurance, i.e. plastic surgery and laser eye surgery among them. It funny how much doctors who don't rely on government subsidies or insurance payments really do try to help their patients. While Stossel, of course, can only profile a couple of doctors, he does well with his choices. When government and insurance companies are kept away from the transaction, good new things happen. He writes:

A doctor in Tennessee I talked to publishes his low prices, such as $40 for an office visit. can't make money this way. But Dr. Robert Berry told me you can. "Last year, I made about the average of what a primary-care physician makes in this country," he said.

Berry doesn't accept insurance. That saves him money because he doesn't have to hire a staff to process insurance claims, and he never has to fight with companies to get paid.

His mostly uninsured patients save money, too. Unlike doctors trapped in the insurance maze, Berry works with his patients to find ways to save them money.

"It's coming out of their pockets. And they're afraid. They don't know how much it's going to cost. So I can tell them, 'OK, you have heartburn. Let's start out with generic Zantac, which costs around five dollars a month.'" When his patients ask about expensive prescription medicines they see advertised on television, he tells them, "They're great medicines, but why don't you try this one first and see if it works?"

Sometimes the $4 pills from Wal-Mart are just as good as the $100 ones.

Speaking of Wal-Mart, medical clinics are popping up in Wal-Mart stores and in other similar markets. The clinics offer people with simple problems like sore throats and ear infections relatively hassle-free care cheap. Almost everything costs $59 or less. And the clinics are typically open seven days a week.

It really is as simple as market economics. The demand for health care is there, we know that it is. There is a vast supply of health care avaialable, perhaps too much. So market forces say that prices should go down. However, they don' because of government and insurance company intervention. But when those two forces are absent, the market works, just like it should.

When consumers pay for medicine themselves, saving insurance for the big things, and doctors deal directly with consumers, doctors begin to compete. They start posting prices and work to keep them low.

And consumers gain more control of their health care. Instead of governments and insurance companies deciding for patients, patients decide.

Competition gives consumers more choices. And choice gives them power. Remember that when you hear a politician promise to make health case accessible and affordable through the force of government.

Health care is not a right and there is no need for government intervention beyond being a market player as an insurance agency. If consumer paid for routine care out of their own pocket and saved insurance for the big things, like a long term illness or a surgery, then you see costs go down.

Tell that to the Presidential candidates.

This is How Free Will Is Undermined--One Little Thing at A Time

Hillary Clinton:

She said she could envision a day when "you have to show proof to your employer that you're insured as a part of the job interview — like when your kid goes to school and has to show proof of vaccination," but said such details would be worked out through negotiations with Congress.

Of course, there are lots of things that would have to be worked out with Congress--hence the brilliance and the weakness of the plan.

Interesting Questions on the Hillary Health Plan

From The Corner.

Hillary Care and Illegals

Hot Air has links to the question, will Hillary Clinton's $110 billion boondoggle health plan cover all Americans or everyone living in America, legally or not:

Senior [Clinton] policy adviser Laurie Rubiner–-while acknowledging that undocumented immigrants are a “huge issue” in this country–-said, “That’s one we’re going to have to think through a little bit.”
“We have not dealt with every single detail with this plan,” Rubiner continued.

Translation: We’re not sure yet how the majority comes down on that point and want to feel them out. A day doesn’t pass lately, though, that doesn’t include a few new warnings from the media that the GOP’s reluctance to effectively dissolve the country’s borders is costing them big time among Latino voters. The Democrats won’t want to squander that advantage by withholding “free” health care from the “undocumented”; why, to do so would be downright nativist.

Hmmm.

Health care in America is not cheap, we all know this. But given that we are facing entitlement budgetary pressure, how can we afford to have another entitlement that will almost certainly top the $110 billion that Clinton claims her plan will cost?

Hillary Care, Redux

Clintoncare exposed.

Now that Hillary has announced her health care plan, comparisons to failed policy of 15 years ago are going to be commonplace.

Oh, yeah, and the new plan sucks too!!

Edwards: Go to Doctor Or Else

It is no secret my loathing of government run health care proposals being bandided about, but John Edwards' plan right now leads the pack in stupidity:

Democratic presidential hopeful John Edwards said on Sunday that his universal health care proposal would require that Americans go to the doctor for preventive care.

"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

He noted, for example, that women would be required to have regular mammograms in an effort to find and treat "the first trace of problem." Edwards and his wife, Elizabeth, announced earlier this year that her breast cancer had returned and spread.

Edwards said his mandatory health care plan would cover preventive, chronic and long-term health care. The plan would include mental health care as well as dental and vision coverage for all Americans.

"The whole idea is a continuum of care, basically from birth to death," he said.

Cradle to grave health care and the social welfare state is a European invention that is leading to their stagnating population and decline. Is this really where America wants to go?

Then there is the issue of requiring medical care. How is Edwards going to know whether someone has gone to the doctor or a woman has gotten a mammogram? Right, the doctor will have to report you for failing to go to the doctor once a year. Does anyone else see a problem with this? Oh, and by the way, it may very well be illegal under current federal law barring the sharing of personal, private medical care outside of a few cases. It is one thing for the doctor to submit a claim for payment for services rendedered and quite another to submit a report for failing to take advantage of health care.

More and more Americans are starting to see through the smoke and mirrors of universal health care and they do not like what they see.