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What Will Obamacare Do –To You? Part 5

Monday, November 30, 2009  |  posted by Hugh Hewitt

More e-mails:


As a physician (rheumatologist) listening to your guest, Jonathan Cohn, I found myself yelling at the radio “you have no idea what you are talking about!” repeatedly during the interview.

If he is going to hold himself up as an informed “expert” on the subject then he should know that physicians, after years of static reimbursement, are now facing a 21.5% cut in fees in January 2010 increasing to a total 40% cut in, I believe, 2014. In addition, starting Jan 1 2010, consultation fees for specialists are being eliminated (watch as seniors no longer have access to specialist care).

His comments on nosocomial infections and the ease with which they can be eliminated “if everyone would just wash their hands” exudes ignorance. Please send him into the ICU where someone has been on a ventilator for weeks, or the dialysis unit where the disease causes immunosuppression, or the oncology unit where chemotherapy has just wiped out an immune system. Every effort is made to prevent infections, but they occur anyway.

Then he tells me that once we all have electronic records we are going to become SOOO much more productive that they will easily be able to cut the reimbursement for the productivity part of the calculation! Funny, but every practice I know that implements EMR loses productivity and the records these things generate are generic and tell me, on the receiving end little about what is really going on with the patient. (Then there is the privacy issue…). I will have said goodbye to my Medicare patients long before.

I could go on. But the sad fact, as related to me by Phil Roe, a physician (OB-GYN) and Congressman from Northeast Tennessee, is that in neither the House or Senate was even one physician legislator asked for input on the healthcare bill. The law of unintended consequences is going to have a far reaching effect if this abomination becomes law.


Orlando, FL


My sister-in-law graduated from medical school in May, 2010. She will have a tremendous amount of debt as most medical students. She told us that she and her colleagues are very worried about how they will be able to pay off their debt. I don’t know if most people understand how difficult medical school is, how hard they work, the hours spent on call, studying, loss of vacation/holidays and cost. The number of doctors will go down if there isn’t some type of monetary incentive for all of the difficulties they incur.
Also, I heard on another show over the weekend a bit about Massachusetts where they have a similar plan to what is now being debated in the Senate. I was surprised to learn health insurance plan restrictions there, for example, the highest deductible plan allowed is $2000 a year. I currently have a $4000 deductible plan which I’m sure is less expensive. Also, in Mass. they have a mandate that the insurance plans have to cover invitro fertilization. That surely drives up the cost of insurance (who knows what other mandates they have there?). Mitt Romney’s future is not helped by what’s gone on in Mass.
It was scary to hear your guests and their uncertainty about what the plan will or won’t do. They are unable to foresee the consequences of the legislation, which is not surprising due to length and complexity of the bill.
This will be a disaster. My youngest son was diagnosed with type-1 diabetes last year. I just worry that the great care we have had so far is going to deteriorate in the future.


Well, you said you thought those Docs for Obamacare would view the real world from a distance, and that guy from Brookings sounded like just what you were talking about. When he claimed that Obamacare would increase efficiencies in health care delivery, would that be like the increased efficiencies of the Indian Health Service? Or the efficiencies of the Medicare billing center that the insurance IT caller deals with every day? Or would they be like the efficiencies of Britain’s NHS?
Talk about out of town!


Hi, Hugh,

Thanks for keeping up an informative discussion on healthcare. I’m sure you are getting swamped with e-mails on this!

First, here is a little about our healthcare situation. My husband lost his job at the end of August 2008. One of the first things we did was look for our own health insurance. A quick online search gave us 20 pages of offers. (So much for the argument that individual policies are hard to find). The costs range from $220 to $2,500 per month, depending on the coverage. When we found out that our COBRA would cost us $1,100 a month we wisely decided on a low premium ($370)/high deductible with a health savings account (HSA). The money we saved on the premiums would go into the HAS, tax free. In the mean time, my husband found a temporary job, making him self-employed so our entire premium amount also became tax deductible.

We are healthy, active, and in our mid-fifties. Our health emergency struck in March, and my husband needed emergency gall bladder surgery. Even after paying the premiums and the deductible, we still spent less than our COBRA would have cost. We had complete control over the treatment, and did not need permission to be seen. We are paying premiums we can afford, since my husband is now unemployed again. We are protected against a catastrophic health emergency that could wipe us out.

Here is where I see Obamacare having a profound effect on us. If there is a limit placed on the deductible, and the elimination of the HSA, our plan would be eliminated. We would be forced into a higher premium plan. So much for “if you like your insurance, you can keep it”. With the shortage of the vaccine for the H1N1 virus, the change in the recommendations for mammograms and pap smears, I can see the future, and I don’t like it. Right now I have complete freedom to seek my own medical treatments without having to ask the government, or any one else for permission. If I don’t like the decision by my insurance company, I can dispute it, and I have an 800 number to speak to Customer Service. Under Obamacare the treatments and innovation won’t even be there for me to use, and who will we be able to call to complain? The short answer to the effect on us is MORE expensive insurance and LESS choice in medical treatment.

I live in Illinois, and the person I would like to hear interviewed to defend Obamacare is our own Senator Dick Durbin. I have written to him at least two dozen times over the course of the summer and fall. I have asked him how I can keep my insurance, which he keeps insisting I can, when he will mandate what I must purchase. I have asked him how he can vote for a bill when he does not know what is in it, or how it will affect us, or how the inevitable mistakes in it will be corrected. I have asked him how I will dispute a denial of service from the public option, and who I would sue for any resulting damages. That is just a sample of some of the concerns I have, but I have received NO satisfactory response. I know it is just wishful thinking, but I would really like to hear him defend this in a tough interview. He actually sent me an e-mail claiming that 80% supported the public option! I’d like to know where he got that figure.

Thanks for seeking our thoughts on this important issue.

Mundelein, IL

P.S. I just finished listening to Jonathon Cohn while I was typing this. He sounds like a kid with book smarts and no common sense! He needs to get out into the real world.

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What Will Obamacare Do –To You? Part 4

Monday, November 30, 2009  |  posted by Hugh Hewitt

After guests Jonathan Cohn of The New Republic and Henry Aaron of Brookings –both supporters of Obamacare– appeared on today’s program, the e-mails began to flood in. The transcripts of both interviews will be posted here later. Here’s a long thread of e-mail responses:


I have a cancer that, like so many, is treatable, but not curable at present. The same disease that has killed Peter Boyle and Roy Shieder, and that Geraldine Ferraro and Hobie Alter are currently suffering from – multiple myeloma.
Treatable means that big horrible greedy pharma co’s need to keep coming up with treatments. I’m taking Revlimid, which is a derivative of Thalidomide – so consider the faith that Celgene had to have to stick with such a scary drug to use today to save my life.
I have no confidence at all that once things shake out, and the Public Option sucks the INVESTORS out of the game, that the funding of what the miracle of medical science will continue at nearly the same rate that capitalism brings to game.
And as someone that once the president of an Ins. co that booked 90% of its premium in A & H I know that a public option funded by by a printing press in Philadelphia, controlled by a Congress in D.C. that within 10 years there will be no choice left.
Which, I guess to end my digression, will parallel the hospital industry, which has the same investor paradigm and will leave us with gov’t run hospital/clinics where we can wait in line.
Oops; one more digression. The abuses that will be used by those looking to make money off of such a large part of our economy suddenly run by Feds will be a thing to behold. Maybe you remember what we used to call “Rolling Labs”; they were big old RV’s that would roll into a strip mall offering free physicals. Once they had your Soc. Sec. and health plan number the diagnosis started coming in from all angles. Can you imagine the Fed plan giving a rip? My wife worked for IRS in Ziggaraut Bldg in Laguna Niguel and I’m here to tell you that one walk through the hallways of that facility give you great pause as to who we actually even employ in our Fed gov’t… but there needs to be a place for everyone willing to work, sort of work that is… 😉


Your guest was not accurate about Medicare fee cuts to doctors. There is a 21.5% cut scheduled for 2010. By 2014 the total cut will be 40% according the Center for Medicare and Medicaid Services. The are cuts in nominal dollars. Doctors’ fees will also be reduced by inflation, as we have experienced the past few years when fees were “frozen.”


Hello Hugh,

For 2010, Medicare Advantage [ obtained through my former employer]
will cost me $273.93 per month. Traditional medicare [also through
my former employer] would cost me $357.90 per month. Both totals
include prescription drug coverage. Jonathan Cohen’s statement that
traditional Medicare would cost less for the Medicare participant
LESS is clearly wrong!

New Kensington, PA


The gentleman you’re speaking with has the preprogrammed salespitch for single payor healthcare down quite well. Unfortunately it’s a ruse. The spiel that the “savings” are based on savings in Medicare Advantage programs is made for publication. In reality, there is NO way the gov’t would save more than a pittance by eliminating Advantage coverage. All Advantage participants pay a premium for additional services. Often the benefits received by the plan participant do not exceed the premium. (I.e., there are a lot of “services” offered for partial coverage, but the number of enrollees that utilize the majority of those services is not that significant)
Medicare supplements (that provide coverage for patients with Medicare part A, part B, and part D) are increasingly expensive. The graph of the cost escalation for this coverage is necessitated by the “gap” from Medicare reimbursement.
The number of medical clinics that are refusing new Medicare patients is rising. In the twin cities, MN, there are more each and every day. Without private pay or “good” third party payors, there is no way a competent physicians’ practice can afford Medicare. Good examples are radiology, anesthesiology, specialty surgeons, and a growing number of professionals with outstanding quality care.
With the collossal number of states well within the financially destitute range, the amount of Medicaid expenditures for poor seniors necessary medical services that Medicare does not cover is skyrocketing. This is no where in the media. Since the number of poor elderly patients is growing rapidly, the state outlay is growing. It is easy to see why Arizona is marketing the state capital. The question is… What is the state budget item that is growing the fastest? The answer is clearly Medicaid for the elderly.
Your guest’s statement regarding nosocomial infection prevention is somewhat valid, but horrendously myopic. It is liberalism without objective thought. Realistically, dialysis patients with multiple depressed immune status’, immunosuppresssion, and a high need for medical treatment, are at major risk for acquired infections. No resistance and multiple ports of entry are a virtual guarantee. To not cover care for these patients is ridiculous. Liberalism is devoid of fundamental analysis. Conclusions based on trend line analyses fail to incorporate legitimate facts pertinent to quality medical care. Generic criteria used to generalize “how to save” by policy makers have a chronic history of ineptness.
Have a good week,
Gene in St Paul

What Will Obamacare Mean –To You. Part 3.

Monday, November 30, 2009  |  posted by Hugh Hewitt

From another reader:

Thanks for the invitation for input.

First my mind-set. I don’t think Democrats give a rats backside about what the American people think. Polls could be 65 / 35 against and they will still impose the Obamanation.

Next my situation. I am 69 years old and have worked for Lockheed-Martin for 30 years. I had hoped to retire at 70, but since the economic melt-down, will probably work to 75. For 30 years we have been covered by one HMO or another (“worker-bee” coverage, not executive level). We have been very satisfied with the coverage. This year, Lockheed-Martin is instituting its own coverage. We will see how that works out. If Obamacare becomes law, the corporation will dump us into the government system. That’s what corporations do.[# More #]

As I said, I’m 69 and my wife is 65. If Obamacare had been in place 5 years ago, we would both be dead. As Mark Steyn says, the government would have reduced our carbon foot prints to zero.

Five years ago on Christmas, I had a massive heart-attack. I was rushed to a brand-new private hospital in south Denver, where all of the latest technology was used to save my life. I was given 3 stints (the latest improved models) that are still working perfectly. The HMO paid almost all of the bills.

Three years ago my wife was rushed to the same private hospital. After 12 hours of extensive tests, a specialist discovered that an old spine injury was putting pressure on the spinal column and that she was in danger of complete paralysis. She was in surgery the next day (with the best surgeon and the best support team in Colorado). She has since made a full recovery. The HMO paid almost all of the bills.

We are not stupid people. We know how Obamacare works in Canada. We know how Obamacare works in Britain.

This is not a rational argument (at least not at the level of how will this work or what will it cost?).

Democrats are dead set on taking control of every aspect of every individual American’s life (and death)….

Our only hope is to identify the few remaining sane Democrats and get them to vote against the bill (and while we are at it, we will need a few extra votes to off-set the RINOS).

What Will Obamacare Mean –To You? Part 1.

Monday, November 30, 2009  |  posted by Hugh Hewitt

Below I asked for first person accounts of what the Senate’s version of Obamacare is likely to mean for readers. Here’s the first response, from Andrea in Sacramento:

Hi Hugh –

Thank you for taking input from plain, ordinary citizens about the horrendous “health care” the legislature wants to thrust upon us. We are a homeschooling family, and my husband Mark is self-employed, so we don’t represent the bulk of the nation; but I am very well acquainted with the costs of health care because I have had to buy it for our family for nearly 20 years. Our income is low enough that we qualify for Healthy Families and quite likely qualify for Medicare or Medicaid or whatever they call it, but we don’t believe it is the government’s job to provide health insurance for our family.[# More #]

We were priced out of HMOs years ago when our monthly premium went from about $450 to over $600 (and that was not with a change in age bracket). That was the largest increase we have had in all our years of buying health insurance, but we generally do see a 25% increase each year. I often hear that health insurance costs rise about 10-15% each year; that certainly has not been our experience. Following that huge increase, we switched to PPOs to lower the costs, and we found a great plan for $178, but it nearly tripled in cost in just three years. We then discovered that the insurance company had developed a lower tier without notifying us, so they were charging us $100 more per month than we ought to have been paying. We then began to do business through a broker, thinking that they would have informed us that there was a lower rate that we qualified for. I’ve since learned that that is not the case when earlier this year, I learned that our plan had been lowered by $30 per month; I had to follow up with both our broker and our carrier to get our premium lowered to the new, lower rate.

Every couple of years I have to find a new plan because our current plan becomes too expensive. Usually that means switching insurance companies. In California, we basically have only three choices (excluding Kaiser)–Blue Cross (now called Anthem), Blue Shield, and Health Net. Since Blue Shield was the company that overcharged us for over a year, that leaves just two options for us. Each plan that we have switched to has been a plan newly developed by the insurance company, and with each change in plan, we lose more and more benefits. Right now, for $360 per month, we have a plan with no prescription coverage and a $2,500/$5,000 deductible and a $5,000/$10,000 out of pocket maximum. We essentially pay for everything ourselves, and thankfully we rarely need to use our health insurance, with the exception of my oldest daughter who is being treated for acne.

If the government really wanted to help us (which I don’t think they do), the first thing they could do is allow us to deduct our health insurance premiums as a business deduction rather than merely as an income deduction where it is still subject to self-employment taxes. Another thing they could do would be to allow companies to sell insurance across state lines to give us more options. I’ve even heard of very low-cost programs with doctors and hospitals that are available in other states but not here in California. Through your show, I’ve also learned that the states (and California is likely at the top of the list) have certain mandates that increase the cost of insurance. If those were removed, that would also be a big help to us.

As far as guests to have on the show, the first person I thought of was Bobby Jindal. I would really like to see him run for president in 2012, and I understand he has a background in health care through the Bush administration. We need government officials committed to fixing the problems. I also would like to hear more observations and suggestions from Clayton Christensen. His ideas on innovations in the way health care is delivered seems to be the way to improve the system–using technology to help nurses take on the routine tasks and diagnoses now handled by doctors, thus allowing general practitioners to move into the more routine areas now handled by the specialists so that the specialists can concentrate on the complex cases.

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