California Reinvents Medical Tourism

Until very recently medical tourism was traveling from your home to find less expensive medical care, usually overseas. Medical tourists were leaving the warm embrace of the American Medical Association and the FDA to journey far from home. There were three motivations: Elective plastic surgery not covered by insurance, wanting to try an experimental procedure not covered or getting surgery done without benefit of any insurance at all.

That’s why breasts were being lifted in Brazil and hips replaced in India. Particularly courageous patients scheduled foreign heart transplants. I know all about this because I was almost a medical tourist myself. A few years ago we had what was laughingly called health insurance. Our deductible was so high you had to have been on life support for a week before coverage started.

I had a sports hernia, which meant the problem was on my dime. While pondering options, I devised an effective, temporary solution for the gym. After carefully folding a washcloth over the leak, I’d wrap myself with a giant Ace bandage.

Frankly, I liked my new slim waistline with only a hint of bulge in the intestinal wall. There were days when the Ace came loose and I trailed spandex out of my shorts like toilet paper stuck on a shoe, but it was a small price to pay.

The wife didn’t agree. Janet said it was gross and told me to quit procrastinating and get the hernia fixed. The medical tourism broker’s choice was Thailand or Oklahoma City. I couldn’t see paying $1,000 for an airline ticket on top of the procedure when the Okies were so much closer. Even then the procedure would set me back about $4,500.

That was still too much. In the end I opted for Dr. Amazon and bought a 12–dollar truss, which didn’t make me look as slim, but kept my lower tract in place.

California politicians have a proposal before the legislature that would totally eliminate my worries about cost. Instead of patients traveling overseas and paying for medical care, California politicos will have foreign patients coming to the Golden State and it won’t be to consult with me about trusses.

After the airline ticket or the coyote’s bill is paid financial worries are over. California taxpayers will cover the rest.

That’s just one of the disasters awaiting passage of what the LA Times terms “government–run universal healthcare.”

The Times description: “SB 562, would establish a publicly run healthcare plan that would cover everyone living in California, including those without legal immigration status…The state would pay for all medical expenses, including inpatient, outpatient, emergency services, dental, vision, mental health and nursing home care.”

Talk about no “pre–existing” condition worries. One doesn’t even have to be a pre–illness resident. Just make your way from the airport or border crossing to the hospital and watch the doctors scrub up. California welcomes Anchor Babies and Anchor Patients!

Lefty politicians claim the program will be paid for by what is nebulously described as “broad–based revenue.” This sounds ominous to me. California’s tribal Democrats oppose rounding up illegal aliens, but they have no qualms about corralling taxpayers and squeezing them until their wallets pop out like hernias.

Supporters of the bill were the usual suspects: Unions looking for guaranteed taxpayer–financed positions with permanent job security and clueless members of “Our Revolution,” a Bernie Bros conglomeration.

The support of the Saunders’ crowd is particularly interesting because Vermont tried a version of single–payer healthcare and it was so expensive it collapsed before it was implemented, which must be a record of some sort.

In Vermont the bill was passed and prior to the program’s kickoff the legislature got cold feet and commissioned a financial projection study. It found the cost would be $4.9 billion a year, which would double the state budget. To pay for it payroll taxes would have to be increased 11.5 percent, individual income taxes would jump 9 percent and a border wall would be built to keep rich people from fleeing to cheaper states.

The governor and legislature were so taken aback the plan was shelved.

Cost estimates for the Golden Fleece, I mean Golden State plan put the yearly total at more than double (there’s that word again) the state’s current budget of $180 billion. But there’s no need for California single–payer fanaticists to worry, their legislature never learns. They plan to seize the $50 to $100 billion the private sector currently spends on employee health insurance and then wait for the rest of the money to turn up.

In the meantime many trips are anticipated at taxpayer expense. Legislative “fact finders” are planning trips to Canada, Taiwan and Maryland to learn “best practices.”

The only place they won’t visit is Vermont.

The Car Dealership Solution to Health Insurance Costs

Bloomberg reports Obamacare premiums are scheduled to skyrocket up to 59 percent in Maryland, 38 percent in Virginia and 34 percent in Connecticut. A Baltimore 40–year–old would pay $715.00 a month for a plan with a $2,500 deductible.

Health insurance is costly for three reasons: Government interference, lack of price transparency and consumer overuse.

Here’s what would happen if we used car insurance like health insurance.

We’d expect oil changes to be covered after our $20.00 co–pay. There’d also be a long list of routine checks and diagnostics run each time your ride was in the shop, because the Dept. of Transportation requires mechanics to treat every vehicle like it was a 1961 DeSoto that had never had the oil changed.

Your $250.00 invoice would have itemized charges for GoJo, shop rags, coveralls, disposable ratchets, oil, opening the oil, oil filter and about a hundred other entries.

But that doesn’t matter, since after the co–pay, everything is free! Besides you feel sorry for DeSoto owners.

Later the car breaks down on the highway. You tell the CarFlight pilot to drop it off at the Mercedes dealer. Cost doesn’t matter once the deductible is paid, but you do demand a nice loaner while your car is in surgery.

Before leaving, you tell the mechanic to check the tires and see if they need replacing, because after all that’s what insurance is for, isn’t it?

Car insurance usage at that level would end our obesity crisis, because we’d soon be a nation of pedestrians. Obamacare would be joined by Obamacar.

Real Obamacare reform would require the health market to operate like the auto market.

I don’t mean the patient goes in the doctor’s office, negotiates for six hours and agrees on a price have his appendix removed. Then, in his weakened state, the finance manager pressures him into breast implants for the wife.

What I do mean is allowing consumer choice and provider accountability.

Smart consumers get an estimate before their car is serviced. If it’s too high, they talk to another shop. If it’s too much money to sink into an old car, you start shopping for new.

That’s price transparency. In health care we have price opacity. If you ask the hospital what it costs to have your appendix removed you get one of three replies: Uproarious, table–pounding laughter. Dead silence. Or thinly veiled contempt at such an ignorant question.

Price uncertainty might make sense if it was a brain transplant. Plenty of variables there, but that’s not the case with appendectomies.

The Annals of Surgery estimates 280,000 are performed each year. Producing a reliable cost estimate should be routine — give or take a sponge left inside.

Yet you can’t get an estimate because consumer knowledge is consumer power.

One way to begin imposing market discipline would be to require any hospital taking federal money to post turnkey prices for the 25 most common hospitalized surgical procedures; the 25 most common out–patient procedures and the 25 most common tests. All charges must match the best price offered insurance companies.

The howls this would generate from the medical–industrial complex prove how useful the information is. (More details on this in an earlier column here.)

And speaking of sponges, if you take your car in to the shop for an engine overhaul and a mechanic leaves a wrench in the crankcase, that car is going back to the shop. The subsequent repair–to–fix–the–repair is free.

That’s not the way it works with hospitals. Hospitals make money on their mistakes and get away with it because consumers send the bill to the insurance company.

That means higher premiums in the long run and it encourages incompetence. If the guy who works on your car has to fix his mistakes for free, the guy who works on your heart should, too.

People should pay for routine doctor’s visits out of their own pocket and save insurance for major expenses. When my family was between insurance policies I negotiated the cost of doctor’s appointments and lab tests by offering to pay in full right before I left. I saved 30 to 40 percent by taking the insurance company out of the equation.

Putting a middleman between the provider and the patient adds another layer of cost and bureaucracy. Hiding the cost of medical services encourages overuse.

Consumers can choose health insurance coverage options just like they can choose auto insurance coverage. Government “experts” requiring coverage simply guarantees a lifetime income to lobbyists and treats citizens like serfs.

My car market analogy isn’t perfect. Legislators protect in–state auto dealers from out of state completion, just like health insurance companies are protected now. It is certainly a start, though, and a vast improvement over what we have now.

Ryan’s Obamacare Lite Is Another Travesty & Betrayal

Freshman Rep. Moira Walsh had an unusual explanation for some of the bad lawmaking in her state capital during an interview on Rhode Island’s WPRO, “It’s the drinking that blows my mind. You cannot operate a motor vehicle when you’ve had two beers but you can make laws that effect people’s lives forever when you’re half in the bag?

Too bad Moira isn’t in Congress. Booze would be a more acceptable explanation for Paul Ryan’s Obamacare replacement bill than the truth, which is this bill is a betrayal of conservatives seven years in the making.

As the Heritage Foundation points out this slap in the face protects the Democrat base that got free or heavily subsidized coverage at the expense of the GOP base that earns the money to pay for Democrat’s discount insurance.

As I’ve pointed out to friends in the past the price of an Obamacare policy isn’t bad if you remember your premium is buying for two policies: One for your family and another for the moochers.

Ryan evidently believes Republican meddling in the health insurance market is such a big improvement over Democrat meddling that he’ll rule for decades. The truth is the base didn’t vote to swap incompetent meddlers we don’t know for incompetents we do know.

Our mistake was believing the lie that once Republicans controlled all three branches of government they would repeal Obamacare.

My doubts began when “repeal” was amended to “repeal and replace.” Why replace Obamacare’s socialized medicine with the Republican’s Obamacare Lite?

A simple return to the situation that existed before the passage of Obamacare could mean a reduction of up to 30 percent in the cost of insurance premiums and the return of the missing doctors. That alone should be enough win re–election.

The insurance market circa 2008 will cause problems in the dependency class that doesn’t like their handouts interrupted. But I have news for Ryan and his RINO gang — they don’t vote for you anyway. Your voters are the people this bill continues to burden.

Ryan and the rest of his brain trust would rather betray the voters who supported them than risk headlines from the Opposition Media about taking free insurance away.

Ryan’s bill fails in three major areas.

First it does nothing to increase competition in the insurance market. Insurance companies still can’t sell nationwide, the “lines around states” Trump mentioned in the debate. This change alone would lower prices because companies would compete against each other. That’s why you can afford homeowner’s insurance and you can’t afford health insurance.

Second it does nothing to lower prices because the onerous and expensive coverage requirements for every policy are still included. If the consumer wants to buy a policy that covers him from Q-tip to transplant, fine he can pay for it. But if all he wants is major medical, he should be able to make that choice.

Finally it penalizes Republican states that didn’t expand Medicaid and rewards Democrat states that ran up a tab on Uncle Sam. The bill promises this will be phased out in the future, but we’re supposed to believe a Republican Congress that won’t boot 25–year–olds off daddy’s policy today will find the backbone to cut Medicaid tomorrow?

This debate isn’t really about health insurance and discussing it in those terms lets leftists set the parameters. This debate is about personal liberty. The liberty, as an adult, to make your own decisions regarding the future.

Government isn’t the national airbag saving the impudent and foolish from the consequences of their own stupidity. This only encourages more irresponsibility among the demographic whose only long–term commitment is a tattoo.

Healthcare isn’t a right. You don’t have the right to make someone go to medical school, graduate and then treat you for a price you think is reasonable, any more than you have a right to make the barber cut your hair.

I hope there are enough conservatives in the House to defeat Ryan’s disingenuous travesty. Because if they don’t it, means Obama won.

It’s obvious only difference between Nancy Pelosi as Speaker of the House and Paul Ryan is velocity. The train just moves slower and the conductor’s assurances are less believable under Ryan, but the final destination is still Greece.

Passage of this bill will raise a very pertinent question for conservatives: Why do you have a stronger belief in conservative principles and the power of the free market than the politicians who get your vote?

Why should we pretend anymore?

My suggestion next November is vote for the politician who promises to give away the most; at least he’s not a hypocrite. Maximize benefits now and hope the money doesn’t run out until after you’re dead.

Congressional GOP: The Dogs that Caught the Obamacar

Pity the poor Republican leadership in Congress. There they sit – paralyzed by the power for which they pleaded over the last four elections.

In 2010 when the GOP took control of the House they were powerless because Republicans didn’t have control of the Senate.

obamacare-crushes-middle-classIn 2014 Senate control fell into their hands, yet they were still powerless because Democrats controlled the White House.

Now they control the House, Senate and the presidency, but they remain powerless. This time because the left still controls the media and Jake Tapper doesn’t stand for re–election.

The Obama presidency was really the good old days. Congress could bravely vote to repeal Obamacare secure in the knowledge the bill would never take effect because Obama would veto it. And it he did.

All those votes were so many talking points in a re–election commercial. Now a vote to repeal Obamacare will pass and result in the Opposition Media’s veto. And our timid, public trough–feeders fear the consequences.

Damn, no one told them winning in 2016 would mean they’re now responsible!

So what are Congressional Republicans going to do? You’ll have to read the rest of my column on Newsmax to find out. Plus there’s a bonus: I answer the main arguments leftists have against repeal. Clip and save for your member of congress. Thanks for reading.

http://www.newsmax.com/MichaelShannon/Obamacare-premiums-repeal-replace/2017/02/23/id/775154/

 

Uncle Remus’ Solution to Obamacare Repeal

“Roast me! Hang me! Do whatever you please,” said Brer Rabbit. “Only please, Brer Fox, please don’t throw me into the briar patch.”

Uncle Remus Stories

Gullible Republican House and Senate members, convinced that repealing Obamacare also involves replacing Obamacare, are preparing to throw Democrats right into the middle of the federal briar patch that is their natural home.

repeal-obamacare-cartoon-heller-495x342

Sure Democrats are making a big deal out of the repeal of Obamacare — there are even rumors Obama himself cut back to golfing only six days per week — yet replacing Democrat meddling in the healthcare marketplace with Republican meddling is no improvement and worse still, gives Democrats an avenue to expand their interference in the future.

Think of Obamacare as one of those patients with a pre–existing cancer. The merciful response is to eradicate the cancer once and for all. There will be some pain and uncertainty, but in the long run the patient and the country will be much better.

Exchanging Obamacare for some jury–rigged replacement only means Republicans decided they want a tumor of their own. It makes federal intrusion into healthcare a permanent feature of modern life.

Our weak, vacillating GOP leadership faces a Treaty of Versailles situation. At the conclusion of World War I the allies wanted to end Germany’s war–making capability, but during negotiations the allies made a crucial mistake. They repealed the Imperial German Army and its General Staff, replacing it with a smaller Weimar Army. German bureaucrats just hid General Staff personnel in a tame sounding “troop office.”

When Hitler came to power the foundation of the Wehrmacht already existed, all he had to do was add manpower. That’s the danger for “Mitch McClellan” and Paul Ryan: Replacing Obamacare with the Wehrmacht–in–waiting. When the next Democrat Congress or president takes office they simply have to ramp up spending and “reform” the Republican replacement and we’re back where we started.

So what should Republicans do after repealing Obamacare? I have a four–point program that protects Constitutional government, taxpayers and patients. You can find all the details by clicking on the link below and going to my Newsmax.com Insider column.

Thanks.

http://www.newsmax.com/MichaelShannon/obamacare-repeal-replace-legislation/2017/01/12/id/768208/

 

 

Congressional Obamacare Hypocrisy: They Get the Subsidy, Taxpayers Get the Bill

Sen. David Vitter (R–LA) is in lonely fight against Congressional Obamacare hypocrisy.

Republicans claim to be against Obamacare, yet many protect their staff, along with their health plans, from the same federal meddling, cost and inconvenience taxpayers must suffer. One expects that from Democrats but it’s infuriating from Republicans.

Vitter has been trying to end this shuffle for more than two years.

Now there may be hope that Vitter will succeed with a little help from you over the Christmas and New Year holidays.

Complete details in my Newsmax column at:

http://www.newsmax.com/MichaelShannon/Congress-Staff-Taxpayers-Vitter/2014/12/12/id/612685/

Lies. Damned Lies. And Obamacare Statistics.

Carnac: The software that knows what you want to spend before you spend it.

Carnac: The software that knows what you want to spend before you spend it.

The latest batch of October statistics from the Obama White House credits me with buying a Mercedes, BMW and an Audi. And the best part is it didn’t cost me a dime! All I did was take three test drives and here I am: A GDP–generating fool.

This flexible interpretation of window–shopping and tire–kicking has great potential for the future. I’m thinking about taking credit for job creation when I get a haircut or have my car washed. With just a bit more attention to my personal appearance I could find states competing to offer me subsidies and tax breaks like Terry McAuliffe got from Mississippi.

And wouldn’t you know it, this conceptual breakthrough started with Obamacare and the HealthCare.dud website.

Some of my conservative colleagues complained when Obama minions began counting people who only visited the HealthCare.dud website and selected a plan, but didn’t pay for it as Official Obamacare Enrollees. These stalwarts contend that until the victim has actually paid for the plan there is no sale and consequently no enrollment, regardless of how much they need the insurance or how many hours they wasted on the website.

What’s more, if we let Obama get away with this, soon people who only thought about health insurance would be counted as part of the system.

The private sector equivalent of this new White House statistical interpretation would be Amazon.com counting items still on shopper’s ‘wish lists’ as being revenue generating sales; and then releasing the information to Wall Street so as to drive up the stock price.

Since he’s not president, the result would be Jeff Bezos facing charges, while Obama merely faces a hostile — make that mildly annoyed — press corps that is having trouble coming up with new excuses for the president’s failures.

The conservative objection, while true, misses the larger point. Based on the Phantom Obamacare Enrollee Precedent, when I buy my 2013 copy of TurboTax and fill out the form, I should be counted as having paid my taxes without sending the IRS a check!

I call it my own private sequester. And when you consider how the number of people who take more from the government than they pay in taxes is increasing, it finally puts me on the right side of history.

The Obamacare rollout — or ground out, if you prefer — does have implications for Obama’s future after the White House. If he’s as smart as the MSM assures us, Obama will steer clear of the private sector. That’s because if he tried the same marketing tactics outside of government, he would be subject to fines and possibly jail time.

As Orson Swindle, a Federal Trade Commission member from 1997 to 2005, pointed out in the National Review the HealthCare.dud website is deceptive, misleading and illegal. Jay Carney’s “wild west” indeed.

You may recall a recent furor over airline websites that were allegedly hiding baggage and other add–on fees until just before the consumer purchased the ticket. “Consumer advocates” and other busybodies complained that by waiting until the end of the purchase process to give the consumer a total price, airlines were trying to pull a fast one.

Airlines responded that where else would you give a total price unless it was at the end of the purchase process?

And besides the Carnac the Magnificent software was not ready for launch. Protests fell on deaf government ears and the FTC required the websites to be reprogrammed to sound a klaxon and flash red lights every time a consumer made a choice that would add more than a nickel to the ticket price.

Soon shopping for a big–ticket airfare came to resemble crash–diving in a submarine.

Yet the HealthCare.dud site is programmed to hide any cost information until after the consumer has created an account and been forced to divulge detailed financial information. And even then the information is purposely inaccurate.

As Swindle says, quoting CBS News, “HealthCare.gov contains a pricing feature that tends to “dramatically underestimate” the cost of insurance. The website’s “shop and browse” feature divides users into two broad age categories: “49 or under” and “50 or older.” Price estimates for the first age group are based on what a 27-year-old could expect to pay, whereas as the latter group’s price estimates are based on what a 50-year-old would pay, a practice that inevitably produces wildly misleading results for individuals significantly older than the base age. In some cases, actual premiums are nearly double the projected amount.”

Swindle concludes, “The bottom line is that no private entity would be allowed to get away with what the Obama administration is trying to get away with.”

And we haven’t even mentioned the “if you like your health insurance, you can keep it” shuffle.

The bad news is we have conservative busybodies, too. Rep. Fred Upton (R–MI) — descendant of Civil War hero Gen. Emory Upton — passed a bill in the House to allow insurers to continue to sell policies that the feds have canceled. What’s more, Upton persuaded 39 Democrats to join him in supporting this “bi–partisan” legislation. (Unfortunately for comity in the House, the bill must have passed on the weekend, because I don’t remember any praise for Upton from the MSM for reaching across the aisle to garner Democrat support.)

Too bad this is exactly the wrong thing to do.

If we are to rid ourselves of this Obamacare monstrosity, it will only come after the pressure on Democrats is so great they beg for political mercy. And that will only happen after all those who didn’t take time to read the law, feel the impact of the law.

Interim fix–its to reduce the pain undermine what should be conservative’s long term goal, which is end it, not mend it.