Category Archives: FedMed

Friday Follies for February 24, 2012

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Gas Prices: A refinery fire in Washington state is the trigger, so says news sources, for the recent spike in retail gas prices. A fire last Friday at the BP Cherry Point site at Blaine, WA, is the trigger for the increases.  Gasbuddy.Com, a website that tracks gas prices across the country, says the fire halted production at the site.  The BP Cherry Point refinery produces 90% of the transport fuel for the west coast.

This weekend a major fire that started Friday at the BP Cherry Point Refinery in Blaine, Washington has left the refinery unable to take in its daily intake capacity (230,000 barrels per day), much of which arrives from Alaska. Approximately 90 percent of the crude oil refined there emerges as transport fuels making it the largest marketer of gasoline and jet fuel on the West Coast.
…

The refinery is on a massive sprawl of 3,300 acres and was built in 1971, making it one of the newer refineries in the U.S. Until this weekend, it was producing 3.5 million gallons of gasoline; 2.5 million gallons of jet fuel; and 2.2 million gallons of diesel per day. — GasBuddy.com

The suddenly cut in production was felt across the country.  West Virginia saw a $0.20-0.30 per gallon jump reports the West Virginia Gazette.

CHARLESTON, W.Va. — Gas prices in Charleston rose between 20 and 30 cents per gallon on Wednesday.

According to Gasbuddy.com, a company that tracks gas prices at more than 140,000 gas stations in the United States and Canada, gas prices at most stores in the area were between $3.49 and $3.58 early in the day and had risen to $3.79 and above by late afternoon.
Jan Vineyard, president of the West Virginia Oil Marketers and Grocers Association, said the cost from one of the area’s major suppliers went up 15 cents for gas stations, causing the higher prices. — WVGazette.

The West Virginia report also blames the crises with Iran and the transition to summer blends contributing to the increased prices.

Locally, here near KC, we could expect another ten to twenty cent increase in our gas prices before the weekend according to GassBuddy.  The price here has already risen twenty to thirty cents just this week.

***

My wife and I hit 65 this year.  Like it or not, we’re being forced to sign up for Medicare.  My former employer only provided health insurance until we reach 65. At that point we’re dropped and expected to join the Medicare crowd.  Frankly, I couldn’t afford to stay with my employer’s health plan, it was costing me $1400/mth.  Up to this point, the cost was covered by a savings fund created when I was working.  Contributions to that fund ended years ago with the merger of Sprint and Nextel.  Sprint had a pension plan, Nextel didn’t.  After the merger, Sprint didn’t have a pension plan either.

The survival and efficiency of Medicare is an interest for us. A vital interest you might say.  There have been several Medicare reform plans submitted recently.  One, the abomination called Obamacare, is now the law of the land if it isn’t repealed.  Obamacare will replace Medicare.  Oh, the name Medicare will continue but the fact is with Obamacare Medicare will cease as it currently exists.

Paul Ryan submitted a plan last year.  The left went into a frenzy over it.  It was a good plan but some better ones have emerged since.

Burr-Coburn: The Best Medicare Reform Proposal Yet

Many politicians (and many voters) duck the hard choices when it comes to Medicare reform. But what’s remarkable about the past year is that, in some ways, momentum appears to be building for real improvements to the program’s quality and sustainability. Based on a new proposal from Sens. Richard Burr (R., N.C.) and Tom Coburn (R., Okla.), the impossible seems within reach: the triumph of sound policy over interest-group politics.
…
If Wyden-Ryan and Lieberman-Coburn got together to do what many people did on Valentine’s Day, Burr-Coburn would be the result.
I’d previously called Wyden-Ryan a “game changer” for its utilization of two key reform principles, premium support and competitive bidding. Lieberman-Coburn hits the other key principles of reform, including cost-sharing and fraud prevention. As I wrote last June,

I have a lengthy essay in the Summer 2011 issue of National Affairs on Medicare reform, entitled “Saving Medicare from Itself.” In it, I discuss six core concepts for real Medicare reform: (1) preserving benefits for people aged 55 and older; (2) making sure that retirees share more of the costs of their care, and thereby a stake in prudent consumption; (3) means-testing; (4) indexing the Medicare retirement age to life expectancy; (5) aggressive fraud prevention; (6) allowing seniors to shop for value in insurance plans. The Lieberman-Coburn bill hits on many of these points in a way that well complements Paul Ryan’s premium support proposal.

Wyden-Ryan hits (1) and (6), while Lieberman-Coburn hits (2) through (5). Together, they comprise the most complete Medicare reform proposal, using bipartisan policy principles, that has yet been put together.
The plan includes these elements.
Premium support and competitive bidding
Burr-Coburn incorporates something quite similar to the Wyden-Ryan system of competitive bidding and premium support, in which retirees would be able to choose among private plans and a “public option” of traditional Medicare.
…
One key difference between Burr-Coburn and Wyden-Ryan in this regard is that Burr-Coburn implements competitive bidding and premium support in 2016, not in 2022. On the plus side, this six-year difference has a huge impact on the long-term cost savings of Burr-Coburn.
Increasing the retirement age
As with Lieberman-Coburn, Burr-Coburn gradually increases the Medicare eligibility age from 65 today to 67 in 2027. This will allow Medicare’s eligibility age to match that of Social Security.
Improving the Medicare benefit
One thing that most people don’t realize is that Medicare, designed in 1965, has significant gaps and flaws in the design of its insurance benefit. Medicare doesn’t cover catastrophic costs, forcing many seniors to buy supplemental Medigap plans for their own protection, and giving providers perverse incentives to favor expensive hospitalizations over more efficient outpatient care.
Burr-Coburn would combine Medicare Part A (hospitalization) and Part B (outpatient physician services) into a single deductible, with a unified deductible of $550, co-insurance of 20 percent of costs until a retiree had spent $5,500, co-insurance of 5 percent until he had spent $7,500, and full coverage above $7,500.
Means-testing
Burr-Coburn requires greater cost-sharing for people with higher incomes: a far superior solution to raising taxes to subsidize these individuals. Those with incomes above $85,000 as individuals or $170,000 as married couples would be subject to a higher cap on out-of-pocket costs: $12,500 instead of $7,500.  For those with incomes above $107,000 individual or $214,000 family, the cap would be higher ($17,500) and even higher ($22,500) with those making $160,000 as individuals or $320,000 as married couples.
In addition, the plan would charge lower Medicare premiums to lower-income seniors, and higher premiums to higher-income retirees.
Cost-sharing reform

One of the worst aspects of Medicare is the way it is almost intentionally designed to waste money. Medigap plans are a big part of this, by providing private-sector supplemental coverage that undermines Medicare’s ability to incentivize seniors to be mindful of wasteful medical spending.

Flattening the “doc fix”
One of the worst and most persistent problems with federal budgeting has been the Medicare Sustainable Growth Rate, a global cap on the growth of Medicare payments to doctors and hospitals.
Because the global cap doesn’t keep up with the rise in the cost of health care, and provides no incentive for doctors and hospitals to be more efficient in the way they provide care, Congress has had to routinely step in with “doc fix” legislation that jacks up Medicare spending.
Repeal IPAB, Obamacare’s Medicare rationing board
Obamacare’s vision of government-rationed health care was on full display with the enactment of its Medicare Independent Payment Advisory Board, a new bureaucracy that seeks ultimately to control which treatments seniors can receive, based on the board’s view of their cost-effectiveness.
There are several problems with this approach, despite its enduring appeal to central planners. First is that rationing has done nothing to control the growth of health spending, as Britain has shown. In addition, “cost-effectiveness” is subjective, and imposes a one-size-fits-all formula on a diverse country of 300 million people, who respond differently to different treatments. (For more on this topic, see my report on my appearance before Congress at an hearing on IPAB.)
Burr-Coburn repeals IPAB and replaces it with a system that allows seniors to voluntarily chose the benefits and plans that best suit their needs.
Is Burr-Coburn the best solution? No. It is significantly better than what we have and more so with what we’ll get with Obamacare.  What it is, is a good start.  I’ve heard many conservatives complain about the Bush Prescription Drug plan. What those conservatives fail to see is that it works.  In fact it is the only Medicare segment that uses market forces to control costs. It works.
My wife and I are in a gap at the moment. My retiree heath insurance ended in December. My Medicare won’t start until March, May for Mrs. Crucis. At the moment we’re paying our own insurance.  I’ve found that catastrophic insurance isn’t too bad, about $150 for the two of us each month. Our prescription drugs aren’t too high either due to the price pressure from the Bush Subscription plan. It does make us watch our medical expenses and plan what should be done, what must be done, and what we can skip.
All-in-all, that’s a good thing.  It makes me wonder how much medical costs would drop if we repealed Medicare all together?  It’s an idea to consider.

Obamacare Unconstitutional

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Today’s post won’t be very original. The news was released Monday afternoon that Federal Judge Roger Vinson of the United States District Court for the Northern District of Florida declared Obamacare to be unconstitutional.  

Judge Vinson quoted Obama’s own words from his 2008 campaign, Thomas Jefferson and James Madison, and cites from The Federalist Papers.

“It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place. If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain for it would be ‘difficult to perceive any limitation on federal power’ and we would have a Constitution in name only.” — The Morning Bell, February 1, 2011.

Judge Vinson is the second Federal Judge to declare Obamacare to be unconstitutional.  That second Judge, Judge Hudson was in Virginia sitting on Virginia’s suit against Obamacare.  Judge Vinson’s case had 25 states suing Obamacare. There is also one Federal Judge that declared that Obamacare IS constitutional.  One difference is that Judge Vinson declared the entire bill unconstitutional while the Virginia Judge just declared the mandate to buy health insurance unconstitutional.  Because those portions of Obamacare is not net in force, he did not issue any injunctions.  Those could still come.

For you of a legal bent, here is a link to Judge Vinson decision. It’s a .pdf file. You’ll need a PDF reader or a plugin for your browser.

Can Medicare survive?

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This has personal interest for me and my wife.  We signed up for Social Security last week.  Neither of us is 65, we’ve a couple of year yet for eligibility. But our healthcare options are limited and growing smaller thanks to Obamacare.

This column published in the Washington Times is more optimistic about the survivability of Medicare.       

SAVING & GOODMAN: Obama murdered Medicare

But the market can bring her back to life

By Thomas R. Saving and John C. Goodman
–
The Washington Times
7:32 p.m., Friday, October 15, 2010
The health care reform law enacted in spring will have a devastating impact on elderly and disabled Medicare enrollees if its provisions are not substantially changed.
The law creates a new mechanism to reduce the rate of increase in Medicare payments to doctors and hospitals. As a result, Medicare payments will fall below Medicaid rates before the end of this decade, and they will fall increasingly behind the rates paid by all other payers in succeeding decades.
To appreciate what that means, consider that Medicare currently pays about 20 percent below what private insurance pays. At those rates, hospitals lose money on Medicare patients. Under the spending cuts called for in the Affordable Care Act (ACA), payments will get worse in the future.
According to estimates from the Office of the Medicare Actuary, Medicare will be paying just two-thirds of what private payers spend by the end of the decade and just one-half as much by midcentury. Moreover, as Medicare rates fall increasingly below Medicaid rates, the elderly and the disabled will be the last patients doctors will want to see – if they have time for them at all.
Compounding these problems is the fact that the ACA will create a huge rationing problem systemwide. Although the law is expected to create as many as 34 million newly insured people, all funds to create new health care providers were zeroed out of the bill. Subsequently, the administration has promised new funds to increase supply, but they will be nowhere near the increase in demand.
Additionally, Medicare spending cuts will create enormous financial stress for the nation’s hospitals. According to the actuary’s office, more than one in seven health care facilities will be unprofitable before the end of the decade. That number will climb to one in four by 2030 and to 40 percent by midcentury.
One way to think about these changes is to consider the reduction in spending on Medicare beneficiaries relative to the expected path prior to the legislation. Under the new health care law, the average senior on Medicare will receive $2,300 less in annual benefits within 10 years and $3,844 less after 20 years. (All numbers are measured at current prices.) By midcentury, average spending per beneficiary will be $9,413 less than it would have been.
…

Fortunately, there is a better alternative. Instead of encouraging draconian price controls that will drive doctors and hospitals out of the market and leave Medicare beneficiaries with less access to care, we should allow the market to respond to patient needs. 

During the Clinton administration, the majority of the members of the National Bipartisan Commission on the Future of Medicare favored a “premium support” approach. Medicare would be converted from a top-down pricing system to a bottom-up system, in which providers would compete for patients. Individuals could shop for health care plans and use their premium support amount as full or partial payment. Such a reform would bring to all parts of Medicare what competition already has done for participants in Medicare’s new Part D drug program.
If the premium support amount were adjusted upward with the growth in per-capita national income, the resulting cost growth would be very similar to the path the health overhaul bill has set us on.
But unlike the price controls imposed by the ACA, premium support would not cause any providers to go out of business. Significant changes would occur in health care delivery. With Medicare participants paying directly for some of their health care, there would be an increase in the variety of delivery systems as providers competed for patients based on price and quality. A reform structured in this way would free doctors and patients from the cost-increasing, quality-reducing constraints of the current system.

You can read the entire column here, courtesy of the Washington Times.

What the dems don’t say and don’t want known is that Obamacare will cut $600M from Medicare to help “pay” for Obamacare.  The result is the Medicare will be destroyed on the alter of the libs “single-payer” system like the Brit National Health Service—a service that is actively imposing death panels to choose who will live and die.

This nation is still a republic, not a socialist oligarchy—yet and won’t be if I can do anything about it.                

More Information on Missouri’s Prop C voting Distribution

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Some interesting statistics is emerging on the voting trends for Missouri’s Proposition C that passed last week.  The issue appeared on all party ballots.  In addition, there was a ballot available that contained ONLY Prop C.  If your party didn’t have a ballot or if your choice for political parties was “None of the Above,” you could still vote on Prop C.  Forty thousand Missourians did so and democrats added another 40,000 “Yes” votes to the tally.  More interesting is that one in eight of those voting on the democrat ticket also voted “Yes” on Prop C.

I do have an anecdote about this.  An acquaintance mentioned that an elderly lady went to the polls and asked if she could vote just on Prop C or if that would invalidate her vote.  She said she’d voted democrat all her life but wouldn’t anymore.

She was given the single Prop C issue ballot. 

Another statistic that emerged from this primary election was that it appears of the 668,000 who voted in favor of Prop C, 578,000 of them were republicans.  The democrat turnout in Kansas City was only 12 per cent and statewide was also lower than expected.  The Kansas City Star had this addition tidbit.

…almost 669,000 Missourians said “yes” to Prop C, almost as many as voted for U.S. Senate candidates Roy Blunt (R) and Robin Carnahan (D) combined.

Missouri Prop C Wins! (Updated)

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Just a short opening note. Missouri Proposition C, to block the federal government’s orders that require everyone in the state to acquire health insurance—whether they wanted to or not, passed by a 71% margin. The proposition was on all primary ballots regardless of party. That means the win included large segments of democrats as well as of the other parties.

At my polls, I saw ballots for the Democrat, Republican, Libertarian and Constitution parties. Proposition C appeared on all of them. The proposition wasn’t just a Republican choice.

Even before the election, Chris Stigall, KCMO 710 morning radio host, accurately predicted the media’s response. “Tuesday’s vote was seen as largely symbolic because federal law generally trumps state law.” “The health care referendum was helped by a high Republican turnout.”

Opposition to the proposal came from a surprising direction—a segment that will be most drastically affected by Obamacare, the Missouri Hospital Association.

Proposition C faced little organized opposition, although the Missouri Hospital Association mounted a mailer campaign opposing the ballot issue in the last couple of weeks. The hospital association, which spent more than $300,000 in the losing effort, said that without the new federal law, those who don’t have insurance will cause health care providers and other taxpayers to have higher costs.

“The only way to get to the cost problem in health care is to expand the insurance pool,” said hospital association spokesman Dave Dillon. He said the hospital association didn’t plan to sue over the law, but he expected it would be challenged.

The proposition was intended as a rallying point for Tea Party supporters and Republicans around the country. It worked in Missouri. Several other states were waiting in the wings while Missouri tested the political waters. Now, that question has been settled. I expect other states will join the party.

One factor that appears to be overlooked is that now Missouri, like Virginia, has grounds to sue the federal government over Obamacare. US District Judge Hudson determined that Virginia had standing because Obamacare affected state law. Missouri is now in that same category.


The New Thuggocracy

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I was listening to the news a few moments ago and I heard that Obama said that instead of waiting until 2014 to enact Obamacare, he, by executive fiat, would move that date up to January 2011. That’s next year.

The question rises, why? Well, apparently Obama’s parasite base is just realizing they’ll have to wait two more year before they can begin feeding at the public healthcare trough. (Let’s not go into the fact that anyone can get free healthcare just by going to the closest Emergency Room.)

So, by executive fiat, Obama is going to ignore the law, again, and do whatever he wants. Folks, that is dictatorship and tyranny. Thomas Sowell ponders this point in his post on Investor’s Business Daily.

Is U.S. Now On Slippery Slope To Tyranny?

By THOMAS SOWELL Posted 06/21/2010 06:13 PM ET

View Enlarged Image

When Adolf Hitler was building up the Nazi movement in the 1920s, leading up to his taking power in the 1930s, he deliberately sought to activate people who did not normally pay much attention to politics.

Such people were a valuable addition to his political base, since they were particularly susceptible to Hitler’s rhetoric and had far less basis for questioning his assumptions or his conclusions.

“Useful idiots” was the term supposedly coined by V.I. Lenin to describe similarly unthinking supporters of his dictatorship in the Soviet Union.

Put differently, a democracy needs informed citizens if it is to thrive, or ultimately even survive.

In our times, American democracy is being dismantled, piece by piece, before our very eyes by the current administration in Washington, and few people seem to be concerned about it.

The president’s poll numbers are going down because increasing numbers of people disagree with particular policies of his, but the damage being done to the fundamental structure of this nation goes far beyond particular counterproductive policies.

Just where in the Constitution of the United States does it say that a president has the authority to extract vast sums of money from a private enterprise and distribute it as he sees fit to whomever he deems worthy of compensation? Nowhere.

And yet that is precisely what is happening with a $20 billion fund to be provided by BP to compensate people harmed by their oil spill in the Gulf of Mexico.

Many among the public and in the media may think that the issue is simply whether BP’s oil spill has damaged many people, who ought to be compensated.

But our government is supposed to be “a government of laws and not of men.”

If our laws and our institutions determine that BP ought to pay $20 billion — or $50 billion or $100 billion — then so be it.

But the Constitution says that private property is not to be confiscated by the government without “due process of law.”

Technically, it has not been confiscated by Barack Obama, but that is a distinction without a difference.

With vastly expanded powers of government available at the discretion of politicians and bureaucrats, private individuals and organizations can be forced into accepting the imposition of powers that were never granted to the government by the Constitution.

If you believe that the end justifies the means, then you don’t believe in constitutional government.

An accurate analysis and it’s appropriate that we remember just what happened after the last “great” depression.

The New Thuggocracy

Posted on by

I was listening to the news a few moments ago and I heard that Obama said that instead of waiting until 2014 to enact Obamacare, he, by executive fiat, would move that date up to January 2011. That’s next year.

The question rises, why? Well, apparently Obama’s parasite base is just realizing they’ll have to wait two more year before they can begin feeding at the public healthcare trough. (Let’s not go into the fact that anyone can get free healthcare just by going to the closest Emergency Room.)

So, by executive fiat, Obama is going to ignore the law, again, and do whatever he wants. Folks, that is dictatorship and tyranny. Thomas Sowell ponders this point in his post on Investor’s Business Daily.

Is U.S. Now On Slippery Slope To Tyranny?

By THOMAS SOWELL Posted 06/21/2010 06:13 PM ET

View Enlarged Image

When Adolf Hitler was building up the Nazi movement in the 1920s, leading up to his taking power in the 1930s, he deliberately sought to activate people who did not normally pay much attention to politics.

Such people were a valuable addition to his political base, since they were particularly susceptible to Hitler’s rhetoric and had far less basis for questioning his assumptions or his conclusions.

“Useful idiots” was the term supposedly coined by V.I. Lenin to describe similarly unthinking supporters of his dictatorship in the Soviet Union.

Put differently, a democracy needs informed citizens if it is to thrive, or ultimately even survive.

In our times, American democracy is being dismantled, piece by piece, before our very eyes by the current administration in Washington, and few people seem to be concerned about it.

The president’s poll numbers are going down because increasing numbers of people disagree with particular policies of his, but the damage being done to the fundamental structure of this nation goes far beyond particular counterproductive policies.

Just where in the Constitution of the United States does it say that a president has the authority to extract vast sums of money from a private enterprise and distribute it as he sees fit to whomever he deems worthy of compensation? Nowhere.

And yet that is precisely what is happening with a $20 billion fund to be provided by BP to compensate people harmed by their oil spill in the Gulf of Mexico.

Many among the public and in the media may think that the issue is simply whether BP’s oil spill has damaged many people, who ought to be compensated.

But our government is supposed to be “a government of laws and not of men.”

If our laws and our institutions determine that BP ought to pay $20 billion — or $50 billion or $100 billion — then so be it.

But the Constitution says that private property is not to be confiscated by the government without “due process of law.”

Technically, it has not been confiscated by Barack Obama, but that is a distinction without a difference.

With vastly expanded powers of government available at the discretion of politicians and bureaucrats, private individuals and organizations can be forced into accepting the imposition of powers that were never granted to the government by the Constitution.

If you believe that the end justifies the means, then you don’t believe in constitutional government.

An accurate analysis and it’s appropriate that we remember just what happened after the last “great” depression.

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