A Visit to the Supreme Court

Photo: Ileana Johnson

On a sunny but cold day in December, we were guided on a tour of the Supreme Court, the bastion of definitive justice in the U.S., handed down by the nine black-robed group, a chief justice and eight associate justices, who ultimately decide, in case by case they cherry-pick, the hanging-in-the-balance fate of our Constitutional Republic.

Liberals in this esteemed group echo the sentiments of Democrats who keep telling us non-stop that we are a democracy that we must promote by twisting our Founding Fathers’ documents and intent because Americans are too dumb to know the difference and know so little of their history thanks to the socialist leaning education system and academia.

Photo: Ileana Johnson

Photo: Ileana Johnson

The Supreme Court is in a cold marble building, with 16 huge and overwhelming Corinthian columns.  Just in case you missed the profound power and importance of the Supremes in our daily lives, a triangle-shaped pediment with a group of figures reminds you with the words, “Equal justice under law.” Somehow flawed human beings with biases and different backgrounds are going to use a perfect measurement to deliver equal justice to each case brought before them.

Male statue facing the Capitol building
Photo: Ileana Johnson

Female statue 

Photo: Ileana Johnson

Two marble statues by sculptor James Earle Fraser are located on the side of the main entrance - a seated female figure on the left called the “Contemplation of Justice,” and a seated male figure on the right called the “Guardian or Authority of Law.”

The building faces the other part of our governing system, the Capitol, with the House of Representatives currently suffused with Democrats eager to deliver us as quickly as possible on a downward slide into socialism and communism.

Photo: Ileana Johnson

Photo: Ileana Johnson

John Marshall statue

More busts along the marble corridors

Photo: Ileana Johnson

The interior is also cold and rich in marble, decorated with Greek keys and blue rosette freezes, and heavily brocaded red velvet curtains trimmed with gold rope. Statues, portraits, and court memorabilia adorn the interior. Antonin Scalia’s portrait, a favorite among conservatives, hangs near the entrance to the cafeteria’s serving line.

Ceiling
Photo: Ileana Johnson

The Supreme Court Police, the law enforcement arm, was present everywhere throughout the massive building with bronze doors that weigh 6.5 tons each. The Great Hall is 91 feet long, 82 feet wide, and has an overwhelming 44-foot ceiling. The rich marble was quarried from Alabama, Georgia, Vermont, Italy, and Spain.

To keep the support staff entertained and in good shape, the fifth floor has a basketball court referred to as “the highest court in the land.”

RBG rack in gift shop

Photo: Ileana Johnson

Across from the cafeteria entrance is a small museum gift shop filled with trinkets and books written by or dedicated to current justices. An entire shelf is dedicated to Justice Ruth Bader Ginsburg, the declared heroine of the communist left. She hangs on to her powerful seat despite severe health issues. She was in court asking questions, fresh from her hospital bed.

The Court, we are told by the guide, holds sway over judicial review and the power to invalidate a statute that violates a provision of the U.S. Constitution, or to strike down presidential directives that violate either the Constitution or statutory law. When it was asked to decide if forcing Americans to buy insurance under the Affordable Care Act of 2010 was constitutional, Justice Roberts’ Court decided that buying health insurance was a tax and therefore constitutional.

“The Court may decide cases having political overtones, but it has ruled that it does not have power to decide non-justiciable political questions.” If you are confused, you are not alone.

Photo: Ileana Johnson

Article III of the Constitution established the Supreme Court and the 1^st Congress established its composition and procedures through the Judiciary Act of 1789.  In the Judiciary Act of 1869, the Court was to have a chief justice and eight associate justices with lifetime tenure, until such a time that one resigned, retired, died, or was removed from office. The President, with advice and consent of the Senate, appointed a new justice. There have been as few as five and as many as ten justices on the court as determined by Congress.

Before this building was dedicated, the Supreme Court met in locales outside of Washington, D.C., i.e., the Merchants Exchange Building in New York City, Philadelphia in 1790, and finally moved to Washington in 1800 where it met in the newly built U.S. Capitol Building. Thanks to President William Howard Taft, himself a Chief Justice, this permanent home for the Supreme Court was completed in 1935.

According to the guide, in this life-time government job, the chief justice is remunerated $260,000 annually, and the associate justices $250,000 each.

In Marbury v. Madison, judicial review was established, making the Supreme Court the final arbiter and say of what Congress and what the President do. If it’s not consistent with the Constitution, it is supposed to be illegal. However, the interpretation of the Affordable Care Act requirement to buy health insurance as a tax was decided and influenced for political reasons.

During argument, the lawyers on each side have 30 minutes each to present their cases. For each lawyer, the first two minutes are uninterrupted time. The next 28 minutes are constantly interrupted by various justices who ask questions. The fine art of winning is a lawyer who answers questions in such a way that his answers may sway the decision of the individual justices. Justices do have their own histories and political biases, have read the underlying briefs, and have probably already decided how they would vote in the case.

The opinions of the court are given out during the term of the court, October through September. Once a majority decision has been reached, the chief justice decides who writes the opinion of the court.

Male statue by Fraser overlooking the Capitol

Photo: Ileana Johnson

The actual courtroom is average in size, with seats for the press on the right of the bench, black chairs for the court families and friends on the left, seats for the lawyers in the middle, and seats for the audience in the back. The clerk of the court sits under the flag. A female marshal times the proceedings and, when the 30 minutes are up, a red light turns on. The case is thus submitted but nobody knows whether they’ve won or lost.

Photo: Ileana Johnson

The Supremes meet once a week and talk about the cases they’ve heard that week. Once five justices agree on how the case will be decided, then a written opinion is issued. A dissenting opinion can also be issued and a concurring opinion, meaning, it agrees with the ruling but for a different reason.

During oral argument justices ask questions, letting the world know in what direction they lean on a case. Two lawyers for each side can argue but usually one speaks. During court session arguments are heard on Monday, Tuesday, and Wednesday from 10-12.

Behind metal gates on both sides, corridors are lined with chairs where clerks can sit and listen during arguments.

Photo: Ileana Johnson

The audience red velvet seats are occupied on a first come, first served basis, but the lines to get in are formed days and hours in advance. There are actual companies which, for a fee, will send line sitters for you.

The press is not allowed any recording devices or photography. The court sketch artist sits behind them.

Per tradition, no video is allowed during proceedings on the bench, per decision of the justices, but there is an audio and a video transcript of the proceedings posted on the website. The recording device is located on the left side of the Chief Justice and the human timekeeper sits on the same end.

The guide informed us that the court hears only about 60 cases (less than one percent) per term out of more than 7,000-8,000 petition cases that are brought for consideration to be heard by the court.

Photo: Ileana Johnson

The Chief Justice of SCOTUS sits in the middle chair (John Roberts), on his immediate right sit justices in order of seniority. The Associate Justice with the most time on the court is Clarence Thomas. On his left sits Justice Ruth Bader Ginsburg, the second one with seniority on the court.

Spiral staircase

Photo: Ileana Johnson

As I left the marble mausoleum-like building, I wondered how many millions of Americans across many generations have been affected by the good and bad decisions made by nine fallible, biased, and all-powerful humans in black robes, decisions that can never be reversed?

The Right Man for Healing and a Rare Find

Hippocrates of the Hippocratic Oath

I was not sure my ENT specialist was a good fit for me even though I read the glowing praises framed on his office walls, praises coming from his patients, colleagues, and other doctors. The young man seemed to know what he was doing but his bedside manner was brief and rather cold.

I attributed his demeanor to his introverted personality, his professionalism, and to his respect for his patients’ time. Very punctual, he very seldom made anybody wait to see him, he was always on time.

One day I realized that he was much more caring on the inside than he let people see. A young woman with her mom and a three-year old in tow had an appointment to see the doctor. The receptionist, Lupe, asked her if she was prepared to pay for that day’s visit. The young woman had a grief-stricken look on her face and wondered how much the visit was going to be. The receptionist told her that she did not know because each patient was different, depending on the problem. The prospective patient replied in a sad and disappointed voice that she will reschedule until such a time that she would have enough cash on hand to pay for the visit.

Lupe kindly explained that her insurance, Obamacare, had a huge deductible, and unless she met this deductible for the year, it will not pay the doctor anything. She offered to ask the physician, left the young woman waiting, and returned to tell her that the good doctor will see her anyway.

I decided then that this man was the right person to see in an ENT medical emergency or a problem requiring a caring specialist. His humanity, in addition to his medical professionalism, punctuality, and his education in the U.S., made him, in my opinion, an exceptional doctor, a rare find.

At the other end of the spectrum was the endocrinologist’s office in Fairfax who told me, they are no longer taking any new Medicare patients, just the already established ones who were in transition to Medicare. The receptionist’s explanation was that Medicare does not allow their patients to be seen every three to six months as needed.

I was told previously by a doctor friend that Medicare made low and very slow reimbursements to physicians because of Obamacare; therefore I did not believe the office’s explanation. Personally, I would not want to be seen by a doctor who put her profit motive above the care for a patient, any patient.

But I pressed on. What if I paid in cash, could I then see the doctor? The answer was again no because, she said, they had a contract with Medicare and thus could not accept cash payment.

Having read the pertinent section of the law, I knew this was part of the Affordable Care Act as well, the euphemistically named piece of legislation Obama’s administration and Nancy Pelosi’s Congress forced down middle class America in the middle of the night, “pass the bill to find out what’s in it.”

We did find out all right, and we did not like the price we had to pay for it in order that the Democrat Party could unilaterally force an entire nation, one fifth of the economy, to become a socialized medicine nightmare for decades to come.

More insultingly, members of Congress have their own subsidized and separate health care insurance and can see whatever doctors they wish to see.

It used to be the case in America once when patients could pay cash for doctors’ visits and the fees were affordable. But that gradually changed thanks to modifications in health insurance, new cafeteria health insurance plans, in-network and out-of-network type of employer insurance, and health savings accounts that disappeared at the end of the year if unused.

If you lost your job or quit, the insurance terminated, and you were at the mercy of Cobra insurance for a while, at confiscatory monthly premiums, but nothing as expensive as Obamacare premiums today that can easily exceed a family’s mortgage and car payments combined.

Lack of insurance portability across state lines had always been a problem for Americans seeking affordable insurance. Aggressive law suits against doctors and medical malpractice awards by the courts, forced doctors to drastically buy more and more expensive malpractice insurance, making care more expensive for the average patient who did have insurance. The infamous $50 aspirin in a hospital setting was legendary.

As a student without insurance in the early 1980s, I paid $10 cash per visit to my children’s pediatrician. Once we could afford and bought insurance, each visit was $85. The pediatrician made a comfortable living, had a thriving practice, but he was certainly not a millionaire.

If you ask most doctors today what they spend a good portion of resources and time, it is not patient face to face care time but electronic documentation, record keeping, and staff to handle insurance justifications and payments – bureaucracy.

Primary medical care, day-to-day healthcare, is now provided by a general practitioner, a family physician, a gerontology, pediatric, or family nurse practitioner, a physician assistant, a registered nurse, and even a pharmacist who coordinate and triage specialist care that a patient may need.

Secondary and tertiary care is harder to find as physicians are cutting their losses and focusing on accepting private insurance rather than Medicare and Medicaid.

We are headed to a single payer socialized medical insurance which will limit doctor visits and access to procedures based on rationed care. The entity that will hold the key to your ability to pay for and receive medical care when you need it will be the federal government, the same bloated, out of control entity that spent your Social Security lock-box savings and has doubled the national debt in eight years of the Obama’s administration.

Obamacare, This Won't Hurt a Bit

Thousands of articles have been written and commentaries made since the Affordable Care Act nobody can afford had passed. In spite of the vociferous demands to defund it coming from the majority of the American people who work for a living instead of voting more welfare for themselves, the best health care in the world will gradually disappear, replaced by a radical form of socialized medicine that most Americans are not prepared to understand or accept.

Obamacare is now the law of the land for some, depending on which parts the president decides to implement and which to delay. The elected representatives have turned a deaf ear to all the calls, rallies, faxes, letters, op-eds, and direct visits to their offices. They were so sure this type of medical insurance/care that John Roberts termed a “tax” was right for Americans that they exempted themselves from its burden. Furthermore, when our Congressmen who make a six-figure salary complained that the exchange rates were so prohibitively expensive, they received a special 75% subsidy to defray the cost. Who is going to help Americans who make too much income to qualify for subsidies?

Sen. Ted Cruz of Texas made a 21 hour valiant effort in the Senate to give a final voice to the unhappy Americans who wanted to keep their private medical insurance, their doctors, the affordable insurance rates and plans, their full-time jobs, and the ability to see a physician or have a test in a timely manner. Sen. Cruz was ridiculed and maligned not just by liberals. Supposed conservatives and RINOs were tripping over themselves on the way to the microphones in a chorus of criticism to attack Sen. Cruz’s character, credentials, experience, and his noble intentions.

The government computers were not properly working and interfacing yesterday to tell Americans exactly how much they would need to pay come October 1, 2013. And these bureaucrats are going to tell us whether we can or cannot have certain medical procedures and are going to be the repository of more than 307 million people’s medical records, including our sexual habits, and the most intimate details of our lives from birth to death.

A neurosurgeon called into a nationally syndicated show telling the host that the infamous death panel is already at work, advising him on whom he can operate and to whom he must refuse surgery. I wonder how that would square off with the Hippocratic Oath doctors have taken upon medical school graduation.

Even the Teamsters union, the main supporters of the Obamacare, have change their tune now and asked for another exemption from a law that will destroy their Cadillac insurance plans and medical care.  They were denied.

Since 85 percent of Americans had some form of medical insurance, The Affordable Care Act was supposedly designed and passed to help the 15 percent uninsured. At the end of the full implementation of Castro Care, there will still be 30 million uninsured and millions of workers relegated to part-time work to help employers avoid the penalties of the law. Employers could not continue to offer highly expensive private insurance plans whose cost have been driven into the stratosphere by the onerous demands of Obamacare.

Obamacare has turned our country’s labor market into a part-time work nation. It is debatable that it was an unintended consequence. If this law was about health care, wouldn’t it have been cheaper to just purchase insurance for the 15 percent uninsured through some federal program? After all, we waste billions and trillions on wars without end and purpose, and we have enough money to arm Al Qaeda terrorists and the Muslim Brotherhood in the Middle East.

Come January 1, 2014, people who chose not to buy insurance because they cannot afford the bare minimum $20,000 a year Bronze Plan for a family of four, they will have to pay a fine/tax of $95 or one percent of their incomes. Since taxes are paid for the previous year when the ACA was in force only three months (October-December), would the fine/tax for 2013 be prorated? I don’t think so.

We have been bombarded by doctors, including our cat’s vet, to create a portal into the electronic compliance that the doctors must submit to the federal government in order to make sure that all of our medical data is out there for the world to hack into. The emails keep coming with messages from family doctors to create these portals and I keep ignoring them.

Concierge medicine is more and more enticing to a lot of people until Congress will pass an amendment to the Obamacare that will ban medical services for cash. In northern Virginia many doctors already do not accept any form of government insurance and concierge medicine is quite popular. But some people cannot afford the upfront membership fee being that it is higher than the yearly premiums they used to pay for comprehensive insurance through their employer.

Trader Joe’s part-time employees and other companies’ employees had really good insurance for affordable monthly premiums. Not anymore, Obamacare made sure that it was destroyed. I hope that these very people who voted so enthusiastically for President Obama twice, and have now lost their health insurance, realize that this law was not about insuring the uninsured or improved health care delivery or fairness, it was about control. “Evil” capitalist choices who kept people alive and well, the envy of the rest of the world, have been eliminated with the stroke of a presidential pen. Americans have nobody else to blame but themselves.

My sweet Mother, who is 81 years old and way passed Castro Care’s cut off age for any meaningful medical care, visits, tests, or procedures, has become a “unit” and must already beg her physician for her arthritis medication refills. They are too expensive when computed into the death panel formula for her usefulness to society.

Mom helped raise three children and survived the oppressive communist regime in Romania. She immigrated to the United States, the land of abundance and freedom, to live the rest of her life in peace and free of worries.

My Mom is a lucky octogenarian who does not have any major health issues. If she did, she would be told by the IRS, our new doctors, to go home and take a pill, she had lived a long life already.  It angers me that Obamacare makes mom’s life irrelevant and inconvenient.

The worth of any society is dictated by how well they treat the sick and the elderly and how much they value life. It is shameful how low we have fallen since we’ve allowed a liberal minority to control who lives and who dies. As a society, we have lost our humanity.

Dental Floss and Castro Care

The economy is not experiencing scarcity yet but I did notice lately that the range of choices for various goods has diminished. It has been three months or longer since my favorite dental floss and toothpaste have been missing on store shelves. They finally reappeared recently, to disappear again, an obvious sign of manufacturing shortage. This prompted me to check out the new sonic care air flossing gadget. The price alone could buy 40-80 rolls of floss, not to mention the need of electricity to make it work.

People don’t realize how important their teeth are. There is a direct correlation between the health of one’s teeth and the overall body health stemming from the ability to chew and eat nutritional foods, including the health of one’s heart, which can be adversely affected by oral bacteria and decaying dentition.

I am not sure when flossing was revealed as a necessary dental hygienic tool. Anthropologists found evidence that ancient peoples and even isolated tribes used sticks for interdental cleaning. Credit for inventing the dental floss goes to a New Orleans dentist in 1815.  In 1896 Johnson & Johnson patented its silk version produced out of the same thread used for surgical stiches.

Some toothless 45-50 year old Europeans might have saved their teeth and the troubles of finding a dentist who would properly fit them with dentures if they had known about flossing. Come to think of it, the Eastern Europeans, in their utopian socialist/communist states, did not have floss and had difficulty finding toothpaste and toothbrushes, much less adopt a daily brushing routine. On my last trip, young women were selling Crest toothbrushes and handing out leaflets in a strip mall with instructions on how to properly brush your teeth, including the tip that it had to be done daily. When I asked her if I could photograph her booth, she refused.

Growing up in the village, Grandma and Grandpa had two toothbrushes made of rough and uneven bristles, stored outside by the water pump, hanging on a wooden board with nails for hooks. The tube of gritty toothpaste hanged in a cloth bag. The water coming out of the ground was as cold as a mountain spring. Each family member used the same two brushes once a week, making sure they were properly hanged on the hooks. Flies loved to land on them during the day. After a year of two, when the bristles were so bent out of shape or have fallen, a new toothbrush was purchased.

The socialized medicine dentists who were paid the same as everybody, a miserable salary decided by the communist elites, could not care less about the people’s dental hygiene or keeping their teeth. They got paid the same whether they did their job well or poorly. Anesthetics were non-existent. I had root canal at the age of 15 without any anesthetics, howling and wriggling in the dental chair, and the torturous “treatment” stretched over six months, at the end of which he had to pull the tooth out anyway.

When braces became popular, a close relative, who is a dentist and had terrible misaligned teeth herself, chewed me out for putting braces on my two young daughters. “What kind of ignorant mother are you, did you not know that braces cause cavities and ruin people’s teeth?” Thank God, her “stellar” socialist medical training was wrong, my beautiful daughters have gorgeous pearly-whites.

Western European dental care did not fare that much better. There is a good reason why so many Brits have yellow and bad teeth. Their national medical care rations healthcare and the waiting period is so long for many procedures, tests, and labs, including dental care, that people pull their own teeth out after weeks and months of agony while waiting to be seen by a doctor.

I can still see my dentist, buy floss, see my doctors; I can have a needed test within a reasonable amount of time because capitalist competition works well. Come 2014, under the “new and improved” unaffordable socialist and misnamed Affordable Care Act, our medical care will more closely resemble the care we used to get under socialist medicine – rationing, special polyclinics for the elites, black market for needed drugs, empty pharmacy shelves, bring your own drugs and syringes to the hospital, and shortages of basics, either over the counter drugs, vitamins, and prescription drugs.

The Affordable Care Act Nobody Can Afford

I was just handed the Phreesia computer tablet by the receptionist under the guise of updating my medical and insurance information. I had seen this orange notebook in another doctor’s office and I became suspicious. Is this really meant to verify, as the website claims, my insurance eligibility automatically and help doctors collect on their insurance while easing the load of paperwork? Or is it forced electronic data compliance to Obamacare?

As soon as I started reading each screen, I realized that it was asking me to consent to third parties to obtain my medication prescription history from my pharmacy and to my entire medical history.

I had the right to request and restrict as to how my protected health information was used or disclosed. However, when I declined to sign, the computer stopped, and prompted me to talk to the receptionist. She informed me that diagnosis and/or treatment “may be conditioned upon my consent.”

The electronic screen and the paper copy the receptionist gave me said, “The [name withheld] is not required to agree to the restrictions that I may request and may refuse treatment based on my restriction as permitted by Section 164.506 of the Code of Federal Regulations.”

Suddenly, because I refused the IRS and HHS meddling in my personal health affairs, I had become persona-non-grata (unwanted person) to my doctor who had sworn a Hippocratic Oath to care for me and any patient who comes across his/her path.

In other words, I would not be treated if I did not sign yes. I had the right to say no, don’t’ give my medical information and history to anyone else but the doctor is not required to honor my request and may refuse treatment to me as permitted by Section 164.506 of the Code of Federal Regulations. http://www.gpo.gov/fdsys/pkg/CFR-2011-title45-vol1/pdf/CFR-2011-title45-vol1-sec164-506.pdf

What if I said no, do not release my medical history to a third unapproved party and I paid cash? The doctor would not see me. Welcome to the destruction of our stellar healthcare and patient/doctor confidentiality, compliments of Obamacare.

How affordable is this Obamacare, the unfortunately named, the Affordable Care Act? The Democrats and the President said that costs would be so much lower; it would save the typical family $2,500 per year.

The cheapest category of Obamacare is the Bronze Plan which costs $20,000 per year for a family of two adults and three children and it pays only 60% of medical costs after the deductibles for the year have been met. And the deductibles are high per person and per family. The following tiers are Silver (70%), Gold (80%), and Platinum (90%).

During my 30 year teaching career, I seldom had to pay more than $3,600 a year premium for private insurance for my family. Even a retirement private plan did not cost more than $8,000 per year with 80% reimbursement as opposed to only 60% reimbursement under the Obamacare Bronze Plan. Is Obamacare really affordable? The answer is a resounding no.

According to the IRS, the penalty for not buying insurance is capped for now at either the annual Bronze premium, 2.5% of taxable income, or $2,085 per family in 2016.

President Obama said, “If you are one of the more than 250 million Americans who already have health insurance, you will keep your insurance.” Heritage’s Amy Payne estimated that “more than 11 million people will no longer have their employer-sponsored health coverage once Obamacare is fully implemented.” (Businesses Cutting Hours, Bracing for Costs of Obamcare, December 6, 2012)

Obamacare employer mandate is killing jobs. An employer with 50 employees must provide coverage or pay $2,000 penalty for each employee after the first 30 workers. It is easy to see how an employer would have to cut back employees to 30, replacing full-time employees with part-time ones, in order to avoid the penalty or the skyrocketing premiums for private coverage.  These private insurance premiums rose significantly because Obamacare mandates insurance for all children up to 26 years old and for those insured with pre-existing conditions whose treatment can be costly.

Breitbart News reported that Pennsylvania Community College of Allegheny County had already cut the hours of 400 adjunct professors, staff, and part-time teachers, saving $6 million in potential Obamacare fees. (Wynton Hall, Obamacare Layoffs, Hiring Freezes Begin, January 5, 2013)

Because of the Obamacare medical device 2.3 percent excise tax, Stryker medical supply cut 1,170 employees (5%). Boston Scientific, Welch Allyn, Medtronic, Kinetic Concepts, and Smith & Nephew are also contemplating cuts in their work force. Zimmer Holdings, makers of hip replacement implants, laid off 450 workers in expectation of a $60 million tax bill in 2013. (Bob Unruh, Democrats in Congress ‘want out’ of Obamacare)

Everybody’s private insurance has been disrupted and private premiums have escalated, in addition to adding the “Cadillac tax” to plans that are judged too generous. According to Jonathan Gruber of MIT and the actuarial firm Milliman, non-group premiums rose 19-30% in some states and 55-85% in others.

The federal government has built a data hub to be used only for Obamacare without saying how it will be run. The HHS has released 13,000 pages of regulations with only 30 days for public comment while attempting to re-engineer 17% of the economy. (WSJ, It’s a Mad, Mad, Mad Obamacare, December 13, 2012)

On the deadline of December 14, 2012 states had to declare health insurance exchanges. At that time, only six states (Colorado, Massachusetts, Maryland, Oregon, and Washington) received conditional approval from the Department of Health and Human Services (HHS) to operate their own exchanges. Twenty-six states stated that they will not set up exchanges.

If a state operates its own exchange, it must come up in 2015 with its own source of revenue to run the exchange, making a state a vendor to HHS. The state running an exchange must also expand Medicaid to “able-bodied, low-income, childless adults” in spite of the fact that the Supreme Court ruled the Medicaid expansion voluntary. The federal government was not planning on covering the full cost of such Medicaid expansion. “Half of the reduction in the number of uninsured promised under Obamacare was based on mandating that states expand Medicaid.” (Heritage’s Morning Bell, December 13, 2012)

Several states asked Sibelius, the HHS Secretary, if they could expand Medicaid less. The answer was that only full compliance with the law will garner 90% reimbursement from the federal government. Nine states have refused to expand Medicaid to cover new populations. The feds will set up their own exchanges in those states but final regulations and specifics for the federal exchanges are not made public yet. Oklahoma and Maine have sued over Medicaid expansion and over statutory language and Medicaid expansion, respectively.

Three deadline extensions of implementing health exchanges have passed. Most states will share responsibilities with the federal government or default to a federal-run exchange. Only a minority of states have agreed to run their own exchanges.

A 3.5 percent administrative fee on coverage sold through federally-run exchanges will be levied. An additional $63 fee per employee must be paid in federal fees to cover people with pre-existing conditions.

Government funds will be set aside to promote/advertise [on primetime] Obamacare. Critics of the unaffordable health care law call such advertising “political advocacy.”

Practicing medicine will become more and less a government-run monopoly instead of the current monopolistic competition where patients are free to choose what doctors they go to, based on preference, doctor qualifications, specialty, reputation, insurance types, and premiums they choose to pay.

Doctors will either merge with hospitals, insurance companies, and specialty management firms or become “concierge” doctors, serving a reduced number of patients for a set fee. Consolidation will have a negative effect on patient access, price, and competition. Mergers in the 1980s and 1990s had negative effects in terms of patients being restricted or blocked from access to specialists and procedures.

More than $719 billion will be taken from Medicare over the next ten years to pay for Obamacare. According to Rep. Wally Herger, Chairman of the House Ways and Means Subcommittee on Health, the Independent Payment Advisory Board established by Obamacare is authorized to unilaterally impose price controls and de facto rationing of medical care.

http://www.washingtontimes.com/news/2012/dec/11/medicare-reform-crucial-for-economic-health/

Medicare is already in trouble. Taking $719 billion over ten years from Medicare to fund Obamcare will exacerbate financial problems. Medicare benefits are not a return on taxes paid into the system over time because Medicare is run as “pay as you go” - today’s wage earners pay taxes to fund benefits for today’s retirees. Since people live longer, “Medicare payroll taxes cover only 38 percent of current benefits.” (Rep. Wally Herger)

Obamacare depends on bringing young, healthy people into insurance markets to help offset the costs of insuring the old and the sick. If young people do not participate in the program and elect to pay the fine instead, Obamacare will not be able to make coverage affordable for the uninsured.

Most young Americans do not have insurance. Young people who do have insurance purchase less coverage. Under Obamcare, young Americans must get more coverage and pay more whether they want the added coverage or not. Private insurers have increased their premiums because the law prohibits them from rejecting the sick, and are no longer allowed to charge higher premiums to older customers. Premiums for a young, healthy male could go up as much as three times. Young adults could then opt out of private coverage, causing the market to implode. (Washington Post, Insurers Warn of Health Law ‘Rate Shock,’ N.C. Aizenman, February 16, 2013)

To make matters worse, government officials announced on February 15, 2013 that state-based “high-risk pools” under Obamacare will be closed to new applicants on February 16 through March 2, depending on the state, because funding is running low. The existing 100,000 enrollees will not be affected. If the funding is running low now, what will happen by the time Obamacare is fully in force?

There is a glitch in Obamacare that could leave more than 500,000 children uninsured. Congress defined “affordable” in the Affordable Care Act as coverage not exceeding 9.5 % of family income. If people have coverage that fall under this 9.5% affordable, they cannot get subsidies to go into new insurance markets. This restriction was put into place to prevent people from switching from employer coverage to exchanges in droves. “Affordable” was calculated based on self-only, individual worker, with an average market cost of $5,600. But the current market family coverage, according to the Kaiser Family Foundation, is $15,700 per year. IRS announced on January 30, 2013, that employers are not required to pay for dependents, leaving the employee to pay the family premium since he/she will be locked out of subsidies in the federal exchanges.

Betsey McCaughey wrote that Congressional Budget Office (CBO) prediction that Obamacare would leave only 30 million people uninsured in 2016 was predicated on the assumption that kids would be covered by employees. If a parent is covered at work, no subsidies will be provided for the child in the health exchange.

Millions of people will remain uninsured because their states are choosing [wisely] not to expand Medicaid. The states do not have the money to expand Medicaid.

By the time the uninsured will be counted, almost as many Americans (40 million plus) will be left without insurance as the number of uninsured before the Democrats passed their signature monstrosity, the Affordable Care Act. Having sat in a drawer for decades, the bill was dusted off, repackaged, and polished. Nobody took the time to publicly debate or read the bill that passed after some arm-twisting.  The Democrats, who had promised free health care for all, feverishly proceeded to spend trillions of dollars we did not have to re-engineer our health care system in the name of social justice.

The states that refuse to set up health exchanges are expected to sell the government-mandated plans and to give out taxpayer-funded subsidies to those who enroll. Betsey McCaughey identifies the glitch:

“The law says that in states that refuse, the federal government can set up an exchange. But the law empowers only state exchanges, not federal ones, to hand out subsidies. The Obama administration says it will disregard the law and offer subsidies in all 50 states anyway, but the case will likely go to the Supreme Court.” http://www.nypost.com/p/news/opinion/opedcolumnists/wheels_coming_off_QPojjZX0Bd8BU80hDpcKZP

To safeguard from disaster, take care of your body, eat right, exercise if you can, and pray very hard that you will not get sick. There is a good chance that there will not be enough highly qualified doctors to deliver care when needed even if you do have insurance. Should you need specialists, expensive drugs or surgery, you are out of luck. Rationing will tell you, “no, you can’t have it.” The emergency rooms will be filled to capacity with confused, desperate, sick people, and new illegal alien arrivals.