Obamacare and Your Grocery Store

obamacare and your grocery storeWhat does Obamacare and your grocery store have in common? Nothing really, until the FDA decided they wanted to mess with us.

For those who have been on an alien space ship for the last 3 years, Obamacare is the massive health “care” law that is growing more heads than Hydra. Just when you think you have a handle on it, the damn thing grows another head that infringes on personal liberty and steals more money from your wallet.

In this case, Obamacare and your grocery store are now married in a twisted sort of way.

If the Food and Drug Administration gets its way, your trip to the grocery store could get a tad pricier.

Supermarket owners argue a pending federal food-labeling rule that stems from the new health care law would overburden thousands of grocers and convenience store owners — to the tune of $1 billion in the first year alone.

The rule stems from an ObamaCare mandate that restaurants provide nutrition information on menus. Most in the restaurant industry were supportive of the idea, but when the FDA decided to extend the provision to also affect thousands of supermarkets and convenience stores, the backlash was swift.

The proposed regulation would require store owners to label prepared, unpackaged foods found in salad bars and food bars, soups and bakery items.

Fox News

We already have the Internal Revenue Service, the Social Security Administration, the U.S. Department of Homeland Security, the U.S. Department of Veterans Affairs, the U.S. Department of Defense, the Peace Corps and the federal Office of Personnel Management with their fingers in Obamacare. What’s one more federal agency and another billion or so in extra hidden taxes?

Yes, I said hidden taxes.

The Supreme Court said Obamacare is a tax, and this will be an additional consumer cost directly tied to Obamacare which means it is a hidden tax.

The FDA says much of ObamaCare is aimed at helping Americans live healthier lives, and these proposed labeling requirements would help them do just that. In the text of the proposed regulation, the FDA states: “[The information] should help consumers limit excess calorie intake and understand how the foods that they purchase at these establishments fit within their daily caloric and other nutritional needs.”

Nutritional labels have existed on pre-packaged foods for years now and yet we, as a nation, are becoming fatter. So why will this proposed FDA rule change things?

Obamacare and your grocery store. Just one more stupid government trick.

Navigators on the Obamacare Exchange

navigatorsLet’s say you have a new give away and need to sign up 30 million folks in 90 days. What do you do?

In the case of Obamacare, you plan to hire “navigators” to assist in the process. These navigators are kind of like online Wal-Mart greeters whose job is to direct you to the right health insurance plan.

While some people will find registering for health insurance as easy as booking a flight online, vast numbers who are confused by the myriad choices will need to sit down with someone (navigators) who can walk them through the process.

Enter the “navigators,” an enormous new workforce of helpers required under the law. In large measure, the success of the law and its overriding aim of making sure that virtually all Americans have health insurance depends on these people. But the challenge of hiring and paying for a new class of workers is immense and is one of the most pressing issues as the Obama administration and state governments implement the law.
Tens of thousands of workers will be needed — California alone plans to certify 21,000 helpers — with the tab likely to run in the hundreds of millions of dollars.

Washington Post

California is broke, as are several other states. Where will they get the money to pay for these navigators?

Groups such as unions, chambers of commerce, health clinics, immigrant-service organizations, and community- or consumer-focused nonprofits can use the grants to train and employ staff members or volunteers to provide in-person guidance — especially to hard-to-reach populations — and to provide space for them to work.

That is a rather diverse group that is expected to become versed in the business of health insurance terms, plans and procedures. So if you need landscaping work, a green card and health insurance you can get it all at one place . . .

Compounding the difficulty, de Percin said, is that many of the uninsured struggle with English or don’t have easy access to the Internet. Others aren’t familiar with concepts like co-payments and deductibles, let alone the subsidies that will be provided for lower-income people or the new eligibility rules for Medicaid.

And the folks that wrote this law never considered any of this . . .

In a kind of Catch-22, the money must come from an exchange’s operating funds, which will rely on fees from insurers. But those won’t be available until at least Jan. 1, well after navigators must be in position.

States can pitch in during the meantime. But that’s an unlikely option in Colorado, which has stringent rules governing its budget.

Buy now, pay later. Hire someone that knew how to ask if you want fries with that order and make them navigators.

What could possibly go wrong?

Georgia Hospital Closing

Calhoun Memorial Hospital is closing. The loss of this Georgia hospital is a combination of the failing economy and financial strain caused by uninsured patients and increased number of Medicaid patients.

A handful of other rural hospitals in the state also may be teetering on the brink, with rising levels of uninsured patients and with Medicaid continuing to pay low rates for services.

HomeTown Health, an organization of rural hospitals in Georgia, says a half-dozen facilities could follow Calhoun Memorial’s move and shut down in the coming months.

Georgia Health News

Providers that accept Medicaid patients receive roughly 20% less than Medicare pays for the same services and Medicare pays about 15% less than private insurance carriers. With more patients relying on Medicaid doctors and hospitals feel the squeeze and have to take action.

Hospitals that accept any kind of federal funds cannot refuse Medicaid patients but doctors and other medical providers are not obligated to treat Medicaid patients.

The 25-bed “critical access’’ Calhoun Memorial is the first rural Georgia hospital to close since Telfair Regional Hospital in McRae, in south-central Georgia, closed in 2008, Lewis said Monday.

Earl Whiteley, CEO of Calhoun Memorial, cited the increase in charity care that the Calhoun County hospital incurred as a major reason for the hospital’s demise.

He told GHN on Monday that indigent charity care rose from $834,000 in 2008 to $1.8 million last year.

“You just can’t continue to give away free care,’’ Whiteley said.

Tell that to the low information voters that gave Obama another 4 years.

Whitley said part of the financial crisis is due to the loss of indigent care funds under Obamacare. Those patients were supposed to be covered under Medicaid expansion but Georgia, like most other states, do not have the money to pay their share of the cost of Medicaid.

Prior to Friday’s action, the Calhoun hospital authority had sold an assisted living facility and its nursing home. The hospital had stopped admitting patients, so there were none left to transfer to other hospitals. A medical clinic will remain open in Arlington, Whiteley said.

The economic impact on Arlington and Calhoun County will be profound, with up to 100 employees losing jobs.

With the closing of this Georgia hospital, local residents will have to drive about 45 minutes to the nearest hospital.

No More Babies

Hospitals in Georgia are closing the maternity dept. and saying “No more babies“. Hospitals lose millions each year on maternity patients and closing the maternity dept. is one way of saving money.

Last year, Burke Medical Center faced some tough math in trying to keep its childbirth services going.

The 40-bed hospital in Waynesboro, in rural east Georgia, was losing more than $1 million per year on its obstetrical services.

Given the high overhead, a hospital must deliver 500 babies or more a year to break even on that service, says Stephen Shepherd, CEO of Burke Medical Center. “In rural areas, getting up to 500 babies is tough.’’

Georgia Health News

Hospitals that say “no more babies” is a growing trend.

Among Georgia’s “critical access” hospitals –- rural facilities with no more than 25 inpatient beds –- 32 of 34 have given up maternity services, according to Jimmy Lewis of HomeTown Health, a rural hospital organization.

About 60 percent of births in Georgia every year are covered by Medicaid, and Georgia physicians and hospitals say the government insurance program generally does not pay them enough to make up for the costs of the care. Georgia OB/GYNs have not had a Medicaid pay increase in more than a decade.

Mothers that rely on the taxpayer to fund the cost of labor and delivery might have to reconsider the consequences of their actions. You can’t expect doctors, hospitals and staff to perform services at a loss if you don’t have the means to pay for your care.

Obstetricians will not be getting an increase from Medicaid due to restrictions in Obamacare. In fact, most will be expected to take a pay cut.


Obamacare Insurance Exchange

If you can’t wait until the Obamacare Insurance Exchange is up an running you might be very disappointed. It has been painted as a streamlined market place where online shoppers can view plans, provisions and rates and pick the best plan.

Sounds great, doesn’t it?

The truth is, the Obamacare insurance exchange may never materialize, complete with taxpayer subsidies, and if it does come to be it probably won’t be anything like you have imagined.

Like paying taxes, buying insurance is a complicated proposition, rife with jargon and high stakes: Errors can cost big money and run afoul of the law.

And like doing taxes, buying a policy on the exchange means interfacing with state and federal government agencies, too.

Kaiser Health News

After more than 37 years in the health insurance business, working in many capacities and now the last few years dealing with Medicare on behalf of my clients, I can tell you that the only thing worse than trying to get help from an insurance carrier is getting a straight answer from the government.

Like the bumper sticker says, “If you like the U. S. Post Office you will LOVE government health care“.

 Jargon is a big issue for consumers, who want to be able to hover a mouse over confusing terms to get a quick explanation of something they need to know, a popular feature of the tax software.

The insight comes from discussion groups convened last summer by three Colorado nonprofits. The groups found 414 people in eight urban and rural locations to help the state’s exchange board understand what people are going to need to shop on the exchange. Participants were volunteers, not scientifically selected, but organizers said their demographics roughly match those of anticipated exchange users.

The feedback tells exchange planners that they have a high mountain to climb. Consumers said they know very little about insurance and will need a lot of customer support to use the exchange.

Isn’t it a shame the Obamacare insurance exchange will all but eliminate the role of the insurance agent, many of whom have spent years learning their trade and assisting clients in finding the right plan that meets their needs and budget? Instead of relying on experienced agents, consumers will have to hope that “Suzie” is available to answer their questions and has learned enough from her 2 week training course to offer real advice and assistance.

More than half in the discussion group were under 30 years old. When asked “who helps you choose a health plan now?” 215 said “parents,” and 105 said a family member. Only 17 said they turned to the Internet for help picking a health plan now, fewer than named brokers/agents (22), employers (45) or “myself/nobody” (44).

That’s a real vote of no confidence for this process going forward.

Affordable Health Care Through ACO’s

The government has promised affordable health care but has yet to deliver. Truth is, most of the proposed solutions do nothing to lower the cost of health care. Everything they have tried, and most things they have proposed, will not result in more affordable health care.

Washington’s big idea in making health care more affordable is to pay doctors and hospitals LESS for the services they provide.

Consider this. How enthusiastic would you be if your employer told you they were going to reduce your pay by 27% but expected you to do the same amount of work for less pay? Medical providers that treat Medicare and Medicaid patients feel the same way.

But one part of the incorrectly named Affordable Health Care Act (Obamacare) may indeed provide a way to improve the quality of health care while lowering costs. Accountable Care Organizations, or ACO’s, are an attempt to hold providers accountable for the level of care they provide.

Emory and Blue Cross said in a press release that a goal is “to bring together the often fragmented health care delivery and reimbursement systems to create an integrated model of coordination and shared accountability among hospitals, doctors and insurance carriers.’’

An Emory official, Janet Christenbury, said the two organizations will have more to say about the collaboration in coming weeks. She said the talks were driven, in part, by changes in the health care marketplace and by the Affordable Care Act.

Charles Goldberg, an Atlanta-based health care consultant, said the Emory/Blue Cross collaboration could be a response to recent moves by Piedmont Healthcare and WellStar Health System. Those two organizations have formed a partnership and are working to offer a health insurance product.

“There’s a lot of momentum’’ toward these combinations, Goldberg said. “It will be interesting to see what happens over the next couple of years.’’

Georgia Health News

One potential downside of ACO’s is this. Since providers are penalized for poor results, the ACO’s may limit or refuse to take on the most difficult medical cases or limit the number of sick people with traditionally poor outcomes. By restricting the number of patients to those who have a better than average chance of recovery, the ACO can maximize their revenues.

This will limit access to health care, affordable or otherwise, which is never a good situation.

Affordable health care may or may not prove effective. Still, it is an attempt to change the status quo but completely ignores the one element that can truly lower the cost of health care.

The patient can make health care affordable by taking personal responsibility in their health. Proper diet and exercise go a long way toward affordable health care.

Georgia Child Only Health Insurance

Children’s health insurance is only available through Healthcare.gov

Free Health Care for Illegal's

Seems there are still folks out there that believe they are entitled to free health care. Unlimited, unrestricted health care, as long as someone else is paying the bill.

(Jorge) Mariscal moved from Mexico to the U.S. when he was 1 year old. Now as a 24-year-old graphic-design student, he considers it his home.

He says he nearly returned to Mexico after doctors said he wouldn't be able to receive a kidney transplant in the U.S. because he is undocumented.

Chicago Tribune

Since he came here when he was 1 it is obvious someone brought him. Why has he lived here for 23 years without ever registering?

Why did he stay here vs. going to Mexico for his surgery?

As an illegal immigrant, Jorge Mariscal waited eight years for a kidney transplant he feared would never come.
After years of uncertainties, Mariscal said he's excited about his future and grateful for the help he received. But he remains frustrated with a health care system that he worries might leave out an untold number of illegal immigrants in need of lifesaving treatments.

"Why can't we be treated the same?" he asked while sitting in his hospital room. "Health care should be a human right, not a privilege. At least give us the chance to fight for our lives with dignity."

Why can't you get a job with benefits that will pay for your medical needs? Why is it OUR collective responsibility to pprovide you with free health care?

Where is the dignity in demanding that someone else pay for your care?

Mariscal's treatment is far from over. The pills he'll need to make sure his body doesn't reject the new organ can cost upward of $10,000 a year for the rest of his life. And paying for those, just like the surgery, is complicated by his immigration status.

He applied for a grant through the Simon Bolivar Foundation, a medical nonprofit, that would help cover his first year of anti-rejection pills. But without health insurance, he expects he'll have to pay for most of his medication.

In 2014 under Obamacare he will be able to purchase health insurance without restriction. I wonder if he will buy insurance then or expect the rest of us to continue providing him with free health care.

Universal Health Care

It seems the folks in Vermont, home to Ben & Jerry's, decided to get a jump on Obamacare with their own universal health care program.

Last year, Vermont enacted a single-payer health plan to cover everyone in the state. One problem: The state did not fund it. That has led some in the state to look to legalizing assisted suicide as one means of making the plan easier to pay for

NRO, "Vermont pushes assisted suicide"

What a novel idea. 

If the government can't afford to pay for universal health care, they will pay for the final solution.

After all, what could be a cheaper “medical treatment” then providing drug overdoses to expensively sick patients? And think of the money to be saved if very ill patients die sooner rather than later. 

Wonder if the Obamacare folks have thought about this?

Let's hope not.

The Reality of Obamacare

What Obamacare has done is create a series of perverse incentives that encourage businesses to stop providing health insurance. As a business you have the choice of providing a rather gaudy health care plan to your employees or paying a tax. I say gaudy because the the basic requirements of the package, providing enough birth control pills to satisfy Sandra Fluke’s appetites, for instance, adds cost on to the plan. Contrary to what a lot of people seem to believe the health care plan provided by your employer is not YOUR health plan, it is your employer’s.

So by paying a tax, a business can avoid the human resources head ache of managing a health plan and reduce costs. What option do you think many businesses will choose.

But wait there is more.

An employer only has to provide a health plan for full time employees. There is no penalty for not providing health coverage to part-time workers. And there are no penalties if you employ fewer than 50 persons (by person I mean full-time equivalents: if you have part time workers and your average number of hours worked exceed 50 x 120 (4 weeks x 30hr/week). You can read more on the nuances of calculating what is a full time equivalent worker courtesy of RedState member jayp.

Faced with the prospect of paying as much as $40,000/year some employers are reducing both full time positions and total number of employees.

Companies as diverse as Papa John’s, St Jude’s Hospital, and Murray Energy have all announced layoffs that are linked to Obamacare.

What Obamacare has done in the name of providing universal health care is to make it advantageous to employers to provide no health care whatsoever. This isn’t necessarily bad, in my view one of the major shortfalls of our current system is that the policy is owned by the employer rather than the employee, but what is bad is when such a sea change occurs when the actual operational concept was to expand the scope of coverage provided by employers.

By gold plating the minimum policy, employers are encouraged to carry no policy at all. To avoid the fines associated with not providing coverage employers have an incentive to reduce a vast majority of employees to working less than 30 hours per week. If you are a waiter, your employer now has an incentive to reduce your tip income to avoid health care costs:

Bob McAdam, Spokesperson for Darden, parent company of Olive Garden and Red Lobster restaurants, stated that they were still in a test stage back in October. The company had made plans to reduce hours and require tip-sharing from waitstaff to the remainder of employees, which would eliminate the owners from having to provide tip-credit*. (*A set hourly pay amount for waitstaff established by the local government and is divided into two parts. If the waiter doesn’t earn tips then they receive the whole amount of both parts. If the waiter does receive tips then they only receive half of the hourly amount.)

On the subject of employers wanting to reduce the incomes of waitstaff for his own benefit, it certainly isn’t going to encourage staff members to purchase food at his restaurant.

One issue that concerns career waiters is that they choose the field because they can earn up to $200 per day in tips, having to share their income with remaining employees reduces their own income.

When is a waiter responsible for paying for the wages of his co-workers? For that matter why is the paying consumer responsible for paying for the wages of a business above and beyond the price of his meal? The tip has always been a gratuity, a thank you, an appreciation, not meant as a subsidy for business owners to underpay their employees.

Since the government assumes that the waiter is earning at least 8 percent in tips figured on his gross sales for the day; reporting less could trigger audits.

In the view of Obama and his minions companies are in business to provide free stuff to their employees (so his view on economics parallels his view on governance) and since a vibrant middle class has health care provided by their employer if the government merely mandated this to happen we would suddenly be prosperous.

Now the demographic Obamacare sought to help is finding itself not only without health coverage, it is also required to work two jobs to make ends meet. Well played, President Obama.