OBAMA’S PLAN: Single-Seller to Single-Payer

 



December 12, 2013
 
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Last week I talked about entrapment – the various methods President Obama is using to entice people into the Obamacare exchange. Help us derail Obama’s entrapment schemes in the critical year of 2014 by donating $15, $45, or $95 today!

This week I’ll predict how the Obamacare exchanges, if allowed to survive despite all their missteps, shutdowns, intrusions, and fraud-enticing tendencies, could lead to a single-payer system where government pays for all health care services -- and people suffer and die from perfectly treatable diseases while waiting in line.  As healthcare.gov has a waiting line to enroll, so will “singlepayer.gov.”
 
To get to single-payer, Obama needed a state-based apparatus. America is a large country. A federal takeover apparatus with computerized monitoring and control capabilities would have to be installed in every state.
 
Enter the Obamacare exchanges.
 
The Exchanges are a Trojan horse. You see them, but you can’t readily see the dangers deep inside: the federal data collection, national surveillance of insurance status, IRS enforcement of the mandates, the single-seller plan, and the federal government in control. Euphemisms abound. Exchanges have been called “marketplaces” when they are government bureaucracies. The administration claims they sell “private insurance.” They do not. Every exchange application form is a federal form issued by and sent to the federal government and through the IRS.
 
I predict Obama’s plan for single-payer may be as follows:
 
  1. Government exchanges with rich federal taxpayer-funded premium subsidies draw in many Americans and drive private insurers out of business, turning the government exchange into a single-seller system -- the only place for Americans to secure coverage.
  1. Physicians, no longer independent due to costs and controls imposed by Obamacare, become employed by hospitals in Obamacare-established Accountable Care Organizations, sometimes called “HMOs on steroids.”
  1. Congress and/or state legislatures increase taxes to provide annual capitated (limited) payments to the Exchange to cover the cost of health care services given to citizens of each state.
  1. Government agencies in charge of exchanges take a cut of the payments for “administrative expenses” and divide remaining capitated funds between exchange “insurers” participating in each state.
  1. After taking a cut for “administrative expenses,” exchange “insurers” divide capitated funds between Obamacare Accountable Care Organizations (ACOs).
  1. As ACOs begin to bear the financial risk of their enrolled patient populations, exchange “insurers” no longer bear risk for cost of patient care and become simply administrators in the government exchange as well as patient-tracking centers for the ACOs (which must protect their annual government payments by corralling their entire patient population into ACO-controlled clinics and hospitals).
  1. To protect themselves from financial risk, the ACO’s administrative arm (hospital) uses health surveillance systems (and Obamacare’s “comparative effectiveness research” studies of patient medical records) to seize control of the physician’s practice of medicine through computerized tracking of treatments and pay-for-performance initiatives that constrain physician autonomy and ration patient access to medical care.
 
Here’s the good news. Obamacare is not yet a fully functioning single-payer system -- and 34 states have created significant resistance by refusing to fund or install a state-based exchange -- but President Obama doing all he can through the federal law and the power of his office to “prepare the soil” for single-payer.
 
They face a hard deadline. By law, Obama’s exchanges must be financially self-sustaining on January 1, 2015. All federal funding disappears and operating funds must be secured from enrollee premium payments or state taxpayers. This is why CCH Freedom is focused on limiting exchange enrollment in 2014.
 
According to The Washington Post, it is less important for the Obama administration to get the seven million enrollees they want during 2014 than it is to make sure sufficient enrollees are young and healthy. Otherwise the exchanges could enter a “death spiral” resulting from enrolling less healthy, older people with high-costs.
 
Help CCH Freedom keep the young and healthy out of Obama’s exchanges!
 
 
Planning to stop Obamacare in 2014,
 
Twila Brase, RN, PHN
President and Co-founder