Tom Pittman's WebLog

2009 September 9 -- ObamaCare Is Good (for Me)

No, not its health care provisions. No "insurance" can hold a candle to the quality of service I get from a fee-based system.

No, not what it does to the American tax system and thus to the economy and my personal finances. That's an unmitigated disaster. You see, I'm one of those low-income "uninsured" people this bill intentionally sets out to destroy.

But let me start at the beginning.

The first thing you need to understand about ObamaCare is that nobody wants it. NOBODY. Since the details were first disclosed, I have never yet heard a single good thing about it from anybody anywhere. Not even the politicians who say they plan to vote for it really want it. That's why they exempted themselves from its provisions. So I hear. I have not heard of a single politician volunteering to be covered by it. ObamaCare has united our country. That's a good thing, in a diffuse sort of way. But it's of no particular benefit to me personally.

This week I met with a potential client for my software services. I expected, as is my custom, to meet with the top decision-maker to listen to where he wanted to take his business, and then to offer my skills and services to help him get there. It didn't turn out that way. He'd already pretty much decided he wanted what I could do for him. His agenda for this meeting was to feel me out to see if he could trust me with a job this big. I'm the expert -- that's what you bring a consultant in for -- but he wanted to believe I wasn't scamming him. Or something like that. Nothing like this was ever said.

Instead we talked about operating systems, and why I like the MacOS and not OSX. I told him everybody knows that eunuchs are missing a vital organ and therefore cannot perform; the unix system is aptly named. As a physician, he got a hearty chuckle out of that. He later asked why his iPhone crashes surfing the web. I told him it's OSX under the hood and he understood.

We talked about the C++ programming language, and why it's better than what his programmer is using today. Technically, it's not better, but at least it's not a proprietary system. A couple years of license fees will pay for what I cost him to convert.

And of course we talked about his business prospects in the current economy. I think ObamaCare nailed it for me.


As a physician, he is incensed. He has experience with MediCare to base his opinion on. He mentioned a particular procedure he does often, one that I have also undergone (and paid for). BlueCross pays him (for example; these are not the actual numbers he mentioned, only proportional) $800 for this operation; Medicare pays $300 for the same operation (I paid $4000, but that included the OR and other people involved; I don't recall the physician's portion of it). Obama announced that there is 15% "fraud, waste and abuse" in the payments they are making, and they are on the doctor's case to reduce his billings so as to eliminate this "fraud, waste and abuse" portion. All you need to do is look at the difference in payments to see that there is no fraud or waste in that procedure being paid by MediCare. More than that, I heard the next day from an independent source that this physician has a reputation for integrity above reproach in that community.

There probably is fraud, waste and abuse in MediCare. Some of the things I saw going on in connection with my late mother's transfer to nursing care, I would not tolerate on my own behalf as a matter of conscience. But there is a problem when a commercial health insurance company pays nearly three times what MediCare pays for the same procedure. Somebody is unwittingly subsidizing the services provided to somebody else. That is what the Bible calls "unequal weights" and the rest of us call "fraud." The Federal government is the perpetrator, not the victim. That is the kind of health care Barack Obama wants us all to have. All except himself and his cronies, of course.

This is nothing new. There is a very old joke, that "there are two ways to do something, the right way, and the government way." That's why there is fraud, waste and abuse. Doing things badly (the government way) encourages fraud, waste and abuse. It is unavoidable when there is no profit incentive to do things better, and no way for an employee to be fired for bungling it -- I know: my first job out of college was civil service, and I did a lot of work for the Personnel Manager. We got to be good friends. One day he told me with a straight face, "Civil Service performs a valuable social function: it provides employment for people who would otherwise be unemployable." His exact words. It's true, I saw it myself, all around me every day. That's why I got out 40 years ago. It also explains a lot.

So how does this disaster help me, besides clinching a software development contract with one physician? Simple: America has a heritage of ingenuity and cleverness. Whenever there is billions of dollars being managed by fools and idiots (aka civil service), clever people -- both knaves and honest people (I hope you will forgive my conceit to imagine myself among the latter) -- will find ways both to work the system and to work around the system, thereby to siphon off some of those billions -- again, I remind you, both by providing honest services as well as by fraud, waste and abuse. The reason Medicare pays only $300 for the same operation that honest and well-run organizations pay $800 for is that the other $700 was squandered in fraud, waste and abuse. That builds a huge economy in services to be paid for, which translates into work for me. I'm already on public record as refusing to sell directly to the government, but hey, this doc is as honest as the day is long, and government bungles makes my services attractive to him. In that way, ObamaCare is good for me.

During the peak of my contract programming days I noticed a curious phenomenon, that my personal income was related to the negative derivative of the national economy. Math whizzes and others who learned to hate calculus know that means when the economy was on the way down, I did great; when it was recovering, I did poorly. I could only guess at why that was. Weep and mourn, you suckers who voted for Obama: my indicator once again shows a season of national plight, possibly as bad as when FDR prolonged the Depression 12 years by his bungling. You knew Obama sees FDR as a role model?

There is another way ObamaCare works in my favor. As more and more suckers get sucked into the vortex of ObamaCare, they leave behind the quality fee-for-service operators to a diminishing clientele, still hopefully including me. Market economics operating on that drives the price down and the quality up -- at least temporarily, until the practitioners just drop out of the system. Thus even paying what I now call "the Obama campaign lies penalty tax" over and above my medical expenses is likely to still give me cheaper and better health care than capitulating to the Obama machine.

The final thing you need to remember about medical care in the USA is that even if ObamaCare passes unchanged (and we hope it does neither), the ship of state is too big to turn on a dime. Most of us will never see anything different -- other than higher costs and less availability and higher taxes, of course. But we already have that, don't we? The rich will always have the money to get the medical care they want when they want it. They will buy (and ignore) a token insurance policy, or else just pay the penalty tax because it's insignificant to their wealth. A few (but not many) of the poor people will get access to services they can afford, which they cannot get today. And a somewhat larger proportion of the middle class will find themselves in a position of not being able to get medical services they can afford today. But mostly it will be the same as today. Except everybody -- especially the poor -- will pay higher taxes. See my posting, "Change? What Change?"

Maybe, if we are lucky, the American people will wake up and realize that we can do something about this fiasco, and throw the bums out of office who voted for it, and hopefully also repeal the law itself. If we are lucky.

Unfortunately, a large part of the population is "poor, uneducated, and easily led." They are the ones who voted Barack Obama and his cronies into office, and if his administration continues to lie to the American people about what is going on, the people may never figure out that


Additional ObamaCare remarks and links here

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