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Obamneycare – Another Win-Win for the Oligarchs ~ Robert S. Dotson, M.D.

“Mitt Romney is a wolf in a wolf’s clothing. Barack Obama is a wolf in a sheep’s clothing, but they both essentially have the same agenda.” – Jill Stein

“Bipartisan usually means that a larger-than-usual deception is being carried out.” – George Carlin

“But we have to pass the bill so that you can find out what is in it away from the fog of controversy.” — Speaker of the House Nancy Pelosi, remarks at the 2010 Legislative Conference for the National Association of Counties prior to passage of PPACA

October has brought the mini-series that accompanies our quadrennial exercise in faux democracy, the Presidential Debates. As has been usual for many decades, the public was entertained by carefully vetted corporatist representatives of War Party A and War Party B via the televised game show format that is sold as “serious debate” here at the End of Empire. Nothing illustrated the silliness and irrelevance of such spectacle better than the inane exchanges between Obama and Romney concerning healthcare. The charade was played out yet again when the Vice Presidential candidates, Biden and Ryan, performed in another nondebate on October 11th.

The Patient Protection and Affordable Care Act (PPACA, aka Obamacare, aka Romneycare or, most accurately, Obamneycare) is the 21st century poster child for social legislation in our corporatist state. Despite its origins, Obamneycare is simply another hand-out to the ruling oligarchy. In true New Speak fashion, despite the title patients will not be protected nor will healthcare become “affordable”.

Doubt it? Just reflect for a moment on how well We-The-People are “protected” by a government “of the corporations, by the corporations, and for the corporations.” We can be “disappeared” and “killed” at the whim of the President or his minions. We are looted daily – trillions for the banksters, trillions more for the Military-Security Complex, trillions for Empire, and declining real median incomes for the peasants.

For those with an interest in how they and their families will be impacted by Obamneycare, legislation that was actually signed into law, Public Law 111-148, the legislation can be read here:
and http://en.wikisource.org/wiki/Patient_Protection_and_Affordable_Care_Act [1]
Wading through 906 pages is a formidable task The law requires citizens to purchase a product under penalty of law.

Failure to purchase the required medical insurance carries significant civil penalties. Though these penalties are only monetary at this time, one can easily imagine incarceration in health care prisons in the near future. Perhaps those reported FEMA camps will be used for jailing Americans for their failure to purchase Obamneycare ordered insurance.

The mandated increase in government bureaucracy at all levels is astounding, and the sums of money and manpower that will be required to implement this law are staggering. Dozens of new grant programs, bureaucratic entities, demonstration or pilot programs, regulatory systems, compliance standards, taxes, and entitlements are found within Obamneycare diagrammed at the link below. Though this flow chart was compiled prior to finalization of PPACA, it is still accurate in its representation of the Byzantine healthcare system that has been created and is worth examining in detail. http://dailybail.com/home/obamacare-complicated-check-out-the-flow-chart.html [2]

Every decision, every transaction, every treatment plan, every payment, every hospital admission – in short, every contact between patient, provider, and healthcare system – will now be monitored and evaluated and ultimately dictated by the Federal Government. The Secretary of Health and Human Services is granted near god-like powers to manage this medical system, and he or she is empowered to multiply bureaucracies with the abandon of a Federal Reserve printing press in order to implement every jot and tittle of the law. The Act requires massive increases in reporting of any and every healthcare related event and similar increases in documentation of any and all interactions between patients, providers, and healthcare system.

The adoption of electronic health records (EHRs) – already underway following passage of HITECH (Health Information Technology for Economic and Clinical Health Act of 2009, part of ARRA) – will help expedite implementation of PPACA. Needless to say, all of this data management will require untold years of man hours and billions of dollars to implement. Perhaps, this mess was viewed as a solution to unemployment. If so, it certainly fails out of the starting blocks, as no products are created, no one is healed – in fact, nothing of discernible value is produced at all, except more bloat in government, more cost for the common man, less health care and more profits for the private insurance companies who sell the mandated policies.

Private health care providers do not come out as well. PPACA creates panels of experts to define what are acceptable standards of care and, of course, to insure compliance with those standards. To aid in achieving this goal, the Act increases government enforcement activities astronomically. The Feds need revenue and it has not been lost on those in power that providers are easy targets for “recovering” billions of dollars in “fraud” judgments and settlements. The government banked $4.1 billion in fraud “recoveries” in 2011 alone. Since 2009, the government’s return on “investment” in fraud recovery has been $7.20 for each dollar expended on enforcement. The preponderance of fraud appears to be billing mistakes made by clerical workers and computer programs. But government doesn’t acknowledge mistakes, only crimes.

When mandated electronic health records are merged with the on-going (and, unconstitutional) Total Information Awareness (TIA) program of the NSA, then the dystopian dream of every Central Controller will have been met. Each and every soul within Homeland Amerika will be numbered and monitored from conception until death. It goes without saying that this control grid will provide our Ruling Elite with the tools to maximize the profit that can be extracted from each peasant unit and ensure that they are “retired” from service when their usefulness to the corporate state expires.

All of the regulatory and enforcement levers for ensuring compliance with our dystopian future are enumerated and funded within the pages of PPACA. Vast numbers of new bureaucrats at all levels (local, state, federal) are specified. These people will define standards of care, dictate where healthcare dollars are spent, determine how providers are reimbursed, identify and collect future taxes, and insure that existing corporate interests are protected from competing entities that might threaten profit margins.

It is common knowledge that the IRS will be the enforcement and administrative arm for PPACA and that as many as 16,000 new agents will be necessary to manage implementation of the new healthcare system. This seems appropriate since the Supreme Court has declared that the Act is a tax, in spite of Presidential protestations. The White House has already, in fact, transferred over $500 million to the IRS to begin work on expanding the Service and its new medical police powers. It is estimated that the IRS will spend nearly $1 billion through 2013 in information technology (IT) costs alone. Tax expert, Dan Pilla, has written a twenty page analysis of PPACA detailing its oppressive tax ramifications for residents of Homeland Amerika.

He rightly describes the IRS as the new “face of American health care.” Pilla’s research is an important and apolitical analysis of the disastrous policies set in motion by this legislation. Read it here:

This report should be required reading for anyone sporting an “I Love Obamacare” sticker. Of course, the Republican Party faithful should not be excused from mandatory reading of this important work, especially since their standard bearer, Mr. Romney, played such a seminal roll in its creation. Romney has said that there are “a number of things” that he likes about PPACA, but he wants to impose his own version upon the peons.

So what alternatives do the competing candidates offer? Essentially, they both propose to privatize Medicare by diverting tax revenues to the subsidization of policies sold by private insurance companies. PPACA promotes the fiction that the federal government will return “fairness” to the health care system by insuring that the “rich” contribute “their fair share.” Of course, it does nothing of the sort. Romney achieves the same result by allowing “free choice” through the use of “vouchers” (a Republican version of company store scrip).

Despite the mainstream media portrayal of the 2012 Presidential Election race as one of real choice between different political and socioeconomic world views, nothing could be further from the truth. Each major political party promotes the fiction that there is substantial difference between them on issues affecting the lives of millions of Americans and, literally, billions of our fellow humans across the planet. In reality, the two parties are the same side of the same coin, delineated by a few emotionally charged talking points. Behind the façade, any thinking human can readily discern that the policies of War Party A and War Party B are virtually the same – more military adventurism abroad and now at home, more Military-Security State, more wealth transfer from the 99% to the 1%, more corporatism in all areas of endeavor, less freedom and less security, the further de-industrialization of America under the guise of “free trade,” and the continued collapse of a once vibrant Middle Class. Both parties have scripted a “health care” system that is expensive and ineffective and sacrifices health care to corporate profits.

Both political parties have a vested interest in PPACA or its equivalent, and the parties colluded to pass the present law for the benefit of their corporate sponsors. Though both parties will doubtless fine tune the Affordable Care Act, health care has been sacrificed to private profitability.

So what does one do about any of this? Short of armed revolution, not much. The train left the station long ago. Resist however you can, but also spend time with family and friends, help your neighbor, learn new skills, grow some of your own food, and practice to be more self-sufficient and a good shot. Love much, and laugh often. Most importantly of all, learn to care for your own health needs, as much as possible, and minimize contact with the health care system.

The failure of Amerika, Inc. and collapse of Empire will give us the opportunity to build something new and better from the rubble. Come November 6th, I will be staying home and amusing myself with a good book, good conversation with friends, and, perhaps, a glass of wine. A few years ago, libertarian humorist, P.J. O’Rourke, wrote a book entitled: Don’t Vote—It Just Encourages The Bastards [3]. Amen, P.J.

If you must vote, vote Third Party.

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