Uncommon Sense

politics and society are, unfortunately, much the same thing

What happens when no one asks whether insurance is really a good way to deal with health care costs?

original article: How Obamacare Hurts Millions Of Americans By Robbing Peter To Pay For Paul
May 10, 2017 by Scott Ehrlich

In my prior article, I tried to outline the pre-existing condition issue. I concluded the amount of people potentially affected by this issue ranged somewhere between 500,000 and 1.9 million and, due to political reasons, it is much likelier to be on the lower end of that spectrum.

So for this article, I will use 1 million people as my number. Based on this data from Avalere, it’s a pretty sensible estimate, if you only count states that are solely Republican-run and therefore likely to seek a waiver.

This 1 million people are adults covered by the individual market, at the moment largely through the federal exchanges. People on group insurance are not affected by pre-existing conditions laws, as those plans do not do individual underwriting. People in government insurance such as Medicaid, Medicare, and Tri-Care are guaranteed issue upon meeting certain conditions. Children under 19 who aren’t covered by Medicaid are covered by the Children’s Health Insurance Program, which has no pre-existing condition exclusions. Futher, people in Maine, Massachusetts, New Jersey, New York, Vermont, and Washington have state laws that mandate guaranteed issue.

So our at-risk people are made up of the remaining 7 million or so people in the other 45 states who choose to self-insure, have pre-existing conditions that stop them from getting insurance, have states granted waivers under the American Health Care Act (AHCA, if it passes Congress in its current form), and have failed to keep continuous coverage.

Assuming your eyes glazed over a quarter of a way through that sentence, that shows just how many safety nets one has to fall through to be at risk of being denied coverage at the market rate, or any rate, for pre-existing conditions. Recall that just because someone has a pre-existing condition or is denied by an insurance company for one, doesn’t mean he will be denied by all. So that is why my numbers are lower than many others being reported.

Let’s Pin Down How Much These Folks’ Health Care Costs

So let’s go with that 1 million number, which is still a lot of people needing help. What can we do with them? That is the challenge. When enrolling a random assortment of 1 million Americans in a pool, theoretically about 27 percent could have some sort of ailment requiring immediate treatment. Depending on the mix of other people, it’s possible to make that pool actuarily sound.

But high-risk pools don’t work that way. In that pool, 100 percent of enrollees have pre-existing conditions. Therefore, it’s impossible to provide them insurance and keep a stable pool. You can’t insure someone for a condition he already has any more than you can insure a house that is already on fire or a car that has already crashed. There is no ability to pool risk.

So this group of people is very expensive to cover, as they are already sick and use a lot of health care. Average costs in the PCIP federal high-risk pool, the one the Affordable Care Act set up as a bridge to the exchanges, averaged more than $32,000 per enrollee per year. Based on those numbers, at 1 million enrollees, we’d be looking at more than $32 billion annually in costs for high-risk people. That $8 billion that got Rep. Fred Upton to vote yes on House Republicans’ Obamacare tweaks? That would cover only three months of expenses at full enrollment.

If the entire amount appropriated in AHCA were applied to pre-existing conditions, a whopping $123 billion, we’d only have enough to make it through four years if that cost were accurate.

Luckily, That Cost Is Likely Overstated

Reading deeper into the report, you find that, fortunately, it may not be. Not all people with pre-existing conditions are created equally: “4.4 percent of PCIP enrollees accounted for over 50 percent of claims paid, while approximately two-thirds of enrollees experienced $5,000 or less in claims paid over the same period.” So while Avalere used the $32,000 figure, it probably vastly overstates the cost of a program like this. That’s because the people most likely to have been enrolled in PCIP would be the sickest, who need the most care immediately.

Someone with early-stage diabetes with no side effects, like myself, who may currently be tough to insure may ignore a high-risk pool like this since it costs more than I spend on treatment, while someone with advanced cancer requiring frequent doctor visits, expensive medication, and consistent chemotherapy would seek something like this out. Therefore, if the pool of 115,000 enrollees in PCIP were expanded to the 1 million people who have pre-existing conditions but couldn’t be insured, we’d likely see many more costing about $5,000 per year than the ones costing $100,000 and up.

Therefore, I prefer the number $12,000 as the cost per additional enrollee. This uses the average benefit used by a person enrolled in Medicare based on the total benefits paid divided by the total people covered. Since these people are older, sicker, or disabled and have high health utilization, I think it makes a good proxy for the sort of person likely to seek a high-risk pool who would not have jumped at the opportunity to sign up for PCIP.

Adding 900,000 people at that cost to the 100,000 people at $32,000 in PCIP gives us a total annual cost of $14 billion. That means if people in these pools were to cover about 10 percent of their own health-care expenses, the money AHCA appropriates could cover the entire affected population of the high-risk pools for the entire 10-year budget window.

This Is Still a Lot of Money

So now we’ve seen the numbers. About a million people may need help. Pooling them with the healthy has real costs to a lot of people to help a few. But we have decided as a society that we can’t just let those few suffer. Yet helping pay for their care will be staggeringly expensive. Even in my example, with this smaller pool and smaller assumed costs, we would burn through the entire pool of $123 billion in a decade. These people will still need help at the end of that decade. How do we take care of our sick population into the 2030s without busting our budget?

That is why people argue we should keep the Affordable Care Act provisions regarding pre-existing conditions, which are community rating and guaranteed issue. The benefits are obvious, as they have been blasted all over the media. People getting operations they might not otherwise have had, seeing doctors they couldn’t otherwise see, getting care they wouldn’t have otherwise received. Who would be so heartless as to take that away?

This is a classic example of concentrated and observable risk and diffuse and hard to see benefits. Remember what has happened to premiums since ACA was implemented. All these people were not covered without a cost. That cost comes out of the pockets of everyone else in the exchanges. While much harder to see, and much less heart-wrenching in a soundbite or a video or a tweet, those costs did make a difference.

Adding a few hundred dollars a month to health premiums can mean the difference between eating terrible food and eating healthy, not working out and a gym membership, scrimping and stressing over every dollar and rationing essentials which adds mental and physical health costs, or a budget that more comfortably covers your fixed expenses.

More severely, higher premiums for lower-quality policies may mean that some people who may have formerly been able to afford some form of insurance now are going without, causing exactly the sort of problem ACA was supposed to fix. To act like the days, weeks, months, and years taken off the lives of some people due to the costs ACA imposes to help others is without consequence is sadly mistaken.

When Compassion Is Cruel

Those realities aren’t purely speculative, either. Rates are rising year over year. Even with rising subsidies, the plans get more expensive to both buyers and the taxpayers. And there is no sign these rising rates will abate, as more people for whom insurance has a marginal value will choose to go without, leaving a sicker pool, causing not only rates to rise but insurance companies to lose more and more money on these policies.

That leads to insurers dropping out of markets entirely. This is why doing it the “compassionate” way has not only costs for people whose rates will rise, but also costs for those this is supposed to help, as this adverse selection will result in many of them also having no insurance options. Guaranteed issue and community rating do very little good if no one is willing to sell policies because the cost risk is too high.

That is why, whichever way you lean politically, both the ACA and AHCA seem to be just a band-aid. Neither are sustainable, needing significant federal money pumped into them to survive. ACA will need it to subsidize the cost of policies to get healthy people to sign up while also subsidizing the losses insurance companies suffer in an effort to keep them on the exchanges when they don’t.

AHCA will need massive continued subsidies to fund high-risk pools, all as health-care gets more individualized and potentially more expensive. This is in addition to the increasing burden Medicare will put on state and federal budgets as baby boomers retire and live to a ripe old age, while higher birth rates among poorer Americans, in addition to ACA expansion, should cause a massive increase in Medicaid spending.

This is why any comprehensive health insurance reform is doomed to fail. Americans want great quality care at cheap prices that is abundantly available. At best, we can get two of those three. At worst, we get very expensive plans that provide very little real health care for the most vulnerable while making things worse for everyone else. That is why our efforts should focus on ways to provide better health care for everyone, increasing the size of the pie of good-quality, available health care rather than locking in the worst parts of our current system and merely fighting about who should pay for them.

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No, GOP’s Obamacare Update Doesn’t Make Rape A Pre-Existing Condition

original article: No, GOP’s Obamacare Update Doesn’t Make Rape A Pre-Existing Condition
May 8, 2017 by Robert Tracinski

The American Left is finishing its sixth straight month of losing it. They have been pegged at “total freakout” for so long now that it is impossible to tell when anything they say is valid or wildly exaggerated.

Take the headline you undoubtedly saw, or had forwarded to you on social media if you interact much with people on the Left, which proclaimed that the American Health Care Act—House Republicans’ Obamacare tweaks—makes sexual assault a pre-existing condition.

AHCA_preexisting

What’s actually going on here? The House bill, which mostly just tinkers with Obamacare instead of actually repealing it, still contains a requirement that insurers have to cover people with pre-existing conditions. But a late addition, the MacArthur Amendment, gives states the ability to ask the federal government for a waiver that would allow insurers to charge people with pre-existing conditions higher rates.

The amendment itself—and I had to search around for a while to find its actual text rather than somebody’s short-stroke summary of it—makes no mention of sexual assault or rape.

Ah, but somebody realized that rape victims sometimes suffer medical problems as a consequences of the assault and that these problems would count as “pre-existing conditions” under the law. They would count as such because they have always counted as pre-existing conditions. But so would any number of other conditions resulting from other tragic and unfortunate events. In other words, this headline is so misleading that even PolitiFact rates it as “Mostly False.”

The new law does not “make” sexual assault a pre-existing condition. The medical consequences of rape have always been considered a pre-existing condition, because that’s what the phrase “pre-existing condition” means. It refers to a condition that existed previously.

“Pre-existing condition” is not a value judgment. It does not imply that the pre-existing condition is the patient’s fault, or that this person is somehow unworthy of receiving medical treatment. It is a merely factual description, but one that has special relevance when talking about insurance. When you require insurance coverage for a pre-existing condition, it’s no longer insurance. Insurance is a financial mechanism for hedging against an unknown future risk, not a way of seeking compensation for damage that has already occurred.

If that seems like a nitpicking distinction, it’s one with very big real-world consequences. Telling insurance companies that they have to cover pre-existing conditions and can’t charge more for that coverage breaks the actuarial calculation behind insurance and contributes to the “death spiral” of escalating premiums, which we could already see under Obamacare. So you can understand why there’s a rational argument for not requiring pre-existing conditions of any kind to be covered under the heading of “insurance.”

So are Democrats making this claim about sexual assault because they want to lobby for free medical treatment for victims of sexual assault—a worthy cause they just discovered five minutes ago? No, they’re doing it because evoking sexual assault victims, as opposed to sufferers of any other kind of pre-existing condition, packs a special emotional wallop. Then when somebody responds by carefully and rationally explaining what’s really going on and why pre-existing conditions can’t be covered if health insurance is going to function properly—as I just did above—that person suddenly looks like a callous heel. How can he approach the issue with such cool logic? How can he be so insensitive to the victims?

In short, it’s a raw appeal to emotion, specifically designed to make rational analysis of the issues look not just inappropriate, but positively immoral.

The Appeal to Emotion is a fallacy that’s thousands of years old, but what makes this particular case a microcosm of today’s style of argument is one extra twist. If the purpose of the Appeal to Emotion is to make logical analysis seem insensitive, the purpose here is to make the user of logic seem insensitive specifically to women. This fits right in with the target audience’s prejudices. Of course those evil people on the Right, those old white men reveling in their patriarchal privilege, would be callously indifferent to the suffering of women. Of course they want women to bear the blame for their own sexual assaults. It’s just like “The Handmaid’s Tale.” We knew it all along!

That’s what makes the headline “too good to check” and ensures its entry into the natural life cycle of a “fake news” story: blaring viral headlines, followed by low-key, surreptitious corrections in the more reputable outlets, followed by the cementing of the headline as an established fact that will never be dislodged from the minds of its target audience. We’ll still be hearing about it 30 years from now.

This fits into a larger problem with how the Left tends to interact with everyone else while they’re in Perpetual Rage Mode. As someone who attempts to interact with the other side pretty regularly on social media—and not always just to score rhetorical points—I’ve begun to notice a distinct pattern. People on the Left will interact with someone on the Right just long enough to be able to find some sign, some slip of the tongue, some violation of accepted speech codes (like not being a prig about Cinco de Mayo) that allows them to dismiss that person as racist, sexist, homophobic, or just insensitive—which provides an excuse to ignore anything he has to say. The conclusion is always the same: all arguments from the Right can be dismissed without consideration because they come from bigots.

They need to stop doing this, and not for our sake—if you’re on the Right, you’re probably used to coping with an omnipresent background radiation of political hostility—but for their own sake. It is a spectacularly unconvincing method of argument that drives people back into their own social media “filter bubbles.” It doesn’t convince anyone. It just convinces them not to talk to you any more. Then you end up on an evening in November, stunned at the fact that so many people voted for a candidate whose sole political function is to stick a finger in your eye.

The Left is already paying the price for making “race, class, and gender” into a substitute for argument and persuasion. They might want to consider not digging that hole any deeper.

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Compulsory medicalized killing on the rize

So you thought you lived in a free country? How quaint. Two recent stories should prove that ignoring political and social issues is not the way to defend liberty.

Oh, you forgot liberty had to be defended? Don’t you remember the saying “if you can keep it”? That’s an American saying, sure, but it applies to all countries who purpose themselves a nation of free people. Most people seem to think merely living their lives in peace is enough. Sadly, that is simply not the case.

Take, for instance, the idea of a doctor who doesn’t want to violate the hippocratic oath and kill, ahem, “euthanize” a patient. Well, instead of actually killing patient, how about at least referring a patient to someone else who will? Currently, Canadian law protects a medical practitioner’s right to NOT do this. But in Ontario that may soon change.

Doctors shouldn’t be forced to comply with patients’ suicide. Ontario gov’t may change that by Alex Schadenberg

Doctors speaking out say they shouldn’t be forced to refer their patients to another doctor who is willing to help them die if they disagree with the practice.

“None of us ever envisioned whether we took our hippocratic oath 40 years ago or 4 years ago that we would one day be legislated to cooperate in the death of our patients.”

Another story stems from Sweden where a nurse was fired for refusing to participate in abortions. This is not a mere “referral” type situation. No, this nurse was told to actually participate in medicalized killing to keep her job.

Court Rules Nurse Fired for Refusing to Assist Abortions Must Do Abortions to Keep Her Job by Steven Ertelt

The Swedish Appeals Court decided Wednesday that the government can force medical professionals to perform abortions, or else be forced out of their profession. Because the ruling in Grimmark v. Landstinget i Jönköpings Län contradicts international law protecting conscientious objection, Grimmark is now considering whether to take her case to the European Court of Human Rights.

This nurse has tried to find work at several other locations in her city and been refused.

In Europe and in the new world we find a steady march away from respecting the rights of those performing work toward an environment of compulsory labor. Keep in mind conscientious objection is a big deal in most Western countries. Many (but not all) have done away with compulsory military service, for example. The right to NOT participate in religion is another example of the importance of letting people live by their own conscience. Bruce Springsteen shows us another example, where he refused service in Greensboro, North Carolina due to his personal conviction on what he perceives as a moral issue.

But on some issues it seems only one perspective is to be respected. On matters related to medicalized killing, the right to die and the right to kill one’s own child prevail over the right of medical personnel to refuse to participate in such killing. As should be obvious to all (and is to those who can think past the end of their own nose), if one group can be compelled into service against their beliefs, another group can be as well. It seems not to matter that the right to conscientious objection is being infringed upon, apparently the only thing that matters is whose right to conscientious objection is being infringed upon.

abuse, civil rights, corruption, crisis, culture, ethics, extortion, extremism, freedom, health care, hypocrisy, ideology, justice, political correctness, reform, relativism, tragedy, unintended consequences

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Confusion between care and insurance guarantees costs will rise

original article: When Replacing ObamaCare, Remember Health Insurance Isn’t Health Care
March 7, 2017 by WILLIAM M BRIGGS

Big Louie whispers to you, “Say, Mac. The fix is in. The Redskins are throwing it to the Browns. It’s all set. Guaranteed.”

“No, kiddin’, Louie?”

“I’m tellin’ ya. Now listen. I want you to bet me the Skins win.”

Wha…? But you just told me ….”

“You aren’t paying attention. What’s wrong with you, Mac? You want trouble? I said the Skins will lose and you will bet they’re going to win. Now gimme sixty bucks that says the Skins will win.”

“Hey! You don’t have to be so rough …”

“Say, these twenties are new! Considerate of you. Listen. Don’t be so glum. You’re contributing to a good cause: me.”

What Insurance Is

Any of this remind you, Dear Reader, of the insurance business? It shouldn’t. Yet the word insurance has undergone a strange metamorphosis, which is caused, as you won’t be surprised to learn, by government.

Insurance used to be a bet you would make that you hoped you wouldn’t win. You went to an insurer and made a bet that something bad would happen, say, you got cancer or your house would burn down. The insurer figured out how much it would cost to pay you to fix the bad thing. He then said, “Okay, gimme Y dollars, and if the bad thing happens, I pay you X.” If you didn’t like Y or X, you negotiated with the insurer until a pair of numbers were mutually agreeable — or you agreed to part ways.

But suppose you told the insurer, “I have cancer. It will cost X to treat. I want to bet with you that I get cancer. What’s the minimum Y I should pay you?”

The insurer would either laugh you out of his office, as he commiserated with you about the sad state of your health, or he would pick a Y greater than X. Why? Because it was guaranteed that the insurer would pay out X. Why would he ever take an amount less than X?

The Government “Fix”

Because government, that’s why. Because your cancer is a “pre-existing condition” and it was seen as cruel and heartless for the insurer not to lose money on your behalf. But government forced the insurer to lose money. Government enjoyed playing Robin Hood. Hood as in criminal, crook, confidence trickster (did you not know that? Big Louie knew).

However, because the entities that comprise government move in and out of insurers (and their banks), the government also took pity. Government knew insurers had to make up their forced deficits. So it mandated that citizens who did not want to make a bet with any insurer had to give the insurer money for bad things that would almost never happen. ObamaCare became Big Louie muscling twenty-somethings to insure themselves against Alzheimer’s.

Thanks to Supreme Court Justice Roberts, you being forced to fork over funds to a private entity was called a tax. (Same thing Big Louie calls it!) Thus, not only was the word insurance gutted of most of its actual meaning, so was tax. Orwell lives.

Of course, insurers assisted in their own demise. They, like everybody else, were happy to let folks conflate the incompatible terms health insurance and health care. Once people could no longer keep these separate in their minds, the end of insurance was guaranteed.

What Insurance Isn’t

Insurers blurred these distinctions by separating themselves from the purely betting side of business, by dealing with people’s employers and not people (a condition ensconced by further Government mandates), by paying doctors and hospitals and not people, and by writing blanket instead of specific contracts. It came to be seen as normal for a person to expect “insurance” to pay for their kid’s visit to the doctor for sniffles.

Having the sniffles is almost guaranteed; it is thus numerically no different than a pre-existing condition. Having an insurer pay out on these “sure bets” meant that an additional layer of bureaucracy had to be built to handle the paperwork and shuffle funds around. Insurers unwisely moved to make a profit on these sure bets, which caused them to be penurious when paying out on large claims. Doctors had to increase their staff to handle the busywork. Monies that would have gone to pay for “bettable” diseases had to be diverted to pay for aspirins and bandages. Every step along the way caused premiums to be driven higher.

Now no one understand’s the true cost of care. Worse, we’re at the point where the true meaning of insurance is under active attack. A recent article in Bloomberg complains that it would be better if insurers used data to calculate a person’s chance of this or that disease — which is exactly what insurers should do. The author of that article also frets that insurers might “once again [be] allowed to charge extra for pre-existing conditions, an idea currently being debated in Congress.” In other words, the author is worried that insurers might once again be allowed to do what insurers are supposed to do, and what they must do if insurance is to work.

When Congress scraps ObamaCare, they must not replace it with any scheme that confuses insurance and care. This confusion guarantees that costs will go up and the bureaucracy will grow.

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What happens to societies that embrace a right to die?

Holland has been on the bleeding edge of the “right to die” movement (please forgive the pun), a movement employing Physician Assisted Suicide (PAS). Most people supporting this supposed right have never actually thought through the long term consequences on a grand scale, and that is true of such supporters in the U.S. as well as Europe.

Just last month the DailyMail reported a Dutch doctor killed an elderly patient, a woman over the age of 80. The patient at some earlier time expressed a wish to be euthanized, but later (several times) expressed her desire to live. When the doctor decided it was the “right time” to perform the medicalized killing she drugged the patient without the woman’s knowledge. But the patient unexpectedly awoke during the lethal injection and struggled and resisted so much the doctor asked the family to hold her down. The patient’s right to change her mind seems to have been entirely ignored. Or does the patient even have such a right?

During the court proceedings, the panel charged with handling the matter wanted the case to go to court not to prosecute the doctor, but to have “greater clarity” on the rights of the physician who engages in medicalized killing. Read the full article to see the horrific reasoning used to justify the situation. Those of you who didn’t have your head buried in the sand during the Obamacare debates may remember warnings of “death panels” and other dangers that corrupt health care by allowing elitist government bureaucrats to interfere. Keep in mind, the right to die movement is already here in the U.S. and is growing with the help of various left wing groups.

This is by no means the first incident of PAS where the patient was euthanized against their wishes. But when a society embraces the right to die, with not only the approval but also with the assistance of the state, any person capable of thinking past their own nose should see the obvious problems that will arise. In the name of a persons’s “choice” to die we are seeing government endorsement of medicalized killing without the patient’s consent.

How does government-endorsed medicalized killing go so wrong? Ryan T. Anderson examines this important question in his report Always Care, Never Kill: How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine, Compromises the Family, and Violates Human Dignity and Equality from March, 2015. It’s a lengthy report but touches on very important issues such as:

  • changing how society deals with the marginalized
  • fundamentally altering the doctor-patient relationship
  • compromising the nature of the family
  • damaging the essential premise of human dignity

It might be funny if this weren’t so serious hearing people pretend to be well informed on this issue while they insulate themselves from the anti-euthanasia side of the debate. When “thinking for yourself” involves intentionally avoiding a view you disagree with (which implies you may not actually know what you disagree with) it becomes a euphemism for not thinking at all. If you claim to care about people you should read the full report. And while you do, think about how compassionate a health care system is when the state is run by enlightened people who think overpopulation is one of the greatest dangers the world faces.

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Doctor who forcibly euthanized elderly woman ‘acted in good faith’

original article: Dutch gov’t panel: Doctor who forcibly euthanized elderly woman ‘acted in good faith’
January 31, 2017 by Claire Chretien

NETHERLANDS, January 31, 2017 (LifeSiteNews) – A Dutch doctor who forcibly euthanized an elderly woman without her consent “acted in good faith,” a euthanasia oversight panel decided when it cleared her of wrongdoing. The chairman of that panel has expressed hope that the case will go to court – not so the doctor can be prosecuted, but so a court can set a precedent on how far doctors may go in such cases.

This particular case was sent to the Regional Review Committee, which oversees the country’s liberal euthanasia regime.

The woman, who was over 80, had dementia. She had allegedly earlier requested to be euthanized when “the time was right” but in her last days expressed her desire to continue living.

Nevertheless, her doctor put a sedative in the patient’s coffee. The doctor then enlisted the help of family members to hold the struggling, objecting patient down so that she could administer the lethal injection.

“I am convinced that the doctor acted in good faith, and we would like to see more clarity on how such cases are handled in the future,” Committee Chairman Jacob Kohnstamm said. Taking the case to court would be “not to punish the doctor, who acted in good faith and did what she had to do, but to get judicial clarity over what powers a doctor has when it comes to the euthanasia of patients suffering from severe dementia.”

Society has “flipped everything completely upside down,” Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, told LifeSiteNews. “This is a prime example of another upside down attitude in the culture.”

“Doesn’t someone have a right to change their mind?” he asked. “They sell it as choice and autonomy, but here’s a woman who’s saying, ‘no, I don’t want it,’ and they stick it in her coffee, they hold her down and lethally inject her.”

“It’s false compassion,” Schadenberg continued. “It’s killing people basically out of a false ideology” that treats euthanasia as somehow good when “it’s the exact opposite of what it actually is.”

“All signs say she didn’t want to die,” he said. “Canadians should take notice of this because this is exactly what we’re debating in Canada.”

A current debate in Canada is, “should they expand euthanasia to people who ask for it in their power of attorney…so if they’re incompetent, they can have euthanasia anyway,” Schadenberg explained.

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A Closer Look At Why There Aren’t More Black Conservatives

In January of this year The American Conservative published “Why Aren’t There More Black Republicans” by Musa Al-Gharbi. I found some excellent and insightful points in Al-Gharbi’s piece. While there are also some legitimate grievances mentioned (which the GOP needs to take seriously) I believe many of these grievances are aimed in the wrong direction. I admit my perspective is not one of a political insider or policy wonk. I’m just a regular Joe trying to make a living. With that in mind, please consider the following.

Al-Gharbi makes the remarkable (and rare) point that the GOP has a positive historical record on civil rights and that Americans need to be reminded of this history. Al-Gharbi also touches on some important Democrat history of American politics and race. Can you imagine what campaigning would be like today if Americans were reminded of historical Democrat opposition to civil rights (including filibustering civil rights legislation in the 1960s)? For more eye opening info on this topic, Bruce Bartlett writes about the abysmal Democrat past on civil rights in his book Wrong on Race: The Democratic Party’s Buried Past. Dinesh D’Sousa’s movie “Hillary’s America” is another good place to look.

But when Al-Ghardi moves off of history and into the meat of his article there is a vital distinction between Republicans and Conservatives that is not mentioned – the difference between conservatives and RINOs (Republicans In Name Only). This distinction, I believe, would reshape many of his points. Another point I want to reexamine in Al-Gharbi’s article is what appears to be a left wing perspective on many issues.

Take, for instance, the argument on the supposed harm inflicted on black Americans “by advocating for voter ID laws, which disenfranchise primarily low-income and legal minority voters.” We can ask, in what way does a common sense (and internationally speaking, a very common) election security precaution disenfranchise anyone? The “widespread evidence” standard is a legitimate one, and I’d like to see widespread evidence that such abuse is inevitable in the implementation of voter id laws. For the liberal left it is standard procedure to ignore or downplay stories of various forms of election fraud, and we should not neglect the fact this fraud is so often in their favor. The numerous cases of voter fraud are often simply ignored or actively covered up by those who benefit from them (which should not be surprising). I humbly suggest the complaints of Voter ID laws should not be taken at face value.

EDITORIAL: North Carolina answers Democrats’ question ‘What vote fraud?’

N.C. proves multiple voting occurs and dead cast ballots

Voter Fraud: We’ve Got Proof It’s Easy

53,000 Dead Voters Found in Florida

If “widespread evidence” and “a single example of when such voting has actually turned an election” (criteria Al-Gharbi mentions) are the standard Voter ID proponents must measure up to, why not hold opponents of Voter ID to that same standard?

A couple examples of voter fraud come to my mind. A Philadelphia man gleefully admitted on live television he voted multiple times for Barack Obama. Imagine all the details that have to work together for this to occur. First, the only system innate in the voting process to prevent multiple voting is the poll workers. Unfortunately, the poll workers either don’t notice or don’t care that he voted more than once. And he feels so confident that nothing is wrong with this he is willing to admit on TV that he committed the crime. Some questions ought to naturally follow. Was this man charged? Did anyone in law enforcement follow up?

In another example, this woman, (who was a poll worker at the time) admits voting for Obama multiple times and yet denies committing voter fraud. When the perpetrators of voter fraud don’t recognize or even deny their crime it makes sense there would be difficulty in finding “widespread evidence” for it. As an experiment, one could show these two examples of voter fraud to people who voted for Barack Obama and ask them if these incidents qualify as voter fraud, and subsequently discover why “widespread evidence” for this crime is so difficult to find. Many people are so enamored with the idea of the first black president, election laws seem to be irrelevant.

On the other hand, there was an article a few years back on how the current election system (regardless of voter IDs) may be designed to disenfranchise black voters by default. Could it be that requiring voter ID might help liberate the black community from this and other common election shenanigans which already disenfranchise them?

I would also ask for widespread evidence that “Republican legislators court Neo-Confederates and other ethnic nationalist movements” as Al-Gharbi states. There seems to be no concern for nuance here (such as the difference between groups reaching out to politicians and politicians actively courting organizations). Do we know such groups reach out to conservatives and not to RINOs? RINOs are more likely to get government involved and appeal to special interest groups because RINOs act more like Democrats than like conservatives.

But does it matter when questionable groups have ties to politicians? It apparently didn’t matter in regard to the late Democrat Senator Robert Byrd, as Bill Clinton explained Sen. Byrd was merely “trying to get elected” by being a member of the KKK. A lame excuse, sure, but it worked. Evidently it doesn’t matter that Robert Byrd spent half a century representing people for whom a “fleeting association” (full blown membership) with the KKK counted as an asset rather than a liability. As Al-Gharbi already mentioned, the liberal narrative would sugar coat and disregard this record with a racist hate group. Then, curiously, Republicans would be blamed for the evils committed by that group. Despite many theories, the reality of why Democrats and Republicans are treated so differently on matters of racism escapes me. Even the myth that the parties “switched sides” is losing its influence as more people learn the truth of the matter, yet Democrats often get a pass for overt racism. There are no more whites only water fountains, restrooms, lunch counters, etc. It is not incidental that Republicans dominate the American South during its LEAST racist era. Racism abounds throughout the country, we are constantly told, and the South is no longer the preeminent example of it.

On the matter of affirmative action, I don’t doubt there was a time for this sort of government intervention. But it has become a crutch for the black community. The left wing narrative constantly promotes the idea that black Americans cannot survive without Uncle Sam’s helping hand on a daily basis. This, of course, makes it easier to displace white people to make room for demographic quotas in various jobs (though I don’t see much effort to REDUCE counts of blacks among professional athletes (such as the NBA or NFL) to make the demographics more closely match those of the general population). This narrative is promoted largely by perpetuating the belief that there has been no progress in the battle against racism over the last half century, that racism still lurks around every corner. No one claims racism has been eliminated but it certainly sounds like Democrats infuse race into every discussion possible. Fear mongering and race hustling work for Democrats.

But what should we expect from people who, as Bob Parks put it, make money finding racism even when it isn’t there? The Duke Lacrosse scandal is one of the more prominent examples of how the ghost of racism is kept alive because the fear of racism is fuel for the fire – even if liberals have to lie about it. But let us not forget that manufactured racism and affirmative action both provide the same benefit for Democrats: a belief that the black community needs government, and that government can solve all of life’s problems.

We should question whether government can solve such problems. There is an astounding degree of blind faith in the magical powers of government. This faith is often supported by questionable data if not outright lies. The figures Al-Ghardi provides sound familiar, much like the feminist data constantly touted about the supposed wage gap. I’d like to see the data that show “Black families have, on average, 5 percent of the wealth of their white counterparts.” How do we know “blacks earn only 60 cents for every dollar that white people earn in salary and wages.”? (And if blacks did earn 60 cents for every dollar that whites earn, wouldn’t blacks have 60 percent of the wealth of their white counterparts?) Are these numbers produced in the same way the specious 77 cents wage gap figure was produced? And if the methods for producing the 77 cent or 60 cent figures are valid there are other questions we should put on the table; such as is it okay for Hillary Clinton to pay her female workers 72 cents for every dollar she pays a male?

Others have made good points in that the data show the black community was stronger and more likely to overcome the lingering effects of slavery and racism before government started trying to “help” in the 1960s. In fact, Dr. Thomas Sowell and others who have looked into this issue make a good case that the lingering effects of slavery and racism we see today are largely perpetuated by government intervention (meaning Democrats and RINOs).

In conservative thought, a nanny state government is an insatiable government. Every decision the government makes on our behalf is a decision we no longer have the right to make for ourselves. Every effort for the government to “help” people grows the power and influence of the state, which diminishes the autonomy and liberty of the individual. Over time this sort of help infantilizes people, who look to government more and more to take care of them, and they eventually become slaves to their own government. Conservatives expect other conservatives to accept this viewpoint. RINOs don’t really care about the size or fiscal appetite of government.

I appreciate the viewpoint diversity Al-Ghardi speaks of. I would like for viewpoint diversity to be valued among our increasingly closed minded, intolerant, progressive culture. Progressives are astoundingly judgemental and abusive to those expressing dissent. (Just as an experiment, find a moment to say out loud to a group of progressives “marriage is between one man and one woman” as if you actually believed that statement, and tell me how tolerant they are of a view they disagree with.)

On any number of issues you can find ample viewpoint diversity among conservatives, of any race. But on the fundamental issue of liberty vs. government influence, to veer away from this premise is to veer away from conservatism. Given there are relatively few people who subscribe to this belief, conservatives gladly embrace all who agree with this view regardless of race. It is one of the building blocks of all conservative thought.

But to Democrats and liberals/progressives, to free people from a nanny state form of “help” is uncompassionate and even dangerous. Stoking racial strife is one of the most common ways for Democrats to promote their idea of benevolent government. Alan Keys, Herman Cain, and Ben Carson do not “downplay the significance of historical disadvantages or institutionalized racism” when they speak of the natural result of increasing government power, as Al-Gharbi suggests. Slavery is in fact the destination at the end of that road. Democrats, on the other hand, do downplay the significance such evils when they constantly accuse Republicans of racism, such as VP Joe Biden’s comment about putting black people back in chains.

As to alienating blacks, quite frankly it is not conservatives who do that. According to one of my favorite conservative commentators, Alfozo Rachel, it is the black community who alienates Republicans. And it is liberals who accuse black conservatives of being sell outs among other things. There is a concerted effort to marginalize black conservatives. Black conservatives often pay a huge price for coming out of the closet as conservatives.

RINOs do in fact offer the “top down” approach Al-Ghardi mentions, the same government-knows-best approach Democrats offer the American people. But RINOs and Democrats fail to understand something about economics that is common sense among conservatives: poor people don’t create jobs. On the other hand, somehow the American people have largely been convinced raising their taxes helps them.

One of the biggest lies in American politics is about taxes. So many people who claim to want “fairness” are led to believe “the rich” and “corporations” don’t pay their “fair share”. I’m still waiting for someone to tell me what “fair share” actually means. One question on this issue conservatives like to ask is “how much of other people’s stuff are you entitled to”? Many Americans are in fact “looking for government handouts” and they are “demanding wealth redistribution as a corrective for historical disenfranchisement”. It is not conservatives who are doing this, it is liberals/progressives. I see it in the black community, the hispanic community, the white community, etc. American culture, with the exception of conservatives, is largely infected with an entitlement mentality – an attitude of “somebody owes me something”.

Everyone claims to desire a “fair playing field, opportunity for social mobility” but many people will likewise demand government handouts without even noticing the contradiction. In fact, from what I’ve seen, when liberals say they want a fair playing field and opportunity for social mobility, they actually mean government regulations and handouts. Thankfully conservatives are pushing back against this distortion. Black conservatives are doing a lot of this pushback but they are often marginalized and ignored, or attacked with racial epithets by those favoring government handouts.

I don’t know anyone who actually opposes a social safety net that prevents people from sinking into total despondency (though I know many who are blithely accused of opposing any social safety net at all). The biggest objection I see to the current American social safety net is that it is corrupt and inefficient, and has a tendency to trap its recipients in poverty. As Bill Whittle put it, the food, housing, education, and even cell phones offered by the government are all crap, crumbs from Uncle Sam’s table. And human beings deserve better than that.

Sadly, crumbs are the best we can expect from a massive, corrupt government. This is what “micromanaging the poor” looks like – the government-run social safety net. It is not conservative Republicans who support the inefficient social safety net, it is RINOs and Democrats who support it. That’s why conservatives preach so much about freedom. Crumbs we can get easily but if we want more than crumbs we have to work for it. This is why conservatives are constantly talking about getting government out of our way – so people can live their own lives.

But that brings us to a core difference between the way conservatives and others see life. Conservatives don’t look at life from a perspective of helping people attain minimal survival, but from one where people should be allowed to thrive. We don’t seek a social safety net as the peak of civilization, we seek prosperity so that a social safety net does not overwhelm all of us (as is inevitable given the way Democrats and RINOs constantly seek to expand that net). These things require work, a lot of work. Smart work. Making good decisions is crucial to prospering in life.

Making good decisions is a challenge faced by us all, but it seems the black community is more challenged than any other group of Americans. We can tell ourselves this is a result of slavery and discrimination, but perhaps a closer look might shed further light on the matter. Unfortunately, this closer look could lead to some socially unacceptable observations, even if they are true.

In the black community there is very common disdain for education, especially among young males. And why shouldn’t this be the case? From decades of telling the black community they can’t succeed because of racism, and then forcing the black community into what is arguably the worst sector of American education (often riddled with a political agenda), why should the black community believe success is possible for them? Why shouldn’t they expect a life of government handouts? That’s an alarmingly common attitude among the general American population, not merely in the black community. Many times I’ve witnessed people share ideas on gaming the entitlement system, with the mentality of getting as many benefits as possible from the government. And that’s one result that can be traced back to slavery but perpetuated by government: dependency on a master.

Conservative Republicans want to set people free from this kind of misery. One major effort to achieve this freedom is school vouchers. School vouchers empower parents to decide what sort of education is best for their children. But school vouchers take this power away from a bureaucratic state, which is the lifeblood of progressivism today. Thus Democrats typically oppose school vouchers, and make people fear the freedom this would grant them by making that freedom look “raysiss”.

The same is true of government entitlement programs. These programs often trap people. Promoting liberation from a minimum standard is often viewed as “draconian restrictions” on the “assistance provided” by government. And this brings us from bad government programs back to good individual decisions.

Government handouts have made headlines for buying alcohol, drugs, and other entertainment. To the people whose resources were confiscated by government and then redistributed, these sorts of purchases look like a betrayal of trust. We have been lead to believe the social safety net is intended to prevent “people from sinking into total despondency.” Buying booze, drugs, porn, etc., make it seem some of the recipients of these benefits are not as poor as we’ve been lead to believe. Like anything else in life, the people who genuinely need the social safety net have to suffer consequences of others, of those who abuse or defraud the social safety net. Republicans don’t want to make “draconian restrictions” on those who actually need assistance but they do want to stop fraud and abuse of programs which spend other people’s money. Social trust is an important element for those being forced to pay the bill. As long as abuse and fraud occur conservatives will be offended by the waste of aid intended for those who really need it, and seek to prevent such waste. Wasting this aid harms those who really need it. Shouldn’t we all be offended by that?

But rather than simply cleaning up corruption in the system, conservatives want to move beyond merely talking about setting people free and actually set people free. This requires a total change from the predominant safety net paradigm.

Which brings us back to taxes. The current government structure rests on making people think someone else should pay more taxes. The brilliance of this progressive system is that most people don’t realize they are the “someone else”. Businesses “pay” business taxes because they first raise the prices we pay – we the people actually pay all taxes. We can call it corporate tax, or employment tax, or whatever the government wants. But it is we the people who pay. Raising taxes directly impacts we the people, hitting the poor the hardest. Rather than building a massive government scheme designed to control wealth (the progressive way), conservatives prefer to reduce government involvement to the minimum required (military, police, courts, roads, etc.). With minimal government control over wealth there is also minimal government appetite, and thus less government involvement, thus minimal burden on the people. Imagine the jobs that would naturally be created if even 10% of the wealth currently confiscated by the government were instead left to the people who generated that wealth in the first place. People who create wealth naturally put it back into the economy in the form of purchases and business expansion. But we are supposed to call this greed, and consider increased jobs a bad thing when businesses are allowed to create them rather than the government.

And that leads us to another difference between conservatives and others. The ability to freely exchange among our fellow Americans is hampered by over taxation and corrupt regulation. Making life more expensive works quite well for government as it feeds the perceived need for government intervention, thus making a self fulfilling prophesy. But it does not work so well for the people, particularly the poor. Government’s strength is greatest in the act of taking and controlling, but the market’s strength is greatest in offering goods and services for voluntary exchange.

Which brings us back to politics. Conservatives want to change the “getting help” paradigm (government intervention) to a paradigm of achievement (individual liberty). Conservatives also want to redirect the new cultural obsession with “fairness” and return to an obsession with liberty. It is possible. There are prominent black Americans showing us success is possible if people were simply free from an over burdensome government. But that’s the rub; to be free to live one’s own life also entails the responsibility of doing so. A very important question conservatives should ask is “do you want to be free, or do you want to be taken care of?”. It is alarming to see how many people say they want the former but act like they want the latter.

Blind faith in the power of a benevolent government does more harm than good, especially to those it is allegedly trying to help. Democrats have an unwavering faith in the myth. RINOs share this faith. RINOs betray the Republican identity by becoming nothing more than diet Democrat. Democrats and RINOs betray the American people by making false promises resulting merely in more expensive government control of people’s lives. Obamacare is a prime example, from lies about keeping your insurance, to lies about reduced costs, to lies about improved access to health care.

Conservatives should work harder to reach the culture rather than look to politics to solve life’s problems. The “if government doesn’t help, no one will get help” myth must be confronted. So should the lies told which make people think a nanny state government taking of them and making decisions for them is “empowering”. Democrats and RINOs have a vested interest in making people look to government to solve life’s problems. The American people have a vested interest in the truth. It is conservatives who must tell it.

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My 96-percent increase in premiums is a useful, unvarnished look at Obamacare’s effects

original article: My Defective Obamacare Health Insurance Product Just Blew Up
October 27, 2016 by Mary Katharine Ham

Like many other Americans, I got a letter last week. This letter is becoming an annual tradition, arriving on my doorstep in October to inform me of my Obamacare insurance premium hike.

Last year, the letter said my Bronze plan, purchased on the marketplace formed by the, ahem, Affordable Care Act, would increase by almost 60 percent.

This year, my premium is going up 96 percent. Ninety-six percent. My monthly payment, which was the amount of a decent car payment, is now the size of a moderate mortgage. The president refers to these for thousands of citizens as “a few bugs” when to us it feels like a flameout.

For this astronomical payment, I get a plan with an astronomical deductible that my healthy family of three will likely never hit except in the most catastrophic of circumstances.

Let’s rewind to my pre-Obamacare health care situation. Throughout my life and career, I have had both employer-based coverage and significant periods during which I bought private insurance with high deductibles and low premiums. During the run-up to Obamacare, President Obama referred to these plans as “junk” plans, but my family and I received perfectly good care and service through them. We were responsible, healthy citizens consuming a small amount of health care, paying out of pocket for most of it, and making sure we weren’t deadbeats should something catastrophic come to pass. Our health insurance was a rational and responsible purchase.

The President’s Huge, Broken Promises

When President Obama sold Obamacare to the American people, he promised three things. 1) That we could keep our plans if we liked them. 2) That the new system would offer competition between great options through an Obamacare marketplace, and 3) That our premiums would go down. Not “go up slower” or “go up but eventually go down,” but go down— $2,500 was the figure.

The letter I got last week is a betrayal of every one of those promises. I did not get to keep the plan I liked. The new system does not offer competition between great options through an Obamacare marketplace. And my premiums have gone up more than 150 percent in two years.

This was all predictable and predicted, by many (including me!).

Hillary Clinton conceded this reality at the second debate in response to an audience question about the Affordable Care Act. She said, in effect, “It’s not affordable, but it does other stuff.”

“Well, I think Donald was about to say he’s going to solve it by repealing it and getting rid of the Affordable Care Act. And I’m going to fix it, because I agree with you. Premiums have gotten too high. Copays, deductibles, prescription drug costs, and I’ve laid out a series of actions that we can take to try to get those costs down.”

As most apologists for the law do, she listed the handful of things people like the sound of— more people insured, no pre-existing conditions, lifetime limits on out-of-pocket costs, stay on your parents’ insurance until you’re 26!

But those benefits came with added costs, mandates, and overhead, and we’re now seeing the fruits of the whole law in a 25-percent average rate increase. When congressional Democrats were constructing the worst legislative Jenga tower of all time, they called critics’ predictions “lies.”

But here we are with lower-than-expected participation in exchanges, extremely low numbers of healthy young people in the risk pools, and insurance companies jacking up rates or exiting the exchange entirely in an attempt to remain solvent under the weight of increasing benefits for increasingly older, sicker customers.

This in turn leads to less competition on the exchanges, which leads to fewer young and healthy people buying into these terrible and terribly expensive products. The Department of Health and Human Services determined one of every five people shopping on Obamacare’s exchange has only one insurer to choose. This is what the death spiral you may vaguely recall the president dismissing in 2009 looks like.

Buying Really Expensive Junk

I have many blessings, two of which are the means to pay for health insurance and the good fortune not to need much of it. As a result, in the post-Obamacare world, I am a prime gouging target. I’m seeing a 96 percent increase because I am healthy, unsubsidized, and getting fewer and fewer choices. My health care companyabandoned the lowest-tier Bronze option entirely in its attempt to stay solvent, funneling me into a Silver plan with higher levels of care I don’t need at a higher price I don’t want.

My individual deductible is more than two times the high deductible on my old “junk” plan. My family’s deductible is ten times what the IRS defines as a high deductible. I now pay a high premium for a high-deductible plan, while also paying co-pays and out-of-pocket costs, meaning my plan is both junkier and more expensive.

Two points follow from this, neither of which has anything to do with feeling bad for me. But my 96-percent increase in premiums is a useful, unvarnished look at Obamacare’s effects. One, if this is a hardship for me—if I’m sitting around thinking about all the lost opportunity and savings in that giant monthly sum— so are many others who have far less than I do. Even with subsidized premiums, many are finding they can’t afford their deductibles, making their “affordable” health insurance useless.

Mr. Fanning, the North Texan, said he and his wife had a policy with a monthly premium of about $500 and an annual deductible of about $10,000 after taking account of financial assistance. Their income is about $32,000 a year.

The Fannings dropped the policy in July after he had a one-night hospital stay and she had tests for kidney problems, and the bills started to roll in.

Josie Gibb of Albuquerque pays about $400 a month in premiums, after subsidies, for a silver-level insurance plan with a deductible of $6,000. ‘The deductible,’ she said, ‘is so high that I have to pay for everything all year — visits with a gynecologist, a dermatologist, all blood work, all tests. It’s really just a catastrophic policy.’

Further, the system simply funnels customers into far more expensive plans every year unless they go to the semi-functional exchange during November and December to look around for something else. How many miss the letter and open enrollment thanks to living their lives between Thanksgiving and Christmas and end up with a New Year’s present in the form of a new bill they can’t afford?

Punished For Rejecting Expensive Junk

Two, is it any wonder exchange enrollment isn’t what the Obama administration hoped and needed it to be? Putting aside the embarrassing launch debacle (also predictable and predicted by me!), the law has created products that aren’t worth buying. I’m a responsible citizen and single parent of two young children. Let’s think about the incentives this system presents.

It would make far more economic sense to pay the tax penalty for not having insurance, save the monthly payment, and squirrel it away for a catastrophic event that may never occur. Should a catastrophic event occur, work out a payment plan with doctors and hospitals, for which you’d use the squirreled away premiums until the next open enrollment period, at which point you just jump right back into a plan again because they can’t keep you out for preexisting conditions. Should a catastrophic event never occur, you’ve got no small part of a college education put away. My health insurance used to be a rational and responsible purchase. It’s beginning to feel like neither.

There are plenty of young, healthy people the system needs who are finding the same.As the New York Times reported last year at this time:

Alexis C. Phillips, 29, of Houston, is the kind of consumer federal officials would like to enroll this fall. But after reviewing the available plans, she said, she concluded: ‘The deductibles are ridiculously high. I will never be able to go over the deductible unless something catastrophic happened to me. I’m better off not purchasing that insurance and saving the money in case something bad happens.’

Those who support the law during its meltdown suggest jacking up the cost of rejecting this terrible product to make it more painful than the cost of the terrible product. To them, we are but Westley in the Pit of Despair and they are the technocratic torturer at the switch puzzling just how much pain they can inflict without going full Humperdinck and killing the strapping, young patient.

That’s how the Affordable Care Act became neither affordable nor care. It’s almost as if you could have predicted it. Inconceivable!

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Doctors give up on post-traumatic patient, how about euthanasia?

original article: Sex abuse victim in her 20s allowed to choose euthanasia in Holland after doctors decided her post-traumatic stress and other conditions were incurable
May 10, 2016 by STEVE DOUGHTY

A former victim of child sex abuse has ended her life under Dutch euthanasia laws because she could not live with her mental suffering.

The woman, in her twenties, was given a lethal injection after doctors and psychiatrists decided that her post-traumatic stress disorder and other conditions were incurable.

It went ahead despite improvements in the woman’s psychological condition after ‘intensive therapy’ two years ago, and even though doctors in the Netherlands accept that a demand for death from a psychiatric patient may be no more than a cry for help.

The woman, who has not been named, began to suffer from mental disorders 15 years ago following sexual abuse, according to the papers released by the Dutch Euthanasia Commission. The timescale means she was abused between the ages of five and 15.

News of her death angered anti-euthanasia MPs and disability campaigners in Britain. One Labour MP said it meant sex abuse victims were now being punished with death.

It comes at a time of continued controversy over assisted dying in Britain. A steady flow of people from this country travel to die legally at the Dignitas clinic in Switzerland, and judges and the courts appear to be leaning in favour of making it legal to help someone to die.

Details of the Dutch case were released by authorities anxious to justify euthanasia laws and to demonstrate that mercy killings are carried out under full and correct medical supervision.

The papers said that the woman, who was killed last year, had post-traumatic stress disorder that was resistant to treatment. Her condition included severe anorexia, chronic depression and suicidal mood swings, tendencies to self-harm, hallucinations, obsessions and compulsions.

She also had physical difficulties and was almost entirely bedridden. Her psychiatrist said ‘there was no prospect or hope for her. The patient experienced her suffering as unbearable’.

However, the papers also disclosed that two years before her death the woman’s doctors called for a second opinion, and on the advice of the new doctors she had an intensive course of trauma therapy. ‘This treatment was temporarily partially successful,’ the documents said.

Treatment was abandoned last year after independent consultants were called in and said the case was hopeless.

The consultants also said that despite her ‘intolerable’ physical and mental suffering, chronic depression and mood swings, she was entirely competent to make the decision to take her own life.

The patient, they said, was ‘totally competent’ and there was ‘no major depression or other mood disorder which affected her thinking’. A final GP’s report approved the ‘termination of life’ order and the woman was killed by an injection of lethal drugs, the report said.

In Britain yesterday her case was condemned as ‘horrendous’ by Labour MP Robert Flello.

He said: ‘It almost sends the message that if you are the victim of abuse, and as a result you get a mental illness, you are punished by being killed, that the punishment for the crime of being a victim is death.

‘It serves to reinforce why any move towards legalising assisted suicide, or assisted dying, is so dangerous.’

Tory MP Fiona Bruce, chairman of the Parliamentary All-Party Pro-Life Group, said: ‘This tragic situation shows why euthanasia should never be legalised in this country. What this woman needed, at a desperate point in her young life, was help and support to overcome her problems, not the option of euthanasia.’

Nikki Kenward, of the disability rights group Distant Voices, said: ‘It is both horrifying and worrying that mental health professionals could regard euthanasia in any form as an answer to the complex and deep wounds that result from sexual abuse.’

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Obamacare Premium Hikes Expected in 2017

original article: Get Ready for Huge Obamacare Premium Hikes in 2017
April 21, 2016 by Eric Painin

Amid rising drug and health care costs and roiling market dynamics, the spokesperson for the nation’s health insurers is predicting substantial increases next year in Obamacare premiums and related costs.

Without venturing a specific percentage increase, Marilyn Tavenner, the president and CEO of America’s Health Insurance Plans (AHIP), said in an interview with Morning Consult that the culmination of market shifts and rising health care costs will force stark increases in health insurance rates in the coming year.

“I’ve been asked, what are the premiums going to look like?” she said. “I don’t know because it also varies by state, market, even within markets. But I think the overall trend is going to be higher than we saw previous years. That’s my big prediction.”

If Tavenner is right, Obamacare will jump dramatically—last year’s premium for the popular silver-level plan surged 11 percent on average. Although Tavenner didn’t mention deductibles, in 2016, some states saw jumps of 76 percent, while the average for a 27-year-old male on a silver plan was 8 percent.

The warning to consumers from Tavenner, the former administration official who headed the Center for Medicare and Medicaid Services (CMS) and oversaw the disastrous launch of HealthCare.gov, the Obamacare website, comes at a time of growing uncertainty about the evolving makeup of the Obamacare health insurance market. With many insurers struggling to find profitability in the program, the collapse of nearly half of the 23 Obamacare insurance co-ops and this week’s announcement that giant UnitedHealth Group intends to pull out of most Obamacare markets across the country, anticipating future premiums and copayments is largely risky guesswork.

Premiums for the current 2016 season rose on average by 8 percent over the previous year, with 12.7 million Americans enrolling for coverage and government subsidies, according to CMS. Federal officials stress that the average rate doesn’t tell the whole story, and that in many cases after consumers shop around for the best price and government subsidies are applied, the actual premium increase is lower.

The Department of Health and Human Services did a study looking at what consumers were estimated to pay based on initial filings compared to what they actually paid. The study found that last year, the average cost of Obamacare marketplace coverage for people receiving tax credits went from $102 a month to $106 per month, a 4 percent change — despite warning from some of double-digit hikes.

Tavenner’s prediction may well be an opening gambit in the negotiations between the industry and insurance regulators about the 2017 premiums. As Morning Consult noted, many insurers have begun submitting opening bids on raising their premium rates and copayments, which will then be reviewed by the government and finalized this fall.

With a major presidential and congressional election looming this fall, the administration is doing all that it can to tamp down fears of major hikes next year in Obamacare insurance premiums and related out-of-pocket costs. Benjamin Wakana, a Department of Health and Human Services spokesperson, said on Thursday that changes in health care insurance rates are “not a reliable indicator” of what typical consumers on average will pay. “Marketplace consumers would do well to put little stock in those initial numbers,” he said in an email.

But Tavenner outlined several factors that she could put considerable pressure on premium prices next year. Those include:

  • A general rise in the nation’s health care tab. Overall, U.S. health care spending grew by 5.3 percent in 2014 – reaching an historic level of $3 trillion, after years of relative cost stability. Medical costs rise from year to year and will certainly affect the next round of premium hikes.
  • Soaring prescription drug prices. Insurers as well as government health care programs have been struggling to keep pace with rising drug prices, especially newer specialty drugs to treat the Hepatitis-C virus and cancer. Pfizer Inc., Amgen Inc., Allergan PLC and other companies have raised U.S. prices for scores of branded drugs since late December, with many of the increases between 9 percent and 10 percent, according to the Wall Street Journal .
  • The combination of market forces and limitations imposed by the Affordable Care Act will put enormous pressure on insurers to up their premiums. Under the law, there is a cap on insurers’ profits, companies are obliged to insure anyone regardless of their general health or pre-existing conditions, and the insurance plans must be structured in a certain way that often lead to losses.
  • Finally, two of three federal “risk mitigation” programs created under Obamacare are due to expire in 2017. Those programs were set up to protect insurers from huge, unexpected losses from providing health insurance on the Obamacare exchanges. UnitedHealth and other major insurers have found it difficult to accurately anticipate their costs in providing coverage to sicker or older Americans, and set premiums that were inadequate to cover their risks. Without those programs to fall back on, many companies likely will seek to jack up their premiums.

“It’s kind of a myriad of factors,” Tavenner said in predicting rising premium costs. “It’s not one factor.”

Clare Krusing, director of communications for AHIP, said in an interview on Thursday that health insurance companies “are working through” these factors right now in setting rates for the coming year and deciding whether to participate.

“Plans are just beginning to file their rates, and it’s a long process with state and federal regulators, until those are approved,” she added. “Certainly plans are going to evaluate market conditions and regulatory approvals, and that will all impact their participation overall” in Obamacare.

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Filed under: bureaucracy, crisis, economics, government, health care, legislation, medicine, nanny state, public policy, reform, tragedy, unintended consequences

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