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	<title>Civitas Review &#187; Obamacare</title>
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	<link>http://www.civitasreview.com</link>
	<description>The Blog of the Civitas Institute</description>
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		<title>The IRS, the Miami Heat and Obamacare</title>
		<link>http://www.civitasreview.com/healthcare/the-irs-the-miami-heat-and-obamacare/</link>
		<comments>http://www.civitasreview.com/healthcare/the-irs-the-miami-heat-and-obamacare/#comments</comments>
		<pubDate>Tue, 14 May 2013 19:22:35 +0000</pubDate>
		<dc:creator>Jim Tynen</dc:creator>
				<category><![CDATA[Budget & Taxes]]></category>
		<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[internal revenue service]]></category>
		<category><![CDATA[irs]]></category>
		<category><![CDATA[Obamacare]]></category>

		<guid isPermaLink="false">http://www.nccivitas.org/civitasreview/?p=14088</guid>
		<description><![CDATA[The IRS scandal is blowing up bigger every hour, but it&#8217;s important to remember why it&#8217;s important to rein in the government. Take the Cary man who says he was harassed by the Internal Revenue Service because he was active in the tea party movement. Beginning now, such claims have much more credibility; in fact, [...]]]></description>
				<content:encoded><![CDATA[<p>The IRS scandal is blowing up bigger every hour, but it&#8217;s important to remember why it&#8217;s important to rein in the government.</p>
<p>Take the Cary man who <a title="N AND O" href="http://www.newsobserver.com/2013/05/13/2890282/nc-man-thinks-he-was-harassed.html" target="_blank">says </a>he was harassed by the Internal Revenue Service because he was active in the tea party movement. Beginning now, such claims have much more credibility; in fact, now the claimants have more credibility than the government.</p>
<p>Even Jon Stewart admits that. I would link to the comedian&#8217;s clip lambasting the Obama crowd over the IRS scandal, but he uses language I&#8217;m sure many of our readers would like to avoid. In any case, he admits that now the critics of government on this and other matters have more credibility than ever before.</p>
<p>More important, it doesn&#8217;t matter how effective the IRS pressure was. Some apologists say that the IRS audits and hassles didn&#8217;t slow down the tea party.</p>
<p>That&#8217;s not the point. The threat on its own is in fact even more effective, because it touches everyone and the government doesn&#8217;t have to do anything.</p>
<p>Look at it this way: There are NBA basketball games almost every night, and in most you can see the effect of shot-blocking.</p>
<p>Take last night. The Heat <a title="box" href="http://www.nba.com/games/20130513/MIACHI/gameinfo.html" target="_blank">smacked down</a> the Chicago Bulls. The Heat blocked 9 shots.</p>
<p>Now, that&#8217;s a small percentage of the Bulls&#8217; shots; they took 74. But that&#8217;s my point: in basketball, you don&#8217;t have to block all the shots, you just have to make the opponent afraid of getting their shots blocked. They hesitate, they shoot differently, or they don&#8217;t shoot at all.</p>
<p>In the Bulls case, they apparently decided not to get too close to the basket, where most blocks take place, and instead went to take 3-point shots, which are less often blocked but also less often made. They made only 2 of 17; overall, they made only 25 percent of their shots, which will doom any basketball team. The Heat didn&#8217;t have to block every shot; they just had to block enough to intimidate the Bulls and make them change the way they play.</p>
<p>The same is true with IRS intimidation. They IRS doesn&#8217;t have to audit everyone. They just have to audit enough people, and be ruthless enough, to make taxpayers afraid of them. It doesn&#8217;t matter what happens with any investigation, if, when it is over, taxpayers still think: <em>I&#8217;d better avoid donating to this group or being involved with that group because I don&#8217;t want to be stuck in a hassle with the IRS for a year.</em></p>
<p>And here&#8217;s the kicker: The IRS will be the enforcement arm for Obamacare. <a title="reason" href="http://reason.com/blog/2013/05/14/how-the-irs-scandal-threatens-obamacare" target="_blank">According </a>to Reason.org, the Affordable Care Act &#8220;relies on the tax collection agency to both enforce its individual mandate and administer the tax credits the law offers to subsidize the purchase of health insurance.&#8221;</p>
<p>So how do you feel today about having the IRS gain such power over the most intimate and important  aspect of your life?</p>
<p>Especially since the evidence is also mounting that Obamacare will indeed be a <a title="xTO" href="http://www.hoover.org/publications/defining-ideas/article/146866" target="_blank">trainwreck</a>.</p>
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		<title>Lawmakers, Aides may Get Obamacare Exemption</title>
		<link>http://www.civitasreview.com/healthcare/lawmakers-aides-may-get-obamacare-exemption/</link>
		<comments>http://www.civitasreview.com/healthcare/lawmakers-aides-may-get-obamacare-exemption/#comments</comments>
		<pubDate>Thu, 25 Apr 2013 14:18:01 +0000</pubDate>
		<dc:creator>Jim Tynen</dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Obamacare]]></category>
		<category><![CDATA[Richard Burr]]></category>

		<guid isPermaLink="false">http://www.nccivitas.org/civitasreview/?p=14011</guid>
		<description><![CDATA[The North Carolina legislature and the governor took some heat for trying to exempt the state from parts of Obamacare, including the much-hyped exchanges. It turns out our fearless leaders in Washington want to do the same &#8212; for themselves. Politico reports: &#8220;Congressional leaders in both parties are engaged in high-level, confidential talks about exempting [...]]]></description>
				<content:encoded><![CDATA[<p>The North Carolina legislature and the governor took some heat for trying to exempt the state from parts of Obamacare, including the much-hyped exchanges.</p>
<p>It turns out our fearless leaders in Washington want to do the same &#8212; for themselves.</p>
<p><a title="politoc" href="http://www.politico.com/story/2013/04/obamacare-exemption-lawmakers-aides-90610.html" target="_blank">Politico </a>reports: &#8220;Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.&#8221;</p>
<p>Sen. Richard Burr notes how the mandate&#8217;s burdens will especially hurt low-paid staffers, but added:</p>
<blockquote><p>“I have no problems with Congress being under the same guidelines,” Burr said. “I think if this is going to be a disaster — which I think it’s going to be — we ought to enjoy it together with our constituents.”</p></blockquote>
<p>The signs are mounting, almost every day: Obamacare is going to be ten-car pileup. NC is will advised to stay as far away as possible.</p>
<p>&nbsp;</p>
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		<title>Shunning the Obamacare Nightmare</title>
		<link>http://www.civitasreview.com/healthcare/shunning-the-obamacare-nightmare/</link>
		<comments>http://www.civitasreview.com/healthcare/shunning-the-obamacare-nightmare/#comments</comments>
		<pubDate>Thu, 11 Apr 2013 20:00:59 +0000</pubDate>
		<dc:creator>Jim Tynen</dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Obamacare]]></category>
		<category><![CDATA[patient protection and affordable care act]]></category>
		<category><![CDATA[senate bill 4]]></category>

		<guid isPermaLink="false">http://www.nccivitas.org/civitasreview/?p=13969</guid>
		<description><![CDATA[Nearly every day brings a new story that indicates Obamacare will be a horror show. Liberals whined when the legislature and the governor refused to expand Medicaid and set up health exchanges as demanded by the health care takeover, the hilariously misnamed Patient Protection and Affordable Care Act.  (See Senate Bill 4, No N.C. Exchange/No [...]]]></description>
				<content:encoded><![CDATA[<p>Nearly every day brings a new story that indicates Obamacare will be a horror show.</p>
<p>Liberals whined when the legislature and the governor refused to expand Medicaid and set up health exchanges as demanded by the health care takeover, the hilariously misnamed Patient Protection and Affordable Care Act.  (See <a title="sb 4" href="http://www.ncleg.net/gascripts/billlookup/billlookup.pl?Session=2013&amp;BillID=S4" target="_blank">Senate Bill 4, No N.C. Exchange/No Medicaid Expansion</a>.) But the program is already failing.</p>
<p>Here&#8217;s the latest scoop, &#8220;<a title="r" href="http://reason.com/blog/2013/04/11/uh-oh-building-obamacares-health-exchang" target="_blank">Uh-Oh! Building ObamaCare’s Health Exchanges Has Already Cost Double the Expected Amount</a>&#8221; from Reason.com: &#8220;The Department of Health and Human Services admitted yesterday that setting up the law has cost twice as much as expected so far.&#8221;</p>
<p>This doesn&#8217;t even mean the project is going well: &#8220;A big chunk of the grant money doled out so far went to California. &#8230;.[Nevertheless, the] state&#8217;s insurance regulators have <a href="http://reason.com/blog/2013/02/19/obamacare-friendly-states-prepare-for-he"> warned</a> that residents should expect &#8216;rate and market disruption&#8217; when the state&#8217;s health insurance exchange opens.&#8221;</p>
<p>Obamacare isn&#8217;t full implemented, but some of the programs have already closed their doors to new patients because of cost overruns, for one example. And &#8212; big surprise &#8212; setting up a system to handle all the health needs of 300 million people isn&#8217;t easy.</p>
<p>More details will be in the April Civitas Capitol Connection, which will be going out soon. And just keep an eye on your usual news sources: there&#8217;s little doubt there will be many more news stories about Obamacare&#8217;s many flaws.</p>
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		<title>Facing Up to Fed Funny Money</title>
		<link>http://www.civitasreview.com/healthcare/facing-up-to-fed-funny-money/</link>
		<comments>http://www.civitasreview.com/healthcare/facing-up-to-fed-funny-money/#comments</comments>
		<pubDate>Tue, 12 Feb 2013 18:39:26 +0000</pubDate>
		<dc:creator>Jim Tynen</dc:creator>
				<category><![CDATA[Budget & Taxes]]></category>
		<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Medicaid]]></category>
		<category><![CDATA[Obamacare]]></category>
		<category><![CDATA[Thom Tillis]]></category>

		<guid isPermaLink="false">http://www.nccivitas.org/civitasreview/?p=13821</guid>
		<description><![CDATA[February 2013 might &#8212; might &#8212; signal a real watershed in NC history. The legislature and governor seem to be willing to face the fact that many government programs are based on delusions. As noted in the Civitas Review post below, the governor came out today in favor of halting Medicaid expansion as long as [...]]]></description>
				<content:encoded><![CDATA[<p>February 2013 might &#8212; might &#8212; signal a real watershed in NC history. The legislature and governor seem to be willing to face the fact that many government programs are based on delusions.</p>
<p>As noted in the Civitas Review post below, the governor came out today in favor of halting Medicaid expansion as long as the program is wasting hundreds of millions of dollars each year. And the legislature seems willing to move on reining in unemployment spending.</p>
<p>Thom Tillis addressed the Medicaid problems in his <a title="wral" href="http://www.wral.com/news/state/nccapitol/video/12095143/#/vid12095143" target="_blank">news conference</a> today. (Medicaid discussion begins at about 2:40.)  He noted that the State Auditor, a Democrat, had found that those hundreds of millions had been churned through a wasteful and inefficient program.</p>
<p>He added that current efforts to stop the expansion Medicaid are more about setting a tone, about setting expectations, at this stage. So it&#8217;s a start. But the problem is obvious: If there&#8217;s a hole in the bottom of your fishing boat, you don&#8217;t dump more buckets of water into it, till you&#8217;ve fixed the hole.</p>
<p>And the sudden move to hyperinflate Medicaid has other ill consequences. Look at California, a state that did take the bait and plans to fully implement Obamacare. It will be facing a severe shortage of doctors, the Daily Caller <a title="caller" href="http://dailycaller.com/2013/02/12/california-facing-doctor-shortage-amid-obamacare-implementation/" target="_blank">reports</a>.</p>
<blockquote><p>The Los Angeles Times <a href="http://articles.latimes.com/2013/feb/09/local/la-me-doctors-20130210" target="_blank" rel="nofollow">reports</a> that only 16 of the state’s 58 counties meet the federal government’s recommended standard of primary care physicians, and almost 30 percent of California’s doctors are close to the retirement age — the highest percentage nationwide.</p></blockquote>
<p>According to the Caller, even one Democrat legislator realized belatedly “What good is it if they are going to have a <a id="itxthook1" href="http://dailycaller.com/2013/02/12/california-facing-doctor-shortage-amid-obamacare-implementation/#" rel="nofollow">health<img id="itxthook1icon" alt="" src="http://images.intellitxt.com/ast/adTypes/icon1.png" /></a> insurance card, but no access to doctors?”</p>
<p>Let&#8217;s hope our leaders keep their resolve to fend off this disastrous plan.</p>
<p>The Obamacare implementation will be a nightmare. NC is well advised to stay out.</p>
<p>Much the same goes for the federal unemployment boondoggle.</p>
<p>Tim Phillips, national president of Americans for Prosperity, spoke today at the John Locke Foundation. He noted that the state can&#8217;t count on the feds keeping their promises. After all, they&#8217;ve promised over and over to rein in spending.</p>
<p>As he and we have noted, there&#8217;s no free money from Washington. In fact, there&#8217;s no money at all. Washington has to borrow 40 cents of every dollar it doles out.</p>
<p>Washington isn&#8217;t giving out real money &#8212; it&#8217;s giving out wheelbarrows of $13 bills, all with Joe Biden&#8217;s picture on them. The Old North State should refuse to be taken in by this con game.</p>
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		<title>McCrory Statement: NC Should Not Expand Medicaid or Set up Exchange</title>
		<link>http://www.civitasreview.com/healthcare/mccrory-statement-nc-should-not-expand-medicaid-or-set-up-exchange/</link>
		<comments>http://www.civitasreview.com/healthcare/mccrory-statement-nc-should-not-expand-medicaid-or-set-up-exchange/#comments</comments>
		<pubDate>Tue, 12 Feb 2013 14:56:27 +0000</pubDate>
		<dc:creator>Brian Balfour</dc:creator>
				<category><![CDATA[Budget & Taxes]]></category>
		<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Miscellaneous]]></category>
		<category><![CDATA[Gov. McCrory]]></category>
		<category><![CDATA[Medicaid]]></category>
		<category><![CDATA[Obamacare]]></category>

		<guid isPermaLink="false">http://www.nccivitas.org/civitasreview/?p=13819</guid>
		<description><![CDATA[Gov. McCrory&#8217;s office this morning issued a statement asserting the administration&#8217;s belief that North Carolina should not expand its Medicaid program per Obamacare nor establish a state-based health insurance exchange. “In light of recent Medicaid audits, the current system in North Carolina is broken and not ready to expand without great risk to the taxpayers [...]]]></description>
				<content:encoded><![CDATA[<p>Gov. McCrory&#8217;s office this morning <a href="http://www.newsobserver.com/2013/02/12/2673891/mccrory-says-state-not-ready-for.html">issued a statement</a> asserting the administration&#8217;s belief that North Carolina should not expand its Medicaid program per Obamacare nor establish a state-based health insurance exchange.</p>
<blockquote><p>“In light of recent Medicaid audits, the current system in North Carolina is broken and not ready to expand without great risk to the taxpayers and to the delivery of existing services to those in need. We must first fix and reform the current system,” McCrory said in the statement.</p>
<div>&#8230;</div>
<div></div>
</blockquote>
<div>
<blockquote><p>As for the health exchanges, in his announcement Tuesday morning, McCrory said there had not been enough preparation in state government during the past year to build “necessary and reliable systems to implement a state exchange.”</p></blockquote>
<p>Some details still need to clarified as to whether or not NC would need to return all of the money it has recieve from the federal government to set up an exhcange because some of that money was devoted to the state upgrading its IT capabilities for Mediciad registraion and fraud detection unrelated to the actual exchange itself.</p>
<div></div>
</div>
<div>In late 2011, <a href="http://www.nccivitas.org/2011/ten-reasons-to-avoid-a-state-health-insurance-exchange/">Civitas wrote 10 reasons</a> why NC should not establish a state-run insurance exchange, virtaully almost all of those points still hold.</div>
<div></div>
<div>In regards to Medicaid expansion, estimates say the expansion would flood our state&#8217;s already overloaded Medicaid system with another 500,000 enrollees and in a few years cost the state roughly $500 million in additional Medicaid funds per year. And make no mistake, Medicaid expansion is <em>not</em> about granting people access to medical care. Indeed, <a href="http://www.nccivitas.org/2008/less-affordable-less-access-less-coverage/">back in 2008 I looked</a> at the state trends from 2001 to 2006, and showed that the number of Medicaid enrollees increased by 28%, while at the same time the number of physicians accepting Medicaid patients <em>decreased</em> by 23%. Since then, Medicaid enrollment has continued to skyrocket, while the number of doctors accepting Medicaid patients has likely continued to dwindle. Bottom line, Medicaid already is strained by too many patients chasing too few doctors; cramming half a million more patients into the system will only strain the system further. There simply are not enough medical care providers to see all of these Medicaid enrollees.</div>
<div></div>
<div>McCrory&#8217;s statement backs <a href="http://www.ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=2013&amp;BillID=sb+4&amp;submitButton=Go">Senate Bill 4</a>, which passed the Senate last week and is on the schedule to be discussed in</div>
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