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Tags: Obamacare | Spurs | Doc | Shortage | High-Speed Trains | Jim Lehrer | Obamas Brother

Obamacare Spurs Doc Shortage; High-Speed Trains Run Slow

By    |   Sunday, 15 May 2011 02:17 PM

Insider Report

Headlines (Scroll down for complete stories):
1. Ariz. Attorney General: Declare Drug Cartels Terrorist Groups
2. Mass. Medical Plan Foretells Obamacare's Ills
3. Americans Work More Than 2 Hours Per Day to Pay Taxes
4. Obama's 'High-Speed' Trains Won't Run at High Speeds
5. Pakistanis Angry at Own Govt, Not U.S., Over bin Laden
6. Obamacare Spurs Doctor Shortage Crisis
7. We Heard: Jim Lehrer, Obama's Brother

1. Ariz. Attorney General: Declare Drug Cartels Terrorist Groups

Arizona Attorney General Tom Horne told Congress on Wednesday that the United States should designate Mexican drug cartels as foreign terrorist organizations.

Such a designation by the State Department would place Mexican drug trafficking organizations on the same list as al-Qaida, the Taliban, and the Revolutionary Armed Forces of Colombia.

And it would subject the cartels to the freezing of monetary assets and tough criminal prosecution of those who provide them with material or monetary support.

Rep. Michael McCaul, R-Texas, has introduced a bill calling on the secretary of state to officially list Mexican drug cartels as foreign terrorist organizations.

Testifying before a House Homeland Security Oversight, Investigations, and Management Subcommittee hearing, chaired by McCaul, Horne said, "I certainly do agree with the chairman's bill to designate cartels as terrorist organizations. Among other things, it makes it an enhanced crime to supply aid to those organizations and that obviously would be a very powerful tool in fighting them."

McCaul said the bill would provide "more authority to go after [Mexican drug cartels] and those who provide them with assistance," adding that they should be called what they really are — terrorists, CNS News reported.

Federal officials maintain there is no need to make that designation because there are already enough laws on the books to punish the cartels. "The designation I don't think would help us," said Grayling Williams, director of the Office of Counternarcotics Enforcement in the Department of Homeland Security. "I think we have laws on the books that we need to apply and have worked with us for several years."

Rep. William Keating of Massachusetts, the ranking Democrat on the subcommittee, said the United States "has successfully used the Foreign Narcotics Kingpin Designation Act to sanction Mexican drug trafficking organizations." But McCaul said that the act goes after only the cartel leaders, not the people under them.

Rep. Ted Poe, R-Texas, told Newsmax.TV on Wednesday: "The administration's own inspector general has said the border is 44 percent secure. If it's only 44 percent secure, that means somebody else controls the other 56 percent. If it's not the United States and it's not Mexico, then it's the drug cartels and anyone else who wishes to come in."

Editor's Note:

2. Mass. Medical Plan Foretells Obamacare's Ills

Five years ago, Massachusetts' then-Gov. Mitt Romney approved a new medical plan that requires almost all state residents to have health insurance, just as Obamacare's individual mandate would for the entire nation.

Today in Massachusetts, the wait time to see a doctor can be as long as seven weeks, and many doctors won't accept patients in the subsidized insurance program. That does not bode well for national healthcare reform if it is fully implemented as planned by President Barack Obama and the Democrats.

A new study by the Massachusetts Medical Society (MMS), which has 23,000 physicians and student members and publishes the prestigious New England Journal of Medicine, takes an in-depth look at healthcare in Massachusetts under the state program, which is often regarded as a model for Obama's 2010 healthcare reforms. Among its findings:

• The average wait time for an appointment with an internist is 48 days, and the wait time to see a family physician is 36 days.

• The average wait time for pediatricians is 24 days, according to the MMS's "2011 Study of Patient Access to Health Care."

• Access to primary care physicians is becoming more restricted — 53 percent of family physicians and 51 percent of internists are not accepting new patients.

• Patients wait an average of 43 days to see a gastroenterologist, and 41 days to see an obstetrician/gynecologist.

• While 87 percent of family physicians accept Medicare, only 62 percent accept MassHealth, the state's version of Medicaid.

• Only 56 percent of family physicians and 43 percent of internists accept Commonwealth Care, an insurance program for adults who don't have private health insurance and don't qualify for Medicare. Just 44 percent of family physicians and 35 percent of internists accept Commonwealth Choice, a program for uninsured adults that offers unsubsidized health insurance to people who are not eligible for Medicaid or Commonwealth Care.

• Due, in part, to a shortage of doctors participating in the program, the number of emergency room visits has actually risen under the Massachusetts plan.

"Massachusetts has made great strides in securing insurance coverage for its citizens, but insurance coverage doesn't equal access to care," said Alice Coombs, M.D., president of the MMS. "We still have much work to do to reduce wait times and widen access. This has important implications for healthcare cost control, as difficulty or delay with routine access to care leads people to seek other options, such as the emergency room, which is much more costly."

Editor's Note:

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3. Americans Work More Than 2 Hours Per Day to Pay Taxes

Americans who work 9 to 5 don't get to earn money for themselves until 11:13 a.m. each day — before that, they're working to pay taxes.

In 2011, Americans will devote 2 hours and 13 minutes of each 8-hour workday, or 27.7 percent of their working hours, to pay their share of taxes at the federal, state, and local level, the Tax Foundation reports.

But if the federal government was collecting enough in taxes this year to finance all of its spending, instead of borrowing, Americans would work past lunchtime, until 12:07 p.m., to cover their overall tax tab.

The biggest tax bite comes from individual income taxes. In addition to the federal government, all but seven states also levy an income tax, as do some localities. Total income taxes require 46 minutes of work in an 8-hour workday, according to the Tax Foundation, which does a similar analysis each year.

Social insurance taxes, including Social Security and Medicare, require 29 minutes of work, sales and excise taxes take 20 minutes to pay, property taxes require 16 minutes, and corporate income taxes require 16 minutes. The remaining 6 minutes go to estate and gift taxes, and other taxes.

Tax burdens in the states vary because of differing state income and sales taxes, and differing federal taxes due to income disparities.

Workers in Connecticut toil the longest to pay their taxes, until 11:40 a.m. New Jersey residents work until 11:36, and New Yorkers, until 11:30.

At the other end of the scale, workers in Mississippi work "only" until 10:51 to pay their taxes.

Back in 1940, Americans worked until 10:25 to pay their taxes, but the tax bite has gone up steadily since then.

Editor's Note:

4. Obama's 'High-Speed' Trains Won't Run at High Speeds

They're calling it the "train to nowhere."

California is ready to spend $5.5 billion to build a high-speed rail line from Corcoran, a town about 30 miles south of Fresno known for the prison housing Charles Manson, to Borden, a ghost town north of Fresno.

But trains on the line in the state's Central Valley are not scheduled to stop at either Corcoran or Borden.

It's true that the roughly 70-mile line would be the first leg of a planned rail line between San Francisco and Los Angeles estimated to cost between $43 billion and $81 billion. But there is no guarantee that once that leg is built, the entire line will then be constructed, leading Democratic State Sen. Alan Lowenthal to tell CNBC, "I don't know if it's a train to nowhere, but it could possibly be an orphan set of tracks."

At least the first leg will be built to accommodate trains traveling at speeds of up to 220 miles per hour. Other plans for so-called "high-speed" train travel — a pet project of President Barack Obama — would achieve speeds of no more than 110 miles per hour, "which high-speed rail aficionados do not even consider to be true high-speed rail," a report from the Cato Institute observed.

Congress appropriated $8 billion for high-speed rail in Obama's 2009 stimulus bill and $2 billion more in the 2010 appropriations bill.

But newly elected governors in Florida, Ohio, and Wisconsin rejected rail projects in their state, and Congress declined to provide more funds in 2011.

"President Obama's dream of connecting 80 percent of Americans to a high-speed rail line appears to be dead," Cato Institute's Downsizing the Federal Government website declared. But the $10 billion already committed will go toward several questionable projects, according to the site:

• Illinois is spending more than $3 billion to add three trains daily to the current five between Chicago and St. Louis and increase the average speed of trains on the line from 51.6 miles per hour to 56.8 mph, saving travelers 30 minutes on the current 5 1/2-hour trip.

• Washington State is spending $700 million to add two trains per day to the current three between Seattle and Portland, Ore., and boost speeds from 53.4 mph to 56.1 mph. That will save travelers 10 minutes on the current 3 1/2-hour trip.

• North Carolina is spending $545 million to increase speeds between Charlotte and Raleigh by about 3 mph, saving travelers 12 minutes on the current 3.2-hour trip.

"While high-speed trains in Europe and Japan are technologically impressive, nearly all the routes in those jurisdictions lose money and need large subsidies to stay afloat," the site concludes. "America's geography is even less suited for a successful high-speed rail system than Europe or Japan because our cities are less dense and spaced farther apart. The federal government should withdraw its support for high-speed rail, and instead focus on major aviation and highway reforms to improve the nation's mobility."

Editor's Note:

5. Pakistanis Angry at Own Govt, Not U.S., Over bin Laden

Surprising man-in-the-street interviews conducted by NPR during this past week show that ordinary Pakistanis are more critical of their own government and military for not capturing Osama bin laden than they are of the United States for killing him.

A shopkeeper in Islamabad's twin city Rawalpindi, Tariq Iqbal Mir, said through an interpreter: "The military establishment has been ruling over us for 60 years. They should come forward and accept their incompetence and responsibility. A huge portion of our budget is given to the military. The ISI [Pakistan's intelligence agency] chief should also share the blame. Bin Laden lived for five years under his nose. He should resign, too."

Another vendor, Shaikh Mohammad Aslam, told NPR that if the Pakistanis had found bin Laden themselves, "it would have made a huge difference. We would not have been defamed. The United States would have greeted us. The international community would have saluted us."

Mir said the security apparatus in his country "must be overhauled."

"The United States has proven its point," he stated. "They said bin Laden was in Pakistan, and we said he's not, and now he's been recovered here."

Pakistan's Foreign Secretary Najmuddin Shaikh conceded: "There is triumphalism in America. And there is a sense of enormous outrage in Pakistan — an outrage not merely against the United States but much more against the ISI, the army, and the government."

Editor's Note:

6. Obamacare Spurs Doctor Shortage Crisis

The healthcare reform bill enacted last year will significantly increase the number of Americans with health insurance and exacerbate an already looming doctor shortage.

The Association of American Medical Colleges reported in 2010 that the United States will need an additional 130,000 doctors — general-practice physicians and specialists — in 15 years, 20 percent more doctors than are currently practicing. But medical school enrollment has been essentially flat, and about a third of American physicians are over the age of 55 and likely to retire by 2020.

Making matters worse, Congress in 1996 capped the number of new doctors Medicare would pay to train. And President Barack Obama's National Commission on Fiscal Responsibility and Reform proposed cutting Medicare funding for training even further, by $60 billion through 2020. "If this cut is enacted, the doctor shortage would get far worse," The Wall Street Journal reported.

At the same time, the number of patients is certain to increase. Baby boomers will be retiring at the rate of 10,000 per day, and they will require more medical care as they age. Plus, Obamacare will boost the number of Americans with health insurance or participating in Medicaid, which will mean greater demand for doctors' services.

At present, physicians are reimbursed at roughly 78 percent of costs under Medicare, and just 70 percent under Medicaid, according to Michael Tanner, a Cato Institute senior fellow.

As a result, more and more physicians are choosing to opt out of the government programs altogether. Already, as many as a third of doctors will not participate in Medicaid, and 13 percent won't accept Medicare patients.

With cuts in reimbursements on the horizon with Obamacare, "retirement in Florida may begin to look like a very good option" for many older doctors, observes Tanner, whose article appeared in the New York Post. "Are they really going to want to stick it out for a few more years if all they have to look forward to is more red tape for less money?"

A 2010 poll by IBD/TPP found that 45 percent of physicians would at least consider leaving their practice or taking early retirement as a result of Obamacare.

These various factors will combine to produce a shortfall of more than 150,000 doctors over the next 15 years, according to the Association of American Medical Colleges.

As a start in dealing with the problem, the Obama commission's recommended cuts in training funds should be set aside, Dr. Herbert Pardes, president and CEO of New York-Presbyterian Hospital, writes in the Journal. "Secondly, the cap enacted in 1996 on training new doctors should finally be lifted. These two steps would go a long way to addressing our country's medical needs."

Tanner concludes, "Promising universal health coverage is easy. But what does universal coverage mean if you can't actually see a doctor?"

Editor's Note:

7. We Heard . . .

THAT America's longest-running national anchorman, Jim Lehrer, has announced he is leaving "PBS NewsHour" after 36 years.

Lehrer, 76, said he would leave as anchor on June 6 but continue to appear on Fridays to moderate the show's weekly news analysis segment, The Washington Post reported.

Lehrer left the show in 2008 to undergo heart-valve surgery but returned within three months. He is best known as the moderator of presidential debates — he has handled 11 of them.

THAT President Barack Obama's half brother has paid his first visit to Israel to reconnect with his Jewish roots.

Mark Ndesandjo, 45, was born to Barack's father's third wife, a Jewish-American kindergarten teacher.

Ndesandjo's visit to Israel was kept secret to protect him from feared attempts to avenge America's assassination of Osama bin Laden, Ynetnews reported.

During his stay in Israel, Ndesandjo — who now lives in China — met with Yona Metzger, Israel's chief Ashkenazi rabbi. Metzger beseeched him to try to convince the president to release Jonathan Pollard, who since 1986 has been serving a life sentence in the United States for spying for Israel.

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Editor's Note:

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Insider ReportHeadlines (Scroll down for complete stories):1. Ariz. Attorney General: Declare Drug Cartels Terrorist Groups 2. Mass. Medical Plan Foretells Obamacare's Ills 3. Americans Work More Than 2 Hours Per Day to Pay Taxes 4. Obama's 'High-Speed' Trains Won't Run...
Obamacare,Spurs,Doc,Shortage,High-Speed Trains,Jim Lehrer,Obamas Brother,. Pakistanis Angry
Sunday, 15 May 2011 02:17 PM
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