A couple of polls have shown an uptick in approval for Obamacare.
The CNN poll has good cross-tabs, so I was curious about support from Democrats.
One of the problems with the ACA was it is an orphan child. Anyone familiar with its origins knows this was initially a Republican idea, born out of the AEI. As a result from the beginning there was a lack of enthusiasm about it from the Democratic Base. It was basically positioned as “this is the best we can do”. While I think this was probably true, it is also true that people tend not to man the barricades for “the best we can do”. Exit polling shows that most Democrats wanted it expanded – a reflection of the fact that 81% of Democrats wanted Single Payer, not the ACA.
So whatever the merits on policy (I think they are substantial) it is difficult to argue that it was a political success.
And that is because even within the Democratic Base it isn’t viewed as one.
In the past I have noted that solutions that are “wonky” are often extremely complicated, as a result are damn near impossible to explain. Clinton’s education was one example. And Obamacare is another.
Most people are pretty confused about what it is. Part of the reason for this is IT DOESN’T EFFECT MOST PEOPLE. I get my insurance through my firm, and the effects of Obamacare are not direct. Since most people aren’t directly effected, most people aren’t invested in it.
Consider this:
Even most DEMOCRATS say it hasn’t improved their lives.
And since they have no direct experience with the law, they aren’t ready to claim it is a success. MOST DEMOCRATS SAY IT IS TOO EARLY TO TELL IF IT IS A SUCCESS:
The problem isn’t that Democrats don’t support it, as this shows:
There are a number of lessons to be learned from all of this. Among them:
*Good policy isn’t enough unless you can explain it
*It is not enough to get people to say the support something, they need to be ready to defend it.
There are others. I think in retrospect had Obamacare dealt with drug prices for example, everyone would have been aware of the law and seen it benefits in a more concrete way. Successful entitlements are ones in which everyone feels they have a stake. This was simply not the case for Obamacare.
I am kinda shocked that it has not improved our infant mortality numbers two yrs in. That should have seen a significant improvement IF people were actually getting health CARE.
Are all the forced pregnancies in non-Medicaid expansion red states like Texas skewing the numbers THAT badly? We sure seem to be trying over here.
Not sure if anyone has looked to see if Medicaid expansion has had an effect on infant mortality, though abortion declined again.
Man, our post-partum mothers in Texas are dying like never before… We do have very restrictive abortion regs and have monkey wrenched Medicaid as much as possible, of course.
So, yeah. Lower abortion numbers can come from things besides contraception…
Incredible…
just makes you speechless.
“…Anyone familiar with its origins knows this was initially a Republican idea, born out of the AEI.”
Liberals have their own zombie lies. They get repeated over and over and over despite their departure from the facts. This is one of them.
In more frequently forwarded versions of the zombie lie, the Heritage Foundation birthed the Affordable Care Act. Heritage’s decades-old proposal differed from the ACA significantly. No proposed conservative plan has ever expanded Medicaid eligibility while maintaining its regulations, as Obamacare does. In fact, the Heritage proposal destroyed Medicaid’s guarantees. It also turned Medicare into a voucher program, among its many, many major differences with the ACA.
Here’s a helpful side-by-side comparison.
As further proof that the ACA is not a conservative plan, the Heritage Foundation joined AEI and all other conservative organizations in launching unhinged attacks against the ACA from the moment it was being debated in Congress until this day. In fact, Heritage has written amicus briefs supporting legal cases attacking the ACA.
Ever heard of Romneycare? Or is that a Zombie lie?
The central part of Obamacare is the individual mandate. Dude straight up that is a conservative idea, and it is the heart of Obamacare.
I am not sure why you are incapable of saying anything without Ad hominem attack. Or punching liberals.
But I have wasted enough time with you and your have truths and evasions.
I ceased respecting you long ago.
Forbes recounts the history here
The New York Times:
You are straight up wrong.
The fact that Heritage and the AEI launched attacks showed that the debate had moved to the right since the early idea was formulated.
Put another way, having given achieving the goal DEMOCRATS wanted, the right attacked the idea of Romneycare.
So now we’re taking Forbes’ claims about what were the “core drivers of the health care act” as gospel. I dunno, just seems like misplaced faith.
AEI and Heritage launched lie-filled attacks on the ACA because they want to destroy Medicare and Medicaid and maintain poor regulations of health insurers and providers. The ACA stood in opposition to those tenets, so conservatives lied about the prospective and actual effects of the Law and ran away from their support for mandatory insurance purchase because it was a potent political rock to throw at President Obama and the Congressional Democratic party caucuses.
None of you comments actually address the polling.
This diary wasn’t an attack on the ACA – it was about why it wasn’t viewed as a political asset.
You really didn’t get the point of this post at all.
Which is not surprising.
I was speaking directly to the point of the post.
One of the things which has contributed to the Law’s mediocre polling is that too many Americans believed the zombie lie. The Law didn’t create an easily identified effect on all Americans right away, so their opinion of the Law depended on things they read and heard. They didn’t know about many aspects of the Law, were misinformed about others, and were encouraged to believe that all problems in health care, from broad statistics to personal anecdotes, were caused by the ACA. Another lie, but a lie that many conservatives and liberals liked to tell themselves and others.
And here we are. The contradictions will be thoroughly heightened.
The history is a little more complicated than the Heritage plan is ACA.
The Heritage plan was a non-serious counter to the Clinton health care proposal (talk about complicated) that Romney picked up and ran with as Romneycare in Massachusetts.
The experience in Massachusetts formed the basis of many health care proposals trying to dodge what conventional wisdom said was sudden death or a Truman-like national health service or a Medicare-for-all single payer plan.
That conventional wisdom was gamed by health care lobbyists, Wellpoint in particular, in relationships with Evan Bayh (through his wife’s seat on the Wellpoint board), Max Baucus, and Kent Conrad. The VP-Governmental Relations of Wellpoint took a job as an aide to Max Baucus specifically to write a health care plan; the result is ACA.
Time has moved on and so has the Heritage Foundation and its change of leadership from Paul Weyrich to Jim DeMint. While Paul Weyrich was trolling the Clintons, Jim DeMint is a scorched earth Republican. Of course they have been supporting amicus briefs.
It would be interesting to assess what was in the Baucus draft and the final bill. There were a lot of members of Congress and Senators who succeeded in getting amendments that altered some major parts of the original bill at the edges. Bernie Sanders was reponsible for raising the medial cost ratio requirement and for authorizing the funding of rural and urban community health clinics aimed at underserved areas.
What is fascinating is to go back and see how the Clinton health care plan fell apart with competing proposals from other Democrats and attempts at single-payer coverage. And the key role in killing the Health Security Act of Daniel-Patrick Monyihan.
To the extent that the ACA focuses on the insurance industry and existing patterns of highly conglomerating private and university-based large health care systems, it is a a conservative plan that saves the salaries of the CEOs, adds marketing, billing, and collections costs, perpetuates the idea that patients have bargaining power with health care systems, and eliminates any effective cost containment outside of limits on funding and CMS regulations.
The second reason that is it is a conservative plan is that it does not touch the golden handcuffs relationship that some employers have with their employees by providing steadily degrading health care insurance plans. Now ACA has become the scapegoat for the poor performance of those plans.
There are enough partisan zombie lies in the debate over ACA to go around for quite a while.
Likely it was sold out before Obama took office, and Obama just tried to hold the politics of the bill together. He certainly did not exert any leverage over the content that I can tell besides lecturing on the art of the possible.
It will be interesting to see the polls after the 1095-A’s come out and after the impact on taxes hits on January 15. The damage-limiting part is the fact that it did dramatically lower the cost in the individual insurance market by creating large risk pools. And it got state insurance commissioners temporarily working on the same page so there was slightly more uniformity and harmonization of state regulations.
The Republican Party’s and Trump’s difficulty here is with the individual market and the fact that repeal breaks up large risk pools into cherry-piced market segments again. And Health Savings Plans are a cruel joke on workers whose plans are constrained by their employers lack of generosity in compensation decisions.
The core ideas are Conservative:
There are more core ideas that are distinctly liberal. First is Medicaid expansion – a single-payer plan – which increased coverage for people as much as the exchanges did.
Second is insurance subsidies targeted at lower-income individuals and completely excluding higher-income individuals.
Third was profit and overhead caps on insurance companies. Definitely not a conservative idea.
Fourth is community rating. Equal treatment is not a conservative value.
Fifth is government-enforced quality control. Somewhat to everybody’s surprise, this has been a rousing success, with hospital death rates down by about 10,000 per year.
Obamacare has lots of parts. It’s not the second coming of Karl Marx, but it distinctly leans liberal.
81% of Democrats disagree with you.
Which was the point of this diary – and which you are simply to dense to understand.
At its core it subsidized corporate profits.
That isn’t a liberal idea.
Come on, you know better than to parrot that absurd claim that the point of the ACA was corporate profits. Health insurers have actually lost money on ACA policies, and health care spending has been setting all-time records for slow growth. The point of the ACA was to get insurance to most people who didn’t have it, and that’s exactly what it has done.
The ACA provided the largest redistribution from the rich to the poor and working class in 50 years. It’s very much a liberal idea. The fact that most Democrats wanted something even more liberal doesn’t change that.
It is taking them a while to learn to game the ACA, but rates of reimbursement are already distorting the health infrastructure.
As far as losing money…”It also was a good year to be an executive at the “big five” payers, as total compensation rose for four out of five CEOs. Aetna CEO Mark Bertolini and Cigna CEO David Cordani for example, both saw their total pay surge to $17.3 million in 2015 after earning $15 million and $14.5 million, respectively, in 2014.”
Who are the top-earning CEOs of them all? A new report says it’s the heads of pharma and health care companies. (You may imagine what TTP would have done for pharma.)
Well, then the market… Nope. “A Salon analysis of regulatory filings found that the top five health insurers — UnitedHealth, Anthem, Aetna, Humana and Cigna — have doled out nearly $30 billion in stock buybacks and dividends from 2013 to 2015.”
The health care market rise is beating the averages in all categories, even hospital stock.
The biggest reform brought on by the ACA is the Medicaid eligibility expansion. As mentioned by others here, increased regulations of insurers and providers are additional core ideas of the Law; those are antithetical to conservative ideals. The ACA has also strengthened the financial viability of Medicare, an outcome that was extraordinarily necessary to achieve. Again, a core conservative idea re. health care, always expressed in their reform proposals, is to destroy Medicaid and Medicare; the ACA did exactly the opposite.
With its substantial taxation of wealthy Americans, the Affordable Care Act has been very redistributive in favor of low- and middle-income Americans. That is a core idea and important outcome of the law as well.
One sure certain bet…the Obamacare cuts to Medicare reimbursement that they negotiated with hospitals will never get reversed. And it is decimating rural hospitals already.
The Medicare reimbursement adjustments are not primarily responsible for the financial problems which have cropped up at both rural and urban hospitals which have the greatest social safety net responsibilities. In the ACA’s design, the Medicare payment cuts to providers were made up for by the number of additional Medicaid and private insurance beneficiaries, almost all of whom were among the over 50 million Americans with no health insurance. More than 20 million of those people have now gained insurance, and the safety net hospitals gain particularly strong benefit from the increased revenue they gain from the insurance plans of those Americans.
Unfortunately, John Roberts killed the ACA’s essential mandate for Medicaid expansions in the States, and many to most of the same States which refused to expand Medicaid also refused to properly administer and publicize their private health insurance exchanges. Texas is a prime example of these practices, which is why rural hospitals in Texas are collectively in worse shape than rural hospitals in bluer States.
Yes, you’ll hear from hospitals everywhere that they want the higher Medicare reimbursement rates restored. But they want reimbursements from all patients, and uninsured patients create much bigger reimbursement problems and financial losses for them. The uninsured rate for Texas residents in 2015 was 17%, way, way higher than any other State.
This is the heart of the matter….ACA is conservative because it focuses on insurance, not healthcare.
One does not guarantee the other. ACA guarantees insurance customers, period.
Insurance doesn’t guarantee health care, but lack of insurance guarantees much, much poorer access to health care.
That is the problem, especially in poorer communities. You still had people who were afraid to enroll in Obamacare because of the deductibles and co-pays on the insurance whose premiums they could afford and the fact that providers still turn unpaid co-pays over to aggressive debt collectors.
What it did was lower the amount that those people who had primary communities through family or church has an easier time fundraising to wipe out those medical debts.
It sorta froze provider costs a little but did not get to the point of bringing costs down. And it is clear that insurers played politics with their rate announcements in 2016 even as they were leveraging for consolidation within states. That monopolization in more states will make the cost situation worse.
What people feel is out-of-pocket costs, premium costs, taxes, and quality of care. In most cases their experience dealing with the health care system was worse instead of better because of how insurers and providers were gaming the law.
“That is the problem, especially in poorer communities. You still had people who were afraid to enroll in Obamacare because of the deductibles and co-pays on the insurance whose premiums they could afford and the fact that providers still turn unpaid co-pays over to aggressive debt collectors.”
In poorer communities, most of the uninsured should have qualified for the Medicaid eligibility expansion. And for those who had the misfortune of being in a State which refused to expand Medicaid, blame should be placed on their Governors and Legislatures, not the President and Congress.
Finally, those with higher incomes who chose to bear the deductible and co-pay costs gained greater access to health care and protection from financial ruin. Financial difficulty is not financial ruin. We all should talk up the importance of protection from financial ruin which the ACA has delivered. Almost no one with an Obamacare-delivered plan has a bankruptcy-forcing health care bill. For 2017, out-of-pocket maximums are capped at $7,150 for an individual plan and $14,300 for a family plan before marketplace subsidies.
“In most cases their experience dealing with the health care system was worse instead of better because of how insurers and providers were gaming the law.”
If this were true, approval polling on the ACA would be trending down, not up. We also wouldn’t be going through another successful enrollment/re-enrollment period.
Lack of insurance also creates much greater risks of bankruptcy and financial/social insecurity.
Curious, are you so invested in Obamacare that you would want to campaign in 2018 on restoring it?
That’s an interesting response.
The Republicans are about to try to take away a bunch of things in the ACA that Americans value. They are even considering going further by block granting all Medicaid programs and privatizing Medicare. You may have heard that people are yelling at their Congressmembers to plead the case for valued health programs:
Extra points for metaphorical use of the crime scene tape.
Instead of preparing the 2018 campaign, perhaps we would better serve our needs by busying ourselves calling our Congressmembers and new President every fucking day and reading them the riot act. We have a chance to stop a lot of the worst they want to do. Let’s do that.
Well that’s certainly a better idea than just sitting around pissing and moaning about some lost Camelot and the dethroned rightful Queen.
I’m not sure every day is a good idea, but you are finally on the right track. Republican constituents are giving Republican Congressmen holy Hell about replacing Obamacare now and maybe coming up with some nebulous plan in the future. Not to mention hard pushback on vouchering Medicare. We should join. Write the White House and ask if Trump is the President or Ryan? Drive a wedge between them. Use Trump’s ego to your advantage. And it wouldn’t hurt to send letters to newspapers reminding them of Trump’s promises. Instead of wailing about pussy grabbing and Russian moles, push back hard on his (contradictory) campaign promises. That way you are doing something constructive instead of being a sore loser like those disgusting anti-democrats on the Mall today.
Upgrade for the agreement that policy demands on the new President and Congress are advisable, not for the denigration of peaceful protesters and those who think justifications for sexual assault and overt foreign interference in our elections is not OK.
Any protesters throwing rocks and damaging property are totally unhelpful right now. I hesitate to call many of them protesters, given the incoherence of their message and motivations.
You do understand that policy demands on this President will not be made in Congress at least until 2018. It will be made with massive marches it the street that disillusion the idea that he is a populist or popular.
That is a difficult strategy to hold together for many reasons.
The reason is that members of Congress are isolating themselves more from their constituents who are not adulatory, not less.
For Senate votes which require a bare majority, we don’t need to pick off very many Republican Caucusmembers to cause them to lose those votes. For Senate votes which need to gain cloture, which will be the case for many of the important votes, we just need to hold the Democratic Caucus together. Trump and McConnell and his Caucus are making our jobs easier by acting so offensively.
That’s not to say I believe we can stop all or most of the bad stuff; I am worried that McConnell will hold his caucus an unpleasantly large amount of the time and I am becoming more and more convinced Trump will conduct massive, immoral, lawbreaking damage in his Administration. But it also doesn’t mean I am going to passively encourage people to sit on their hands in 2017 and wait until the 2018 campaign. That can’t happen.
We can win a lot of votes in Congress this year. We should go and win them. I’m sick and tired of people who complain about Democratic Congressional Caucusmembers, when there is a big damn sty in their own eyes. More Americans should stop acting like passive consumers and start acting as constituents and citizens. The American people are primarily responsible for putting us in this predicament; Hillary Clinton and the DNC did not do this to us.
Sorry but they remind me of the people that just couldn’t accept the Obama was the lawful President. It’s just the flip side of the same thing. They weren’t protesting policy or actions. they were protesting the election.
And Booman’s front pages could have been copied from Red State, just changing the name.
This scorched earth no cooperation stand is just like theirs too. What’s next? Shutting down the government?
Voice, what issues in this conservative movement’s retrograde, unpopular policy agenda should draw the cooperation of progressives and Democratic Caucusmembers?
Pretty much everything on Ryan’s agenda: repealing Obamacare without replacement, vouchering Medicare, pushing SS age to 55, ending COLA’s (which unfortunately have been a joke under Obama), removing Career employee protection. That’s what comes to my mind just off the top of my head.
To get widespread support you need to attack the policies and actions. When you do ad hominem attacks and do name calling the public just tunes it out as “just politics”.
And I think that the Party should punish the 13 that voted against drug re-importation. We can’t trust the Canadian government but we can trust Indian subsidiaries of big Pharma? Give me a break!
Democrats and progressives should support everything on Ryan’s agenda that you name here? Is that what you meant to write? (BTW, the representation you give here of Ryan’s SS policy position is counterfactual.)
Most of the protests yesterday and today have been very policy-based, with a diverse set of specifically named policies on signs and everything.
And me, when I am told that a politician wants to make new policies which hurt Americans and force women to take pregnancies to term against their will and at risk to their health, I’m not adverse to seeing someone attack that politician personally.
The performance of nonstop “ad hominem attacks and…name calling” and “government shutdowns” against President Obama and Democrats seems to have turned out well for the conservative movement and Republicans. What you propose here is a unilateral disarmament, for no identifiable good purpose.
Punish Senate Democrats who voted No on the Pharma Bill, if that’s the only vote or position you care about. Call their offices, write to newspapers and agitate Democratic Party leaders in their States, support their opponents in their next Party primaries.
Of course not. They should support opposition to Ryan’s agenda.
Trump has repeated recently that Obamacare should be repealed and replaced simultaneously. Ryan’s response is that a repeal bill now and replacing with something to be figured out by March 3 is simultaneous. The Democrat’s response? Attacking Trump not Ryan. That doesn’t make any sense to me. Make them show the new plan first. Instead we get the same tired personal attacks. You did know that JFK did his share of pussy grabbing, too? It’s what rich men, born to the purple do. Even FDR had an affair while in his wheel chair.
FDR and JFK didn’t brag about their affairs publicly. They also didn’t brag about sexually assaulting women. There’s substantial character qualities which are revealed in the contrasts to Trump here.
It’s pretty clear to me that you didn’t go to any of the rallies or look at many of the reported summaries. Voice, participants at the rallies offered a ton of criticism of very specific policy proposals meant to to take away health care services and criminally punish women who avail themselves to their right to abortion. These policies have been discussed and passed by State and Congressional Republicans.
It would be a terrible idea to wait to “make them show the new plan first.” Republicans have passed ACA repeal legislation in previous Congresses; those legislations have had rudimentary, extraordinarily poorly thought out associated replacements.
A big tell going on right now is that Congressional Republicans have set in place strong standards for when a piece of legislation must be analyzed and reported out by the CBO. Oh, but gee, the one exception is the ACA! In their repeal efforts this month, they literally have banned the CBO from doing an analysis of this year’s replacement Bill and reporting it out.
No, we should not wait until the new plan is shown. I feel confident the replacement Bill will be shown a few hours before it is voted on; that’s the way the modern Republican Party rolls. We need to place the markers in now, and make the presumption that the replacement Bill will be as bad as the last Congress’ repeal-and-replace Bill was.
Fortunately, we gained a CBO report on that 2015 Bill, and it’s really, really bad. 32 million Americans lose their insurance, and a billions-dollar hole is blown in the Federal budget. No, we can’t wait to see what the new plan is. Congressional Republicans have said that the plan is to model this year’s replace plan on the replace plan which is scored by the CBO report discussed at the link. We should take their word on it and run against their previously passed plans.
Neither did Trump. That’s a distortion. Clinton couldn’t win based on the truth apparently, her campaign being devoid of any value to the 99%. Or, it’s possible, that she has been so invested in lies her whole life that she CAN’T tell the truth, even when it’s to her advantage.
LOL.
OK, buddy. With that top-level dissembling, you should send in your resume’ to gain a Trump surrogate sinecure.
At least read what this guy has to say:Robert Reich: 7 hard truths Democrats must acknowledge if they want a better future Of course, he wants to work within the Democratic Party which I think is like working on sainthood within the Mafia.
“Shorter Reich: The confrontation of the Irresistible Force of populism with the Immovable Object of donor control will result in the Oxymoron of “radical reform”.”
I read it. I agree with most of it.
My worry is that I don’t see a mechanism which makes me feel secure that the Party will be sufficiently funded. Because of people power we don’t need as much money as the Republicans, but many of the very best, most progressive/liberal candidates running for elections at all levels and in all regions have lost their campaigns because they were buried by money and a hostile media climate.
If political Parties are insufficiently funded, they can’t get their message out. Liberals can’t register and turn out voters or inform them on the issues without money, and candidates cannot consistently win elected offices with shabby campaign funds, particularly as they seek wins in larger Districts.
Why not? The most effective campaigning is by having someone in the neighborhood go door to door talking to the voters, not by mass mailings that go straight into the garbage or 30 second TV ads repeated three times in the same commercial block. The mailings and TV ads were once effective but now are stale. They mostly affect professional campaigners’ bottom lines.
Didn’t Bernie Sanders register new voters and turn them out without a dime of corporate money? Wasn’t he so effective that the DNC had to cheat to defeat him? And all Democrats can do is rail that Russia helped disclose the cheating instead of being angry that the cheating existed! That’s why I have no hope any more for the Democratic Party as a vehicle for populism. It’s like asking a corrupt judge for justice.
The Green Party delivers the financing purity you desire. The Green Party hasn’t won a damn thing. It has utterly failed to influence local, State and Federal governance and policy.
Yes, well-executed door-to-door campaigning is the most effective method. Guess what? Campaign directors, supervisors and organizers who are skilled and inspired enough to win a campaign need to be paid decently.
You can’t cover a Congressional District or most Legislative Districts with an army of volunteers alone, so paid staff needs to organize and supplement them. In light of this fact, winning candidates also need to produce mail and other paid and free media, and you need to fund the various nuts and bolts of walk/phone bank programs (voter lists/folders/maps/laptops/tablets/phones/campaign offices/custom computer programs/etc.). Everything costs money.
Almost no one can do such a fantastically successful job funding a campaign with small donors as Bernie did, and he still lost. He benefited from the small size of the Democratic Party field; Bernie was competing with fewer candidates. And he still lost. He lost by over 1,000 Delegates. He lost by 13% of the cumulative vote. He lost by over 3.5 million total votes in the various States. If all of the superdelegates voted as their States did, Sanders still would have lost. If there had been no superdelegates, Sanders still would have lost. If DNC officials had not written the emails they wrote, Sanders still would have lost. If those DNC staffers had been fired in August 2015 and been replaced by Bernie fans, Sanders still would have lost.
The DNC doesn’t run the primaries. The State Parties do.
I want our Party to have a strongly progressive and pluralistic ideology. But I also want to govern. That means I want our Party’s candidates to win. History shows that poorly funded candidates, no matter the Party, lose.
Candidates and Parties can defeat opponents who have more campaign funds. But a candidate cannot win if the candidate does not have adequate funds.
If wealthier Party leaders resist addressing the issues on Reich’s list, we should take them out in Party leadership elections or swamp their votes with other leaders. That takes organizing and sticking with it. A Party leadership election is not like a Congressional campaign; almost all Party leadership elections are winnable with few funds.
A superb candidate with a great policy platform, one who addresses all the things Reich mentions in his summary and more, does not win without money. Our Party needs to have the money necessary to do a good job informing and persuading Party members and organizing new people into the Party. Much of the Democratic Party’s problem in red States is that it is poorly funded. People complain that Democrats have abandoned the 50-State strategy. A properly run 50-State strategy costs lots and lots of money.
Great question.
Because we are really lost on HCR at this point.
You are going to get very few politicians arguing for restoring Obamacare. That ship has sailed.
It certainly was partially responsible for the 2010 debacle, and at best turned into a no factor.
Center is too dumb to notice this, but one think I noted was as a policy too few were effected to build s constituency that were willing to go to the mat. for Obamacare.
I am skeptical single payer gets enacted in one fell swoop though.
For 2018 I would be for:
The idea would be to grow Medicare in stages, and offer affordable insurance through the government
But I really don’t know what our 2018 candidates will support.
Yeah. Clapping for Tinkerbell is winding down. It NEVER should have been designed as a 50 state program, imo. It should have been federalized from the get go.
In fact, Medicaid NEEDS to be clawed back from the states and integrated with federal administration.
I don’t think anybody will be buying “public options” either.
No response, huh? That’s curious. Do you care about the people in the video at all?
What are you doing to change the situation? Complaining on a blog about Democratic Party politicians and institutions has not created the change you want.
It’s time for each of us to start exhibiting some more effective leadership in the world. We all have power; we are all responsible.
This Week – This is how American health care kills people.
Without a liver transplant, “possibly” can be removed from that last sentence.
:Gold Plan” Hih! “Fool’s Gold” is more like it. And the House is considering keeping the ACA but “relaxing” some of the restrictions on insurance companies.
So we see the ACA for what it is: A laudable expansion of Medicaid tied to a requirement to buy crap insurance and penalizing those who have good “Cadillac” insurance.
Medicaid, if one can find a provider (a very big if), is better because it doesn’t include co-pays and deductibles.
I do know about that personally.
If you live in rural area, finding a provider, period, can be a problem, regardless of insurance. Major shortage of doctors and dentists.
And hospitals….
So you have nice coverage on PAPER, but no health care unless the local vet is willing.
The way ouf for the GOP is to offer junk insurance coverage which will give lower rates. The young will like this, since they don’t need it very much any way.
What about the young who suffer a catastrophic accident or illness and have their financial futures permanently ruined? Will they like this?
What about the rest of us who will be made to bear the costs of the young people who can’t pay their $1,000,000 bill? Will we like this?
What about the loss of progressive tax policies within the ACA which paid for the Medicaid expansion, insurance exchange tax subsidies, and regulatory goodies? Will you like this?
We should fight to preserve progressive policies. The ACA has plenty of them. Congressmembers and the President need to hear from us.
I’m curious. Have co-pays and deductibles reached such elevations that HSAs begin to make sense?
Seems like reg policies are well on their way to what we used to call Major Medical Coverage–which was very cheap, btw.
The facts that we continue to deny:
What’s not included in that comparison is the percentage of the population in each of those countries that had access to health care. I do know that from Norway through Finland plus Japan it was at or near 100% and would guess that it’s close to that in Spain and New Zealand. Pre-PPACA, tens of millions were left out (except for emergency Medicaid for women giving birth and the use of hospitals by the indigent and uninsured population for emergency medical care.) So, at the outset it’s known that the “annual cost per capita” numbers in the US are understated by at least ten percent (15% would be a reasonable guesstimate).
A well functioning UHC system is one where “private expenditures on heath” are low and a small fraction of the “public expenditures.” On that measure the UK and Japan do it better than the others. The US is down at the bottom with Mexico. Although medical bankruptcies seem to be unheard in most (all?) OECD countries other than the US.
Quality of care? Based on health outcomes, no significant differences from Norway through at least New Zealand.
Cost. US, per capita, public expenditures exceed the total of public and private expenditures in Sweden and all those to the right of Sweden in the chart. And those US, per capita public expenditures are at or nearly equal to the totals in France and Belgium as well.
One of the cost drivers of health care is the age of the population. As a percentage, the US senior population is lower than that in most of the OECD countries.
Contributors to higher total US health care costs are 1) less reliance on public transport and that results in a higher rate of vehicular accidents and injuries 2) military injuries in war theaters 3) gun related injuries. So, for our automobile, war, and gun fetishes, we choose, in the aggregate, to spend more on medical care. The premium for those fetishes is unknown, but not likely that it’s $3,000 to $5,000 per capita per year.
The remainder of the difference in costs between the US and other countries is the additional that gets sucked up by the medical-industrial complex.
Isn’t that up to 30% cream these days? For gatekeeping?
Not understanding the “30% cream.”
Excuse, Medical Loss Ratios do vary. ACA has 80/20 or 85/15, generally.(Thanks, Sanders.) Administrative expenses such as certain fraud and abuse expenses, network and contracting fees, agent and broker commissions and other unrelated activities were excluded from the “quality improvement” calculation of the final rule. (Before the calculation of MLR, iow.)
State waivers can reduce MLRs, too, as far down as 65%. (Nothing is ever written in stone, is it?)
Oh. The administrative costs for UHC should be down around 5%. So, anything above that amount would be “cream” IMHO. It would be hugely dislocating to all those people currently handling the claims; so, any contemplated structurally changes have to include not throwing all those employees out of work. But we could use a lot more government workers to oversee financial institutions, voting systems, and social/welfare programs; so, it’s not an insurmountable task.
The USA is more genetically diverse than most of those countries. In a large way, the USA is all those countries plus more. That may be a factor, although I suspect a very small one.
You are thinking of Western Diet and diabetes?
No, but that is another big factor. I recently read that western Europe does not refrigerate fresh eggs because they don’t allow eggs from sick cjickens to be sold whereas it is a rare chicken in the USA that doesn’t have salmonella.
When my daughter lived in Florida, they raised chickens for the table and had no concerns about salmonella because the chickens had clean straw and wandered the yard eating bugs and worms and such. I guess today they would be called free range Organic chickens, but not vegetarian fed. She tells me that chickens are omnivores and even cannibalistic and eating insects is natural for them. Nasty creatures, IMHO. To me chickens belong in a bucket from the Colonel not a small town backyard.
OECD 2014 obesity rate update.
Somewhat surprised about Finland because once they instituted UHC (early 1970s iirc), they focused on obesity that was higher than in most OECD countries and it was significantly reduced.
The larger part of the increase in overweight/obesity is the greater availability at lower cost of food. But another part is that the western diet disproportionately impacts certain populations. Native Americans, Mexican, and Pacific Island populations in particular.
So, we could say that agribusiness and the processed food industry are fueling the medical industrial complex.
Have you read The Omnivore’s Dilemma? Palin spend some time on chickens and eggs. Quite fascinating.
A few weeks ago I attended a lecture from this doctor. It was all about food and what’s wrong with it. She presented a graph of diabetes incidence in the USA and graph just shot upwards from 1980. She said the graph coincides with the use of corn syrup, high fructose corn syrup and artificial sweeteners. She said that the pancreas reacts to the artificial sweeteners by pouring out insulin. Since the insulin does NOT reduce the artificial sweetener in the blood, as it would real sugar, the pancreas just keeps pouring. After years of this, the pancreas just dies of overwork. There were other health problems from those high insulin levels too.
She also blasted bread preservatives and told us to bake our own bread and make our own pasta. However, when she said the old Italian immigrants made their own pasta, I knew it wasn’t true. My grandmother never made pasta, she always bought it from an Italian deli. I suppose the deli might have made their own pasta. She did make her own spaghetti sauce from fresh ingredients and dried spices. No sugar. I remember the acid bite of that sauce. Don’t get me wrong. I liked that bite.
It was a two hour lecture and although she seemed a little bit fanatic to me, I kept the notes that were handed out for further study. And I’m checking those ingredient labels on the jars now for more than the sodium content.
One last point. She told us to pass by those packets of sliced and ground cheeses and slice and grind cheese from blocks bought from the grocery. I looked at a label next time I was in the supermarket and was surprised to see cellulose added to prevent clumping. They’re putting SAWDUST in our cheese! Being middle eastern, she told us that cow’s milk was bad and to only buy goat and sheep cheese. Well that’s where some of those genetic differences might apply. Northern Europeans can readily digest cow’s milk although most people in the world can’t. Almost all Italian and Greek cheese is made from goats and sheep and I prefer the tang and aroma over bland cow’s milk cheese anyway.
That woman is confusing correlation with cause.
My mother viewed corn syrup (the original Karo stuff) as close to poison. To be used only for candied popcorn once a year. (Her interest, study, and practice of nutrition was always in competition with her sweet tooth, but she did well to instill that sweets were special treats.)
HFCS may be a more harmful sweetener, but so far researchers have been unable to prove it. (I’m reminded of health nuts from decades ago that claimed that cane and beet sugar was poison, but honey was healthy. Honey does have some trace elements but otherwise it’s sugar.) Palin covers sugars in his “Botany of Desire” which is also a good read. Anyway, sugars were not prevalent in the human diet until very recently. Most fruits aren’t particularly high in sugars. And apples today are sweeter than they once were. But we evolved to taste and metabolize both fructose and sucrose because they’re in fruits which existed for humans to feed on and they packed concentrated calories in the sugars when food wasn’t always abundant. However, we weren’t built to live on fructose/sucrose alone. Our organs can only handle a sugar load up to some point.
Nature doesn’t give us granulated sugar; it’s manufactured from cane sugar or beets. So, I’m inclined to accept that HFCS is basically nothing more than another manufactured sugar. The problem is that in the US, a lot of corn is grown and turning it into HFCS is cheap. So cheap that processed food manufacturers can use it far more liberally than they ever did with granulated sugar. And they use it because people prefer sweeter food even if it doesn’t taste sweet. ie. no-sugar pasta sauce with the “bite.” (I actually like bitter.)
What that ends up creating is higher calorie processed foods. Often with barely a perception of sweetness. It’s like salt — a little sprinkled on top is tasted when the same amount cooked into the food isn’t. Consuming 20% more sugar (and calories) beginning in 1980 (and we weren’t a svelte population then) is what has contributed to the increase in both diabetes and obesity. And some populations seem to handle it less well than others. (The same ones that don’t handle alcohol well? Which is another high sugar content drink.)
Now, chickens are very useful critters.
Tasty too. My old dog always went wild for them. She was a mixed breed Virginia chicken thief. She chased rabbits and squirrels too but chickens really set her off.
In the aggregate probably not a factor. A little higher in one demographic gets canceled out by a little lower in another demographic.
True, but I was thinking of things like sickle cell and Tay-Sachs. Also, their is some kind of deficiency disease that’s common in AA communities, but maybe that’s diet related. Thinking of diet, that Southern diet with biscuits and gravy and high fat can’t be good for white people either. At least the African-Americans I know eat greens (albeit with some bacon grease on them), but the Southerners don’t seem to eat any vegetables but corn and potatoes.
The traditional AA southern diet (developed from the food restrictions and limitations they were forced to endure) is unhealthy and extremely unhealthy for a sedentary lifestyle. But it’s very tasty.
I recall watching with a friend the coverage from NO during the aftermath of Katrina and she said, “They’re all so fat.” My response was that it was their diet.
Fast food is another culprit. Some children eat fast food every day.
Compared to fifty-sixty years ago, Americans spend about the same amount on food then as they do today. The difference is that restaurant, fast food meals were rare or special treats. Otherwise people cooked within a budget which meant lower fats and sugars. More meals and fewer snacks. (Again I was fortunate to have had a nutrition minded and very thrifty mother.) That more healthful balance has been upset and we’re rapidly losing it.
I guess our traditional Italian food was healthy, but not so the traditional Polish and German food. And most of us, ethnic or not, ate plenty of traditional American food. Hamburgers, hot dogs, fried chicken, pot roast. Your Mom was exceptional. Mine was careful to grow and feed us lots of vegetables but she was heavily influenced by her German immigrant parents. If my Italian father did not dislike German food so much we would have eaten much more of it.
P.S. As for my Heinz 57 grandsons, they eat anything that can’t run away from them.
I think if you compare to European countries, you have more of the rare diseases from different parts of the world, but on the other hand the genetic melting pot should decrease homozygous inherited diseases where you need to inherit the same damaged gene from both parents. I mean we have some diseases named after villages because they used to only exist there. That is some serious inbreeding we still have to deal with.