Saturday, August 3, 2013

Obama Care So Far

I was glad to see Obama Care made into law and glad the Supreme Court ruled it wasn't unconstitutional because I thought on net it would be good for most people.  It wasn't ideal.  I wanted something more like single payer or a public option.  The kind of thing other first world nations have.  Half the cost, better outcomes.  The Obama Care plan is really a conservative plan.  It was conceived by the Heritage Foundation, a conservative think tank.  I think it was intended to forestall Hillary Care.  Hillary Care would have deprived the non working owners of too much profit.  They don't do anything, but it's Heritage's job to keep the money flowing into their pockets.  Obama Care/Romney Care throws the poor a bone, but still sends money to the rich.  Kind of half way towards what I want, but better than the alternative.

So I thought on net it would be good.  But I have to say that if preliminary indications hold true it's looking better than I expected it would.  Here's a rundown of some of the positive results and expectations so far.  The CBO says it's bringing the deficit down.  A lot of people spend much less, particularly vulnerable people.  Premiums are coming down.  Lifetime maximum limits have been removed for 105 million people.  Pre-existing condition restrictions are gone.  What's not to like?

There are a few things to not like.  As Krugman explains here it's a bit of affliction for the comfortable in order to comfort the afflicted.  Rich, young, and healthy carries a bit more burden while poor and elderly get a break.  But, as Krugman explains, Republicans are starting to panic.  So far it's looking good, like it would be successful.  That's the last thing Republicans want.  For them it's not about doing what's good for people.  This is about maintaining credibility.  Their free market fantasies of how government is bad at everything could be proved wrong, so they are flailing.  So they've put forward 40 futile attempts to repeal it.

But we are going to still get a chance to see if the Republican alternative is better, because in some states, like Missouri they're doing what they can to prevent Obama Care from being implemented, whereas Colorado is doing the opposite.  Seems like a pretty good test.  Place your bets.  As you do maybe keep in mind recent predictions from the conservative universe.

Update: A comment on more of the down side.  One of the groups that in tough shape under Obama Care is the working poor.  Too rich to qualify for Medicaid but too poor to afford the policy they are required to buy if they want to avoid paying the penalty.  As discussed here, what's particularly annoying about this is Obama knows it's a problem and quickly resolved it for people that are close to him.  Congressional staffers are apparently paid little so they would have been subject to this.  It's much like how the sequester impacted the powerful in Washington by making it difficult to fly.  Cuts in funding for staff at airports meant delays.  So our politicians quickly made an exception for this particular bit of federal spending.  It impacted them.  In the same way they fix the problem for friends that suffer now with Obama Care.  The rest can pound sand.


Miles Rind said...

Meanwhile, in Republicanland . . .

>>Many GOP-controlled states resisted cooperating with the health reform law under any circumstances and refused to set up marketplaces on their own. In Missouri, lawmakers actually went a step further and enacted measures to prevent state officials from providing “assistance or resources of any kind” to the federal government’s effort to establish a marketplace. The New York Times reports that’s essentially encouraged confusion among Missouri residents, who have no idea how to enroll in Obamacare plans.<<

Tara Culp Ressler, "In Some Deeply Red States, Figuring Out How To Enroll In Obamacare Is Like ‘Searching For A Unicorn’," Thinkprogress, August 5, 2013

Chad said...

This entire fiasco was designed to fail so more sheep get pooled eventually making it a single payer. Let's ignore the stats about costs overall, individual costs for employers who actually want to give employees health care, cost for the earners while losing quality of care - none of that really matters too you anyway. Healthcare take over by government is just one more step in the socialist takeover playbook.

Here is the real rub you should care about - this house of cards does not, will not and can not improve healthcare for all those you claim to care about the most.

Chad said...

I am changing my tune a bit lately - I am a fan of Liberal Policies now because it benefits me and my family most. The rich keep getting richer because of your ideas. My family is covered, we found a primary care physician group that has done what they need to do to get around Obamacare. They over 24 hr service to my family, they have a very specific client pool and they are full so me and I am guessing 100 other families is all they have to take care of. We pay a modest/affordable monthly payment to be a part of this group, but we get right in when needed - direct pay services - I think they call it concierge services. We've talked about excluding or medical records from the ACO so they can go around the system when a service is needed. We are also gaining access to high quality doctors in other countries in case of emergency - things can get done around this crap. I almost got in a bit of trouble though - saw an Obama sticker on one of the cars at our 'Primary Care' provider - gave that family a mouthful wondering why they Aren't taking their kid (driving an Audi of course) to the general pool of doctors. As always socialism is good for the people just not the socialist.

None of this could have been possible without Obamacare. With the number of physicians falling, experienced doctors considering retirement, the cutting of accepting Medicare - the shrinkage of private practice your heading toward huge wait times and a one sized fits all medical care for your family - unless of course you've already aligned your family with a private care physician group?

Obamacare will live for a relatively short period of time anyhow - it's not sustainable and frankly people will not wait 8 months for a hip replacement. We have already seen the cost double according the CBO, we see what employers plan to do to stay above this mess by stopping at 49 employees or like the unions getting an excemption or they will pay the fine and dump more people into the sess pool.

There is a great pool of new conservatives coming up now and they are gaining traction - eventually they will have the hammer and when they do they strategically make it impossible for Obamacare to exist. It just takes time is all. In the mean time those who earn get to cherry pick the best physicians and will get the best medical care with little effort. Good job and thanks.

Jon said...

The CBO says the costs have already doubled? Do you have a source on that? My source has the CBO saying it is bringing the deficit down. Also earlier I had a link that showed health care costs went up this last year less than they've gone up in 50 years. Not sure Obama Care had much to do with it because it's not fully implemented yet, but where do you get that costs have doubled?

In my case I get health care through my employer, so there's no change for me. I'm not going to go off and get a policy like you did. Though frankly I should perhaps consider it. It's been moving towards a pay for service thing, but premiums are still high. Perhaps I could do better.

Examinator said...

We all know YOU think you're doing just fine.

Frankly, it's time you looked OBJECTIVELY beyond your 'micro world' at the MAJORITY WHO AREN'T. Just maybe, you might be tempted to try to figure out a system that the rest of the PEOPLE in the states can get on, even if just a little better.

Tip; Rigid dogma of ANY type isn't it! With out factoring their context (circumstance) you are like the ugly American overseas. Who when confronted with someone/thing they don't understand either rudely complains or speaks slower and just doesn't work!!

The subtext of most mainstream religions (including Christianity) is to look beyond one's self.
Yes old bean, your role model... Jesus, was a lefty.

Chad said...

Ex - all that goes without saying of course.

JC - when are going to admit that gov't can - if they choose to do so - can make houses cost $100 if they wish. It's all magic, smoke and mirrors regardless, but showing some kind of reduction in cost and debt is easily obtained on paper. My families insurance premium went up the LARGEST amount it has in 10 years, our deductibles are the HIGHEST they have ever been also. No working family will agree with your assessment sir regardless of paperwork.

And again you flew by the reality here - healthcare will get worse, read what physicians are saying, read what the medical world are saying, read what medical device manufacturers are talking about. Continue down this path - check that - when you sit in a waiting room for 6 hours with your sick child or grandchild in a decade to treat a common cold or the croup - remember its for the greater good. I am not waiting and neither will the workers/earners, but feel free.

Chad said...

Patience ... That is the word of the right, patience. We only need to have patience and watch Progressive Cities fail one by one and States like Cali fail one by one - it's happening, the complete failure of nearly all progressive thoughts is happening here and we just need patience.

Jon said...

All right, Chad, when can see where you have placed your bet, because we should be able to evaluate this based on the upcoming results.

You had said the CBO has that the costs doubled, but still no source.

Chad said...

Sorry - here is one that takes a swipe at your Man Crush and how he twisted the data.

Here is one from The Blaze just to get your ire up - but it has links to the Washington Post and directly to the CBO.

Here is another one with more detail and examples.

Maybe the scariest one and written by the Huff Po - not exactly a RW rag.

I am prepared for you to tell me all the reasons why these numbers are skewed, wrong, inaccurate or one sided even though gov't hasn't got 1 budget or program right since the ink dried in 1776.

Besides that your still missing the big picture problem and point. Federal Gov't can dictate through law just about any damn thing they want - who gives two flying shits if costs go down by force? They are making it nearly impossible (by way of costs) for private insurance or company provided insurance to exist. Forcing more and more people to the gov't version giving the gov't the power of numbers. Eventually and this is the plan - they choose who lives, dies - how much a doctor gets paid - how much a pill will cost. People will stop trying to be a doctor based on not making much money, drug companies will stop looking for a cure for cancer because they won't make any money, medical device manufactures (who I work with 3 of the biggest in the US) are laying off people in large numbers because they are being regulated out or now taxed out.

Your ideas and this plan will destroy American medicine and healthcare, but that won't bother you any because you'll just start another gov't program to fix those problems.

We are already seeing this in Liberal Cities like NY and Chicago Jon - they are beyond bankrupt, they hate guns yet have the highest crime rates in the world. They try to control personal responsibility to control costs (no soda or salt for you). Once the gov't controls the healthcare pie - the next evolution will absolutely be to monitor and control what people eat, what they are allowed to watch to avoid any additional health care costs.

Yes - your right we will see what is going to happen and it ain't gonna be pretty my friend.

Jon said...

I am prepared for you to tell me all the reasons why these numbers are skewed, wrong, inaccurate or one sided

Well, let's go through it. Your first link says that premiums are going up for some people. And more than what Obama said they would. I'm not disputing that. Remember, on our prior system rates went up like 5-7% a year, an unsustainable amount. If Obama overstated the benefits, fine. He may have.

You next link says that Obama's estimates for the cost of implementation were off by a factor of 2. The additional cost is 1.8T, not $900B. That must be what you meant when you said the CBO had costs already doubled. Not that overall costs had doubled, but that Obama's estimates of the increase over a 10 year period were off by that much. Could be true. What I'm interested in here though is does this improve the OVERALL cost of health care in the US? Whatever lies he may have told in an effort to get it passed, we have got to come up with something that is better than what we had. I think even you can agree with that.

From the titles it looks like your next two links say the same. Your final link says that health insurance companies will pay 32% more for care. Obviously a lot of people that previously couldn't get coverage are now able to go to the doctor, so that means more payouts. There's also a requirement in Obama Care that a certain % of money spent on premiums must be spent on care. So if an insurance company only spends 70% of the money they take in from premiums on care then they are required to return an additional 10% to the customers, or something close to that amount. So they'll pay more in premiums but waste less on overhead (commercial expenses, CEO bonuses, and dividend payouts may decline, while providing care costs go up). I'm fine with that.

Notice I really didn't disagree with any of the content in your links.

Examinator said...


WTF are you talking about? Houses $100? magic?.... medical corporations are predicting medical chaos?! What would you expect them to say? They're geared to exploit the maximizing of their profit under the current system.

Q.What do you think the Medical association and the peak industry groups, lobbyists are?
A. They are simply their unions by another name.
Ask yourself the basic questions.
Q. what is the function of a union? A.To maximise the benefits for it's constituents how is that different from the above peak groups and lobbyists?

Q.Why the Doctor's associations limit the number of Doctors and specialists admitted each year.
A. reduce competition.

Q.Why are the Drs and specialists congregated in the rich areas?
Q. Are the rich more medically unwell than the poor or rural? Actual evidence would suggest not!
A. that's where the big money is.
i.e. Why open a Mercedes Dealership in say Timbuktu... no one can afford a Mercedes there.

Examinator said...

FYI "socialist Medicine (sic)" works well elsewhere.
The concept is sound all it needs is the parties to make it work.
Drs, specialists and the medical supply industries are doing well in Australia etc.
It's a bit like the Norwegian oil and gas industry paying 60% tax and they complain bitterly BUT after 45 years they're still there and making good profits. If the above medicos and industries weren't doing well...thank you for asking, they'd be elsewhere or in another line.
80% of their public claims are BS to the power of 100.

Chad said...

Ex - the same prediction as well um like what auto companies warned would happen if the unions continued their over reach decades ago when they promised to outsource? Or like what Hostess exec's threatened or wait wait maybe what the steel execs said would happen to jobs and the steel industry if line workers with no special abilities continue making high wages? How about maybe the warnings exec's made about general manufacturing in the US? Why don't you go and ask Elkhart, Indiana if I was a good idea to allow the unions to over price their labor - shoot how about Detroit? Was the dire warnings of Republicans for 30 years a smoke screen lie?

These are not vail threats made by some over paid lobbyist you pompous and arrogant ass - this is a real cause and effect situation. I work with Stryker medical and Hill-Rom, I have friends over thier and other medical device companies - I see the empty desks and hear about the upcoming changes/layoffs and development pull backs.

Ever heard of a program called Section 8? Another brilliant gov't developed program for housing. He $100 reference was a bit over stated, but yeah the gov't helps people with no business living in a particular house and neighborhood to live in a house and neighborhood. Results have been terrible - lots of research on it. Crime rates in Section 8 supported homes up, property damage and property values take a plunge not to mention the neighborhoods go to hell. Ask Lakewood Falls and their owners in Plainfield, IL how allowing section 8 housing has worked out.

Since you were unable to understand let me break it down and talk a little slower so ou can catch up. Gov't big and powerful - policies can be made just like Jon outlined above with the premium dealio. Forcing insurance companies in an un natural direction - he thinks it will lower CEO bonuses and whatever else and it may, but it will also lower average salaries, eliminate new hires and make them run leaner. What would happen naturally in the market place - can't because the policies/regulations stop new companies from forming who could beat his example insurance company straight up in the market because they offer better insurance and they don't pay big bonuses - instead he applauds gov't for forcing an unnatural situation. All that will happen - especially since they realize there will not be any new companies to compete is to raise premiums up high enough to payout bonuses at the same level and cover the whatever percentage - solves zero at best.

What should have been done is to look at how and what policies/regulations stand in the way of a 1,000 new insurance companies from being born and to eliminate every rule In the way stopping that. The big monsters handing out million dollar bonuses wold have to change or die unless of course they continued to have a client base that supported their bonus policy.

Chad said...

JC - since your in a good mood. How about another discussion. What do you think about ideas that are so good that they require specific laws to enforce the reat idea? If a sound idea - why the need for the 70% thing law you mentioned?

Same as Social Security a failing system on its own requires mandatory participation just to look like it it's working.

I always joke that Progressive ideas are so strong that they require 100% participation to work. How about ideas that can stand on their own two feet without mandatory participation?

Chad said...

JC - then there are these worries. I doubt you have read the entire law and nobody it he world knows exactly how it's going to work, but read through these lines - even you should be scared.

Examinator said...

Thank you for your comments.
Yet again you are both reading history selectively and ignoring the reality of Capitalism.

You still refuse to provide Objective specific alternative answers to the questions I posed.

I DID say that the purpose of unions is to advance the interests of THEIR constituents.
I DIDN'T say Unions were immune from excessive claims.
Sorry Chad but if you were versed in
Industrial law or Multimillion $ negotiations ( n know that's not in your lexicon but look it up) you would know the concept of AMBIT claims. Tip it's the opposite to your low balling AS A STARTING POINT.

I'll also point out the historic fact that Since the 1890's when Unions first became a force to be reckoned with Bosses(Capitalist Elites) have been declaring the end of life as we know it because of the Unions.

it is Fact that when American industry was protected from international competition business productivity and equity were also at their peak.

What has changed is that Capitalism in its bid for ever more profit has chosen to go beyond the domestic market (more potential clients... exports) jettisoning national protectionism throwing the workers 'under the Third world bus'. Demanding that they (the workers) make the sacrifices of their quality of life in favor of 3rd world wages and conditions.

Have no doubts the moment almost any corporation (perhaps not Military Manufacturing Complex, mining etc) Recognises that their more profit for THEM by manufacturing O/S they will.

It all comes down to how much control or how readily the industry can be relocated. Wages conditions are the largest recurrent item on the Balance sheet.
Unlike tax they can't be reduced except through mechanising production (aka more productivity)or off shoring.

One doesn't have to be a genius to figure out that reducing labor costs in the US has limitations before it impacts the overall lives of the vast majority of Residents in the US.

Capitalism was predicated on NOT OFF SHORING.

BTW the 'empty desks' you see can be because of many reasons not necessarily as you are told.
I.e. debt reduction, better technology elsewhere, other countries' governments involvement in their domestic drive for export.
Singapore largest corporates are dominated by the government Optus is owned by Singtel a company owned by the Government.
China also owns or has funded, involved in industrial espionage many key companies and industries.
Their Steel and car Industries are in that boat. Keep in mind they jail foreigners who try try to get details into these industries but have no qualms hacking their suppliers before negotiations. As does the US.

Your dogged denialism regarding the actual business principles/practices reducing them to binary simplicity is naïve, myopic self interest.
As for me being pompous and arrogant you really should read the meaning of the words in correct context. I neither make claims to the absolute truth or absolute answers. I simply tire of you aggressively asserting YOUR opinion as irrefutable fact based on your limited less than plausible analysis. You assert I've seen this so it mean that, when in reality there are a myriad of more plausible (based on a more informed less selective bias) explanations.
Nor do I claim my style is as good as Jon's or Jonathan's.

Jon said...

Lot's of ideas are good and require legal implementation because while a lot of people may support the concept, a small number of powerful people that oppose can overturn the will of the majority. This is why a lot of conservatives openly are hostile to democracy, talk a lot about how people are idiots. Our country should be run by only the few intelligent types. Naturally they feel that they themselves are among the intelligent and should be ruling.

So for instance laws that say the oil companies can't just dump toxins in our rivers and streams. Requires a law because while the majority of people like it a lot of people in the oil industry seeking to maximize profits don't. And if there were no law they'd do it, as they do in poorer countries with weaker governments.

What we have in the insurance industry is powerful companies consolidating power that are able to do what the public opposes. Create a system that makes it difficult to get by without buying what they sell. A lot of confusion in terms of prices, in terms of what you are actually buying from them. They exploit that to create a system where for every $1 you give them they spend only 70 cents on care. The rest they do who knows what with. Conservative apologists like to try and convince us that these 30 cents are being used to create value for us customers, but a lot of people don't buy it. But we can't really stop them unless we come up with something just as powerful that can check them. That something is government. I don't like big government, but right now there's no other conceivable check on corporate abuse.

I think at the end of the day most problems in our society stem from highly concentrated power. When a person has power they tend to abuse it in a way that makes life better for themselves. Governments do it too of course. Corporations are entities that put a few people at the top in positions of extreme power. You should always be concerned about that kind of power in the hands of so few. You're right also to be concerned with concentrated governmental power. But I guess my thinking is, what is it that represents the greatest threat to our species? Government is a great threat, but right now corporations are far more dangerous. The abuse government engages in is a result of corporate power at the root. I mean, the arctic is melting so fast, and the reaction of corporations is to rush in and claim the natural resources that are now accessible since the ice is gone. This does nothing but accelerate the crisis. We're talking about survival of the species here, and government at this point is the only thing that has any hope of stopping it because to some degree government is still susceptible to public pressure.

Chad said...

JC - here is a shocker, I don't disagree with most of what you have to say. I hate the concentration of power - if I dislike gov't power it would be hypocritical to dislike private power. The big - huge difference between us is that I would look toward gov't to free the little guy to compete with the big guy. If insurance company X uses only $.70 on the dollar toward care then look at what laws, regulations and gov't red tape is stopping 10 insurance companies from being born that would dedicate $.85 per buck toward care?

When you say 'oil companies dumping toxins' you lose me because in the end no one wants that - I would say almost no one. Rules to ensure good water is legit, but those folks need to be regulated as well for abuse of - guess this power.

Healthcare issues are less of an issue at 3% unemployment too, you know what I am saying?

An idea - any idea needs to stand up on its own if it's good. When you have to set additional parameters inside the idea and need to make that law in order for it to work - well that means the idea is weak. IMO

Examinator said...

The logic flaw in your philosophy is that it is predicated on a series of archaic religiously motivated assumptions.
The first is that good and evil are ABSOLUTES i.e. people and actions are intrinsically and absolutely totally black or white.
I have demonstrated several times that Good and evil are relative i.e. to the culture, society, to the person but even then to the circumstances (context)
Think of it this way, in the ten commandments there is one that says
'THOU SHALL NOT KILL.' It doesn't say 'thou shall not kill except....'
Even in the internal contextual time line 'god' gave the commandments then later commands killing the people already occupying Caanan.
My point is even the authors of the Jewish myths (bible 1300 years after the alleged events)knew that reality reality of good and evil is based on subjective societal context. Even Thomas Aquinas (One of the greatest theological philosophers) acknowledged this in his deliberations.

Therefore MORAL ABSOLUTES are Aspirational (something to PERSONALLY/Individually to strive for) but can't really exist. Again even the bible makes the point we all have sin. It also goes on to say things like ' judge not ….' and “Physician heal thy self...first remove the mote in your eye before criticising other”
Clearly then, it is unreasonable to make absolutist judgement on others. If one were to be absolutist in Christianity then Democracy would be in conflict, (Make no bones about it Democracy was well known to the New Testament Christians.) even the Political Right wing version of it. They tend to strive both homogenise society into one whose practices are mostly in conflict with Christianity. Including letting people come to god BY THEIR FREE will not by force/ intimidation etc.
For example take the left's stance on abortion, homosexuality and euthanasia they DON'T want to force any of the above on anyone. Merely let people do as their conscience dictates that includes the right NOT to participate. As opposed to the alternative right wing view they want to impose their will on others.

One might argue about the above prohibitions are for the betterment of society, however that raises the eternal question “who determines right and wrong?” In essence it's the same as the “who determines legality”.
A logical extension of this question is what under pins the conflict created by the right wing, about universal health care. To justify their selfish POV they break two tenets of Christianity
1. “Love thy neighbor like yourself.” clearly they don't in that they would exclude some people.
2. to do that they break the “Judge not … al” by determining some people “unworthy of Universal health care while ignoring their own failings.
God makes no exclusions even to enemies (see the good Samaritan).

Only the wilfully myopic (selfish) or abiding ignorance could attempt an argument that the US health system is equitable as opposed to equality. Even God make the point that every life has equal weight. He doesn't say that the rich and powerful have preference, in fact the meek will inherit the earth.

From that I would assert that the real issue isn't to universally health cover or not but rather how do we make an equitable system. Anything less is at least UN CHRISTIAN.

Examinator said...

Jon and others
Believe it or not I read this
after I wrote my last missive but it's Gold.
The point he's making is similar to mine when it comes to Chad's over simplistic views.
NB I'm not that enamoured with his uncompromising attitude at times. See his views on The two whistle blowers but this article is priceless. I envy his style.
He manages to write on many levels to make is point.

Jon said...

Chad, what if the reason they spend .70 cents on the dollar is because they want bonuses and dividends? That is, not the stuff that generates quality care. People want a cut, even when they do nothing to contribute. They have the power to do it. We can't stop them ourselves. So without government, how do you prevent it?

And yes, they do want to pollute our waters. The capitalists in China know for instance that dirty water is not their problem. They have private gardens with non-polluted soil. For the rabble to eat from there is a crime. The rich know that they can rise above it with their money. So yes, they pollute the water because polluting is more profitable than running a clean operation. More profitable in the short term that is. You're just dead wrong on this. They already destroy the environment in places where government is weak. They're doing it here as well as government continues down this track of "getting out of the way of business." They are getting out of the way all right. Getting out of the way to allow business to destroy it for the rest of us. But they get right in the way when it comes to helping their rich friends. Pointless wars, farm subsidies, banker bail outs. This is why for the tea party since the more corporate take over of it you hear more emphasis on government intervention that helps the poor. The banker bail outs have pretty much been dropped from the discussion.