Obamacare’s Detractors Finally Running Out Of Time?

Better late than never.

Better late than never.

As The Hill's Jonathan Easley reports:

The Department of Health and Human Services (HHS) is expected to release data later this month showing a “surge” in enrollees in the federal and state healthcare exchanges for November.

The numbers are expected to surpass the paltry figures for October, when enrollments were hampered by an erratic HealthCare.gov website plagued by outages and error messages…

Even with the jump, the administration appears well behind its original goal of having 800,000 people signed up through the state and federal exchanges in the first two months. Still, the figures could be a sign the rollout finally has some positive momentum after a catastrophic launch.

Bloomberg reported on Monday that the HHS will say 100,000 people selected plans through the federal exchanges in November, a nearly four-fold increase over the almost 27,000 that signed up in the first month of its operation.

The Pueblo Chieftain's Loretta Sword updated numbers for Colorado over the holiday weekend:

More than 71,000 Coloradans have created accounts on Connect for Health Colorado, the state marketplace for insurance coverage under the federal Affordable Care Act, often referred to as Obamacare.

The initial rollout of the online health insurance marketplaces, both federal and to a lesser extent in Colorado, were marred by disastrous and in most cases preventable errors. Here in Colorado, many of the functions to calculate available subsidies for health insurance buyers weren't available when the site rolled out on October 1st. A larger and more fundamental problem was discovered in the process flow for new signups to Colorado's health insurance exchange, which has seen thousands of applications stall while awaiting denial for Medicaid coverage. Slowly but surely, the weeks-long story of epic failure is being edged out by newer stories of success–halting, still far below expectations set before the beginning of October, but enough to provide hope that the situation will be brought under control in time to work.

Ever since the passage of the Affordable Care Act over three years ago, Democrats have banked on the promise that at some point, the law would begin providing tangible and undeniable benefits to the public. The answer from Democrats to the hysterical, exaggerated claims from Republicans about the effects of Obamacare was simply going to be a system that voters could see with their own eyes was working.

Needless to say, the last few weeks of highly public dysfunction, at the exact moment a functioning new system was supposed to be reassuring the public, put a giant hole in the plan. When you consider the horrible political situation Republicans were in at the end of the October government shutdown, Obamacare's website catastrophe was the best thing that could have possibly happened for the GOP. The reversal of political fortunes in such a short time was enough to induce whiplash.

But today, it's looking more like delayed political payoff for Democrats from Obamacare, not destruction. For all the self-inflicted damage caused by websites that weren't ready for prime time, if the public's confidence can be restored in the system by seeing it work, even belatedly, that's a win for Democrats. In fact, the startup problems might even work to the long term advantage of Democrats, by lowering expectations which can then be met or exceeded.

The fact is, Democrats still have the upper hand in a debate over something that most everyone agrees is necessary. Unforced errors have extended the pain, but the ultimate goal hasn't changed. Even in the ugliest recent polling on health care reform, voters don't want it repealed–they want it to work. That's an advantage no amount of disparagement can overcome.

108 Community Comments, Facebook Comments

  1. ElliotFladenElliotFladen says:

    Nice burying of the lede:

    [E]ven with the jump, the administration appears well behind its original goal of having 800,000 people signed up through the state and federal exchanges in the first two months.

    Given that the administration might be 1/8 of where they thought they'd be, your post should be retitled.

    • ElliotFladenElliotFladen says:

      And moreover, let's assume that the administration planned 400,000 people would sign up in October and 400,000 in November (probably wrong, because unless there was an increasing rate of sign ups, it would take years [more specifically over 50 years] to get 300 million Americans signed up at the rate of 400,000 a month) at that rate, and with that "surge" included, it would still mean that the administration was only 18.25% of signups for November where they thought they'd be at.  So again, you need to retitle your post. 

      (please excuse any excel errors I made)

      • DaftPunkDaftPunk says:

        How about math and logic errors?

        Math: 100,000/800,000 is only 1/8 if comparing apples–>oranges?  Try reading for content instead of prejudicial confirmation? 

        the administration appears well behind its original goal of having 800,000 people signed up through the state and federal exchanges in the first two months…100,000 people selected plans through the federal exchanges.

        The 8 is federal plus state, the 1 is federal only.

        Logic: 300 million Americans don't have to sign up through any exchange. Between employer provided and federal programs (MA, MC VA, etc.) a small minority of that number need to sign up.

        It's not your ideology that makes you a punching bag here, it's your rank incompetence.

        • ElliotFladenElliotFladen says:

          Fair point about the number needed to sign up being lowered due to the state exchanges.  So that begs the question then – at current rates, how long will it take to sign everybody up?  

          I hope you acknowledge that if it takes too long, the death spiral is at risk of setting in. 

          • MADCO says:

            Is "death spiral" the new "death panel"?

            It's going to take longer than planned, expected or predicted. As it always has, is now and will be.

            Are you referring to an actuarial instabilty?  Because I can solve that in two words no one wants to hear until 2017. (single payer)

            When you realize (note- you don't have to admit it) that when Heritage  invented this scheme, and one Governor implemented it, the projections always showed if it went national, without a stronger mandate or public system (LSE called it a "scheme" which has far less onerous connotation in  British English), it would be unstable.

            If (when) it collapses and leads to a gov't run single payer (for profit FFS health care makes no sense – ie, is non-Pareto optimizing and is inherently destabilizing) can we still call the result  Obamacare?  Or will we have to call it something like Freedom Healthcare for Americans United for LIberty and Mythical Memory of Reagan? 

             

          • DaftPunkDaftPunk says:

            Absolutely.  "Too long" will result in a death spiral.  Of course that begs the question of how long is "too long."

            It also makes me wonder how someone so impressively matriculated as yourself does not understand the proper use of the phrase "begs the question."

            http://en.wikipedia.org/wiki/Begging_the_question

          • ajb says:

            Elliot,

            Apparently, you are completely unaware that something like 40% of Americans already get their health care provided for them by the federal government (Medicare/Medicaid/VA).

            Apparently, all you have to offer is a thoroughly uninformed opinion. Remember that next to you complain about the beating you take 'round these parts.

            • roccoprahn says:

              He's not now. Prior to your post, yes. The Medicare/Medicaid part never registered with him.

              But the part of fladen that's so irritating is that he actually roots for failure. Something in the "conservative" genome maybe, the act of literally hoping yout neighbor's house burns down so yours' might look better.

              fladen is face to face with the fact that the law's in place, permanent, and the site's improving every day. Politico says the jump in young enrolees is remarkable, and over 50% of Americans now say it's "too early to tell" if The ACA will be successfull. For those of fladen's ilk, "too early to tell" sounds very much like the death spiral of thier wild hopes that 40 million Americans would be denied coverage.

              Like all "conservatives", fladen sees the guy down the street who lost his house due to "downsizing" as unfortunate. But if it were to happen to fladen…………now that's an economic depression of biblical proportions. 

    • ParkHill says:

      We keep asking for your homework, Elliot:

      WHAT IS YOUR SOLUTION  TO UNIVERSAL HEALTHCARE? 

      We never get an answer. 

      • DavieDavie says:

        Um, universal sickness, bankruptcy and early death?

      • BlueCat says:

        And we never will. Trust me. I've wasted way too much of my time attempting to have an actual discussion with Elliot, one in which people respond to each other's questions and to the facts each presents to back their points, It's utterly hopeless. I highly recommend saving yourself the aggravation. 

      • ElliotFladenElliotFladen says:

        Parkhill,
        Maybe not having a law that makes healthcare more expensive for people is a start?  ;-) 

        • roccoprahn says:

          Really? You really said that?

          Is this a personal experience? Have you lost your coverage, gone on the exchange, been quoted a higher premium?

          Where is this coming from? I know hannity had a fake panel more than once, complaining about just that, but research showed the "disgruntled" poicy holders had not even actually been on the site.

          And are you the holder of a "catastrophe policy"?

          Because if you are, every point you've ever made is rendered moot.

          As if you'll admit it.

          • ElliotFladenElliotFladen says:

            I have made the following points in this thread:

            1) any "surge" was from a ridiculously low base line (akin to 1 win 161 loss baseball team quadrupling wins following year) and thus is not effective to show "time running out" to criticize Obamacare 

            2) if index for measuring surge is percent compliance with anticipated enrollees on site there might not be any surge at all, or at least a smaller one, as anticipated enrollees should be increasing each month for awhile anyway. (This is where the 300 million discussion came in)

            Neither of these points has been rendered moot.  In fact they have barely been responded to

            • roccoprahn says:

              I'll play but this sounds ominously like you're jerking chains……again.

              Your analogy of winning 4 games out of 162 after just 1 win the previous season……….consider it point taken.

              Now, is there a number you'd accept that would indicate the process is improving, that the "death spiral" has been leveled out?

              Because that's going to be the test of whether or not you'd ever admit the ACA is "successfull. Personal opinion, you don't consider health insurance for millions of people that can't afford to pay what you consider reasonable (based on your means) something the Federal Government should worry about.

              Extrapalating from that, if you doubt the "legitimacy" of the ACA, would you ever consider any numbers "acceptable".

              This is taking for granted you consider yourself to have "earned" health insurance for you and yours, while others are "mooches" or "unworthy".

              Is it a right or a priveledge?

              Fascinating question. 

              • ElliotFladenElliotFladen says:

                I don't know what number is sufficient to avoid it but it seems likely the number now is so low (even with surge) to have things in danger zone of the death spiral

                • roccoprahn says:

                  So you won't answer. You went with "avoid" rather than "accomplish". Another dodge, jerkin' chains by habit.

                  Conclusion…………You don't consider health insurance a right. You're ok (for now), too bad if the other guy isn't.

                  I'll remind you, ayn rand took Social Security Disability  (of course it was under the name "ann o'connor", her husband's last name).

                  Deciding who lives and who dies is a dangerous game. You get a lot less "strict" when you're in a situation.

                  You "libertarians" never think of that……….'till it's you looking down the barrel.

                  • ElliotFladenElliotFladen says:

                    You are correct that I do not consider other people inherently obliged to provide you healthcare

                    • roccoprahn says:

                      But do you consider health insurance a right or a priveledge?

                       

                    • ElliotFladenElliotFladen says:

                      I consider it a service that is generally offered on a voluntary basis.  

                    • ajb says:

                      And if you have a pre-existing condifion, you're fucked. Get over it. Life's not fair.

                    • ElliotFladenElliotFladen says:

                      If you want insurance to cover a pre-existing condition without penalty, is it really still insurance? Or is it instead a wealth transfer?

                    • ParkHill says:

                      And this is precisely where the Magical Marketplace falls apart. It is not possible for the free market to provide healthcare. This market requires regulation in order to function:

                      (1) No pre-existing conditions; no denials, no lifetime caps…

                      (2) Everybody must participate; No freeloaders

                      (3) Affordability; Subsidies for lower-income.

                      (4) Transparency; What am I getting for my money?

                      (5) Cost shifting; Why does an aspirin cost $10?

                      Elliot makes ignorant comments because (1) he believes in Libertarian Unicorns, and (2) He has failed to do his homework in figuring out the 5 market failures listed above.

                      Obamacare is an effort to regulate the healthcare morket so that it functions without disrupting private insurance.

                      It would be much easier to just open up Medicare to everybody.

                    • ParkHill says:

                      Sorry, I forgot to remember the Libertarians idolatry of  property, wealth and class warfare against the 99%.

                      That is a philosophy with which I just disagree. I come from a more christian tradition along with a moral belief that we individually better off if we live in a society with a healthy middle class, and a ladder and helping hand for the lower classes.

                      Don't give us false arguments about success or failure of Obamacare, when your real point is that it is morally wrong.

            • Duke CoxDuke Cox says:

              I have made the following points in this thread

              No…I'm sorry, Elliot,  …you also said this:

               

              unless sign ups increase, (which is happening)the insurance carriers will be stuck only insuring the most expensive patients (which isn't going to happen), forcing them to raise rates, (which also isn't going to happen) and thus beginning the dreaded insurance death spiral (which, as a result, isn't going to happen). 

              So…regardless of your penchant for creative math…your "death spiral" rhetoric is just bullshit, plain and simple.

               

               

               

               

  2. Duke CoxDuke Cox says:

    This isn't going to end well for Obamacare haters, Elliot. I advise jumping ship early, before you have to wipe egg off your face…smiley

  3. Ralphie says:

    Elliot, your premise of 300 million is flawed.  Many people already have coverage privately or through their employers.   The true number of uninsured in this country is about 47 million.  Furthermore, you can't treat each new account or signup as an individual.  Many or most are families.  AND, many are being shunted to expanded Medicaid and don't show up in the Obamacare numbers. So it's not your Excel that's broken, it's your model.  It doesn't reflect reality.

    All the Republican bluster has done is to scare people away from even looking at the exchanges, which was exactly the intent.  But they'll be there.

    Obamacare will make a big dent in the uninsured problem as people continue to sign up.

    • MADCO says:

      What?! Is that some kind of new math?

      I only wanna hear about failure. Success is not an option.

        • Gilpin Guy says:

          Double Benghazi.

          You know it's coming.  When the registration numbers start to increase because of the insurance mandate next year, the Ellidiots of the world are going to scream that the books are cooked.  That surely so many uninsured families wouldn't want to sign up for affordable health care programs because they like paying full retail for all their health care needs.  You can bank on these petty jerk-offs trying to discredit the registration numbers when they start inching toward sustainability.

          • ElliotFladenElliotFladen says:

            If the death spiral doesn't occur, I won't have a problem.  My issue is you guys prematurely cheering that we are out of the woods of that occurring.  We aren't. 

            • Gray in Mountains says:

              I actually don't read anyone cheering that we're out of the woods. Only folks relating the presented facts that the website is working much better

              ACA is working. The cost curve is bending in the right direction

              • ElliotFladenElliotFladen says:

                Working much better?  It is still roughly at 18.25% of what it should have registered for this month.  Yeah, that is better than the roughly 4-5% of the anticipated total the month before, but that is like saying the Cleveland Cavs are a better team now than after Lebron left.  

                • ElliotFladenElliotFladen says:

                  (they still suck)

                  • BlueCat says:

                    1) Perhaps you'd like to google the early results for Romneycare in Mass? Quite a slow start there, too, 

                    2) If anybody here has been doing any cheering about how we're "out of the woods" I haven't seen it. And no, merely noting relative improvement doesn't qualify for any such characterization. That's strictly straw dog stuff.

                    3) In any case the fact that your starting point number is 300 million is so silly it's impossible to take anything else you say on the entire subject seriously. You clearly don't understand that most of those 300 million have no need to sign up at all and therefore you must not understand the purpose of or target demos for the exchanges. 

                    None of which is to say there aren't valid arguments to be made by opponents. Just that you haven't succeeded in making any. 

                    • ElliotFladenElliotFladen says:

                      BC, 

                      Given the large numbers of people that are going to eventually lose their coverage due to one change or another in their policy over the course of a decade or two, I see no reason (besides the possibilty of state exchanges) to see that 300 million is the wrong number. 

                      And lets deal with those state exchanges too.  Let's suppose that 1/3 of people will sign up through the federal website and 2/3 through state exchanges.  And for a fudge factor, I'll let you divide the number above by half again (to account for the possibility that maybe some people will not lose their existing coverage over the course of a decade)  since you and everybody else is so obsessed with 300 million.  So on that basis you will take the 300 million number and divide it by 6.  That still leaves you with 50 million people and at the rate of 400,000 a month, would require over 10 years to sign everybody up.   

                      The point for all of this of course isn't that it will take 10 years to sign everybody up – its that (and what you are all conveniently ignoring) the Obama administration was already likely assuming that the numbers of people signing up would increase each month for a while.   Which would mean that in dividing the 800,000 that they expected to sign up between two months, LESS than 400,000 aniticipated enrolles should be attributed to October and GREATER than 400,000 anticipate enrollees should be attributed to November.  Which in turn would mean that roughly 5% of goal (October) and 18% of goal (November) would have to be shifted around to be closer to say maybe 10% and 10% of goal…meaning that there is even less of a "surge" in application vis-a-vis what was anticipated than even the original article could be read to suggest.

                    • BlueCat says:

                      You throw around the word "you" with great abandon. You can't show me where I ignored what you claim I ignored or showed obsession with anything. What you are you addressing? Never mind. Pointless to ask. You won't answer in any cogent way.

                      And no matter how many paragraphs you write, without anyone having to be the least obssessed with the number 300 million, your use of it in your arguments is absurd on it's face, for reasons I won't bother to waste any time repeating since you don't have any interest in hearing or responding to what people actually say. 

                      You know, maybe you should read some of negev's posts as examples of defending points in a well reasoned debate with someone from the other side.  You really need some help.

                    • ElliotFladenElliotFladen says:

                      Your suggestions that I need help defending my arguments BC are duly noted and given the weight they deserve.

                  • ClubTwitty says:

                    OH NOES!  Unheard of before this, this, this OBAMACARE!  But, EF predicts peoples health coverage policies might change over the course of a decade or two.  OBAMA-nation! 

                     

            • roccoprahn says:

              No. You're actually cheering and rooting for the ACA to fail. Nothing premature there, just clashing moralities. "I've got mine, you go to hell", vs. "A rising tide lifts all boats".

              Got it.

              • ElliotFladenElliotFladen says:

                Where did I cheer for it to fail?  Predicting failure is not the same thing as hoping for it. 

                • ElliotFladenElliotFladen says:

                  (what is interesting here is it seems that a few of you here actually seem to be entertaining the possibility/probablity now that it will fail)

                  • MADCO says:

                    Obamacare, as currently designed and almost implemented, will fail. The only question is when.  

                    If was 2010 when the GOTP House first tried to repeal it, it would have been Bad. Bad policitcs, bad policy, bad, bad bad.

                    If faield 2011, 12, or 13  when the House GOTP voted 35 or 40 more times to repeal it, it would have been bad.

                    If it is in Jan 2017 – it could be Good. Very very good.

                    For your faux libertarian concenr for the 300 million arguments to mean anything you ahve to be hoping for it to fail long before January 17.

                    By Jan 2017 no one with 1/2 a clue will still believe in death panels, 16,000 new IRS agents, 45 million uninsured, or that it would be good to eliminate the part about pre-exisiting conditions, closing the Medicare Part d donut hole, and a hundred other things the 300 milion will love about healthcare then.   So if it "fails" then, it will give way to something better.  Not don't get sick or die fast  and sure as hell not if you aren't rich, blame yourself.

                    Better could be awesome, but at a minimum it will be, well, better.

                    So while it's not entertaining, I know for certain that Obamacare will fail. When is the only thing I don't know.

                     

                    ps- approximately 80% of all economists in the world who have spent any time looking at thie US healthcare market already know what would be better (Pareto efficeint).  It's not hard.

                • BlueCat says:

                  You're pretty transparent, dear Elliot.

                • roccoprahn says:

                  Read your posts, Elliot. 

                  For that matter, you've admitted this morning you think the ACA/preexisting conditions requirement on the providers is a wealth transfer (it's not, and that's about as shitty, snotty, selfish an attitude one can have, Elliot, but it's what makes you a rand acolyte).

                  You inherently believe health insurance is best "offered on a voluntary basis"? So, of course, You're rooting for it to fail, because you ideologically oppose it. To deny that you're rooting for the ACA to fail is fundamentally intellectually dishonest. You know that.

                  BTW, if your kid has a preexisting condition, the company won't insure you, do you still think "too bad, life ain't fair, oh well".? Is it still an unfair "transfer of wealth from somebody to you" if it's your kid? If you're paying a premium under the ACA, and that's wealth transfer, is Medicare? Is Social Security? Will you turn down Social Security and Medicare at 65? 

                  Don't jerk chains, don't avoid the question. For once, please, just answer it.

                   

                  • ElliotFladenElliotFladen says:

                    Rocco,

                    I will decline to answer questions that are not related to the OP and/or are asked in a rude manner. 

                    The OP concerned whether there was a "surge" in Obamacare applications.  What I would do if a family member, heaven forbid, had a terrible illness is irrelevant to whether there has been a "surge" in Obamacare applications.

                    As for your civility, you have said that I have a "shitty, snotty, selfish . . . attitude".  That is not the level of civility that inspires me to go off on your tangents. 

                    In the future, I suggest you strive to stay both on point and to be a better human being. 

                    Sincerely,
                    Elliot

                    • roccoprahn says:

                      So it WILL be different if it's your kid with the preexisting conditions.

                      Then, oh yeah, that's no "transfer of wealth, it's the way it should be".

                      Ok. Just quit hiding behind a libertarian philosophy that falls apart when it's you, not a stranger, that life hits in the face.

                      You don't answer because the truth exposes you. My aggressive approach has nothing to do with it.  

                    • BlueCat says:

                      No reply to last Rocco so using this one. Right on, Rocco.

    • ElliotFladenElliotFladen says:

      You assume though that people who have insurance pre-law will not lose it in coming months.  That assumption, given the cancellation letters that have gone out, seems shaky.  

      As for the article above, it said 100,000 people signed up.  Unless you can point me to something specifically to the contrary, I read that as counting one person singing up a family of four as four people signing up. 

      Also, regarding the insurance death spiral, this portion of the Hill article is relevant:

       

      Many believe the early adopters will be older and higher-risk, as those without current coverage, possibly due to pre-existing conditions, rush to enroll. The administration has been adamant that it expects an influx of young and healthy consumers before the end of the six-month enrollment period, on March 31.

      • Ralphie says:

        I'm not assuming shit.  I got a letter from my insurance company.  I got on the exchange and bought a replacement.  End of problem, end of discussion.

        • ElliotFladenElliotFladen says:

          Ralphie, you said as follows:

          Many people already have coverage privately or through their employers.   The true number of uninsured in this country is about 47 million.

          That assumed that only currently uninsured people would need to be signed up, and not people who would lose their insurance as a result of the ACA/Obamacare. 

           

          • Ralphie says:

            I know exactly what I said (more properly: wrote).  If whoever "loses" their junk policies in January will simply go on to one of the exchanges and purchase replacement coverage, then they're not uninsured, are they?

            Do you have a number for who has "lost" junk coverage and not replaced it? A good enough number to plug into your flawed model? Probably not, since it's not January.

            Armwaving is not rigor.  And all you're doing is armwaving at this point.

  4. MADCO says:

    "…Detractors Finally Running Out Of Time?"

    What aobut 16,000 new IRS agents?

    What about death panels?

    What about the President is a socialist, from Kenya who may or may not be a lesbian?

     

    This is President Obama's Waterloo – there will always be more time to detract and oppose the President.

  5. davebarnesdavebarnes says:

    "More than 71,000 Coloradans have created accounts on Connect for Health Colorado" is a horrible metric.

    I created an account and I am on Medicare.

    You don't measure inputs; you measure output.

    • Cogito says:

      I agree to a point.  The number of accounts opened does not tell you how many bought or plan to purchase a policy.  It does provide a maximum in that it tells us there cannot be more than 71,000 who have taken action to sign up.  And you can count my mother, also on Medicare, and myself, covered by employer health insurance, who created accounts just to get a sense of where we would fall on the spectrum.

    • mamajama55mamajama55 says:

      44,000 of those people are in "Medicare limbo". They signed up, created an account, got an initial estimate as to cost and/or possible subsidy, and are now waiting for Colorado PEAK social services to make a determination as to eligibility.

      I was in that group – on CHCC Oct 7, applied for Medicaid Oct 13, waited for ever to get a decision. Colorado Social Services was just not prepared for an influx of 44,000 people to process for Medicaid eligibility.

      The chokepoint, as I've said before, is in the "PEAKforce" social services system, not in the CHCC website, which was quite easy to negotiate.  So the "output" trickle is real, but it's a problem in the interface and low staffing between the exchange and Colorado's social services system, not in the exchange itself.

      I am a bona fide working poor, uninsured on the individual market health consumer. I am now finally out of Medicaid limbo.

      I have submitted my documents and I am shopping. Looks as though I will pay $30 or less a month for medical and dental after advance tax credits. It's going to be so much more secure-feeling to have insurance again.

      So, for Elliott, N3B, anyone else who feels like chiming in:

      Was that really worth shutting down the government over?

       

      • ajb says:

        Well, Elliot needs to take his vacation in Mexico, so he really resents that subsidy you're getting (just paraphrasing an earlier response of his).

        • BlueCat says:

          But apparently not what he's always paid for our universal crappy health coverage by ER system that doesn't exactly let you die in the street but does bankrupt you, while taking it out of your neighbor's pockets, if you can't get coverage due to a pre-existing condition and can't pay. 

        • ElliotFladenElliotFladen says:

          ajb,

          I am not the one who goes to Mexic.  My wife goes with our daughter (and soon to be second daughter in a week or two).  They go because it is important for my wife and our children to have a relationship with their family down there who cannot afford to come here and visit.  

          Now you may think that seeing immediate family once a year is an unnecessary luxury.  If you feel that way about your family, I feel very sorry for you.

            • BlueCat says:

              1) Why should we be concerned about your family's specific situation? You want to pay less in taxes for roads and bridges, too because of it? That would make just as much sense. You have no such concern for families without access to basic health care due to pre-existing conditions so what's so special about your family that you deserve more consideration for your travel needs? People don't die or go bankrupt without visiting family, after all, nice as being able to visit family may be.

              2) All of us are paying more for healthcare than in any other modern industrialized country as it is. So you're short sighted view of the costs to your family aren't really saving you money anyway, for trips to Mexico or anything else, in the big picture.

              3) You seem to make all of your policy decisions though the prism of you're own personal situation. You follow the rightie line except on immigration and it seems like no coincidence that you happen to personally have a Mexican wife. If you personally had a child born with a condition that, under the supposedly free market system (though what's free market about a system in which a product costs more than almost any individual could afford to pay without assistance in the form of government or private insurance escapes me) made it impossible to obtain insurance for her and you were in danger of going bankrupt as a result I'm fairly confident you'd make an exception and diverge from the rightie line in the area of health care reform as well. I'm fairly certain that if your wife or child was gunned down in a mass school or movie theater slaughter, that would be reflected in your views on gun control.

              Of, course that's not unique to you. It seems like the only GOTPers who change their views on, say, gay rights, only do so if they happen to have a child come out to them. On the right, everything always seems to be viewed from the point of view that until it's a personal problem for me, who cares?

              • ElliotFladenElliotFladen says:

                You ask why you should be concerned about my family's situation.  I never said you should.  On the other hand you have said/implied that I should feel guilty for wishing to voluntarily spend my limited money on my wife/children visiting imporverished immediate family in Mexico instead of being forced to pay for a stranger's healthcare.  I see no reason why I should feel guilty for that.  

                As for personal situations – I was pro-immigrant before I met my wife.  I just wasn't as vocal/passionate about it.  I don't gamble, smoke pot or even drink alcohol (baring family religious occasions for latter) yet I oppose the gov't's level of involvement on those items. 

                • ElliotFladenElliotFladen says:

                  (and I'll mention that I am not homosexual or have any immediate homosexual family but I am also very pro-gay marriage)

                • BlueCat says:

                  You are already forced to pay for strangers health care. Americans already pay much more for strangers healthcare than do the people of any other modern industrialized country.  As far as paying for strangers, that ship has sailed and it sailed long ago. That's the whole point, the whole reason for the need to change our expensive, inefficient system. Why am I not surprised that you are unaware of that simple, salient fact?  Past experience with your severe logic deficit perhaps? Once again, I don't why waste my time. I need another Elliot break so you won't hear from me for a while. 

                  • ElliotFladenElliotFladen says:

                    I'm well aware that we already are forced to pay for strangers.  That was my comment concerned making me feel guilty for not wishing to do so. 

                    Given the steep decline in your civility today, I think a long break would do you some good.  Have a good holiday season!

                  • roccoprahn says:

                    BlueCat, you are one of the most patient people I've ever run across. Just from your back and forth with me I know you think about it before you say it. You say what you mean, mean what you say. fladen never answers you critically. He dodges, jerks chains, runs the red herring, ducks and dodges. And you never stop hitting him with accurate punches he can't/won't return, as he never wants to get tied to a point.

                    fladen might not realize it, but his insincerity looks crass in contrast to your reasoned positions.

                    Thanks.

                • roccoprahn says:

                  Christ, Elliot, stop changing the subject. Defend your logic or don't, but have a point. Have a rebuttal. Have a plan.

                  And stop with the false comparison scam about "choosing between visiting impoverished family members and paying for some stranger's health care". How do you even go from apples/oranges to anything even resembling an intelligent connection of the 2? Even a choice between the 2?

                  This should be good.

                  • ElliotFladenElliotFladen says:

                    I've been called heartless for not wishing to have as much money forcibly taken from me (past/present/future) to pay for a stranger's healthcare when I'd rather use that money to have family see family. 

                    If you want to back off on the heartless comments and similar stuff, I won't raise it.  

                    Not all that complicated.

                    • roccoprahn says:

                      You're right and it's not that complicated.

                      I asked you to correlate the 2. "Visiting impoverished family members" is denied you by "paying for a stranger's health insurance"….how? 

                      Are you saying that you somehow, some way now pay so much for somebody else's insurance premium that you can't travel? When did that start? Why aren't the rest of us noticing this change in our situations. What "tax" is that? Should I look for it on my stub? my witholding? 

                      If that's not what you're saying, what are you saying?

                      So stop whining about your feelings getting hurt, stop with the "heartless" dodge, and explain how you meant it. Or don't. But this is your statement. So what is it? How do you compare the ACA with you not getting to go to Mexico?

                      And you're right. This ain't that complicated.

                       

                       

                      .  

                       

                    • ElliotFladenElliotFladen says:

                      When you tax me, you take money from things that I would spend it on otherwise.  Such consumption thus does not occur or occurs in a reduced form.

                    • Duke CoxDuke Cox says:

                      (using the last reply button)

                       

                      that I would

                       

                      note that middle word….

                      You are a "libertarian"… right?

                  • BlueCat says:

                    Out of reply buttons so using the latest one of yours, Rocco. As far as Elliot's tired old tax argument, money payed in taxes must be bad because it takes away from other spending, that makes very little sense considering that taxes are at historic lows but our economy sucks on terms of job creation and was much, much, much more prosperous for ordinary working Americans when taxes were higher.

                    It's an argument that also ignores the fact that  contributions to a vibrant economy include such things as great infrastructure, research in science and medicine, the development of new technologies, safe streets with adequate police and fire protection, good schools with small classes, a healthy work force and on and on, benefits we get as a result of adequate tax revenue.  Also do living wages for jobs for the masses as was the case when unions forced living wages for jobs in the old industrial sector that had been low wage jobs before workers lerned to organize and wield power. 

                    It's never been as simple as direct zero sum between taxes and money available for economic prosperity or low wages and low prices a creating a prosperous economy for the majority.  The long GOTP jihad against taxes and wages has dragged down the economy for the majority and that's the simple truth. 

      • MichaelBowmanMichaelBowman says:

        I find it ironic that after just celebrating Black Friday, where people are willing to stand in line/camp out for hours/trample others for a deal on an XBox – that somehow being forced in a queue for health insurance is intolerable…we are a spoiled, rotten lot.

        • roccoprahn says:

          No doubt, Mr. Bowman. The irony strikes me every day.

          Americans as a culture, a society, have become so immersed in self indulgence that conservative selfish dogma flourishes like no other time since the guilded age. 

        • mamajama55mamajama55 says:

          I really didn't mind waiting in "Medicaid Limbo" for myself, once I believed that an end was in sight, and not having any unmanaged health issues.

          But as a parent, when I used to take my young kids to Denver Health to wait for hours in waiting rooms and corridors peopled with junkies, drunks, other desperate families,  bloody forms on stretchers, just to get a diagnosis and meds for strep throat, or an Xray for a possibly broken bone, that was tough. I remember my son's wonder, when I finally had a job with insurance, at the short wait and excellent care. "Wow, they just saw me, and said, "Here's your medicine", he marvelled.

          And in the last couple of years, negotiating the practically nonexistent mental health system on behalf of my adult daughter was like being in a Kafka play. Eligible for Medicaid? No. Indigent care? maybe. Wait 6 months and find out. Emergency room care? We'll bill you at full price. Is she suicidal? We'll lock her up for a few days, then bill her at full price. Etcetera. It's why jail is the primary mental health provider for the mentally ill, and jails don't really do squat except medicate.

           

  6. Gray in Mountains says:

    Anyone else notice the TV ads for junk policies lately? $19/mo for $350K

  7. DavidThi808DavidThi808 says:

    This is interesting:

    In the case of these men, when they got Medicare, they took worse care of themselves; they actually exercised less. Among those who didn't visit the doctor after getting insurance, the effect was dramatic: Their overall physical activity dropped by 40%; they were 16% more likely to smoke cigarettes and 32% more likely to drink alcohol.

    The newly insured Medicaid population did go to the doctor more often, used more preventive health services and received more medications. Problem was, in nearly every area, they weren't any healthier. The scientists sat down with more than 12,000 people and compared some of the most important health indicators. They found having insurance did not improve measures of blood pressure, cholesterol or how well diabetics controlled their blood sugar. Furthermore, the 10-year risk of having a heart attack didn't change in those who had Medicaid. It wasn't at all what the proponents of universal access to health insurance hoped they would see.

    There are some benefits to getting everyone on healthcare (bancruptcy due to medical issues drops almost to zero). But it's not a panacea.

    • ajb says:

      It's interesting, but not surprising.

      If you know your next illness will bankrupt you, then I expect that you will be more likely to actively maintain your health. 

    • BlueCat says:

      Also these are all people 65 or older. I'm sure many who make it past 75 or 80 figure, what the hell? Time to stop being disciplined, stop practicing self denial and time to enjoy eating and drinking what I want and dropping activities I don't like. This is a population that doesn't mirror the general population at all.  Most people during the medicare eligible years, for instance, exercise less, sometimes because of physical issues that make it a lot harder to do so. 

      Get back to us with more "interesting" stuff when we have universal single payer health care through medicare, not just for the old in an era when increasing numbers remain on medicare well into their 90s and beyond. And, outside of a tiny exceptional minority, they aren't out there running marathons, in any case.

    • MADCO says:

      That study is flawed in some important ways.

      Example- most people in the newly insured Medicaid population have issues way beyond reducing their cholesterol or exercising more frequently.  They tend to be low income, lower education, and culturally resistant to change. It's not like they got Medicaid and starting eating potato chips and red meat while sitting on the couch living a sedentary life.  It's not like getting Medicaid changed any of that either.

       The study does lend credence to some conclusions, however. People are not smarter because they have access to health care.  To the degree behavior contributes to health or un-health, having access to health care is not the same as changing behavior.  People will think what they want about all kinds of things. The uninformed will think more poorly than others.

  8. mamajama55mamajama55 says:

    Stop picking on Elliott. He'll just get entrenched in his undefendable position and tie himself into logic knots. Elliott, I forgive you for not wanting to pay for my health care subsidy. Your taxes mostly go for defense spending, anyway.

    On a more cheerful note, it looks as though the Affordable Health Care Act really will be affordable.   The upward spiral of health care costs has slowed, which was always the point. Cheers!

    • roccoprahn says:

      MJ, for Elliot, that's not cheerful news.

      • BlueCat says:

        Nope.  Elliot admits that we're already paying for strangers' health care and at a higher rate than in any other modern industrialized nation and still objects to reforms that would give us a system that would allow us to pay less for strangers health care. So there are two possibilities. 

        1) Elliot actually prefers paying more for strangers' health care. Hmmm…that can't be because he says he doesn't like paying for stranger's health care.

        That would leave only possible preference number 2) a system where there are no subsidies payed for by tax payers or others in an insurance pool. After all, even private for profit insurance pools involve paying for strangers' health care. So they'd have to go, too. You either have the cash, the ability to get a loan for the amount you need or you're out of luck. Only those who can pay their own way get health care and very few have that kind of private means if anything at all serious happens to them or their kids. So… lots of dead people but absolutely no paying for strangers.

        I guess door number 2 would fit Elliot's preference best but all those people dying for want of health care in the world's wealthiest most powerful  nation would be a little embarrassing, don't you think? 

        I won't posit that, unless Elliot is very wealthy, some of those dead people could be his own family members because he objects to any hypothetical that involves anything negative that could happen to his own family in a given scenario.  But there you have it. The libertarian solution.

    • MichaelBowmanMichaelBowman says:

      Heres a good WashPo article that shows the average costs of ACA by state.  Minnesota might have to start building a fence on its eastern border to keep the Scott Walker refugees at bay. 

  9. DaftPunkDaftPunk says:

    Her's the conservative/libertarian answer in a nutshell:

    Also, as I slogged through all punditry and quotes from justices there was one that jumped out at me. It came up when Solicitor General Donald Verrilli was explaining the cost impact to tax payers of “free riders”, the crowd lacking insurance who simply show up at emergency rooms for treatment where — because Ronald Reagan signed the law — the government requires hospitals to provide treatment, which is then passed on to everyone else as higher overall costs. Verrilli noted that we are “obligated” to provide this basic humanitarian service.

    And what was the response from Scalia, the Roberts court’s primary ventricle?

    “Well, don’t obligate yourself to that.”

    Think about that one. It’s breathtaking. Never mind the easy jokes about something like that coming from a guy on a lifelong government pension and full government medical coverage. It is also so utterly representative of the modern, hyper-partisan conservative attitude toward all enormous social problems … don’t do anything.

    Let the poor die.  They're moochers anyway.

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