Mandatory Health Insurance part 3

[Diemen]

Here's an interesting read regarding the Obama administration's reaction to the roll out of the ACA so far:

Level With Us, Mr. President � The Dish

The administration is still behaving like it is trying to get Obamacare enacted, and therefore its top public relations task is to bury negative stories about the law and emphasize the upside, like heavy consumer interest. But this is a mistake. Obamacare is already the law, and its long term political success is going to be determined by its substantive policy success — including whether consumers are able to sign up and get the health coverage they want.

...

Perhaps spooked by the 2010 Congressional elections, the president pocketed his controversial domestic win and then laid low. Healthcare was not one of his rallying cries in the election – because it was not the most popular part of his agenda. But over the long haul, legitimizing his healthcare law and reminding us of its core gains – lower costs, no bar on pre-existing conditions, and an end to free-riding – was more important than simply securing re-election the least difficult way. Then, too defensively, the Obama team waited until the website roll-out to make their case – hoping, presumably, to capitalize on what they imagined would be a great online experience. Then came the mismanaged disaster, followed by ever more defensive – and somewhat opaque – public statements. Kathleen Sebelius’s appearance on the Daily Show (a key demographic for the law) was one of the worst performances I’ve ever seen of a public official defending her own work. It was a textbook case in how not to talk to the public. It has gone downhill from there, including the president’s super-lame Rose Garden mix of ebullience and defensiveness.

What we need is candor. We need the president first of all to take personal responsibility for this failure. He needs to apologize to the country for what was either terrible executive branch management or negligence. And he needs to fire those responsible as a simple matter of accountability. If he had no clue of the train-wreck, his administration is not functioning correctly. The problems were foreseen as long ago as this spring by Max Baucus. He wasn’t clairvoyant about the website, but he presciently warned of a looming train-wreck because the exchanges would not be ready on time and because the administration had done such a piss-poor job of communicating the core provisions to the public. He was in constant touch with Sebelius, and regarded their exchanges as futile.

...

I’m sure many are working furiously to fix the website problems. Things may work out in the end, as they did in Massachusetts and with Medicare D, after early choppy waters. But competence also requires confidence. Confidence requires extreme candor from the top. Stop trying to sell a product people cannot easily buy. Explain why this happened, and who has taken responsibility. Fire them. Apologize. Be totally forthright about everything you know. Explain the plan to fix it – clearly. Reiterate the core goals of the law – with an emphasis on its many popular aspects. If some kind of delay is needed, say so now. Don’t stumble back into it later. Or do it in embarrassing half-ass stages.

This is basic public relations. It should be reflexive for a president who told us he would admit error when he has screwed up, unlike his predecessor. Instead, we have defensive acknowledgments of the bleeding obvious, and a drip-drip-drip of bad news leaking from congressional hearings and reporters. At this point, the president is behind the ball. He needs to get ahead of it – and fast. Or he will begin to look like George W Bush spinning his Iraq fiasco. Unlike Bush, Obama has many supporters prepared to confront and criticize him publicly, which is a help. The president now needs to rise to this occasion or have his own singular policy choice, like Bush’s, become a synonym for government incompetence. Confess, Mr President. Americans forgive failures explained forthrightly. They rightly never forgive those who cannot plainly and clearly admit error and take responsibility.

[The_Pac_Mule]

Well, I was hoping I would be able to avoid having to use the VA healthcare system, but looks like Im going to have to. This is absolutely ridiculous. I am in the low income class this bill in college, and cannot afford the absurd new prices for healthcare in Vermont. I have virtually no income, and an unable to work right now. I get 80% disability from the VA. Between that and money from the GI bill, that's my only income. The health plan I've been on was a $300 something a month plan, however the state subsidized most of it, leaving me with a bill of $60 a month. My annual max-out of pocket expense was $1000. I require a lot of physical therapy, so that figure is very important. I pay 80% of all medial expenses, until around $400, at which point the insurance pays 80% and I pay 20%, until the $1000 is hit, at which point the insurance pays 100%.

But contrary to what the President promised, not everyone gets to keep their current health plans. Mine will no longer exist after the end of 2013. So now, I'm looking at a much higher premium, not quite sure how much higher, but anywhere between $100-$300 higher. It doesn't help that the website doesn't work. But more importantly, the medical deductible is going to skyrocket to at least $4000. There is no way I can afford my medical expenses with a deductible that high.

What a load of shit.

I have no idea what I'm going to do.

[solemole]

Sorry, I posted this on the entropy thread... But here's Krugman's OpEd column today:

NYT OpEd: The Big Kludge

But while we wait for the geeks to do their stuff, let’s ask a related question: Why did this thing have to be so complicated in the first place?

It’s true that the Affordable Care Act isn’t as complex as opponents make it out to be. Basically, it requires that insurance companies offer the same policies to everyone; it requires that each individual then buy one of these policies (the individual mandate); and it offers subsidies, depending on income, to keep insurance affordable.

Still, there’s a lot for people to go through. Not only do they have to choose insurers and plans, they have to submit a lot of personal information so the government can determine the size of their subsidies. And the software has to integrate all this information, getting it to all the relevant parties — which isn’t happening yet on the federal site.

Imagine, now, a much simpler system in which the government just pays your major medical expenses. In this hypothetical system you wouldn’t have to shop for insurance, nor would you have to provide lots of personal details. The government would be your insurer, and you’d be covered automatically by virtue of being an American.

Of course, we don’t have to imagine such a system, because it already exists. It’s called Medicare, it covers all Americans 65 and older, and it’s enormously popular. So why didn’t we just extend that system to cover everyone?

The proximate answer was politics: Medicare for all just wasn’t going to happen, given both the power of the insurance industry and the reluctance of workers who currently have good insurance through their employers to trade that insurance for something new. Given these political realities, the Affordable Care Act was probably all we could get — and make no mistake, it will vastly improve the lives of tens of millions of Americans.

...

And Republicans still dream of dismantling Medicare as we know it, instead giving seniors vouchers to buy private insurance. In effect, although they never say this, they want to convert Medicare into Obamacare.

...

No, the assault on Medicare is really about an ideology that is fundamentally hostile to the notion of the government helping people, and tries to make whatever help is given as limited and indirect as possible, restricting its scope and running it through private corporations. And this ideology, at a fundamental level — more fundamental, even, than vested interests — is why Obamacare ended up being a big kludge.

In saying this I don’t mean to excuse the officials and contractors who made such a mess of health reform’s first month. Nor, on the other side, am I suggesting that health reform should have waited until the political system was ready for single-payer. For now, the priority is to get this kludge working, and once that’s done, America will become a better place.

[Irvine511]

Originally Posted by The_Pac_Mule

Well, I was hoping I would be able to avoid having to use the VA healthcare system, but looks like Im going to have to. This is absolutely ridiculous. I am in the low income class this bill in college, and cannot afford the absurd new prices for healthcare in Vermont. I have virtually no income, and an unable to work right now. I get 80% disability from the VA. Between that and money from the GI bill, that's my only income. The health plan I've been on was a $300 something a month plan, however the state subsidized most of it, leaving me with a bill of $60 a month. My annual max-out of pocket expense was $1000. I require a lot of physical therapy, so that figure is very important. I pay 80% of all medial expenses, until around $400, at which point the insurance pays 80% and I pay 20%, until the $1000 is hit, at which point the insurance pays 100%.

But contrary to what the President promised, not everyone gets to keep their current health plans. Mine will no longer exist after the end of 2013. So now, I'm looking at a much higher premium, not quite sure how much higher, but anywhere between $100-$300 higher. It doesn't help that the website doesn't work. But more importantly, the medical deductible is going to skyrocket to at least $4000. There is no way I can afford my medical expenses with a deductible that high.

What a load of shit.

I have no idea what I'm going to do.

i really am taking an extended break from FYM, but i did want to say that this really sucks and i'm very sorry for your situation. i hope you can get the help that you need and i wish you the best of luck.

[nathan1977]

You're not alone, Pac Mule.

http://www.usatoday.com/story/news/2...?csp=fbfanpage

[anitram]

Ya'all need a single payer system.

PacMule, that sounds terrible. Am I understanding your post correctly, that you're a disabled veteran? If so I actually find it appalling you should have any out of pocket expenses at all - the least that the government should do is provide you with free healthcare.

[The_Pac_Mule]

Thanks everybody. I may be able to use the VA as a form of healthcare coverage, they just opened a new clinic near where I live so I'll have somewhere to go.

Ya'all need a single payer system.

Vermont basically already had a single payer system and it worked great here. Anyone could get affordable health care based on their income. But now many of the low income health care plans are being cancelled, and it's bullshit because there was nothing wrong with these plans. They were essentially just standard comprehensive health care plans, with the state subsidizing most of the premium depending on your income. And the most important thing about them was a low annual general medical deductible, which you can't get now.

[INDY500]

Imagine, now, a much simpler system in which the government just pays your major medical expenses.

Imagine having no recourse if the “single-payer” denies your operation.

Of course, we don’t have to imagine such a system, because it already exists. It’s called Medicare

Nevermind that the governemnt’s trustee reports that Medicare becomes insolvent in 2026. Nevermind the reported $250 billion of outright fraud in the system. Nevermind that doctors are fleeing from the program.

[INDY500]

About 50% to 75% of 14 million consumers who buy health insurance individually will receive a "cancellation" letter or its equivalent in the next year because their current policies don't meet the standards laid out by the new law, the news organization reports, citing four sources deeply involved in ACA.

Of those who will be forced to buy new insurance, many will face huge price increases, NBC reports.
NBC alleges the administration knew that up to 67% of customers on the individual market could have their policies canceled, but instead, President Obama said as recently as in 2012, "If (you) already have health insurance, you will keep your health insurance."

Let's play Karnac.

"If you like your health insurance you can keep it. Period"

"The average family will see their premiums lowered by $2500."

"The Affordable Care Act will not add oine dime to the debt."

"Indiana will win the 2013 NCAA Basketball championship."

Name three lies to the American people and a terrible sports prediction.

[anitram]

Originally Posted by INDY500

Imagine having no recourse if the “single-payer” denies your operation.

When does this happen?

[INDY500]

Obama Officials In 2010: 93 Million Americans Will Be Unable To Keep Their Health Plans Under Obamacare - Forbes

Obama Officials In 2010: 93 Million Americans Will Be Unable To Keep Their Health Plans Under Obamacare

Section 1251 of the Affordable Care Act contains what’s called a “grandfather” provision that, in theory, allows people to keep their existing plans if they like them. But subsequent regulations from the Obama administration interpreted that provision so narrowly as to prevent most plans from gaining this protection.

“The Departments’ mid-range estimate is that 66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013,” wrote the administration on page 34,552 of the Register. All in all, more than half of employer-sponsored plans will lose their “grandfather status” and become illegal. According to the Congressional Budget Office, 156 million Americans—more than half the population—was covered by employer-sponsored insurance in 2013.

Another 25 million people, according to the CBO, have “nongroup and other” forms of insurance; that is to say, they participate in the market for individually-purchased insurance. In this market, the administration projected that “40 to 67 percent” of individually-purchased plans would lose their Obamacare-sanctioned “grandfather status” and become illegal, solely due to the fact that there is a high turnover of participants and insurance arrangements in this market. (Plans purchased after March 23, 2010 do not benefit from the “grandfather” clause.) The real turnover rate would be higher, because plans can lose their grandfather status for a number of other reasons.

How many people are exposed to these problems? 60 percent of Americans have private-sector health insurance—precisely the number that Jay Carney dismissed. As to the number of people facing cancellations, 51 percent of the employer-based market plus 53.5 percent of the non-group market (the middle of the administration’s range) amounts to 93 million Americans.

Now you know why the employer mandate was postponed one year.

But it's the law of of the land !!

[maycocksean]

It appears to me that the ACA may be Obama's Iraq War: His signature achievement that went horribly wrong.

[U2DMfan]

Originally Posted by maycocksean

It appears to me that the ACA may be Obama's Iraq War: His signature achievement that went horribly wrong.

The politics of doing it when they did it was the worst political decision made during his first term. That it later became a terrible piece of legislation made it even worse. That it has become a nightmare to implement in his 2nd term probably means that you are exactly right.

[Pearl]

Originally Posted by maycocksean

It appears to me that the ACA may be Obama's Iraq War: His signature achievement that went horribly wrong.

I agree. Its a big disappointment.

[maycocksean]

The "If you like your insurance you can keep it" is perhaps the equivalent of "mission accomplished." :smh:

[digitize]

INDY and other conservatives, I have a question for you: which would you prefer, the Affordable Care Act or a single-payer system? I assume that you detest the idea of either, but which is the lesser of two evils?

[Headache in a Suitcase]

Originally Posted by maycocksean

It appears to me that the ACA may be Obama's Iraq War: His signature achievement that went horribly wrong.

Minus the thousands of deaths and all

[INDY500]

Originally Posted by digitize

INDY and other conservatives, I have a question for you: which would you prefer, the Affordable Care Act or a single-payer system? I assume that you detest the idea of either, but which is the lesser of two evils?

Both are unworkable (in a vast country of 300+ million citizens and open borders), will lower the quality of healthcare as well as being unconstitutional (unless you believe the Supreme Court has the enumerated power to rewrite legislation).

What is the lesser of two "evils" to our liberal friends? The ACA or tort and free-market reform?

[digitize]

Originally Posted by INDY500

Both are unworkable (in a vast country of 300+ million citizens and open borders), will lower the quality of healthcare as well as being unconstitutional (unless you believe the Supreme Court has the enumerated power to rewrite legislation).

What is the lesser of two "evils" to our liberal friends? The ACA or tort and free-market reform?

Do you find them equally bad, or is one even marginally preferable over the other to you? I realize that you find them both unpalatable. I'm not trying to bate you into saying something that I'll later attack; I'm genuinely interested to hear your answer, because I don't know how I'd feel if I were a conservative.

I personally lean towards the ACA, because I think that, in general, universal access to healthcare is a good thing for countries to have. But I'm not one hundred percent positive that I am right about that, and I am not one hundred percent positive that the ACA won't be a disaster. The website issues, while problematic, are relatively meaningless for the long-term success of the act. What concerns me much more are stories like those of The_Pac_Mule, and, especially, the possibility that a lot of people will pay the fee to the IRS rather than buying health insurance, which could cause an epic mess.

[anitram]

It is astounding to me that you can look at other western democracies and then conclude that the ACA is better than universal healthcare. There is just such a complete disconnect from the reality of other experiences that I can't even begin to explain it.

If you guys had what the rest of the free world has for just a week, you'd never go back.