Health Care: Apocalypse Not

Yeah but Joe, Romney is teabagging himself over Romneycare. You know the biggest problem in the country is Republican intransigence and blind rejection of reality as long as it stirs their base.
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Romney knows this is a step to take, but he will denounce his own plan and you know it.

on the other hand it could make him a shoe in come 2012…

Unfortunately the whole scheme violates a more important liberal principle which is that the government shouldn’t force people to give their money to private companies that they have no control over.

All of the benefits of the Massachusetts plan, and more, could be more ethically provided by a public plan, accountable to the people it covers.

The Massachusetts plan does a remarkable job of getting most people covered. However, the out-of-control costs of medical care threaten all plans. It is very important to get everyone covered first, but cost containment must be addressed soon. Even in metropolitan areas two or three corporations now control most medical facilities. There is little competition so costs go up with little resistance. Only some form of single payer can control the rampant greed of medical conglomerates. It may take 10 or 15 years, but that’s where we’re headed.

Seems that Kid Klein missed some of the cuts in HC in MA. Al aimed at low income folks. But ins;t that who is supposed to benefit from the charade of HC reform? Maybe Klein will understand HC a bit better when he actually graduates from having to see a pediatrician to a grown up doctor.

Rationing will be next and while the left denies death panels it will be just that but with a marketing name (a lie) that the left will spin.

In its FY 2011 budget Massachusetts made a $2.2 million, or 6 percent, cut to HIV/AIDS prevention programs, and cut dental benefits for approximately 700,000 low-income residents enrolled in the state’s MassHealth (Medicaid) program. The budget also eliminated a health insurance program for low-income legal immigrants.

Seems to me that 40 million Americans are already being rationed.

“on the other hand it could make him a shoe in come 2012…”
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Yeah, he was so unpopular that he was unable to even get a re-election campaign when he was governor and lost again and again seeking the Republican nomination before Romneycare was regarded as evil by his fellow Republicans.
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Two thirds brain, you have a better chance of getting the 2012 Republican nomination than Mittens does.

Death panels? Oh, do you mean like where the Republican governor of AZ, Jan Brewer cut medicaid to transplant patients, many of whom will die without their heart, liver or kidney transplants.
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Wing nuts like to speculate and fear monger about all the horrible things that will happen under the health insurance reforms. At the same time, they ignore the reality around them.

From Freakinpa’s article:
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“The cuts enacted in at least 46 states plus the District of Columbia since 2008 have occurred in all major areas of state services, including health care (31 states), services to the elderly and disabled (29 states and the District of Columbia), K-12 education (34 states and the District of Columbia), higher education (43 states), and other areas. States made these cuts because revenues from income taxes, sales taxes, and other revenue sources used to pay for these services declined due to the recession. At the same time, the need for these services did not decline and, in fact, rose as the number of families facing economic difficulties increased.”
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http://www.cbpp.org/cms/index.cfm?fa=view&id=1214
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So, please explain why 45 other states and DC are facing cutbacks due to Romneycare, Freak.
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Oh, I know, you’re going to call names and then do a victory dance with Rusty and 3X.
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Fun fake facts from freak foiled again.
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Aren’t you supposed to go offline or, as you said before, it is fate worse than the death penalty for you to not get slammed by the reality based community in Swampland.

Joe Klein:
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Aren’t both of you Kleins having a bit of fun with the math, here, albeit unintentionally on your part?
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Ezra writes:

Jon Kingsdale, who ran the new health-care market, notes that the lower-cost plans have been much more popular than the higher-cost plans. The bigger reason is that the individual mandate – plus the combining of individual and small firms in the same insurance market – brought healthier, younger people into the mix, which brought average premiums down for everybody.

Wow, that’s fantastic! Prices have gone down? For everybody? Amazing! What a policy miracle!
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And yet, there’s this strange situation also described by Ezra:

The state had, on average, the highest health-care costs before reform, and it has the highest health-care costs today.

Hmm…that’s confusing!
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So, how could these two things be?
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How could fundamental cost of health care –what insurance pays for– in terms of the prices of hospitals, prescription drugs, medical procedures, devices and equipment, diagnostics labs, etc continue to be the highest in the nation (and in the OECD world, actually), while insurance premiums’ prices were somehow reduced?
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Is something funny going on with the reporting of those numbers, or does supply and demand not have the same relationship to prices that we’d expect?
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And what does the “average premium” have to do with it?
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To answer the question of whether prices are going down for health care consumers, or whether we’re getting spun on a bad situation by smart folks who are invested in a policy, we’ll have to talk about the “average premium” and what that means.
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You might not be aware of this, Joe Klein (I’m assuming Ezra is), but “everybody” in the state of Massachusetts doesn’t actually pay an “average premium.”
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The “average premium” is a fictional premium that nobody actually pays, believe it or not. It’s an estimated number, not a real-world price tag on any actual policy.
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Here’s how it works: a statistician (or a math student) adds up all of the prices of every single policy, then takes the amount of policies and divides that summed price of all of them by that amount.
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So it’s TotalInsurancePolicyPremiumsInMass divided by TotalNumberOfPolicies. That’s how we get that “average premium” number.
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Do you see where this is headed, Joe Klein?
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Mass has expanded the pool of insured people to include people who wouldn’t have otherwise bought insurance because they’re generally very, very healthy. Then those generally non health-care using individuals have been sold policies that are almost a complete waste of money for them, but are much cheaper than the policies that are sold to people (older and sicker, usually) who actually use health care, and whose premiums therefore go up every year.
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So, because more people have been added to the pool, and their policies are cheaper (and largely unused in terms of claims), Mass can say that the “average premiums” were brought down “for everybody” even though the actual price of health care hasn’t been reduced for the vast majority of the insured who were paying premiums before the mandate was introduced.
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Let’s just take a theoretical case, in which the same claims are made about the “average price for everybody,” and we’ll see whether or not it’s actually an advantageous situation or not.
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Let’s say that Starbucks has been raising prices on their coffee for years, such that their normal consumers –people who work in offices, have families and are tired as hell every day– are paying more and more, something like $10 a cup per day, projected to rise to $40 a cup in ten years. As it happens, the prices of beans, paper cups, water and labor have been steadily going through the roof over the years, so Starbucks as an actual production reason besides paying shareholders dividends for these draconian price per cup increases.
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So now let’s posit that the DLC’s Progressive Policy Institute has a solution for this coffee cost curve: instead of having the government structure the market for what goes into each cup of coffee (beans, water, labor, etc.) so that the price isn’t wildly inflated, PPI declares that this sort of obvious solution isn’t “market-oriented” enough, and comes up with another plan.
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In our theoretical case, let’s say that this new, “modernized government” plan from PPI is a proposed law that mandates that children buy coffee from Starbucks. Also, that Starbucks has to sell kids a special, smaller and less-caffeinated version of their cup of coffee. PPI’s economists say that, if more customers are simply herded into Starbucks, the company should, in theory, reduce their prices for everybody.
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And so, let’s say that the geniuses who run our government are successful, despite enormous public opposition to such a proposal, in enacting into law the coffee individual mandate for kids. They call it “The Affordable Coffee Act” or “ACA,” and they proclaim it a “historic” political and policy success.
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Now, it takes a while for Starbucks to accommodate this new, artificially-created demand for miniature, kids-sized coffee containers and such, but eventually they make it happen, and so children everywhere are now buying smaller, cheaper coffee along with the adults who were purchasing their morning joe every day. The children don’t actually need any Starbucks coffee –they’re little kids with way more natural energy than office-working adults– but more coffee cups are being sold, and some of it is much cheaper than the java that was being sold before the law.
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Success! The most important, historic legislation since Johnson’s Great Society, say the DLC, the Democratic Party, Third Way, various columnists at The New York Times, various partisan Democrats, some pro-Administration bloggers, and, of course, The Progressive Policy Institute.
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And so it comes to pass that there’s some constitutional controversy about the ACA. A number of courts find the individual coffee mandate unconstitutional, Commerce Clause notwithstanding. Also, there’s that problem with people’s expectations of reduced coffee prices. The whole reason for “reform” in the first place was that the price of what Starbucks pays for was climbing through the roof. People hear talk of “historic victory” for the party who passed this new law, look at their own wallets, and are unhappy that they’re still paying what is now $12 a cup (the law took forever to get through Congress, even with a huge majority).
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What do the ACA’s proponents do about the situation? Do they acknowledge that this part of the law is bad, and that the mandate does nothing to solve either the problem of now $12 dollar a cup coffee, or the more important future problem of $40 coffee cups on the horizon?
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Of course not, this is Washington, where acknowledging elite failure is simply never, ever done.
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No, instead the ACA’s proponents make an interesting claim. They say:

“Look at the average price of a cup of coffee since this legislation was enacted. At first, there wasn’t much in the way of change. And, it must be acknowledged that the price of coffee is still too expensive for most people. But one can see that, over time, the individual mandate brought younger, more energetic people into the mix, which brought average coffee prices down for everybody.“

What did those smart folks just say?
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Did they just say that, even though us voters out here are still paying $12 per cup and rising, we’re somehow better off because children are now forced to buy cheap, worthless coffee, and that’s driven the average price per cup down for “everybody?”
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I would suspect that, in our theoretical case, at least, ordinary folks might eventually get a little upset with politicians who made that claim in public. And, when it becomes apparent that standing in line to buy what gets voters through their working lives every day will cost them $16 and then $18 per cup, that theoretical electorate might have some choice words for ACA proponents and their individual mandate, Great Society comparisons aside.
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You see, the problem with claims involving “average prices for everybody” doing down is that, in reality, we haven’t actually solved anyone’s problems, Joe Klein. We’ve just mandated that children buy cheap coffee, that’s it. Ordinary people can see this is the case for themselves, and don’t need a political-media class in the capital to explain it to them. It begets successful conservative arguments about “fuzzy math,” and then we start to experience public crises in confidence with all government intervention in the economy, even when it’s absolutely called for. Even when the bottom drops out, and there’s a great recession involving double-digit unemployment, people still don’t trust anyone in government to get anything right, especially the party that gave them a mandatory coffee law.
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And so many, many problems go unsolved, or are made worse by opportunists who take advantage of the bizarre, disconnected, bubble-bound, establishment elites who write authoritative-sounding praise of the “Affordable Coffee Act” that didn’t make coffee more affordable for ordinary people.
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Do you see which kind of people respond positively to such claims in the real world, Joe Klein, and which kind of people do not?
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If it were my political party which had done such a thing, and followed such poor policy advice from the ivory-towered ideologues at Progressive Policy Institute, I would start to think about how to get miles and miles of rhetorical distance between that party and the price of health care before 2012, especially when one of the policy’s primary detractors was my own President:
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http://www.youtube.com/watch?v=EoSnqofelsQ&feature=player_embedded

OBAMA: Let’s break down what she really means by a mandate. What’s meant by a mandate is that the government is forcing people to buy health insurance and so she’s suggesting a parent is not going to buy health insurance for themselves if they can afford it. Now, my belief is that most parents will choose to get health care for themselves and we make it affordable.
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Here’s the concern. If you haven’t made it affordable, how are you going to enforce a mandate. I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house. The reason they don’t buy a house is they don’t have the money. And so, our focus has been on reducing costs, making it available. I am confident if people have a chance to buy high-quality health care that is affordable, they will do so. That’s what our plan does and nobody disputes that.

Don’t you think it’s just about time for you to spend some quality effort examining what claims about “average premiums for everybody” actually mean for real people, Joe Klein?
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Isn’t it about time for you to stop apologizing for this dreadful spectacle “health reform,” stop justifying idealistic and unworkable “market-based reforms,” and get on to the task of stopping health care prices from literally bankrupting our country –however that policy goal can be accomplished?
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Shouldn’t we all just admit that an individual mandate in a state-based, anti-trust exempt, exclusively private marketplace that excludes the vast majority of policyholders is just as unrealistic, just as ineffectual as the individual coffee mandate in our theoretical “Affordable Coffee Act,” and move on to solving the problem, once and for all?
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Thanks for reading and considering this, Joe Klein.

Romneycare/Obamacare. It pisses me off to no end that journalisst and media types that want to be taken seriously cannot quit giving inane names to serious issues.
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Healthcare is this country is a serious issue involving a lot of money and most important peoples lives. But we can’t have an adult discussion about anything like this because we are so busy coming up with cute friggin names like all this is some sort of game where no one gets hurt.
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Stuart,
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Out of anybody here, you are the last one I would expect to ask for specific examples from, but, you did not say how much the minimum insurance covered in Massachusetts.
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I have a relative there, but he and his family are covered by his work with what might be called “Cadillac” health insurance and I don’t believe that he even sees the bill itself rather than just a part of his benefits.
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I would think that of the two main goals of national or, in this case, statewide health insurance are, to lower the costs per person through preventive medicine and detecting serious illnesses before they become expensive and time consuming (saving lost work time – not usually in the accounting since health insurers do not reimburse companies for a temporary replacement worker, etc) as well as spreading out the costs over the population so that the person unfortunate enough to have a long term, disabling and expensive illness that they will not, also, be hit with bills other than what they paid when they hadn’t sneezed for a year.
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Has the Massachusetts plan succeeded in protecting people from paying huge sums of money all at once for unexpected serious illnesses or is the cheapest insurance so flimsy that they end up being left with a huge stack of bills the insurance company will not pay?
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Please let us know about those cheap plans.

Thanks for reading and considering this, Joe Klein.

I think you probably lost him around page 12.
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FWIW, I enjoyed reading. Not sure I agree 100% with the complete uselessness of the ACA (actual, not coffee-related), but still a useful exercise in exposing some of the claims of cheaper for all. My question is how, after the debacle of the last 1.5 years, could it ever be possible to pass legislation that actually controls health costs? Seems anytime a plausible solution is brought up, 40+% of the senate comes down on the wrong side of the debate between “effective policy” and “distinctly American enough policy”.

Don’t forget Hillarycare!
And also never forget Calabresi’s statement (link) about what a joy it is for the chattering class to watch responsible policy being rebutted with posturing and namecalling.

Why is it only liberal things which get these nicknames from the supposedly liberal media?
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How about Bushwar for the war in Iraq?
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How about the Bushmeltdown for the financial meltdown?
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How about Bushscare for the color coded terror alerts?
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When Reagan had five years of boom times right after three years of recession and right before five years of recession, it was called “Reaganomics” but when Clinton lead us through eight years of growth, why was it not called “Clintonomics”?
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The “liberal” media does a great job of attaching great names to conservative ideals but moronic ones to liberal successes.

2thirdrocks,

If you think Mitt Romney renouncing his own health plan will make him a shoo-in for the Republican nomination, you are delusional.

Now Mittens may still win the Republican nomination, but it will be inspite of, not because of anything he says about Romneycare.

To renounce Romneycare may please the base, but it will alienate independants. Most people already believe that Romney does not stand for anything and believe he will say anything to get elected. Why would he renounce Romneycare and remind people he has no principles?

While he may feel the need to please the base during the Republican primary, assuming he gets the nomination, he does not have to “refudiate” anything. Afterall, are Conservatives going to go for Obama? I don’t think so.

Romney could try to explain why Romneycare is better than Obamacare, but it is a distinction without a difference. Besides, the right wing’s attention span isn’t that long. If he tries to explain the difference, he will actually sound intelligent, which we know the right wingers can’t stand anyone who takes more than 10 seconds to explain a position.

Better to Romney to portend to ignore the issue, if he can get away with it during the primaries.

I think you probably lost him around page 12.
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Hey, if I can get through it (and I did get through it) JK can get through it.

Romney is teabagging himself
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And though anatomically impressive, one really can’t respect a self-teabagger.

Very quickly to (Virtually Speaking Sundays starts in 5 minutes, digby and Susie Madrak are tonight’s panelists) patricksartor:
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To specifics:
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https://www.harvardpilgrim.org/pls/portal/docs/PAGE/MEMBERS/COVERAGE/MASSACHUSETTSHEALTHREFORM/MASS-HEALTH-REFORM-PRODUCTS/CC3913_PULSE_2000.PDF
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This is an example of the “Young Adult” plan, it’s got a $2000 deductible, and $5000 out of pocket max with an annual benefit max of $50,000.
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Everything except first three doctors’ visits (but no procedures or tests), allergy injections and emergency room care are subject to the deduct and co-insurance payments.
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It’s junk insurance, like McDonald’s employee insurance.
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If the average kid between 19 and 26 buys this and really has a problem, they’re broke.
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There’s a “Bronze” junk insurance plan, too.
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It’s really hard to get blind quotes on premiums for these plans from the Connector site, or from the participating plans, just like in NY.
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Specific policies aside,I’m sure that we can both agree that, if public policy increases the pool of insured by the young and healthy, and then insures those people at lower prices than the rest of the pool, it’s highly misleading to cast the “lower average premium for everybody” as a success.
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Must run, here’s the BlogTalkRadio link to Virtually Speaking:
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http://www.blogtalkradio.com/virtuallyspeaking

Pea-brained leftist moron Klein: “As well as a pragmatic liberal principle: the necessity for mandatory participation by all.”

“The necessity for mandatory participation by all”?

You gotta love the latest euphemism of the America-hating, totalitarian marxists, to wit: “pragmatic liberal principle”!

You vill participate, Ja! Or else.
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Forcing Free people to mandatory purchase something is a rather onerous proposition. Not a step forward for human rights.
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The vast majority of Americans oppose the mandatory participation law, with 68% against it. So, that leaves JK, Patty and the rest of the Swampland liberals in support.
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http://www.lenconnect.com/opinions/editorials/x493351170/Our-View-Health-law-mandate-answers-fall-short
“At its core, this dispute is not simply about regulating the business of insurance — or crafting a scheme of universal health insurance coverage — it’s about an individual’s right to choose to participate.”
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With those words last week, U.S. District Judge Henry Hudson called into question the effect of the health law’s individual insurance mandate on freedom of choice. The mandate forces each citizen to buy health insurance from a for-profit company, or face a tax penalty.
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The mandate, perhaps the most controversial feature of the new federal health care act, was ruled unconstitutional by Hudson in a detailed, 42-page decision. Not only did Hudson rule that the mandate exceeded Congress’ powers under the Commerce Clause, he also found its “penalty” does not meet Congress’ power to tax because its goal is not to raise revenue but to guide behavior.
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Then there is the slight problem of enforcement by the IRS. The exaggerated claim that there are 40 million uninsured includes 4 million that choose not to buy insurance and about 30 million illegal aliens that still won’t be covered by this terrible law. So for 6 million people we are going to step all over people’s rights, when we could just cover the 6 million. We do anyway, either through emergency room care, state funded healthcare, or other programs.

So, that leaves JK, Patty and the rest of the Swampland liberals in support.
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I take it you didn’t read my piece?

Thanks for share such nice information keep sharing.

centro salud murcia

“I take it you didn’t read my piece?”
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Reading is one of meltdown’s weak points. That is along with basic math, history, geography and reasoning.

“Then there is the slight problem of enforcement by the IRS. The exaggerated claim that there are 40 million uninsured includes 4 million that choose not to buy insurance and about 30 million illegal aliens that still won’t be covered by this terrible law.”
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The government statistics include illegal aliens?
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Link it or zip it.
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Under no circumstances that I know of do people who are not here legally fit into any statistics other than GNP and other things used by academic economists and never a part of government statistics since the government intends to and under Obama even more than Bush, deports illegal alliens.
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“In a bid to remake the enforcement of federal immigration laws, the Obama administration is deporting record numbers of illegal immigrants and auditing hundreds of businesses that blithely hire undocumented workers.
The Immigration and Customs Enforcement agency expects to deport about 400,000 people this fiscal year, nearly 10 percent above the Bush administration’s 2008 total and 25 percent more than were deported in 2007. The pace of company audits has roughly quadrupled since President George W. Bush’s final year in office.”
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So you are saying that the president wishes to provide health care while they are being deported?

Very useful analogy, stuart. I plan to use it if I ever meet another liberal in this part of my state.

Too many notes, Herr Mozart, too many notes….

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The vast majority of Americans oppose the mandatory participation law, with 68% against it.”
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“The law’s never been popular, with support peaking at just 48 percent in November 2009. Today it’s slipped to 43 percent, numerically its lowest in ABC/Post polling. (It was about the same, 44 percent, a year ago.) Fifty-two percent are opposed, and that 9-point gap in favor of opposition is its largest on record since the latest debate over health care reform began in earnest in summer 2009.

More also continue to “strongly” oppose the law than to strongly support it, 37 percent to 22 percent.

What to do about it is another question: People who don’t support the law fragment on how to proceed, with a plurality in this group, 38 percent, saying they’d rather wait and see before deciding on a direction. Among the rest, 30 percent would repeal parts of the law, while about as many, 29 percent, favor repealing all of it.”
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http://blogs.abcnews.com/thenumbers/2010/12/new-low-in-support-for-health-care-reform.html
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52% opposed!
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29% wishing for total repeal.
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Facts are important.

Stuart,
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Good Post
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Joe Klein agreeing with Ezra is just part of their Journolist brotherhood pledge.
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People like Joe and Ezra and our youthful and ignorant Patrick are prime users of the technique “Figures don’t lie but Liars Use Figures. Facts combined with omissions can be twisted to fit anyone point of view.
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Domestic policy is not JK strength.

“There’s a “Bronze” junk insurance plan, too.”

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But, but, but….
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They all have health insurance, stuart. This is the point of ACA / ObamaCare and RomneyCare, right? Our dear friends on the left can say to everyone, “see, we love you, we have provided 99.9% of all of our base of support with healthcare coverage”.
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In the Free Market, if a policy was truly good. Affordable, people would flock to buy it like a Zoo-zoo pet at the toy store. No individual mandate would be needed. It would be stupid for anyone to think they could go without insurance to protect themselves or their families.
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But, until the actual COST of healthcare overall is addressed. Until all of the fraud and abuse is addressed in Medicare and Medicaid. And, until a healthcare provider knows they will not be sued for everything they are worth is stopped, the cost of healthcare will understandably sky-rocket.
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Despite all of the socialized insurance plans put into place across the world by more progressive countries like Great Britain, Canada, Japan and others, costs continue to out-pace GDP so far as overall cost is concerned. If I only make $10 dollars, and the cost to provide my family health insurance costs $12 dollars. I am still in the hole. I have to make a decision to buy or not buy.
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Not until cost of healthcare is addressed in it’s entirety will this problem ever be solved. Not until people are educated fully about preventative care is completed and they buy into it with life-style changes will this problem be solved.
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As always demand exceeds supply. Prices are fixed on this one basic economic principle. As was earlier stated, the only saving factor for Government programs will be rationing and bogus junk plans. Make people think they have something which is worth something. Sell them the Mayberry life, and hope they do not do any research and find out they have been had.

Reform is certainly an important step in improving the medicare program. Thanks for sharing this new information!

8.1, in a word NO. If you can’t make your point in a more concise manner, I don’t have the time or the inclination to read paragraph after paragraph of you amusing yourself. Sorry.