In the Arena

Sanity on Obamacare

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Shawn Thew / EPA

U.S. President Barack Obama at the White House on Oct. 25, 2013

There’s been so much hyperbolic nonsense written about the Affordable Care Act that it’s hard to discern what’s really happening with this crucial new program.

But a terrific place to start is with two of my favorite young journalists — Ezra Klein and Ross Douthat. Ezra — who is still no relation to me, but a friend — does something courageous in the Washington Post: he writes about the other problems with Obamacare, in addition to the website issues. He also chastises fellow liberals who are saying that progressives shouldn’t publicize Obamacare’s travails. (I mean, it-ain’t-happening ostrichism worked so well for right-wingers when it came to shutting down the government, gay rights and a host of other issues.)

Douthat, who has become an indispensable conservative voice, does something courageous in the New York Times: he unpacks part of the conservative criticism of the ACA — that it was falsely sold by the President, that people will lose their existing plans — but explains that while some will have to pay more because of the law’s new parameters, they will be getting better health insurance and, in many cases, it will be cheaper because of the government subsidies. He allows the unthinkable: that the ACA might work. (Douthat has favored universal health insurance in the past.)

For the record, I hope it does. I’ve been critical of the Obama Administration’s slack-to-the-point-of-incompetent management style in the past — and the disastrous rollout of the health plan is dispositive confirmation of that. (If nothing else, this should convince the President to amp up the management aspects of his Administration across the board.)

But the importance of this program should not be lost in the Administration’s failure to implement it. This is not health care for deadbeats, as many Republicans assume. It is a highly moral piece of legislation: the people most affected will be the working poor and lower-middle class, people who have jobs, often at small businesses, but don’t have health care. (The unemployed and unemployable poor already have health care via Medicaid.) It is a matter of simple fairness that if we, as a society, provide health insurance to those who don’t work, we also provide it to those who do.

This has been part of my mystification with the Republican opposition to this program: they supposedly want to encourage people to work. The ACA, if well implemented, will do that. Another part of my mystification: this is not socialized medicine, as the Republicans charge, but health care via a regulated market system — the health care exchanges, if they’re ever straightened out, will be online health care superstores (think Orbitz or Hotels.com). Various private insurers will compete for customers … with new, more humane ground rules. They’ll have to take all comers, including those with pre-existing conditions. This, too, is a very Republican idea — the idea of health care exchanges was born in the very same Heritage Foundation whose Heritage Action Fund is now trying to kill the plan.

Does Obamacare need to be changed or modified? Absolutely. It would have helped if the Republicans had participated and insisted on medical malpractice reform — Obama was willing to negotiate on this — and on perfecting the market aspects of the program.

In the end, the ACA may not work. The various interest groups — the hospitals, the doctors, the insurers and, yes, the trade unions who limited the ability to make gold-plated health plans eligible for taxation — may have crippled this bill beyond feasible implementation. If that happens, it will be a tragedy. The bottom line is this: the working poor, the small-business owners and the self-employed deserve affordable health care.

So let’s all calm down a bit, listen to voices like Ezra Klein and Ross Douthat, and see if the Administration can get its act together and make this work.

203 comments
dhovgaard
dhovgaard

If the ACA is really going to crash and burn why don't it's opponents just let it happen instead of trying every trick and dodge to prevent it from being implemented? If their predictions come true they will be able to use the failure of this law to beat the democrats with during the next election cycle. The problem however is that they know that a year from now all the problems with the roll out will be forgotten and all the hysteria fomented by the corporate media will fall by the way side and the law will be a net gain for the democrats and an absolute disaster for the party that opposed it.

Xion
Xion

It does not matter how unaffordable or unretainable this law is or how untrue the selling points, unrelenting progressives will never falter nor waiver in their support for this unprecedented suspension of reality.

betherzilla
betherzilla

Meanwhile, we need to be alert to find whatever may be true amid the 'hyperbolic nonsense; otherwise we have no clue as to what needs to be fixed in the law (aside from the website that is).

tfcoleman1
tfcoleman1

The hyperbolic nonsense is a result of all or nothing policies by the political parties, especially by the GOP. If we didn't have such dysfunction in Congress, we could work through these issues and improve the ACA. A strong majority of Americans were and are in favor of healthcare reform.

T.P.Chia
T.P.Chia

It is true that there has been " too much hyperbolic nonsense written about the Affordable Care Act".  In fact, the conservative Republicans have manufactured many distortions and lies against it, saying "Obamacare is hurting millions of Americans, and is an impediment to economic growth". 

The fact is that the ACA is what America needs in order to better serve her people, including the working poor, small business owners, and the self- employed.  America is far behind many European countries in providing universal health care. And the American government has the duty and responsibility to assist those who are unable to afford health care insurance.

It is true that health insurance cost may go up for the high-income group, the business corporations, and government subsidies for the low-income and unemployed would be a fiscal burden, but the ACA would make American a more humane and equitable society.

America and the American people deserve the ACA.  And if the American system of democratic government is to be meaningful and respectable, everyone needs to play a positive part in making it so.

evan13579b
evan13579b

Defining communism or "to each according to their need" as moral is evil and stupid. People have not earned just because they need. Note: its extremely easy to need. Anyone can do it. And anyone can put themselves in a position to need.

You define "giving away other people's money" as moral so that you can derive social capital. Nothing is at stake for you there because you know your job relies on you being liberal and you cannot singlehandedly stop the socialism. So you instead try to get something from it with the absurd proposition that by offering up other people's money you are being moral.


I suppose that getting someone else to do my homework would make me studious! Generosity is really easy in liberal land as it merely corresponds to advocating someone else to give money to the poor.


AlphaJuliette
AlphaJuliette

It's a bad bill/law.  Since it wasn't of a true bi-partisan genesis it doesn't reflect the full spectrum of valid concerns and issues.

I personally favor a single payer system and would be happy to pay a little more in taxes IF those funds were going to be dedicated to such a plan.  But, since tax increases are anathema to the Republicans and since the ACA is a poor law off to a horrible start and is gaining more opposition daily, we should simply consider that we won't address adequately the serious health care insurance and care provider issues this country faces,....among a host of others.

You can thank your dysfunctional congress for that.

orThatGuy
orThatGuy

So moral legislation is ok now or is it only the morality that you agree with?  Can I assume then that you support the moral legislation that prevents the murder of an unborn fully formed child that thinks and can feel what is happening to him or her? 


And since when to we legislate fairness?  I guess that is moral too right? 

MichaelStephenson
MichaelStephenson

Stupid RACIST Conservatives: 

"You can keep your plan. Period. No matter what."  does not mean what you seem to think it means. It means what Obama's surrogates want it to mean. 

Repeat after me: Obama did not misrepresent the ACA. Obama did not misrepresent the ACA.

Obama wants what best for the country and would not lie. Period. No matter what.


justopin
justopin

Moral legislation?? From the  party that supports killing a million babies annually---that is rich!

MichaelUrbanek
MichaelUrbanek

The willful ignorance of so many unsavory aspects of Obamacare make the claim of 'morality' of the legislation laughable. Another case of liberals wanting to be judged by their intentions, instead of by the calamitous outcome of their meddling.

Jokin' Joe, you're a riot.

paulejb
paulejb

"CBS: Millions of cancellations and skyrocketing costs the big problem of ObamaCare"

"For many, their introduction to the Affordable Care Act has been negative: a broken website, and now cancellation notices from insurance companies followed by sticker shock over higher prices for the new plans. It’s directly at odds with repeated assurances from the president, who has said “if you like your insurance plan, you will keep it. No one will be able to take that away from you.”

But people across the country are finding out they’re losing their existing insurance plans under Obamacare because requirements in the law, such as prenatal and prescription drug coverage, mean their old plans aren’t comprehensive enough.

In California, Kaiser Permanente terminated policies for 160,000 people. In Florida, at least 300,000 people are losing coverage."

http://hotair.com/archives/2013/10/28/cbs-millions-of-cancellations-and-skyrocketing-costs-the-big-problem-of-obamacare/

If they ever fix Healthcare.gov it will reveal just how bad ObamaCare really is.

mary.waterton
mary.waterton

http://www.cbsnews.com/8301-505263_162-57609534/policy-cancellations-higher-premiums-add-to-frustration-over-obamacare/

>>>>>

That includes 56-year-old Dianne Barrette. Last month, she received a letter from Blue Cross Blue Shield informing her as of January 2014, she would lose her current plan. Barrette pays $54 a month. The new plan she's being offered would run $591 a month -- 10 times more than what she currently pays.

Barrette said, "What I have right now is what I am happy with and I just want to know why I can't keep what I have. Why do I have to be forced into something else?"

According to HealthCare.gov, Barrette is eligible for some subsidies

<<<<<

destor23
destor23

Douthat is not a reporter.

mantisdragon91
mantisdragon91

The good news is that the website will be fixed withing months if not sooner. It will take years if not decades to fix the GOP.

brucelanc
brucelanc

So, you say don't stick your head in the sand... and then the rest of the article is about sticking your head in the sand and giving blind trust that it will all be fixed and the liberal nightmare will be over.  Huh.  Far out.  --  I think the next time I get that time magazine renewal notice, I'll do the same.  I'll ignore it until they quit sending me magazines.  By then, I'll have forgotten all about it.


thanks for the convoluted advice, I guess...

edwardsmythe1970
edwardsmythe1970

Completely agree.  Would just hope that the Administration would have the courage to call it what it is - extending insurance at discounted rates to people who cannot afford it, and funding it through higher premiums on others, forcing people to take out insurance who would otherwise have opted out, and providing a major windfall to insurance companies in terms of new customers and revenues.  Then society can rationally debate which of the three options is better:

- the current model that supposedly preserves the "free market" and does not work for anyone, but keeps taxes low

- the Obamacare model that depends on market distortions to achieve a noble goal

- a single payer system (as in Canada) with a parallel private system (as in most of Europe) that leads to higher taxes but achieves the objectives through a simpler system that does not involve enriching insurance companies, hiring thousands of bureaucrats, and forcing people to buy a private commercial product.

It really is an easy choice, IF America can get past its semi-literate "debate" run by the extremes on either side and funded by special interests.


fore
fore

mandate is to get everyone to sign up no freeloaders  otherwise as yo know people will take there chances and it will be on your dime to pay for those freeloaders 

AriBenDavid
AriBenDavid

Obamacare is essentially the same as Hillary care. The attempt to keep all insurance companies alive results in a baroque monstrosity. Apparently this country has become -- not a democracy, not a republic, not a monarchy, but a lobby-ocracy, where nobody's business can be impacted by new laws. It reminds me of the boat in a C. S. Lewis novel where they tried to keep everything aboard, including a dragon that would not fit even when wrapped around the planks.

raidx259
raidx259

Not when you make it a mandate and fine people for not participating. If ACA is so just and so needed by the working class, why put the threat of financial penalty?


JonathanSchick
JonathanSchick

This is an interesting article that brings up many points past the problems with the website.  I work for a company called ElectiveRx and we provide affordable coverage that qualifies under Obamacare. Many businesses we talk to are worried about the website and the affects the ACA will have on their business. Everyone needs to do a cost benefit analysis and decide what is right for them.

kajala
kajala

If you want pure market based approach: Insurance is terminated when you reach age of 65 (it doesn't make any commercial sense to insure old people). Then in hospital your treatment stops when you run out of money (this happens in many developing countries every day). Also, all pre-existing conditions will prevent you from having an insurance. If you want anything else than this, you're looking at government messing with things. If you don't believe me, go to any developing country (which has more free market wrt insurance) and try getting a health insurance with pre-existing conditions or if you're over 65.

CarlLegg
CarlLegg

Joe, it's beginning to look like we have a problem with many of the promises of Obamacare. If a significant number of young, healthy don't sign up soon, the cost overruns will be unimaginable. 

And from what I'm reading, the promise that "you can keep your current doctor" may not always be true. 

Bottom line, if they can't fix the website in a few weeks, Obamacare is DOA.

La_Randy
La_Randy

 Twain wisdom


by digby

A little wisdom from America's greatest writer:

That awful power, the public opinion of a nation, is created in America by a horde of ignorant, self-complacent simpletons who failed at ditching and shoemaking and fetched up in journalism on their way to the poorhouse.
- "License of the Press" speech

JimmyDemello
JimmyDemello

We don't want "government subsidies" you dork - we don't want anything from a government that just wants to control us. We can take care of ourselves.

AlphaJuliette
AlphaJuliette

@T.P.Chia There is a lot in your post that I like and agree with.  However, my personal feeling is that the ACA is an ill considered law and will hurt many people.  For instance, if I didn't already have a great and affordable health care plan I would be forced to buy into a plan that would equal a house payment with high deductibles and out of pocket expenses. It would be much much more expensive and provide far less coverage.  And I'm not alone.  We are hearing more such stories as time rolls on.  And, even though I have an insurance plan I'm wondering how it's going to be affected and what is in store for my and my family.

The impact to business isn't good either.  The government is going to charge $63 per person in the first year for every person they currently cover under an employer sponsored plan.  For some businesses this won't be a real problem.  For larger ones it will be a significant and unexpected charge to their cost of doing business.

The tax on medical devices just makes no sense what so ever.  Why tax something that is beneficial overall to the health of the insured?  Same goes for the Cadillac insurance policies.  Why punish those that can afford the best coverage?

The intent of the ACA is understood.  The unintended consequences of such a plan are not and it will fail under it's own weight.

AlphaJuliette
AlphaJuliette

@evan13579b I find the requirement of We the People being forced to buy something we either can't afford or don't want to be disturbing.  Even with subsidies the premiums could be too expensive.  But we have to buy in anyway.

Not good on the most fundamental of levels.

Openminded1
Openminded1

@MichaelStephenson Is that because you say so Mike? Obama has lied about many things, even his true religion that he still tries to keep under raps. He is not the savior you think he is. he also a racist, a quiet under cover racist but a racist.

ThomasDeCive
ThomasDeCive

@MichaelStephenson 

Bizarre Fascist little "Progressive"....a perfect example of the Looney Left.

Your post would be funny if the subject wasnt so tragic.

Obama lied.Period.

He said you could "keep your plan" if you liked it....what part of that is now...."does not mean what you seem to think it means"?

FAIL

Further, your little "Repeat after me: Obama did not misrepresent the ACA. Obama did not misrepresent the ACA." shows you for what you are....a brain washed cult follower in dire need of a severe psychological deprogramming effort.

Openminded1
Openminded1

@paulejb Yes the poor girl was in tears, people messing with her like it was her fault,Morons

SpikeLee
SpikeLee

@paulejb Conservatives like having inferior health care so that there payments can be denied?

paulejb
paulejb

@mary.waterton 

But Dianne should be thrilled that she will now have the ObamaCare coverage for free birth control, pregnancy and mental health care.

PaulDirks
PaulDirks

@MichaelWood In every case the coverage being dropped fails to meet the minimum requirements of the new law. In other words they are Rip-Off policies. 

But then again selling snake oil is a grand American tradition.

Openminded1
Openminded1

@mantisdragon91 This from the king of Libs, Obama and the dems are never wrong to this moron. they always have excuses when a dem screws up. Hey mantis I see many dems are leaving the ship and its captain.

lovism
lovism

@brucelanc Not sure how it is the same thing. His criticism of those sticking their heads in the sand is reserved for those IN CHARGE who are able and should do something about it but chose not do and stayed in denial. His (seeming) advice of sticking one's head in the sand is for YOU: that is, stop believing in the hysteria and lies and have a little trust, even though I don't even see how it can be qualified as sticking head in sand. Because, honestly, on your (and my) part, if you don't trust them, what is there for you to do? despite all the republican rhetoric, can you make everything work by yourself? Can you actually say you trust the government-free, laissez-faire market more? Leaving healthcare completely into the hands of private insurers? 

tom.litton
tom.litton

@edwardsmythe1970 In my opinion those 3 options were debated.

Democrats rejected option 1.  They have been trying to achieve universal healthcare for decades. 

Republicans rejected option 3.  They don't want the government providing healthcare. 

Option 2 seems like the best of both worlds, which is probably why it was originally championed by republicans and implemented by a republican governor in MS.  

It is, in my opinion, how all problems should get solved.  Democrats want to help those in need by doing X, and republicans lay out how to achieve X with limited government resources. 

Another example:
Democrats:  It would really help the economy if we could rebuild some of the broken infrastructure.  Why don't we dedicate a few billion dollars towards that?

Republicans:  Why not an infrastructure bank?  That way we can use private funding with limited government funding to achieve the same result.


Unfortunately, the current group of republicans refuse to even work with the democrats on anything.  Which is a shame, because the only way to make progress now is to hand complete power to democrats (note:  it's extremely unlikely republicans will gain any real power, at least for the next decade or 2).

shepherdwong
shepherdwong

@AriBenDavid"Apparently this country has become -- not a democracy, not a republic, not a monarchy, but a lobby-ocracy..."

Keep it simple, Ari. It's an oligarchy, plain and simple.

tom.litton
tom.litton

@raidx259Because of this:

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

It's in everyone's best interest if they can get healthcare (via insurance) whenever they need it (ie pre-existing conditions).  But in order for that to work, it requires nearly everyone to get insurance, regardless if they need it or not. 

From the perspective of everyone as a whole, it's best if everyone gets insurance, so companies can cover pre-existing conditions.  But from the perspective from an individual, it's best if everyone else gets insurance, so i can get insurance later if i need it.  Hence no one will get insurance (even if everyone agrees it's best if everyone gets insurance) without being compelled to.

lovism
lovism

@raidx259 because not every one understand that it is just, and they are not concerned with the universal fairness of it. What they see is why they have to sign up for the benefits of someone else, but what they don't understand is their act of signing up has the effects of making the entire system better for EVERYONE including themselves.

You have to put in certain incentives/disincentives. It's economics, and in economics you can't just sit there and say oh it's good so people should do this or that. 

JeanLudvigsenBinder
JeanLudvigsenBinder

@CarlLegg Sounds like you are rooting for collapse.  Though I suppose these could be real fears - if you haven't been able to get insurance.  IF so, take heart, you can just call the toll free number and they'll fix you right up.

edwardsmythe1970
edwardsmythe1970

@JimmyDemello The people in America who scream the most about not wanting anything from the government are statistically most likely to depend on redistribution in terms of infrastructure, public transit, social services (such as police, EMT, fire), etc...  If you want a country with no "government subsidies", go see what Somalia is like this time of the year.   

JeanLudvigsenBinder
JeanLudvigsenBinder

@JimmyDemello  Don't presume to speak for others.  Many of us do not need or want subsidies but understand that there are Americans who are uninsured and need to receive them in order to become so.

zaster
zaster

@JimmyDemello As long as you don't use freeways or airports or water from your tap. No smallpox or polio vaccine for you either. And if any NIH affiliated group ever discovers a cancer cure, please promise you will not use it, should you ever be diagnosed with cancer. You can, after all, develop your own cure for cancer, right? And build your own highways?

orThatGuy
orThatGuy

@PaulDirks Obama didn't say you could keep your plan if we deem it to not be a "Rip-Off" policy.  He said if you like your plan you can keep your plan.  

Choosing a plan that doesn't cover maternity care when you are not planning to or done having children is not being duped into a "rip-off" policy.  Nor is choosing a plan that doesn't cover substance abuse when you've never had a drop of alcohol or tobacco in your life.  Those are only two of the things that make these now cancelled plans "rip-off" policies by being mandated by the bureaucrats that you apparently think are smarter than the people making their own decisions.

FrancineBowman
FrancineBowman

@JeanLudvigsenBinder @JimmyDemelloYes Jean and now there are a whole lot more without insurance.  Obama flat out lied. 

 100's of thousands are being dropped.

 “First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan.  Nobody is talking about taking that away from you.” 

raidx259
raidx259

@zaster Everything you mention is elective. I can choose not to use freeways, or use the airport. I can choose not get vaccinated. ACA shoves its mandate down your throat or you get fined. That's the real problem I have with this. If ACA is so great, why institute penalties? Why, because if they don't force it on you under threat, it will not gather the necessary amount of participants. And they know they won't. 


tom.litton
tom.litton

@raidx259 @zaster An you can choose not to use your healthcare.  You still have to pay for it, like freeways and airports.

lovism
lovism

It needs penalties because of people like you, who doesn't think you should do anything for the good of anybody else. The premise of insurance is very simple, go and read a basic knowledge of it. The bottom line is, do you want good healthcare? with people like you, you yourself will end with no healthcare, you understand?

shepherdwong
shepherdwong

@raidx259 "I can choose not to use freeways, or use the airport..."

Really? Clearly then, you're going nowhere. And you'll starve while you wait.