Obamacare false promise could be biggest political blunder ever…

November 18, 2013

Sometimes someone says or writes something that I just can’t put into my own words better (well quite often), so with that in mind I just have to dash off this quotation ripped right out of an article in the Huffington Post, with attribution following:

“The ancient Greeks liked to say that character is fate. The colossal mess that Obamacare has become reflects both the character of the legislation and that of the president who sponsored it. The Affordable Care Act, as a government mandate for people to purchase private insurance with an array of possible subsidies, had too many moving parts. It was an accident waiting to happen. As many of us wrote at the time, Medicare for All would be simpler to execute, easier to understand, and harder for Republicans to oppose. But this was not to be. Instead we got a program that was poorly understood by the public because it was almost impossible to explain and even harder to execute.”

Those words were written by Robert Kuttner, co-founder and editor of “The American Prospect”.

I have not even read the entire article. I am going to in a minute and then later add to this post. I still have hope for Obamacare at this time but continue to be amazed at its poor implementation and sometimes ask myself: “what were they thinking?” And I am glad to hear that others were thinking: “why not Medicare for all?” (well, I actually have suggested an expansion of Medicare for those who could not get insurance any other way).

And now I will finish that article…

Well, that was quick. I read it and it was interesting. If I interpreted it correctly on first read I think one of his points in the body of the piece was that comparing Obamacare to the success of Social Security and Medicare was not an apt comparison because the former were public public, while the latter is something called private public, in that Obamacare is a partnership and really a subsidy to the private insurance industry.

And in my own words I would say that, yeah, private enterprise can be more efficient at times (and maybe most of the time), but it has to stand on its own two feet and be private.

And I am tired of writing about Obamacare and will move on to something else soon.

Okay, one more thing: if Obamacare falls, it’s death knell will have been the cancellation of private insurance policies despite the claim by Obama that such would not happen. It does not matter if it is only a relative minority that affects or whether in reality they could get better and more cost effective insurance via Obamacare. The argument that Obamacare would destroy private insurance, would be a government takeover, a move toward total socialism, was one of the primary weapons Obamacare opponents have used. They have to be overjoyed that in some instances their projections seemingly are coming true. This could go down as the biggest blunder in politics ever. If the Republicans did not have so many crazies in their party, they could already count on total victory. And they might wise up and clean house yet.

P.s.

Here is a link to the full Kuttner article: http://www.huffingtonpost.com/robert-kuttner/obamacare-republicans_b_4293314.html

P.s. P.s.

And to add insult to injury here and through the magic of the computer I go forward in time from when this post was originally posted to now on 11-19-13. I just read a CNN story that says that President Obama cited an Affordable Care Act success story involving a woman in Washington State. But then, and we go to the story:

From CNN:

But in the days that followed that presidential shout-out, Sanford received letters from Washington state’s insurance exchange, notifying her she did not qualify for a tax credit she was originally told she would be getting.

After looking into Sanford’s matter, officials with the exchange admit they made a mistake calculating her benefits, along with those for thousands of other Washington state residents.

“The Exchange would like to sincerely apologize to Jessica Sanford and all those affected in Washington State by this error,” Washington Health Benefit Exchange CEO Richard Onizuka said in a statement provided to CNN.

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All ills or changes in the health care market blamed on Obamacare; free market is great but does not work for everything…

November 14, 2013

I did not watch the president on TV this morning announcing possible changes to his Obamacare but of course I am familiar with the whole story.

Here’s what I think. The free-market conservatives are right in that you don’t want the government trying to take the place of the free market. You really cannot have a free market, capitalism at its best, when the government steps in to run things.

But the free or open market does not always fill the need. If people cannot afford something they really need, such as health care, the market itself is not going to be there for them. So the only choice left without government health care coverage is to cut back on one’s health.

So sometimes the government does step in. That is why we have Medicare, for instance. If the marketplace simply took care of that we would not have Medicare.

Obamacare actually uses the open market with its health care exchanges, but our whole health care/insurance system is highly complex and convoluted. It just evolved that way.

Opponents of Obamacare, or technically the “Affordable Health Care Act”, started their propaganda war early, before it became law, and have been inundating us ever since. A lot of people have no idea what Obamcare is about or what it intentions were, they just know from all the propaganda that it is bad and if they have any problems with health insurance it’s because of Obamacare.

And there is no doubt there is mass confusion out there. And to some extent I am sure that Obamacare has caused problems for people. But I also can see that just the word “Obamacare” is thrown around by people trying to explain away things, sometimes out of ignorance, sometimes laziness, and sometimes malice. I know someone who was told she could no longer use the free health clinic she had been using. She was told it is because she is on Obamacare and they don’t take it.Come to find out it was because she did not qualify because she had moved and lived in a different county. She is not on Obamacare anyway.

Another woman I am somewhat acquainted with was told she could no longer get a medicine she had been taking because she is now on Obamacare. But as far as I know, she is simply on Medicare (which is not affected by Obamacare), and that is not Obamacare. Now there could have been changes in her Medicare, but she is still being misled.

At my own doctor’s office I was asked to sign a notice about some new policy. When I asked what it was all about the receptionist said: “it’s just an Obamacare thing.” Actually I don’t think it was. I think they were simply telling me that they would no longer handle Medicare Advantage plans, which were initiated under the George W. Bush administration (No problem to me. I am not on that). According to a Medicare website (not the Obamacare website), Advantage plans are still acceptable under the new law — but apparently not at my doctor’s office.

That is not to say that Obamacare is not messing some things up. I am not sure but whether I may be affected. I’m going through some changes right now in my own health insurance situation and I have that on my mind. I should know, but to tell you the truth, reading through and trying to understand health insurance material is almost or maybe worse than having a root canal as far as I am concerned.

I have an appointment to see an insurance agent today. I am dubious about it. I have talked to him and others previously. I never do understand them. I don’t care what anyone says. Health insurance is not simple to understand. There are all kinds of limits and exclusions (notwithstanding Obamacare’s abolition of exclusions on pre-existing conditions), and percentages from this to that on one end of the bill and that to this on the other end of the bill, and coverage of some doctors and facilities and not others (and if you are really sick you often don’t have any way of deciding who takes care of you at the moment, especially if you are stuck in a hospital bed, and yet you can be told that one of your providers was not on your health plan). I mean why can’t we just be covered no matter what?

Personally I don’t think the profit motive is good for health care. But the reality in this country is that is our system and I don’t think we are going to change it.

I think the president has good intentions with Obamacare, but I am sad that he and his administration have bungled it so badly so far. If they don’t rescue it soon they will have not only ruined Obamacare but any chance of health care reform in the foreseeable future.

The Republicans are wedded to the profit motive. While they may or may not want a system where all get some kind of protection, their first priority is to protect profits.

Many people identify with that because they abhor or fear socialism. But some at least mild forms of socialism have been with us for a long time — Social Security being a prime example. If the free market could take care of everything we would not have Social Security.

I believe wholeheartedly in free markets, in capitalism. I also believe that the market does not work in some limited areas.


I’m trying to understand, but Obamacare becomes more confusing to me…

November 9, 2013

This Obamacare thing gets more confusing all the time. Now a story I read said that in some states that have opted out of Obamacare the working poor are caught, well just like they always are, with too much income to get help and not enough to purchase health insurance on the open market.

I had thought that although the Supreme Court had ruled that states could opt out, the federal government would somehow step in with expanded Medicaid offerings, but I guess if the state’s refuse that does not happen.

It’s really all very confusing. It’s like the message one Obama disliker acquaintance of mine (hate is an ugly word) sent me that showed Nancy Pelosi’s famous “we have to pass it to see what’s in it…” line concerning the Obamacare legislation and a doctor’s purported retort: “that’s the definition of a stool sample”.

I have been trying my darndest to give Obamacare the benefit of the doubt — but I’m having doubts.

However, I am pretty certain there are bogus or misleading stories galore about people losing health care coverage over it, well, even though President Obama now has apologized to any who have actually lost coverage, being as he spent a whole campaign promising that no one would. Starting his presidency with apologizing to the world for George W. Bush (and others) and now this, he may go down in history as the “Grand Apologizer”. And I really want to like him.

A long time ago I promised to read up on Obamacare. I failed in that. I am not going to apologize, though. I mean if those who passed it into law don’t understand it, I doubt I could.

There are some big positives in Obamacare, such eliminating exclusion of coverage based on pre-existing conditions.

And this law, this new way of doing health care coverage may well work out, but it is not having an easy run of it in the early going…

——————————

What follows is my previous post on health insurance:

Talking about health insurance, here’s one down and dirty:

For the second time in my life I face this dilemma:

I’m having to take some time off work due to health reasons. Problem is, my health insurance is tied to my job. I pay part of the monthly premium and my employer pays the rest. But if I can’t work my employer will drop my insurance because I will not be contributing anything from my paycheck, which I won’t be getting because I am not working. I can elect to pay the full premium myself but how am I going to afford to do that if I have no income, save for a woefully minimal one I might get on state disability (where I live, California, at least we do have disability insurance)?

Once before I was faced with this. But at that time I was in a job where my employer paid all the premium and continued to do so for more than a year that I was off work (that is not usually the case, though). Eventually, though, I was faced with the same dilemma I am faced with today. But as you can see, I survived. It helps to have family, and it helps to be on good terms with them.

Now don’t worry about me. I’m just using this as an example as to what is usually the case. I mean you have insurance through your job but when you need it because your are sick or injured and cannot work, you lose it, or are liable to, because now that you are not working you can’t afford to pay the premiums.

(And I am not addressing on-the-job injuries and worker’s comp. That is another issue.)

Having your health insurance tied to your employment is absurd, especially these days when so much employment is precarious due to the economy and all the constant changes and upheaval brought on by globalization.

To me, that’s a good argument for single-payer government health care. Of course it would not be free. It never is. But all of us pooling together and guaranteeing each other permanent coverage no matter what our current employment status is would seem to be far more practical. Oh, yeah, no one wants to government to run his or her health care because you can’t make our own decisions and government is not efficient. Well how many decisions do you make now? The private insurance companies make the decisions even more so than the medical professionals. And private insurance has to make a profit so it has to charge a lot more.

And all of this is not about Obamacare. I don’t know what to think of that. It may be a step in the right direction, albeit a clumsy one so far.

Personally I am not in any kind of crisis now. I was just using my own plight to make an argument or comment. I don’t want to go into my personal situation any further, other than to say I am still covered and have options.

From what few comments I have heard from just regular people, one of their main objections to Obamacare or any attempt at government health care is centered around having to pay for those who refuse to work but yet expect the government, and thereby the taxpayers, the working people, to pay for them.

Well here’s the deal. There will always be freeloaders and cheats regardless of the system. We need to strictly enforce eligibility standards. No able-bodied person who simply declines to work should get full coverage. We are always going to provide emergency coverage because that is our moral imperative.

We will likely have to let Obamacare play out. If the Obama administration does not get its act together it might die, but it can likely be made to work. But this deal of having your health insurance tied to your job is silly. I am surprised employers are not more in favor of unburdening themselves from it.

Hey, good health.


Despite dubious start of Obamacare, it will likely be taken for granted soon enough…

November 1, 2013

For sure Obamacare has had a dubious beginning. From all reports it could hardly be worse. And yet I have a hunch over the long run, and not all that long of a long run (a year or two), it’s going to work out fine. I’m not saying people will be singing the praises of the Affordable Care Act, that is Obamacare. Actually I imagine if it does what it is supposed to do people will just take it for granted. They will take it as their sacred right and move on to some other bitch about what’s wrong with this country.

It is perplexing that the Obama administration so savvy in using computers for campaigning could fail so miserably in setting up the computer websites for the health care exchanges. They touted them so loudly and when they were finally put into operation people were left out in computer limbo or Catch 22. On the one hand, they are told they must have health insurance or be fined, and on the other hand, they either could not even get on the website or could not navigate it successfully. And sometimes the sites just crashed.

They’re being promised that everything will be fixed by the end of this new month (November). Problem is the credibility of the administration is in doubt these days. How may times did you hear the President say “If you have a health insurance policy you like you can keep it.” Apparently that was misleading at best. It turns out in many cases insurance companies are dropping their old plans, in many cases because they don’t meet the requirements of the new health care law. And there are at least anecdotal reports of people with individual policies facing major boosts in their premiums, supposedly due to Obamacare.

But really all of this has to play out. I think the administration is trying to convey the message that regardless of what might be happening with old policies, in the future with this new law there will be total availability to everyone for health insurance and there will be a much wider variety of options to choose from. And for those who cannot afford insurance there will be a government subsidy. The government already was taking care of the poor, but a lot of people fell between being considered in the poverty class and being slightly but only slightly above that and thus not qualifying for government assistance.

And correct me if I am wrong here, but most of us don’t even have to do anything under the new law (Obamacare). If you have insurance through your work and your employer will still offer it (and that is a question for some, perhaps) then you don’t have to do anything.

Will your insurance from work become more costly? Unless you are one of the few left whose employer pays the whole premium I imagine so. But that has been at least my experience for a long time. Each year my premiums go up and the coverage is somewhat less.

(I hate to even think about it, but some time ago I had a job where the employer paid the whole bill and the insurance was great. I used much of it to fight a bout of cancer. But due to circumstances beyond my control I no longer have that job. But as I understand it, the employees now have to kick in some for their insurance, but I’m sure it’s still good.)

I think the interesting thing to be seen in all of this is will be costs of health care somehow be brought into line. Right now they operate in some kind of never never land, not a real market place. Due to the nature of health care itself it cannot be simply sold on the open market under the same economic rules as most commodities or services. And there is the moral imperative that everyone has the human right to it (from the Republican presidential debates in the last election I realize not everyone agrees with that moral imperative. I’m sorry for that. Well of course not everyone believes in God, mercy, and human dignity either).

However, there does need to be some controls on the amount of care we offer individuals who on their own free will choose to live risky life styles, such as smokers, heavy drinkers, or those who refuse to wear motorcycle helmets. The rest us will continue to pay the tab for many of those people because they often lack resources.

The provision in Obamacare that prohibits people from being excluded from coverage for pre-existing conditions is a boon to the consumer. And so is the one that allows parents to keep adult children on their plans as they finish their schooling.

I don’t think the Republican Party has made much headway in its fight against Obamacare, despite all the noise. It would do better to suggest constructive fixes to it and move on to some other area where it might excel.

Come to think of it, the greatest enemy to Obamacare might be the Obama administration itself. Let’s hope it gets its act together.


Wary of dealing online for Obamacare, insurance people not fun to deal with, how much can government really regulate health care in a free market? Obamacare is the law and will likely succeed…

October 1, 2013

This is just one man’s experience or one disgruntled customer or potential customer’s history, but I am wary of dealing with the health insurance exchanges– but probably in my own personal situation I will not have to — not sure.

But my experience with insurance people (for the most part, not always) is that they don’t always understand what they are selling you. They sometimes brush over things or throw big voluminous books or pamphlets at you, telling you it’s all in there. If you ask questions they roll their eyes and affect that condescending manner because they either don’t know themselves or don’t want you to know the answer.

And now it’s all “online”. Hey I use a computer. I do this blog on a computer of course. But I don’t do business on the computer. Whoops! I just remembered. I buy some books and rent some videos on my Kindle. But other than that…

Another problem is that buying health care coverage is not like buying a car or a computer or a TV set. It does not fit into the market place like that. You can’t just try it out and if it does not work take it back or trade it in for a new one.

And it is not practical to shop around for doctors who will accept your medical insurance. Your relationship with those who take care of your medical needs is rather personal and does lend itself to shopping around for the most part.

I still think single-payer would have been the better idea. I would think one plan would cut down on the paper work, the bureaucracy that stands in the way of getting things done in medical care. Barring that, an expansion and revision of Medicare, with maybe a sliding scale based on income would have been in order.

But despite the efforts of the vocal Republican/Tea Party minority, Obamacare is the law. Apparently they can shut down the government, for a time at least, but as far as I know, it still takes a majority of votes to repeal a law. And Obamacare just might work, especially over the long run — and if you are getting on in years, the long run does not sound promising.

I was just reminded in an article I read this morning that part of the deal to get Obamacare passed was to cutback on Medicare — weird logic.

And I have some sympathy with the free-market purists. I am not sure that the government could or should control costs in the private market. Government can indeed make regulations but it cannot ultimately force doctors and other medical people to simply work for what it demands. And by that I do not mean that we as patients have not been gouged. We have. But there is something natural about the private market place that has to do with human behavior. You can make regulations but you have no way to know what the unintended consequences will be.

Nonetheless, I imagine over the long haul Obamacare will work out. Social Security while often maligned is a sacred cow, and so is Medicare. And like President Obama says: when Obamacare becomes popular because it works, no one will call it Obamacare.

Good health!

P.S.

According to an article in the Wall Street Journal online there are major computer problems involving the government and the insurance exchanges, and they are more than glitches. But then there are problems in the present system, as anyone who has ever had to deal with insurance people knows.


Shut down is all politics and not governance…

September 30, 2013

While what is going on in congress right now might be shameful, I’m thinking a lot about politics is shameful, so what else is new?

And make no mistake about it, the tussle over passing a continuing  resolution to fund the government in lieu of a budget is pure politics and has nothing whatsoever to do with the merits of Obamacare or the desires of the public in general.

I’m thinking right now, forget about it. Just let it happen and go from there.

I don’t think the same thing about the next fight which will be over whether to raise the debt ceiling. I mean if failing to raise the debt ceiling means that the full faith and credit of the United States of America for the first time in history means nothing, well that would seem disastrous and irresponsible. If that were to happen then I would think recall or voting them all out at the polls or whatever can be done would be in order.

Politics, although associated with, is not the same thing as governance, although you can’t have one without the other. Politics is a necessary evil. Right now we seem to have a congress that is incapable of governance. As for the executive, I’m not sure that is true. Certainly his refusal to submit to the demand of a minority — albeit a loud one (as Hillary said the other day) — that he drop his signature piece of legislation that is now law, the Affordable Health Care Act (aka Obamacare), is not a sign of his lack of governance.

And let’s don’t forget he has Iran talking diplomatically to us for the first time in 30-plus years (yes it’s just talk as of now).

Plus, the mere fact that he pushed through a form of universal health care, something that was first suggested by a Republican, Teddy Roosevelt, back the early part of last century, is certainly a sign of an ability at governance.

And of course the big irony that seems to always fall on deaf ears is that the president’s Republican opponent for his job last time around engineered the blue print for Obamacare in Massachusetts where he was governor (I’m talking good old I can’t believe I lost Mitt Romney).

Actually I was reminded this morning in a report on NPR that really only (well, should I say only?) 15 percent of the population lacks health care coverage.

But really the major problem is the ever-escalating cost. It is hoped that Obamacare can eventually bring down that cost by getting everyone into the insurance pool one way or the other. Basically or in general, the rule is that if you can afford to pay a share you will. Also the new law seems to be designed to introduce more competition into the health insurance market. As I have asked before — aren’t Republicans for competition in the free market?

I know that some are concerned that really Obamacare will turn into an eventual full government takeover in the health care business. I’m not sure that such is the case at all. I do know that many on the far left (and others too) would prefer a government takeover — that is a single-payer plan paid for by the government or read that taxpayers. But that is not what Obamacare is.

Whether all these new health care exchanges will work, I have not the foggiest notion. Maybe some think that they won’t and then the government will step in and take charge of it all. I don’t know what the thinking is.

But a big problem I understand is that young people, many of whom could afford or will be able to afford some kind of coverage, fail to purchase it, and might still under Obamacare. That means the pools are or will not be big enough and insurance costs go up because the smaller the pool the higher the risk for the insurance company.

But people who fail to protect themselves still demand care and our laws for the most part require it. We pay for them.

Now I do have issue with the claim when Obamacare was touted that if you have coverage you like you can keep it. That is true as long as it is still available. But with the new reality that Obamacare creates, there may be some question as to whether it will be. This remains to be seen.

Well I did not start out to talk about Obamacare specifically. I was just commenting on the politics of the threatened government shut down.

Obamacare is law. If there are problems with it then they can be worked out. The other side lost one and now it wants to have a second chance via its blackmail technique, that is to shut down the government and scare and make things inconvenient for the public and business and hope that the president who is of the opposing party and the legislators and others of the opposing party get blamed somehow.

If the shut down is short, probably few will notice. If it is prolonged, then as the pain is felt, there likely will be pressure from the constituents. It will be interesting to see how that plays out.

Politics is a game, albeit a deadly serious one at times.

P.s.

If this gambit works for the Republicans, will this be the new politics and will the Democrats pull the same stunt?

That would not be governance.


Maybe competition in the health care market via Obamacare will reduce costs…

September 21, 2013

Call it the law of unintended consequences or call it the Obamacare lie, but the claim that Obamacare will not mess with your current insurance plan is one of those.

But this could be good.

I just found out today that the company I work for may not provide health insurance next year due to the Affordable Health Care Act, aka Obamacare, becoming law — may not being key here. You see two things are happening:

On the one hand employers (with the exception of real small ones) are being required to offer health insurance or pay a penalty (and actually that goes for individuals too, that is everyone is required to have health insurance, or pay a penalty). But some companies are opting to or considering opting to paying the penalty. That is because it may be cheaper for them to pay the penalty than the contributions to a health care plan.

And secondly, consumers are being offered, or will be soon, health insurance plans through exchanges.

I am neither an Obamacare foe nor a supporter. I am neutral. I have read that once everything settles down (maybe over a few years) people will love it and take it for granted, much the same as Medicare or Social Security (oh, yeah, people rag on those too, but just try to mess them).

I am wondering why those in the GOP and those who claim to be free market supporters are opposing Obamacare if indeed it is offering competition in the market place. I think they are spreading the tale (which could have some truth to it) that Obamacare is introducing more government control. But health care has been getting more and more expensive and harder for people to afford and of course a lot of people have lost job-related health care because they have lost their jobs.

As part of the law, people without enough income will be offered a federal subsidy to purchase health care. The federal government through its existing programs has already been hit with ever-escalating debt due to its health care costs, and there has to be some order injected into the system.

The way it all works now is that those of us who pay out of our pockets for health care (even if we have insurance we pay the deductibles and copays and of course usually a premium) pay extra to cover the costs of those who pay nothing and who are are required by already-existing law to get at least some level of care. Poor people often just go to emergency rooms for everything from the common cold to broken bones to major diseases (I know about this because I have been in an emergency room more than once, bleeding profusely due to a cancerous condition I have, now in remission, and have had to wait for someone being treated for sniffles).

I have already written in previous blogs that I have not completely read up on Obamacare, but it looks like I may need to and so should everyone else now that it is the law.

While some in the Republican Party are vowing to dismantle or repeal the law, I doubt that will come to pass. And I honestly feel that their opposition is more for using Obamacare as a political football to advance other interests.

Again, I am neither a supporter or a foe of Obamacare. Right now I see the main effect of it as possibly offering some free market competition into the field of health insurance and an inducement for consumers to pay more attention to what they are paying for.

Correct me if I am wrong, but the trend has been to pay more and more for less coverage.

Oh, and I think what may happen is that a lot of people will opt for high deductibles so they are basically covering themselves for catastrophic occurrences rather than routine costs. That could be good or bad. The bottom line is that people will have to make more financial decisions. A more discriminating consumer could pull down some of those inflated health care costs.

We’ll see.

ADD 1:

I should have also noted above that some employers are now or are considering offering some type of health care stipend to employees to enable them to buy their own insurance plans as a benefit in lieu of the conventional one-plan fits all approach (gee sounds Republican to me).

And I also should have noted that  among the features of Obamacare are that insurance plans will not be allowed to exclude pre-existing conditions and parents will be able to keep their adult children on plans (that offer child coverage) to age 26.