Obamacare second high court victory is good, Republicans should actually breathe a sigh of relief

June 25, 2015

Even though I continue to be neutral on Obamacare I am pleased, very pleased, that the Supreme Court has made a second ruling in its favor.

In my mind the opposition is just afraid that it is working or will work and they are doing anything to stop it.

The court says that although some of the wording in the law, officially the Affordable Care Act, is sloppy, it was clear that the intent of the law was to provide all with healthcare or make it possible for all to have it.

Had the opponents had their way, federal subsidies in states that had not set up their own health exchanges but let the federal government do it would have been eliminated. The result would be counter to the intent of the law.

Now some opine that had the opponents had their way — and most of the opponents are Republicans — it would have had a negative impact politically with millions losing health care coverage. So some might think it would have almost been better, in a political sense anyway, for Obama to have lost this one. So Republicans really ought to breathe a sigh of relief.

But I am pleased that the act has been preserved.

I realize that so-called conservatives will always fight anything that smacks of socialism (and this is really not socialism in that it still depends upon the private market), but they need to get over this one.

What we really needed to do in my mind was expand Medicare and Medicaid  (although I cannot really say that would have not been without pitfalls).

Healthcare is vitally important to our society in order to keep it productive and to alleviate human suffering. Why are people against that? They are against the cost. But there is no free lunch either way. The old system clogged emergency rooms where people could get help when they could not afford a private doctor. And under the old system we have had a large portion of the society in poor health and not productive (this is still so, but hopefully it will change over time).

I will say that I have not seen evidence that Obamacare has done anything to cut down on costs — quite the opposite.

But getting everyone covered is the most important thing to me. I think there will be cost savings in that over the long run.

I don’t think fighting Obamacare is a good issue for the Republicans.


Money and time better spent on Ebola research than on getting customers for insurance companies…

October 18, 2014

The list of people who could have come into contact with Ebola in the United States has grown exponentially, what with the up to 100 original people who might have somehow been in close proximity to the man from Liberia who died from Ebola in Dallas, and then the two nurses who treated him who are now suffering from Ebola, and from the nurse who despite the fact she had symptoms (conflicting stories as to when she first experienced them) took it upon herself to fly from Dallas to Cleveland and back, and a lab technician who is on the watch list who took a Caribbean cruise. I mean no one actually knows what the true number is, but it began maybe at 50 then 100, and now well over that — at least several hundred or more.

(UPDATE, 10-19-14: the lab technician who took that cruise is just now reported to have tested negative for Ebola. Well that’s good news. And now more good news. A Spanish health care worker who was the first reported to be infected with Ebola outside of West Africa has reportedly had a full recovery.)

And the public has every reason not to believe reports from government and health officials are credible after they first assured everyone that there was virtually no risk of Ebola spreading in the U.S. because they had the knowledge and technology to stop it in its tracks, but later admitted mistakes were made and there are a lot of unknowns about Ebola.

Republicans, who will always tell you government can’t fix anything and who decry big government trying to run people’s lives, demanded that President Obama appoint an “Ebola czar”. So he finally did.

He appointed some guy named Ron Klain, a lawyer and seasoned political operative. While some, including me, are skeptical about appointing a non-medical person, at least one medical professional on the front lines welcomed the move, saying another doctor was not needed, rather someone who knew the ins and outs of government was.

And maybe so. Let’s just hope he will get things done, things coordinated, and not just play the role of spin doctor.

I for one would rather see government spend millions or billions on medical research than on programs to help insurance companies get new customers (Obamacare).

Let’s hope the government and medical professionals get their act together in the fight against Ebola.

Except for the very few infected people (well two?) so far in the U.S. and the poor and late Mr. Thomas Duncan, so far it is more of a scare near Halloween time, kind of like the great Tylenol scare of 1982 (seven people were poisoned via tampered bottles) or the great Cranberry scare of 1959, also this time of year (in that one no one died and there was no real danger, but people were advised not to eat cranberries due to a pesticide scare).

The potential of course is far worse. While we should not panic, our government and medical professionals on this case should work like they’re in a panic maybe.

And please,  just tell us the truth. If we lose confidence in the professionals then the zany conspiracy mongers and reactionary it’s-all-Obama’s-fault types will hold sway.

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CORRECTION:

In a previous post I wrote that Duncan came through the Dallas airport a day after me. Actually he was there before me. He was also at Dulles Airport outside of D.C. Once someone travels with a contagion, knowingly or not, the potential for its spread grows exponentially, of course. I think it is not for sure whether he had symptoms before coming into this country. One report suggested he lied to authorities about it.

 


Latest high court ruling shows a problem with health insurance tied to work…

June 30, 2014

Note: I’ve dashed this off without really knowing the full extent of the latest high court ruling on Obamacare, that is exactly who it applies to, but I can revise later. The points I have below would apply anyway I think. Okay, now I’m reading that this was a narrow ruling that only applies to certain for-profit religious run or connected corporations. I’ll take the easy way out here and add this partially explanatory excerpt from an NBC News story: The U.S. Supreme Court, in a limited decision, ruled Monday that closely held, for-profit companies can claim a religious exemption to the Obamacare requirement that they provide health insurance coverage for contraceptives.

For-profit corporations — including Conestoga Wood of Pennsylvania, owned by a family of Mennonite Christians, and Hobby Lobby, a family-owned chain of arts and crafts stores founded on Biblical principles — had challenged a provision of the Affordable Care Act.

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Now back to my own words:

For most working people it is a somewhat uncomfortable but accepted fact that employers pretty much run their lives — even more than government maybe.

They determine what days you work and how much you work, either not enough or too much, and how much you will get paid and therefore what kind of lifestyle you can live.

Now with the latest ruling from the U.S. Supreme Court, employers have even more control, especially if you are female. Since so many people have their health insurance through their employment, employers can now decide whether you will have access to birth control. The court has in effect revised an Obamacare  provision requiring employer health plans to provide birth control provisions — in some cases (some) it can be ignored on religious grounds.

The controversy arises from the objection of employers who have religious convictions against birth control, as in God wants you to be fruitful and multiply.

I’m not sure but what I don’t agree with the court on this one — well actually now I have just hurriedly scanned the opinion and may change my mind. I mean you can’t just not follow the law of the land by claiming religious exemptions for things you don’t agree with, such as paying taxes. Anyway this all demonstrates a problem with having your health care dependent upon your place of work. Health care has come to be seen as a right and Obamacare seeks to implement that right. But why should employers be able to mess with that right? But then again why should employers be in the health care business anyway? I know it all began after World War II when employers in boom times were adding incentives to attract workers and health care was one of them.

But these days the world is more complex and health care has expanded so much and the costs are so high and the work place has changed — so many more women in the workplace for one thing — and the nature of work has changed. People are often forced to move from one job to another and unemployment runs high. It sometimes is difficult to have continuous health care coverage on the health insurance attached to work scheme of things.

And now if the employer can determine what you will be covered for and what not — really that is not practical or even right. But I agree I think that an employer should not have to violate religious convictions, except that maybe that is what the employer takes on when the employer hires from the general public who have First Amendment rights on religion.

And are we talking about employers as individual real people or the imaginary personhood of corporations? That is another subject. But from my limited understanding of constitutional law the personhood of corporations is merely a legal device to confer certain rights and protections in business dealings and should not be construed to confer all the rights upon a corporation  — which is nothing but a set of legal documents — that a real live human being has (except the majority on the high court and Mitt Romney believe corporations are “people too”). But like I say, that is another subject.

So to sum it up, I think health insurance tied to one’s work can be problematic.

P.s.

Here is a link to the ruling: http://www.supremecourt.gov/opinions/13pdf/13-354_olp1.pdf

 


Government commits fraud in Obamacare in California (and this is not your typical anti-Obama rant)…

February 9, 2014

So I was travelling down the road in my big truck and listening to 1070 on the AM dial out of LA and all day long they were repeating this story that Covered California, the state’s health insurance exchange under Obamacare, had taken down some list of insurance companies and doctors that their policies worked with because the list turned out to be bogus. I mean people signed up for the insurance, paid their premiums, and then found out the doctors listed were not approved by their insurance. But Covered California is not going to be helping them get any refunds. Well that is outright fraud.

I at one point promised to study up on Obamacare but it is just too convoluted. The good news for me is that so far I don’t seem to be affected by it, at least not directly (I don’t have to navigate the website or do anything). I still have my employer-sponsored coverage (for which I kick in a way too hefty sum) and through some odd quirk (which I need not explain here at this time) I am also on Medicare (some say I am crazy to have both — but all I know is that when I show my cards to the doctor offices it sure seems to satisfy them. I still get bills. And I do a novel thing. I pay them. I think, or I would hope, they are happy with that too).

Now I still think even with all the problems or at least purported or reported problems, Obamacare may in the long run work fine and become sacrosanct as Social Security, but I also think that it was overkill. The problem was that some people could not get insurance. So help them already. But the federal government has interfered with the marketplace for all and may have screwed things up for all in the process (and don’t I sound Republican, and I am not). And then I keep reading or hearing these stories that there are people somehow caught up in a catch 22 in which they cannot afford insurance but also are offered nothing under Obamacare — this was not supposed to happen. I know that problem supposedly has something to do with some states opting out of Obamacare or the Medicaid expansion or something (a Republican tactic to thwart Obama’s signature legislation). I really don’t care. It just sounds like an incredibly reprehensible and absurd situation that only politicians could have created.

Now I have often written that I would prefer or thought it would be better to have some kind of single-payer insurance funded by the government for everyone. It is hard to have an open market in medical coverage because it tends to lean toward monopoly and there is no realistic price setting structure. But the reality in the United States seems to be that we will continue to resist so-called “socialized medicine,” notwithstanding that many would say Obamacare is a major step towards that or is that.

The problem was that President Obama and others who wanted some type of universal coverage guaranteed by the government or provided by it could not figure out how to get it done without the help of the medical insurance establishment. The insurance establishment captured them — some politicians joined the enemy and became lobbyists for the enemy.

And that is the problem. As long as we have people trying to be representatives of the people not with the purpose of public service but instead to line their own pockets, the interest of the public at large will not be served.

I have suggested before — but have been a little hesitant, but I no longer am– that political office should not pay a salary, only a stipend. There would be a danger of paid staff filling a power void with their institutional knowledge, but the people’s representatives would have to be intelligent and vigilant people themselves who could thwart all that.

Maybe that is impractical. But when I read about the Obamacare mess as I described, I just feel like throwing up my hands or just throwing up.


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…

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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.