What Comes After Obamacare

The GOP has embarked yet another desperate push to persuade the public that the Affordable Care Act is too flawed to tolerate. The far right wins this ill-conceived campaign they may be very, very disappointed when they see their prize.

The core problem behind the GOP’s Obamacare gambit is we still have no alternative to offer. As a consequence, winning this campaign would probably be worse than losing. What comes after Obamacare? At this point the most likely answer is some form of single-payer insurance.

Through the cloud of hype and lies that has obscured the rollout of Healthcare.gov, one fact has emerged which should be giving Republicans pause. Expanded Medicaid enrollments under the ACA are rolling along smoothly. The Federal government, which according to Republican conventional wisdom cannot manage healthcare, is signing up new Medicaid recipients at a breakneck pace without a hitch.

Which part of the ACA is failing so far? The one involving private health insurers.

Without some alternative plan to offer, the GOP will be in no position to gain from Obama’s troubles. Rock-throwing is not policy. The bubble-dwellers have missed out on one crucial fact about public-opinion on Obamacare. A large component of the public opposition to the ACA is based on the fact that it fails to provide a publicly funded insurance program available to everyone.

Oh, and by the way, the process of enrolling new Medicaid recipients is rolling along swimmingly. Did I mention that?

Of all the complaints about the ACA, the one with the most traction in the real world is the fact that many middle earners who were previously paying for their own insurance will now pay more. They will pay more because the lousy policies they had been carrying have been legislated out of existence, they do not qualify for lower-income subsidies, and because they live in states that are resisting the provisions of the law that might otherwise have helped them buy better insurance.

For all the hype about the broken “you can keep your insurance” promise, that line won’t take us very far. Those affected are not a pool of people who loved their insurance options in the pre-Obamacare world. They were suffering some of the worst conditions created by our pre-ACA system.

They may be troubled by receiving cancellation notices, but those notices are not a new phenomenon and for most them their insurance already sucked. A small number of insurance cancellations are hardly going to convince people to return to a scheme under which your insurance could be cancelled because you got sick. If given an option to support single payer insurance or a useless package of Republican tax cuts, which direction is the public most likely to go?

Death Panel politics is short-term politics. The current Republican smokescreen of lies and distortions will have blown away before the mid-terms, much less 2016. What will be left is a country still living under a hopelessly complex, patched-together solution which only extends coverage for a subset of the uninsured. If Republicans expect to gain any credibility, we have to counter with more than whining. We need a plan.

There are a lot of options that could gain public support, but one thing is now crystal clear: whatever program eventually takes the place of the ACA, it will provide affordable insurance coverage for everyone, regardless of income. If Republicans want to present such an option, we will have a solid chance to participate in the debate that’s likely to come. If we don’t devise a plan, then the failure of Obamacare will most likely lead to some version of single payer insurance. It’s as simple as that.

If Republicans are not ready to present America with a proposal to deliver quality health insurance to everyone regardless of income, then it would be wise to shut the hell up about Obamacare. Until we have a plan, not just a slogan, the only people who will benefit from the failure of the ACA are in the progressive wing of the Democratic Party. At this point, the failure of the Affordable Care Act would take America to a place we do not want to go. When the history is finally written, the Tea Party may find that all they gave America was single payer health care and a lingering hangover.

Chris Ladd is a Texan living in the Chicago area. He has been involved in grassroots Republican politics for most of his life. He was a Republican precinct committeeman in suburban Chicago until he resigned from the party and his position after the 2016 Republican Convention. He can be reached at gopliferchicago at gmail dot com.

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Posted in Health Care, Tea Party
85 comments on “What Comes After Obamacare
  1. […] problem can be solved by doing less about it. While the GOP indulges its fantasies, we drift toward an increasingly inevitable alternative solution to the ACA, single-payer, that will take us in the opposite […]

  2. bubbabobcat says:

    From the musings of producer Chuck Lorre in the closing credits of the “Big Bang Theory” last week:

    “I’m confused as to why a poorly designed website means affordable health care is a bad idea.”

    Right wing “logic” at work: Baby buh bye. The bath water is dirty. Problem solved.

    • objv says:

      The key here is that Obamacare is not affordable health care. To millions of middle class people who have been kicked off of employer plans it is unaffordable health care. If website problems are not corrected soon, millions will not be able to sign up for healthcare before the cutoff and will find that they are uninsured at the start of the year. Do you seriously believe that this isn’t a problem?

      The website is not the same as the ACA but is emblematic of deeper problems. I’m reminded of Penny thinking the check engine light was no big deal.

      http://www.bing.com/videos/search?q=check+engine+light+big+bang&FORM=VIRE3#view=detail&mid=C486D97FF8909DD1A757C486D97FF8909DD1A757

      • bubbabobcat says:

        THE SKY IS FALLING!

        Yawwwwwwwwwwn.

        Find a new meme. And some facts.

        “Millions of middle class people who have been kicked off of employer plans”?

        Puhhhhleeeze.

        Prove it. Shrieking it over and over does not magically make it a fact.

      • bubbabobcat says:

        Not surprising a conservie has reading comprehension problems.

        OV, I read that before you had posted anticipating you would seize on that “source”.

        First of all it is an unsourced opinion piece. Again, not surprising that you can’t tell fact from fiction from opinion.

        And speaking of lacking in nuance, your words verbatim again OV:

        ““Millions of middle class people who HAVE BEEN (as in past tense, already done, fait accompli, etc.) kicked off of employer plans”.

        Now when you say “kicked off”, presumably it is the commonly accepted definition of like no longer having it provided by your employer. Well the article doesn’t say that.

        It does say that a 2010 PROJECTION (i.e. guess, educated or otherwise) MAY have a large number of employer sponsored health insurance lose their grandfathered status. Horrors!

        Have you used an employer sponsored health plan? They change yearly and raised their rates yearly long prior to the ACA was a gleam in anyone’s eyes. As Chris already noted and you conveniently ignored.

        Now, one more time OV, please provide real data (not opinion) that “millions” have ALREADY “been kicked off” of employer sponsored insurance plans entirely, and not just have to choose a different employer sponsored program.

        Oh and by the way OV, I was “kicked off” my original employer sponsored health insurance too. And for the first time in decades since I have been working and paying for employer sponsored health insurance, I have had more than a 2 choices of plans. AND my premiums went down. Way down. And If I continue to be a good boy and take care of myself health wise and don’t have any catastrophic medical issues, I will pay ZERO dollars out of pocket in premiums, copays, AND prescriptions combined. And that’s from United Healthcare who had reported its highest profits recently.

        “Objective View”. Oh the irony. The abject irony.

      • Turtles Run says:

        The website is pretty much working now and by next week the websites capacity to handle customers will double? What are the excuses going to be then?

        “The key here is that Obamacare is not affordable health care.”

        Guess what, healthcare is not free. It must be paid for like everything else despite the beliefs of the tea party. You guys need to make up your mind up what the problem is with the Obamacare. For three years the tea party has complained about people thinking they are getting free healthcare and now that the plans and costs are known you guys are complaining that these plans actually cost money.

        Good healthcare coverage costs money, Those crap plans that that people carried and are being cancelled do not make Obamacare a failure.

        These lousy plans just push costs to everyone else. The very thing the tea party types are complaining about. Seems the issue is not with costs being pushed to others more than they now have to pay their fair share.

        As for cancelled plans, well these people still have choices. Too bad you do not seem to be concerned about those that do not have coverage at all. The uninsured far outnumber those that will be negatively affected by the law.

        http://www.salon.com/2013/11/25/right_wing_extremists_face_new_moral_conundrum/

      • bubbabobcat says:

        Oh, and by the way OV, the 3 and a half minute clip on the check engine light you posted from the “Big Bang Theory” actually ran counter to your point. At the end of the clip, the car was still driving and Penny kicked Sheldon out because he was annoyingly and inanely obsessing over the check engine light and Sheldon even admitted he did not have the knowledge or training to diagnose the cause of the check engine light. You know, they don’t call them “idiot lights” for nothing OV.

        Thank you for posting the clip OV and inadvertently pointing out the irrational negativity and obsessive focus on a nonsensical point that the right doesn’t understand but obsesses compulsively over ad nauseum nonetheless.

        Perfect analogy OV. And thank you for your continued lack of nuance.

    • objv says:

      Maybe the short clip didn’t show it, but Big Bang enthusiasts know that Penny’s engine did go dead in a later episode. The irony here is that the check engine light was working much better than the Obamacare website.

      From:

      http://wiki.the-big-bang-theory.com/wiki/Check_engine_light

      The following February, Penny’s car broke down and Sheldon pointed out that he’d warned her about the check engine light months before. She retorted that the light was just fine, it was “still blinking away” and that it was “the stupid engine that stopped working.”

      • Turtles Run says:

        objv – Do you really want to use a comparison of your complaints of fictional problems with Obamacare to a fictional character’s fictional check engine light on a fictional television show to illustrate why it is bad to get uninsured people healthcare coverage? Is that really the best you can do?

        You know what forget about what I said and just keep dealing in fiction. Tell you what…..there…..a fictional solution to your fictional problem.

      • bubbabobcat says:

        Maybe you should have found a better, more accurately “nuanced” clip to illustrate your point OV.

        And I guess you are acknowledging your original point and debunked “fact” and source are pure crap if you are resorting to arguing about a clip from a TV show? That you didn’t accurately utilize to support your “point”?

        By the way, my car has a check engine light persistently on. For the past 3 years.

        Though I did get it checked out by a mechanic I trusted. He could have replaced part after part that would have cleared it. Temporarily. But not resolve the problem. And cost me lots of $$$ unnecessarily. But my trusted mechanic said he couldn’t find anything not working and his best guess from the error code was the sludge in my gas tank (12 year old car) gets sucked in the injectors when the tank is near empty and screws up the injector and oxygen/fuel mix because you know, the idiot light doesn’t say what’s wrong with the car. Even with the error codes the mechanic pulls. So 3 years later after we did nothing, the car still runs fine.

        Sheldon isn’t always right. Especially in the real world.

        Nuance, OV. Nuance.

  3. […] what someone who you don't think is conservative enough to have a say on issues that affect you. What Comes After Obamacare Once again Chris Ladd has words of wisdom for y'all. Listen to them or not. […]

  4. fiftyohm says:

    “They will pay more because the lousy policies they had been carrying have been legislated out of existence, they do not qualify for lower-income subsidies, and because they live in states that are resisting the provisions of the law that might otherwise have helped them buy better insurance.”

    Chris, this is simply untrue. Insurance rates will increase due to the prohibition of pee-existing condition exclusions among other things. They will go up for people like me who, while I’ve been in the private insurance market for many years, will be required to carry lower deductibles than I need, and pay for other coverage and services I will never use. Total medical costs will increase as revenues begin to pour into private insurance company coffers from either government premium subsidies or mandatory participation of the currently uninsured.

    You seem to be suggesting that the proper course of action, absent an alternative, is to do something even though it’s wrong. I completely agree the current system is broken. We agree on just about all of the ways it is. Is it even conceivable the current crop of legislators in Washington, few of whom even took the time to read the executive summary of the ACA, let alone research its ramifications, are remotely capable of finding a solution “in time”? And for that matter, just what does “in time” mean? Why does that mean ‘right now’? This thing is going to be a real mess to unwind. It’s not going to get better with practice, either.

    The argument that “Unless you’ve got something better, just shut up”, is no argument at all.

    • Bart-1 says:

      exactly 50. Here’s a link you might enjoy! http://home.roadrunner.com/~pjrpole/ACA.html

    • lomamonster says:

      As long as the nation is commanded by feral plutocrats there will be no economic justice for it’s citizens. Only those who can afford to feed the animals will establish a symbiotic relationship with the critters, much as vampires have their “familiars” in horror movies. It will be interesting to see what precipitates an awareness which will cause the inevitable uprising leading to a truly civilized society responsible to all…

    • fiftyohm says:

      Please forgive the typo in the above post. I was not in reference to an incontinence disorder.

    • Turtles Run says:

      The argument that “Unless you’ve got something better, just shut up”, is no argument at all.

      I disagree. Your comment would suggest that we leave a failing healthcare system in place instead of implementing a flawed but still better healthcare system such as Obamacare. The opponents of the law are free to criticize but they also need to propose improvements or provide a superior plan but they refuse to do so. They instead sabotage the law and then turn around and scream look how it is failing.

      I am sorry you now have to pay more and your plan changed in ways you do not like but that is not enough of a reason to deny millions an opportunity from even getting coverage. I believe 6% of the insurance market get coverage from the private market and not all of them are affected negatively by the law. Contrast this to the 15% of the nation without access to healthcare insurance prior to Obamacare. The number of people positively affected by the law far outweighs the negative.

    • bubbabobcat says:

      Fitty, I am disappointed that you would partake of abject Chicken Little irrational fearmongering also. Et tu fitty-te?

      One of the first successful provision of the ACA ensures that “total medical costs will increase as revenues begin to pour into private insurance company coffers from either government premium subsidies or mandatory participation of the currently uninsured” will NOT happen. Due to the ACA mandate that insurance companies have to spend 80% of their premium revenues on actual healthcare for their policy holders, they can’t rake in any possible windfalls (but large employers can unfortunately). For the past two years, insurance companies have already had to fork over close to $2 Billion of “excessive revenue” directly back to those self insured and to the lucky/greedy large employers who basically just kept the bonuses for themselves and did not pass on those refunds.

      http://blog.chron.com/healthzone/2013/06/health-care-insurance-rebates-to-texans-to-total-46-million/?cmpid=healthhcat

      http://www.nytimes.com/2012/08/10/nyregion/health-insurance-refunds-may-stall-in-employers-hands.html?pagewanted=all

      http://www.nytimes.com/2013/07/19/us/politics/speaking-out-for-health-care-act-obama-says-millions-will-get-rebates.html?hp

      And any healthcare doomsday prognostications are just Rorschach manifestations of one’s one biases and insecurities minus any real implementation data which are only now just trickling in.

      As someone else already noted, those (Republican) states that weren’t actively trying to sabotage the ACA and did implement their own state insurance exchanges are now reaping the fruits of their efforts.

      California enrolled 80,000 onto healthcare plans via their exchange in November already. A dramatic increase over October. And guess what? Contrary to the doom and gloomers, young people who were purported to be opposed to subsidizing the healthcare of older people who actually use it more, ARE signing up in droves. At least in higher numbers than their proportion of the population.

      “Officials said 18- to 34-year-olds made up 22.5 percent of the nearly 31,000 Californians who selected a private health plan in October. The same age group makes up 21 percent of the state’s population.”
      http://www.nytimes.com/2013/11/22/business/california-encouraged-by-health-plan-enrollment.html?hpw&rref=health&_r=0

      Whadya know, “socialized medicine” is jes’ alright with those who will bear a disproportionate percentage of the cost. Give the kids some credit for decency, intelligence, and responsibility.

      And yet those who will benefit the most from the ACA (old White people in poor health because ya know, it’s my right to not take care of myself!), are those most irrationally opposed. Why is THAT not surprising?

      • fiftyohm says:

        Bubba- The fact that you seem to think your old pal fifty has gone all Chicken Little on you because he opposes what he thinks is a bad piece of legislation, (and certainly not based on anything he wrote in his post), is a bit disappointing.

        Lemme see if I can address a few issues in your post: First you contend that insurance companies will not be enriched by the Act because their rake is restricted to 20% of revenue. Newsflash! That is exactly what they rake right now! Are you suggesting that the forcing of more citizens to buy their product under exactly the same conditions as they now do business is not enriching them? Are you suggesting that $2B in refunds over two years is more than (I was going to say a drop in the bucket, but thought better as it’s far too high), a whisper of the word ‘Vermouth’ over a dry martini?

        Are you suggesting that all those happy Californians are jumping up and down, dancing around the Maypole, and clapping with glee that they now have to pay for insurance, and can no longer suck it for free, so relieved are they to get it off their collective conscience? Wow Bubba! Talk about somebody going off the deep end! Say it ain’t so!

      • fiftyohm says:

        And furthermore- “Old white people” are covered by MediDare and DontiCare a whit about the ACA. The further notion that “bad habits’ contribute significantly to total costs has never, in any significant study, been demonstrated. Even smoking is essentially revenue-neutral. Wanna maximize your lifetime cost of health care? Live to ripe old age. (Look it up.) Don’t buy in to the dystopian “Demolition Man” drivel believing that all will be healthy. happy, and disease-free if we’d just lay off the salt and high-fructose corn syrup. Aggregate healthcare costs are dominated by demographics, genetics, politics, and the marketplace, (such as it is).

        Step away from ‘the three shells’, Bubba!

      • bubbabobcat says:

        Fitty, fitty , fitty, what am I going to do with you? Losing your edge and mailing it in because you don’t have to rise above the dregs of the chron?

        It’s not a perfect piece of legislation and it is an absolutely horrific implementation. Even with the 30 day grace period of the teabaggers immolating themselves over the government shutdown, they couldn’t fix it fast enough. But still a long way from a “bad piece of legislation”. The aforementioned nearly $2 Billion in rebates. Insurance for adults up to 26 on their parents’ policies. No cancelations or denials of coverage for pre-existing conditions (the real death panels). And that’s one point of Chicken Little hysterics (in my opinion). In my best Cher impersonation to Nicholas Cage in “Moonstruck”: Snap out it fitty!

        Will the insurance company reap higher gross and net revenue because of the increased volume of (mandatory) policies? Yes. I’m not saying they won’t be enriched. But that’s an unfortunate compromise. Remember fitty the initial drafts had single payer in the plan and that would have cut out their obscene profits. And you know how single payer would have flown. Like a lead balloon. And 20% is definitely not what the fleecers rake in now. It’s obviously quite a bit more. Hence the Billions of $$$ of refunds from the past 2 years. Status Quo. Before mandating anyone buy insurance. That part of the law is a sort of throttle governor on the unintended consequences of the fleecers making out like bandits even more insanely than they will without the revenue controls. And it may be a drop in the bucket to the fleecers, but not the people paying the premiums (again voluntarily, before anyone is “forcing” them to). $100 – $300 rebate/refund/subsidy/whatever, ain’t chicken feed to the people getting them.

        And as for the happy Californians dancing around the maypole, if the cost of the mandated insurance is such an issue, wouldn’t more of them just not signed up and just pay the $94 penalty instead for next year? Perhaps not exactly dancing around the maypole, but maybe more than willing to shell out the shekels for a little peace of mind from going deep into debt or bankruptcy due to a major accident or catastrophic illness that can happen even to the young and healthy which they are probably aware of and don’t feel so invincible to? And don’t you think any reasonable young person just starting out in their life, career, and family that is not raking in the money right away would rather pay a little for the peace of mind of not having to pay a house mortgage or two of medical bills if something unfortunate befalls them? And I don’t know of any intelligent person young or otherwise, considers the ER after the fact as their only health care choice as the gravy train, “sucking it for free”. I give the young and poor more credit than that.

        Fitty, it ain’t so! The only reason I may be off the deep end is my Giants choked against a bad Cowpunks team yesterday and blew their thread of a chance for the playoffs! Arrrrrrrrggggg!

    • fiftyohm says:

      Turtles- The elephant in the room is not “all the poor people unable to get healthcare”. The very poor get Medicaid. The not-so-poor without coverage for whatever reason go to emergency rooms and other outlets and receive healthcare – albeit at great cost to the taxpayer. The elephant’s real name is “Cost”. The US spends far more than the rest of the developed world as a percentage of GDP on healthcare. (It can be argued that this results in a higher standard of care, and in some cases this is true, this is also not the point.). That percentage will rise to levels that are going to be, if not ruinous, then extremely uncomfortable and counterproductive. The ACA will not improve this situation at all. No one supporting the act has made a credible argument that it will.

      I have held forth (ad nauseum?) on the following: the the medical profession is enriched by the current system that encourages unnecessary care, procedures, and prescription drugs, that the drug companies are enriched by encouraging the use of expensive drugs marketed to both physicians and patients completely with the burden of competitive market pricing, that insurance companies rake 20% of all the funds that pass through their pockets are are back-stopped by the government if poor management causes them to fail, and by consumers who believe there is a pill for every ailment, that it’s OK to rush the kids to the emergency room for every runny nose or earache, and they should have no more sanction than a $5.00 co-pay. Oh yeah – and of course the legal profession.

      Listen: None of these is the entire problem. None of these, taken alone will kill the elephant. In fact, if all were eliminated, there’d be no one left to treat. Any sane approach to the problem must, in some way, address holistically, (god how I hate that word) the cost problem. The ACA doesn’t. Fact is that all those ‘millions of uninsured’ the ACA so benevolently promises to cover are mostly those who chose to go bare, and will now be forced to pay for coverage. Are those the people you’ve been so concerned about?

      • Turtles Run says:

        Of course the healthcare system has many causes for its high costs but the health industry and the CBO agree that the previous healthcare system was unsustainable. Those high cost were also being spread over a shrinking base of insured Americans. Something had to be done.

        Other nations have high quality of care and from what many sources claim superior results and at a lower cost. Something is wrong with that picture.

        We have to address the medical enrichment as you described but that takes intervention by an entity large enough to do it and that is the federal government. Private industry has shown little resolve or ability to do so. Of course such actions are going to be labeled as the destruction of the free enterprise system even if it does not exist in healthcare.

        As for overuse of health services. People with healthcare insurance generally do not use emergency services for minor issues like runny noses, they go to their doctor. The uninsured are the ones using emergency rooms for minor care.

        Finally, as to those to the reasons that people did not have insurance the Kaiser Foundation found that 60% cited too costly or job loss as the reason they did not have insurance coverage. Only 1.5% claimed they did not need insurance. As for medicaid many states left requirements so low that many of the working poor were shut out. Even now with the Obamacare law states like Texas were determined that millions would remain without access to health insurance, do you really thing those officials really give a crap about the uninsured getting access to medicaid in pre-ACA days?

        http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

  5. Turtles Run says:

    Current state of the healthcare.gov website.

    How long does it take a Republican to sugn up on Obamacare. Four hour, the first three hours to take selfies and to spill Maker’s Mark & tanning lotion on the keyboard and 45 minutes to actually enter in info and getting a confirmation.

    Thanks Mr. Speaker

    http://www.huffingtonpost.com/2013/11/21/john-boehner-enroll-obamacare_n_4319933.html

    • objv says:

      Turtles, yes that’s pretty pathetic – especially since Boehner and the rest of congress have better access than other Americans.

      They “can log on to a special Blue Cross and Blue Shield website for members of Congress and use a special toll-free telephone number — a “dedicated congressional health insurance plan assistance line.”

      http://www.nytimes.com/2013/11/20/us/politics/for-lawmakers-a-gold-plated-insurance-exchange.html?pagewanted=all&_r=0

      • Turtles Run says:

        So from your comment I guess you believe that private companies should not conduct business in the a way they belief would advantage their bottom line?

        Why would BC/BS do this? Because I have heard right-wingers claim that Obamacare was going to destroy the insurance companies? Do they want to be destroyed or are the right-wingers just flinging pooh.

  6. geoff1968 says:

    I guess, when it comes down to it, I don’t “believe” in the free market. I believe in magic, and the Easter Bunny, but the free market-no. It doesn’t exist. Unicorns, yes. Free market, no.

    I realize this is right wing apostasy, but how does one go about being apostate among the apostates? I cannot answer that question.

    And what’s with this “Take Back Our Country” jive? Do you think that’s an attractive use of political rhetoric? I don’t.

    It’s just wishful thinking if you expect the GOP to offer a well thought out, persuasive, alternative to the ACA, much less simply helping to implement and improve it.

    • rightonrush says:

      “And what’s with this “Take Back Our Country” jive? Do you think that’s an attractive use of political rhetoric? I don’t”
      It’s the Tea P. mantra….take it back…… to 1776. They aren’t interested in improving ACA, or improving the lives of those less fortunate. They live in a me-me-me-me world, I got mine to hell with you.

  7. MarkG says:

    In 2010, the US spent 17.6% of our GDP on healthcare. No other industrialized nation spent more than 12% of its GDP on healthcare costs and all them provided some form universal healthcare. If the US had spent only 12% of its GDP on healthcare in 2012, it would have saved $893 billion. Can anyone provide any data that shows that our current healthcare system is so superior to other healthcare systems that it is worth paying an extra $893 billion for it?

    If Americans acted rationally, we would be trying to decide which other industrialized country’s healthcare system we wanted to model our future healthcare system on based on how long it would take, what changes we would need to make and what it would cost to replace our current healthcare system with another country’s healthcare system. Unfortunately neither Obamacare or any healthcare plan proposed by the GOP even hypothetically achieves the results in terms of cost or service of any currently existing healthcare system in an industrialized country. Why is it considered to be “anti-conservative” to learn from other countries how to spend less money and provide more service?

  8. objv says:

    Oh! what a tangled web we weave
    When first we practice to deceive! ~ Sir Walter Scott

    “We will keep this promise to the American people. If you like your doctor you will be able to keep your doctor. Period. If you like your healthcare plan, you will be able to keep your healthcare plan. Period.” ~ President Barack Obama

    • Craig says:

      Yes, the President should have kept in mind that Americans don’t do nuance.

      • objv says:

        Millions being kicked off their health care plans and millions unable to see doctors no longer on their plans is “nuance”?

      • goplifer says:

        Yes, it is. Millions of Americans “lost” their health plans last year, and the year before, and the year before that. It happens every year.

        Now every single instance is being attributed to the ACA.

        And unable to see their doctors? We’ll see how that pans out, but if you were lucky enough to get dumped into an HMO by your employer in previous years you’ve seen this movie before. Now at least you get to pick your plan, if you can hack your way through the website.

        Again, Republicans really might want to think carefully before hanging our banner on “you can keep your plan.” You couldn’t necessarily keep your plan prior to the ACA if you got sick.

        IMO, this is going to lead us into a box canyon. All we need to avoid it is a plan. The problem with a plan is that it would force us to confront realities which are ideologically unacceptable. All the complaining about the ACA is just noise to help Congressmen in protected districts keep their seats against far right challengers. This is going nowhere.

    • Did you look at Boehner’s blog post? Too funny. But, hey, as long as you’re Speaker of the House, apparently the live help is pretty good. Somehow, I don’t think my 80 year old mother is going to get the same treatment. Funny, I never have any trouble at all buying stuff on Amazon. A question to ask yourself: Why is healthcare.gov not like amazon.com? Figure that out, and you’ll finally grok all you need to know.

    • Turtles Run says:

      This comment seems to sum up the difference between Obama’s healthcare plan and the GOPs.

      “The reason for my support for the ACA is that the crisis of costs and accessibility is urgent and only Obama had the balls to propose a possible solution.”

      The main issue that the opponents to healthcare reform have is that they still have no plan that can do a better job. Nobody wanted to tackle healthcare reform but Obama did.

      I got a secret for the GOTP. Tackling the hard issues is never easy and seldom appreciated but that is what LEADERS are supposed to do. So the next time the right-wingers want to complain about no leadership from the President, excuse me if I rub this in your faces. Because other than empty rhetoric, you guys ain’t got shait.

  9. “Oh, and by the way, the process of enrolling new Medicaid recipients is rolling along swimmingly.”

    Of course it is. Everybody likes free stuff. Too bad for us, TANSTAAFL.

    As for fixing the mess, we haven’t had a healthcare “market” for decades. There can be no “market” when there is no price transparency. Fixing that should be job #1. Job #2 should be dismantling the perversity of employer-provided health insurance. The tax advantages afforded to employer-provided health insurance should either be eliminated, or made applicable to *all* heath insurance purchases of any sort. (If we truly believe that heath insurance is a basic necessity, the later is preferable. Given the penchant Dems have for raising, ahem, “revenues,” the former seems more achievable.)

    • Turtles Run says:

      How do your ideas help poor people afford insurance, eliminate gender bias, protect against pre-existing condition discrimination?

      No one is going to eliminate tax rules on employer-sponsored plans. That was suggested last year and it went about as well as smallpox lollipops and the right wing is having a fit over providing subsidies to poor people, how is expanding these subsidies (that is what tax benefits are btw) to everyone going to fly.

      Given the penchant the tea party has for opposing anything that could actually, ahem, “help” anyone, I do not see jack coming from them.

      • Actually, Chris, the “people love free stuff” meme is ending our republic as we write. “Republicans” (using the term in the loosest possible sense of the word; “enablers” would be more apt) like yourself are merely accelerating the process. If it isn’t glaringly obvious to you by this point, Obamacare isn’t working because it *can’t* work. Never could, never would.

        Crogged, in my youth I worked for a major oil company based in Europe, and had the to opportunity to observe European healthcare in action from a close second-hand viewpoint. One of my ex-pat coworkers couldn’t believe he had to pay *anything* for a visit to the doctor here in the U.S. At the same time, he was extremely bitter regarding the unfortunate fate of his parents, whom he lost in the span of just one year. You see, his country’s “healthcare” (using the term euphemistically) system refused both of them anything other than palliative care when they happened to be diagnosed with cancer after age 65. Go figure. You may want that here, too, but I don’t.

    • goplifer says:

      Now THERE’S a winning slogan. The problem with Obamacare is that not enough people have lost their health insurance.

      The “people love free stuff” meme is going to end the modern Republican Party if we don’t get over it. You know what people like? They like for things to work.

      We have a health insurance scheme built to meet the needs of an early 20th century economy. We are the last civilized place on earth where people wonder whether they can get access to health care. It’s insane.

    • Crogged says:

      So how many of you have had health care providers from a western European country or Canadian? Single payer doesn’t chase the medical professionals out of those countries and somehow, consistently and continually, delivers health results cheaper and better than our own. It’s just a cold hard fact. Trying to treat the delivery of these services as we do plumbing is the error and problem for those seeking another way. The best insurance policy is ‘socialism’.

    • Crogged says:

      I suppose you aren’t extremely young –have you asked yourself if their fate was due to socialism or the course of the disease? My grandmother died young from complications from rheumatoid arthritis in the 1970s, here in the USA and wouldn’t suffer quite the same fate today because treatment options are better. It’s not a contradiction to have a floor under which no one falls AND allowing an individual to spend the rest of his money as he wishes.

  10. glennkoks says:

    The Republicans need to look at history as a guide. We did not end up with Social Security because we were a nation of free-loading slackers. When faced with a problem people will always choose action over inaction.

    For several decades the dwindling middle class watched as their health care costs continued to rise. In typical fashion the GOP’s only plan was laissez faire – the markets would fix it.

    Well the markets did not fix it, we ended up with a healthcare system that costed five times as much as other developed nations. Hence Obamacare.

    The window of opportunity is rapidly closing for the Republican party to mold the ACA or the remains of it into something that works. But in usual fashion the only solution by those on the right is “NO”. The problem with “NO” is it does not fix a thing and when given a choice between a potential solution and more of the same people will choose action vs. inaction every time.

  11. Texan5142 says:

    The states that are having the most problems are the one’s who’s Republican controlled government is throwing everything it can into the gears to stop it. Why do red states hate their citizens so much? Why do they not want every member of their state to not have health care? What is their plan for those falling without a net?

    Kabuzz wrote;
    “And you are worried about an alternate plan?”

    Yes we are. The status quo is not an option. The Republicans need to put forward a better plan, or shut up and do what they can to make this one work. Ask yourself how much further along would the ACA be or how much better it could be if instead of complaining, everyone worked together to improve it.

  12. Turtles Run says:

    Let me state this. I support Obamacare because despite its flaws it is far superior to the status-quo. Now if any side came up with a plan that is cheaper and more comprehensive then I would support that plan. But the GOTP is not going to be able to come up with such a plan. They have blasted exchanges, individual mandates, cost-saving panels, and support plans that do not actually cover health care costs. So faced with these constraints I do not see how a GOP plan would work.

    Even tea party darling Rafael Cruz, when pressed for a replacement specifics, could only mutter on about buying insurance across state lines. Yeah, that’s the ticket.

    • way2gosassy says:

      It makes one wonder why some of these folks are so hard headed about the ACA. It was predicated on Republican ideas. It incorporated many of their amendments and policy of forcing personal responsibility.

  13. kabuzz61 says:

    Are you kidding me? Is this all you got? Did you know Obama wants to push up the enrollment date to October of next year because of the huge failure it has become? And you are worried about an alternate plan? Obamacare is fine for everyone but congress, unions, and hundreds of waivers. Obamacare opponents in his own party had to be bribed to pass it. Face it everyone but you it seems, knew it was bad law.

    Obama now wants to ask the insurance carriers to let the people keep their policies his law made them cancel. This is a train wreck of epic proportions yet you still carry Obama’s water.

    When the founding father realized the Articles of Confederation was not working, they had to first get rid of it/ignore it and work on a constitution that would work. I believe a much better, rational plan will emerge once the dem’s grow up and admit this law is a failure.

    • goplifer says:

      ***I believe a much better, rational plan will emerge once the dem’s grow up and admit this law is a failure.***

      Emerge from where, exactly? The left has a plan that was left on the cutting room floor – a public option. Right now that’s the only other plan out there. Until we have a different alternative, Obamacare is all that stands between us and single payer.

      • way2gosassy says:

        Other than the rollout what exactly is failing?

      • way2gosassy says:

        Sorry,I meant that question for Kabuzz. More coffee and a little time I may get used to this format.

      • Bart-1 says:

        Maybe it will emerge from the same place you are certain, “whatever program eventually takes the place of the ACA, it will provide affordable insurance coverage for everyone.” For some reason, you can guarantee us of such an impossible-to-predict outcome, while at the same time, question someone who believes that a better plan will be proposed. Could you at leats define what you mean by “affordable”?

    • Turtles Run says:

      kabuzz61 muttered: I believe a much better, rational plan will emerge once the dem’s grow up and admit this law is a failure.

      Really, why do we have to wait till then? If the tea party had a better plan then they would be parading it on TV yelling nah, nah,nah.

      Do not confuse a bad website for the failure of the plan. Enrollments on the state sites is soaring and healthcare.gov is pretty much working now for consumers. In three months this will be forgotten and the tea party will still be claiming they have ideas so good that they cannot share them with anyone.

      • Texan5142 says:

        Yep! The states that truly care about their citizens and took the time to create an exchange are doing just fine in most cases. It is the states with hard headed governors who are having the most problems.

      • JohnGalt says:

        I’m highly amused by this persistent conservative thought that medicine can or should be a free market. Like the person having a heart attack is going to check ER pricing to tell the ambulance driver where to go. This idea, along with the proposal to return to a pre-1932 system, deserves nothing but contempt and derision.

      • JohnGalt says:

        Sorry, this was intended as a response to kabuzz and Tracy, below.

    • objv says:

      Hi Kabuzz! So glad you showed up. I was starting to get a worried that I was going to be the lone conservative in the “echo chamber.”

      • kabuzz61 says:

        Hi Back objv. Sometimes I have to be ‘in the mood’ for the echo chambers constant parroting. I do love the qualifiers they are using today: ‘in most cases’, ‘would have lost them anyway’, ‘bad website’, etc. Everyone with a grasp of the problem would no that you don’t change a huge system with a huge law and expect great results. You don’t change a huge medical establishment for 5% of the population. There was one time when even Glennkoks admitted Obamacare was not the right plan. Now the leftist Chris Ladd wants to know what the GOP plan is, when for years during and after Obamacare, the left could care less what the GOP thought.

        Today is also the day the lefty Oswald assassinated JFK.

      • You know, kabuzz, the interesting thing about this whole ‘debate’ is the seeming acceptance by all parties of the absolutely goofy premise of the left, namely that healthcare needs to be “managed” and/or “planned.” That’s nuts. Markets are emergent phenomena, by definition. The lightest of regulatory hands on the tiller is all that is required, or should be tolerated.

        After the massive, humiliating, and banally predictable self-immolation of Obamacare, the lefties want to know what our “plan” is. Having just watched their magnificent plan crash and burn, they still want more planning. They just don’t get it: no plan is required, or desirable. Free markets invariably provide the highest quality product at the lowest possible price. If you want to help the poor gain access to healthcare, make healthcare cheap, i.e. make sure the healthcare market works as a *market*. Period.

      • goplifer says:

        There is no free market in health care. Never has been. Never will be. That’s the core problem.

        https://goplifer.com/2013/11/17/health-care-is-not-a-market/

      • Au contraire, Chris. There hasn’t been a free market in healthcare since only 1932, when Blue Cross was established as a result of crony capitalism. The skids were greased in 1942, when the IRS ruled healthcare benefits were not taxable income, thus enticing droves of employers to provide healthcare benefits as means of skirting FDR’s wage controls. And the final death spiral began in 1965, when socialized medicine for old folks, i.e. Medicare, was introduced.

        You will perhaps notice that with each foray by the government into the healthcare “market,” healthcare has grown progressively (don’t you just love that work, “progressive”?) more expensive. But before all this nonsensical government intervention, a free market in healthcare was precisely what we had. What we are witnessing at present is merely the gradual implosion of eight decades of socialist theory as applied to healthcare.

        Interestingly, the Soviet Union persisted for 69 years before final collapse. Therein, perhaps, lies a lesson for all our progressive friends.

      • goplifer says:

        No, there’s never been a free market in health care, which is part of the reason medicine lagged so far behind other technologies for so long. Medical scenarios are missing the volition that makes markets work. They are inherently coercive situations in which market conditions can’t be maintained.

        There is no free market for health care because there can’t be. What you had before insurance reforms was pretty nearly no meaningful health care. The system started catching up pretty fast once government regulated insurance markets started to create a workable payment system. Take government out of the picture, and you’ll take medicine out of the picture.

      • Chris, I call B.S. Believe your socialist nonsense if you like, but private health insurance is in reality no difference from *any* other form of private insurance. When I say private, I mean free market-based, as in people exercising their natural right of free association to voluntarily enter into contracts with others under mutual consent.

        You seem unduly worried about the “coercive” nature of the doctor-patient relationship in such cases as when the patient is lying “unconscious under a bus.” Not to put to fine a point on it, but that’s utterly idiotic.

        All of us routinely enter into contracts in which a supplier of goods or services performs outside of our conscious control or even direct observation. We do so with little concern, because we know market forces constrain the provider. A provider operating in a free market who fails to provide contracted services, of any sort, very quickly finds themselves out of business. Only in the monstrosity of socialism, where people find themselves with no right of exit, do we find inferior products and services.

        Coercion, no right of exit, no right of recourse, central planning, central control of the means of production and distribution – these are all the hallmarks of Obamacare. They are equally the hallmarks of socialism. A quick review of 20th century history will inform you as to how this is going to work out.

      • goplifer says:

        There is no capitalism, and no market, if buyers are sellers are not both equally free to walk away from a potential transaction with their lives intact. This is tied to a similar problem at the other end of the spectrum – the protection of property rights.

        This problem may be ideologically inconvenient, but real. If you appreciate the power of markets, then it is really important not to destroy them. Remove government from certain critical points in the economy, and you destroy the power of markets for everyone.

        Our slightly insane fantasy about a free market in health care has created the most devastating force tearing apart the hopes of middle-earners in our country and placed us behind Western Europe – that’s right, Western Europe – in creating upward mobility.

        Reality is a relentless, uncompromising, bitch.

      • Chris, your market ignorance is astonishing to behold in someone I presume to be reasonably intelligent. There are *many* situations is which you, participating in an individual transaction, face the possibility of getting screwed. As you say, reality is a bitch. Nonetheless, word gets around, and providers who screw their customers soon find themselves sans customers. That’s how markets work; I assume you grasp the concept, and that your studied obtuseness is a sham in the service of your leftist political zeitgeist.

        As for upward mobility, I’ve spent a fair amount of time in Europe, and from first hand observation can only note that you and your source are all wet. To the extent that we are having issues with economic mobility, I think we can, with a high degree of confidence, lay them directly at the feet of a host of failed social policies promulgated by the left. But let’s not change the subject, shall we?

        John Galt, I believe I’ve commented in this thread regarding the evils of employer provided insurance. As a business owner, I’m the person who must choose the insurance to be provided to my employees. There is a “market” for employers, in the sense that my broker solicits offers from all the providers serving the small business market in Texas, but that hardly equates to a free market for my employees. As I noted previously, it’s perverse. The only saving grace of this misguided system is that small business owners like myself invariably utilize the very same insurance we provide to our employees. (You will note this practice is notably absent in the conduct of our legislators, who seem curiously untroubled when it comes to exempting themselves from the very law they are foisting on the rest of us.)

        BTW, you actually *do* have a choice. For you to participate in the individual “market,” all you’d have to do is give up the tax benefits that you enjoy through your employer provided insurance. I have a very hard time figuring out how that can be, in any way, shape or form, fair, but there you go. You will note, of course, that your erstwhile savior neglected to address this particular issue in any of the 1,000 pages of the ACA. Curious, don’t you think, for a guy who is going halt the rising of the oceans single-handed?

      • goplifer says:

        Evidence, reason, and facts flee in the face of your irrefutable anecdotes. I stand corrected.

      • Crogged says:

        Really–here’s a link to the rules of NYMEX, which is, after all, a ‘free market’.

        http://www.cmegroup.com/rulebook/NYMEX/

        Listen, waving a magic wand called ‘free market’ doesn’t work. How do you set up a free market in the delivery of medical services. If you don’t have a fungible product you can’t have a “free market” which delivers the most economical product to the most consumers. Why is the natural gas (and oil) market so successful-and why is electricity not?

        As was said by another,

        “The reason that the breadth of options that insurers can offer must be constrained is that if it is not constrained, then that variable, and not efficiency, is the lever that will preferentially be used as the profit generating mechanism. What that means in the real world is that the poor will be poorly insured and the rich richly insured, with the same problems of free ridership and poor long term outcomes due to avoidance of preventive care that we have now … In other words, healthcare really is a different beast in that it cannot be effectively treated as though it were a completely free market at the policy level because it can never, in fact, behave like one. That is not an ideological framing but a hard, cold fact. Healthcare is not a market like other markets and it is not even remotely anti free-market to point that out.”

      • kabuzz61 says:

        Chris, you are using the old democratic trick of redefining free market only it doesn’t work. If you didn’t want insurance, you didn’t have to get it. If you wanted a premium policy, you can get it or if you want a fair policy you could get it and if you wanted the minimum coverage you could get it. I could always shop around as an individual or through my employer or even my wife’s employer. That seems pretty ‘free’ to me.

        With Obamacare, I have limited choice and my policies can only reflect what our government says they can cover. OOPS! There goes the choices. And I thought progressives were so pro choice.

      • JohnGalt says:

        Posted this in the wrong place above…
        I’m highly amused by this persistent conservative thought that medicine can or should be a free market. Like the person having a heart attack is going to check ER pricing to tell the ambulance driver where to go. This idea, along with the proposal to return to a pre-1932 system, deserves nothing but contempt and derision.

      • kabuzz61 says:

        JG, you do know we are talking about insurance? I hope so.

      • Crogged says:

        Kabuzz, read the paragraph above you. The ‘choice’ is limited to insurers providing the same package because the competition regarding a same product results in lower prices to the consumer. This is how competition lowers prices, eg look at personal computers.

      • JohnGalt says:

        Well, Chris and Tracy certainly seem to be talking about health care in general, not insurance specifically. Nevertheless, a free market in insurance allows insurers to choose to not cover inconveniently sick people. I posted on another entry the story of a friend unable to get insurance on the free market due to a pre-existing condition (that was treated and corrected, so should not be an ongoing issue). This was affecting her economic freedom (what jobs she could take) and her interest in entrepreneurship. There are huge numbers of people who would be, and are, “market failures”. This particular person was able to get coverage on a state-run exchange.

      • JohnGalt says:

        For many of us with employer-provided health coverage, there is also no free market. I have utterly no choice about the insurance I get through work beyond take it or leave it. The difference between this and a single payer system to me is whether the faceless bureaucrat making health decisions on my behalf is in Dallas or Washington.

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