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Pipe dream? Obamacare
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swchandler



Joined: 08 Nov 1993
Posts: 10588

PostPosted: Sat Apr 27, 2013 1:55 pm    Post subject: Reply with quote

Like pueno, I respect David Brooks, and I think that he offers a view of things that isn't readily playing to the negative extremes like many Republicans and naysayers often do. Still though, what we're seeing in his commentary is a survey of the potential problems that could surface in the transitional phases associated with the implementation of the ACA. In my view, what is missing in the commentary are any uplifting signs of optimism. The way I see it, we're kind of getting a forecast, much like we get about weather predictions way out into the future. With the weather, we're dealing with the uncontrollable forces of nature, so all we can do wait for an outcome and hope for the best. On the other hand, with the implementation of the ACA, the outcome is much more affected by the parties involved. As Brooks so aptly pointed out, the Republicans in Congress and in many States have been very unsupportive agents doing whatever they can do to thwart progress and obstruct a smooth transition. Moreover, in the time leading up to the 2014 elections, Republicans will be working double time to impede progress and to throw a dark shadow on things. What I hope comes to the surface in this transitional period is that the American people realize that the Republicans aren't offering anything substantive or productive to address our vast array of health care problems. Sadly, that's the truth of the matter.
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isobars



Joined: 12 Dec 1999
Posts: 20935

PostPosted: Thu May 02, 2013 1:49 pm    Post subject: Reply with quote

Daniel Kessler, a professor of business and law at Stanford University and a senior fellow at the Hoover Institution, wrote in the WSJ: "The Coming ObamaCare Shock; Millions of Americans will pay more for health insurance, lose their coverage, or have their hours of work cut back."

Excerpts include:

Montana Sen. Max Baucus, a Democrat, called it a "train wreck." A Democratic colleague, West Virginia's Sen. Jay Rockefeller, described the massive Affordable Care Act as "beyond comprehension." Henry Chao, the government's chief technical officer in charge of putting in place the insurance exchanges mandated by the law, said, "I'm pretty nervous . . . Let's just make sure it's not a third-world experience."

The increasingly unpopular health-care law's rollout will administer several price (and other) shocks to tens of millions of Americans. starting with people who have individual and small-group health insurance. ...

The American Academy of Actuaries writes that around six million of the 19 million people with individual health policies are going to have to pay more even after government subsidies ... many young single adults will see an increase of 46% even after premium assistance from tax credits.

The Department of Health and Human Services admits that around 30 million Americans working in firms with fewer than 50 employees are potentially significantly affected by the small-group "reforms" imposed by ObamaCare ...

This modest average masks big differences ... firms with younger, healthier workers will see very large premium increases: 89% in Missouri, 91% in Indiana and 101% in Nevada.

Tens of millions will see higher insurance bills for 2014 due directly to the ACA.

Higher premiums are just the beginning because of the newly required "essential" benefits [e.g., Flucking, sex change surgery, mental health care provisions even for healthy young people]. Policies without premium increases will have to change, probably by shifting to more restrictive networks of doctors and hospitals. [How can that possibly mean anything besides lower quality practicioners and facilities desperate for patients and the two great physicians who don't want a BMW?]

The CBO determined that three million people will lose their insurance altogether in 2014 due to the law, and six million will have to pay the individual-mandate tax penalty in 2016 because they don't want or won't be able to afford coverage, even with the subsidies.

None of this counts the people whose pay rates, working hours, and/or very jobs will suffer because of disincentives under ObamaCare. The Bureau of Labor Statistics says 10 million part-timers who now work 30-34 hours per week will face higher unemployment due to the ACA.

In total, it appears that there will be 30 million to 40 million people damaged in some fashion by the Affordable Care Act—more than one in 10 Americans. When that reality becomes clearer, the law is going to start losing its friends in the media, who are inclined to support the president and his initiatives. We'll begin hearing about innocent victims who saw their premiums skyrocket, were barred from seeing their usual doctor, had their hours cut or lost their insurance entirely—all thanks to the faceless bureaucracy administering a federal law. The Congress are catching on, and there will be plenty of time before the 2014 midterm elections for them to consider their options.

For more, see http://tinyurl.com/boxlw52 .

Bring on the fart jokes, children.
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mogunn



Joined: 03 Apr 2006
Posts: 1307
Location: SF Bay

PostPosted: Thu May 02, 2013 3:43 pm    Post subject: Reply with quote

So much hand wringing ...
Quote:
Making Harry Truman's Dream Come True

by Mark K. Updegrove
Hardcover: 400 pages
Publisher: Crown (March 13, 2012)


[excerpt] At the top of Johnson’s legislative agenda in 1965 was Medicare, a federally funded insurance program to provide low-cost medical and hospital care for America’s elderly under Social Security. Half of the country’s population over age sixty-five had no medical insurance, and a third of the aged lived in poverty, unable to afford proper medical care; Johnson believed it was high time to do something about it. Shortly after his November election win, he told Health, Education, and Welfare’s assistant secretary, Wilbur Cohen, to make Medicare the administration’s “number one priority.” On January 4, Johnson put the issue front and center in his State of the Union message; three days later he pressed for passage of Medicare, issuing a statement to Congress demanding that America’s senior citizens “be spared the darkness of sickness without hope.”

Franklin Roosevelt was the first President to seriously consider a federal health insurance program. As Congress churned out New Deal legislation, Roosevelt advocated inclusion of a federal health insurance component in his Social Security Act of 1935, before dropping it to avoid jeopardizing the bill’s passage. Fourteen years later, Harry Truman sent the House a bill that would offer health insurance to those age sixty-five and older, but it was blocked by an intractable Ways and Means Committee. Kennedy tried, too, sending a comparable bill to Capitol Hill in 1962, where it missed passage in the Senate by a few votes. In each case, the American Medical Association (AMA) was the chief culprit in killing the legislation, spending millions to brand the concept as “socialized medicine,” an ambiguous characterization that nonetheless made it intrinsically un-American. Conservatives also cast a wary eye. Actor Ronald Reagan, a darling of the growing conservative movement and soon-to-be California gubernatorial candidate, warned that such a program would “invade every area of freedom in this country” and would, in years to come, have Americans waxing wistful to future generations about “what it was like in America when men were free.”

But sixteen years after Truman’s efforts were derailed by an unwilling Congress, Johnson believed “the times had caught up with the idea,” though it didn’t hurt that his electoral mandate and increased majorities in the House and Senate gave him the tools. The AMA would prove to be as big and powerful an obstacle as it had in earlier years, but unlike Truman, Johnson would find some leeway with the House Ways and Means Committee.

Along with most members of the committee, its Democratic chairman, Arkansas congressman Wilbur Mills, had been a fierce opponent of Medicare when Kennedy proposed it, professing it to be fiscally irresponsible. He felt no differently in 1965. Principle, however, would give way to pragmatism; Johnson, he knew, could find the votes to bring Medicare to fruition. Shortly after Johnson’s 1964 election victory, in which Johnson improbably added Arkansas to his win column, Mills stated publicly that he was willing to “work something out” on Medicare and would work closely with Cohen to help shape the bill to ensure its passage and effectiveness.

Telephone conversation with LBJ, Wilbur Mills, U.S. representative, Arkansas 1939–77, and Wilbur Cohen, March 23, 1965, 4:54 p.m.

LBJ: When are you going to take it up?
Wilbur Mills: I’ve got to go to the Rules Committee next week.
LBJ: You always get your rules pretty quickly though, don’t you?
Mills: Yeah, that’s right. LBJ: . . . For God’s sake, let’s get it before Easter! . . . They make a poll every Easter. . . . You know it. On what has Congress accomplished up till then. Then the rest of the year they use that record to write editorials about. So anything that we can grind through before Easter will be twice as important as after Easter.
[Mills gets off the line as Johnson continues the conversation with Cohen.]
LBJ: Now, remember this. Nine out of ten things that I get in trouble on is because they lay around. And tell the Speaker and Wilbur [Mills] to please get a rule just the moment they can.
Wilbur Cohen: They want to bring it up next week, Mr. President.
LBJ: Yeah, but you just tell them not to let it lay around. Do that! They want to but they might not. That gets the doctors organized. Then they get the others organized. And I damn near killed my education bill, letting it lay around.
Cohen: Yeah.
LBJ: It stinks. It’s just like a dead cat on the door. When a committee reports it, you better either bury that cat or get some life in it. . . . [To Mills as he gets back on the line:] For God’s sakes! “Don’t let dead cats stand on your porch,” Mr. Rayburn used to say. They stunk and they stunk and they stunk. When you get one out of that committee, you call that son of a bitch up before [our opponents] can get their letters written.

The plan Mills came up with was described by Cohen as a “three-layer cake.” In addition to including the administration’s original bill to provide hospital care for the elderly as part of Social Security, Mill’s legislation would include Medicaid, a supplemental medical welfare program to offer federal matching funds to states for the indigent, and an opt-in federally subsidized insurance program for doctors’ bills. Much to Cohen’s surprise, Mills had approved a $500 million government subsidy for the latter program after Cohen persuaded him that it would eliminate 80 percent of the doctors’ bills if the patient paid the first $50.

When Cohen asked the President what he thought of the $500 million subsidy, Johnson responded by telling him not to worry about the $500 million before relating a Hill Country yarn:

LBJ: I told [Wilbur] about the test that had been given to a man in Texas who wanted to become a railroad switchman. One of the questions he was asked was: “What would you do if a train from the east was coming at sixty miles an hour, and a train from the west was coming at sixty miles an hour on the same track, and they were just a mile apart, headed for each other?”

The prospective switchman replied: “I’d run get my brother.” “Now why,” he was asked, “would you get your brother?” “Because,” the fellow answered, “my brother has never seen a train wreck before.” I told Wilbur I thought I would run and get my brother if the Ways and Means Committee reported out this extended Medicare bill he had described to me. I approved the proposal at once.

Suddenly, Mills, “the villain of [Medicare],” in Johnson’s words, was “now a hero to old folks” as Medicare sailed through the House and was approved by the Senate on July 9.

But another villain would rear its head: the AMA threatened a national boycott of Medicare, holding out the possibility that as many as 95 percent of American doctors would follow suit. Johnson, who had sent Cohen away with instructions to “watch out for trains,” would shrewdly railroad the AMA into compliance in a meeting at the Ranch with eleven of its officers on July 11. After reminding the group that John Byrnes, the ranking Republican member of the House Ways and Means Committee and former opponent of Medicare, had urged that “all do their utmost to make the program work as well as possible,” Johnson switched gears, asking that the AMA support a program of rotating doctors in and out of Vietnam to serve the civilian population.

When they agreed to the latter, Johnson ordered an impromptu press conference, in which he praised the AMA for its commitment to the Vietnamese. When asked inevitably about whether the AMA would support Medicare, Johnson declared, “These men are going to get doctors to go to Vietnam where they may be killed. Medicare is the law of the land. Of course, they’ll support the law of the land.” He then turned to the AMA president, “You tell him.” Put firmly on the spot, he replied, “Of course, we will. We are law abiding citizens, and we have every intention of obeying the new law.” Within a matter of weeks, the AMA would formally endorse Medicare, with 95 percent of doctors not resisting it but following suit.

On July 30, 1965, Johnson traveled to the Harry S. Truman Library and Museum in Independence, Missouri, where the eighty-one-year-old Truman, lean and bent with age, his wife, Bess, in tow, watched Johnson sign Medicare into law. Proclaiming the thirty-third President the “real daddy” of Medicare, Johnson awarded President and Mrs. Truman the first two Medicare cards, numbers one and two. “He had started it all, so many years before,” Johnson wrote of Truman later. “I wanted him to know that America remembered.”

Jack Valenti: [Johnson] said, “I’m going to make Harry Truman’s dream come true. Old folks are not going to be barred from a doctor’s office or a hospital because they don’t have any money for medical attention. They are never again going to have to be sick and hurt and cry alone. It’s a god- damned crime,” he said, “and we’re never going to have that happen again in this country. When this bill is passed, I’m going to Independence, and I’m going to sign it in Harry Truman’s presence.” He did exactly that.

John Gardner: Medicare made an enormous difference in the lives of older Americans. It has had its problems, as every great social program inevitably must have. But it stands as a towering achievement. That’s not really debatable. You’ll encounter, occasionally, financially secure people who scorn Medicare—and Social Security, too—and cry for the good old days when each family looked after its own aging members. I’m . . . old enough to remember those good old days. So was Lyndon Johnson. In that time old age and poverty were firmly linked, and a good many old folks went “over the hill to the poorhouse.” That was the phrase of the day, “over the hill to the poorhouse.” . . . Don’t talk to me about the good old days.

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mo
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coboardhead



Joined: 26 Oct 2009
Posts: 4303

PostPosted: Thu May 02, 2013 8:47 pm    Post subject: Reply with quote

Mo...thanks...good post!
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isobars



Joined: 12 Dec 1999
Posts: 20935

PostPosted: Sat May 25, 2013 9:17 am    Post subject: Reply with quote

Laughing

New poll shows twice as many people say they're worse off (53%) than say they're better off (26%) under Obamacare.

And look who's now objecting to O'care: the unions. It costs them too much.
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MalibuGuru



Joined: 11 Nov 1993
Posts: 9293

PostPosted: Sat May 25, 2013 11:57 am    Post subject: Reply with quote

I am astonished that a bi-partisan group of legislators hasn't come together to overhaul the bill. I'm not saying destroy it. But at least try to make it better based on the data and implementation.

I think the whole thing is a cluster fuck, so why not add a little KY to it?

It just proves how dug in both side are, and how money and control of our economy, rather than America's best interest are the motives.
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isobars



Joined: 12 Dec 1999
Posts: 20935

PostPosted: Sun May 26, 2013 9:30 am    Post subject: Reply with quote

The IRS pegs the cost of a health care plan for a family of four under the Obamacare exchange program at $20,000. They also have the power to garnish unpaid health care costs from our income. And, of course, the same lady who is now on extended paid vacation for targeting conservative organizations has been designated to run the IRS Independent Payment Advisory Board (IPAB), accurately dubbed the health care death panel.

Are you lefties proud of any of that?
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swchandler



Joined: 08 Nov 1993
Posts: 10588

PostPosted: Sun May 26, 2013 12:45 pm    Post subject: Reply with quote

Bard, when you think about, the Republicans have a golden opportunity to show how creative and innovative they are, but instead, all they can do is repeatedly try to kill the ACA. Rep. Ryan has tried twice now to privatize Medicare, but he remains adamantly against the privatization concept that is at the core of the ACA, which ironically was the brainchild of the Heritage Foundation, a conservative think tank. Even the Democratic party was able to move significantly to the right to embrace and pass the ACA. That is solid evidence the Democrats are willing to compromise in the interest of a stronger more responsible America.

So when you attempt to categorize both parties as dug in against improving the ACA, you fail to recognize that it's only the Republican party that has been uncooperative and unable to show any leadership in addressing America's healthcare issues. They have absolutely nothing to offer, and the passage of time proves it. But, if you look a bit deeper, it's the people, money and influence that is behind the Republican party that reveals why they are such losers. We all know from the 2012 elections, they could give a crap about 47% of Americans. Moreover, given their continuing desire to cripple and disassemble Social Security and Medicare, they may as well advertise their desire to undermine America's best interests.
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MalibuGuru



Joined: 11 Nov 1993
Posts: 9293

PostPosted: Sun May 26, 2013 12:50 pm    Post subject: Reply with quote

Chandler, the Republicans had zero support for this failure. They are not at fault. Dems are 100% responsible for the success or failure of this monstrosity.
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swchandler



Joined: 08 Nov 1993
Posts: 10588

PostPosted: Sun May 26, 2013 2:05 pm    Post subject: Reply with quote

You're right, the Democrats and the president are fully responsible for passage of the ACA. You're also right that it was passed with zero Republican support. So if it's an utter failure, Democrats will be responsible. Yet, it's much too early to call the ACA a failure or a monstrosity. Will there be some difficulties making the transition to the ACA in 2014? I'd bet on it, particularly since many red states are dragging their feet setting up the insurance exchanges, but to assume absolute failure is simply Republican goofiness.

For a guy that talks a lot about folks taking responsibility for themselves, I find it strangely incongruent that you fail to support the ACA. I'm sure that you and your family presently have insurance, so why are you so worried. Surely it can't be for the mass of irresponsible folks that lack suitable health insurance.
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