The Biggest Problem With Obamacare’s Rollout Is Being Caused Intentionally by Republicans

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The media have been buzzing with stories — many of them wildly exaggerated — of people facing higher premiums as a result of Obamacare. But there’s a story about rates you may not have heard: According to Jonathan Gruber, a leading health care wonk at MIT, all private insurance premiums in the 25 red states that are refusing to expand their Medicaid programs will be 15 percent higher as a direct result of that decision.

But those numbers don’t capture the human cost. The reality is that conservatives are complaining about insurance policies being cancelled and the ACA’s error-plagued exchanges at the same time as they actively work to keep millions of poor Americans from gaining coverage under the law’s Medicaid expansion.

The victims of Obamacare’s implementation problems being hit the hardest, by far, are those whose incomes fall between the federal poverty line and the eligibility cutoffs in those 25 states rejecting Medicaid expansion. Not only will they be left uncovered, they won’t even be eligible for the generous subsidies that people earning slightly more than they do can use to buy insurance. It’s brutally unfair. The Kaiser Family Foundation estimates that 4.8 million poor adults may fall into that coverage gap — about twice the number of people expected to pay more for their insurance when their substandard policies are cancelled.

And it gets worse. In 40 states, adults without children are ineligible for Medicaid regardless of their income level. In 30 states, the parents of children who qualify for Medicaid may not be eligible themselves. All of these people would be covered under Medicaid’s expansion, but they’re being left high and dry in the 25 states who have rejected expansion. And while the problems plaguing healthcare.gov result from mismanagement and a contracting boondoggle, those red state lawmakers who refuse to expand Medicaid are inflicting this harm intentionally, based solely on their ideology.

In other words, they’re actively working to maintain America’s shamefully high rate of uninsured. And that comes with deadly consequences. Because, in this country, we do ‘let ‘em die’ – we let the poor and the uninsured die from treatable illnesses every day.

Last week, the Texas Observer ran a heartbreaking essay by Rachel Pearson, who recalled being a young medical student volunteering at a free clinic in Galveston, Texas. Pearson had a patient – a poor, uninsured patient — who was obviously very sick. But Pearson couldn’t properly diagnose his ailment with the resources available to the clinic. When his pain became severe, she sent him to an emergency room, but the personnel there refused to treat him because his symptoms weren’t an immediate threat to “life or limb.” As time passed, his condition deteriorated until he began having difficulty breathing. It was only then that an emergency room finally admitted him and diagnosed the cancer that had metastasized throughout his body. “It must have been spreading over the weeks that he’d been coming [into the clinic],” she wrote. He died a few months later. “The shame has stuck with me through my medical training — not only from my first patient, but from many more,” wrote Pearson, who now heads the clinic.

A 2009 study published in the American Journal of Public Health linked 45,000 deaths every year to the uninsured, even “after taking into account education, income, and many other factors, including smoking, drinking and obesity.” The lead researcher of the study, Andrew Wilper of the University of Washington School of Medicine, told the Harvard Gazette, “We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease — but only if patients can get into our offices and afford their medications.”

This is the real-world backdrop for our fierce debates over Obamacare. Yet Republicans’ answer to the uninsured crisis is to claim that having no coverage at all is better than being enrolled in Medicaid. And that’s why conservatives have no legitimate leg to stand on in griping about the program’s flaws, no matter how deep they run. Because when it comes to health care, the American conservative movement has nothing constructive to offer to fix the problem of getting more people health insurance — they can only whistle past the graveyard.

Here’s the sum total of what conservatives propose to fix our health care system. “Tort reform” remains popular; the argument is that malpractice suits drive up insurance premiums and make health care less affordable for the rest of us. But according to a 2009 study by the Congressional Budget Office, the total cost — “malpractice insurance premiums together with settlements, awards and administrative costs not covered by insurance” — makes up just two percent of our health care costs, and Republican proposals to limit payouts would reduce the cost of American health care by just one-fifth of one percent. When the CBO included the indirect effects — doctors performing defensive medicine to ward off lawsuits — they concluded that tort reform would only reduce health care spending by half of one percent. It’s an empty proposal that has more to do with dinging trial lawyers, who tend to support Democratic campaigns, than with improving our health care system.

Allowing insurance companies to sell policies across state lines is another reform proposed reform. Conservatives argue that more competition would lead to lower insurance costs. The problem here is quite simple: The US faces sky-high costs for health care goods and services — we pay more for everything from primary care visits to prescription drugs to surgeries thanpeople in other wealthy countries. Insurance costs reflect health care costs, and interstate insurance sales wouldn’t touch the underlying problem. Rather, it would create a race to the bottom, with insurance companies setting up shop in states with the least consumer protections so they could fleece their customers with impunity. None of this would expand coverage to the uninsured, improve care or bring down costs in any meaningful way.

Today’s conservative movement would only offer assistance to those who are already getting help from the public sector. But ironically, Paul Ryan’s Medicare proposal would restructure the system so it looks like Obamacare. His plan, passed with an overwhelming majority of Republican votes in the House, would offer seniors vouchers to purchase private insurance on an online exchange. But the value of Ryan’s vouchers would only increase a bit faster than the rate of overall economic growth, which is projected to be far slower than the growth in health care costs. Over time, the vouchers would lose value, and the scheme would simply shift costs onto the backs of seniors.

For the poor, Ryan’s plan would have a similar effect. Rather than the federal government sharing the actual costs of Medicaid as they grow, Ryan would turn the program into a block grant to the states that would increase with inflation and population growth. In real-world terms, this would cut spending on health care for the poor by about a third by 2023, according to analysis by the Center on Budget and Policy Priorities.

There are only two ideas conservatives support that might help the tens of millions of Americans priced out of decent health care. In theory, they support community health centers like the one Rachel Pearson runs in Texas. (Although in practice, Paul Ryan’s budget imposes deep cuts on America’s 8,500 community clinics.) The other is to provide the poor with vouchers to purchase insurance on the private market. The idea has been embraced by some conservative intellectuals, but it hasn’t been offered as a legislative proposal. It has, however, been enacted in Arkansas under the Affordable Care Act and other states are considering following suit.

This is all today’s right has to offer.

Liberals like to point out that the Affordable Care Act was modeled on a conservative, market-friendly approach to reducing the number of uninsured – a plan born at the Heritage Foundation and championed by such conservative luminaries as Newt Gingrich.

But that’s only half true. It was a Republican plan 20 years ago, when conservatives still expressed an interest in governing responsibly. Today’s tea party-dominated movement sees health insurance as something that fosters dependency on the government, and must therefore be limited to those who can afford it themselves or get it from their employers.

Liberals have every reason to be dismayed over the maddeningly problematic launch of the Affordable Care Act’s exchanges because their preferred route to expanding coverage – building on the popular and already functional Medicare system – would have avoided many of the problems plaguing this overly complex, public-private scheme. But conservatives, serving up only red-meat rhetoric about government takeovers and litigation run amok, have nothing real to offer in terms of solutions. As such, in a rational world they should have nothing to say about Obamacare’s rocky rollout.

Joshua Holland is a senior digital producer for BillMoyers.com. He’s the author of The Fifteen Biggest Lies About the Economy (and Everything Else the Right Doesn’t Want You to Know about Taxes, Jobs and Corporate America) (Wiley: 2010), and host of Politics and Reality Radio. Follow him on Twitter or drop him an email at hollandj [at] moyersmedia [dot] com.
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  • Jess Manuel

    These are facts. And as far as the GOP is concerned…so freakin’ what? They hate the black guy in the White House and they will do anything to make his life and all progressives miserable.

  • Ted

    …Take responsibility for you mess up and fix it. Is that all these folks do is look who to blame for their latest failure?

  • Diana Reichardt

    Granted there are problems with the AFA but it will be fixed. People need and look forward to having it. As far as the Republicans are concerned, I can’t wait for them all to be voted OUT!

  • Anonymous

    You can blame the GOP all day long, & it may be deserved in some small areas, but the simple fact is that it’s a “reaction” to a plan that isn’t going as…well, planned. The jig is up, it’s too well documented that the WH knew years ago this scenario would happen & now it’s all about damage control. Even Mark Shields on the PBS News Hour admits the president refuses to “own” the situation. Please, just stop “it’s the GOP’s fault” rhetoric, the management & implementation of the ACA that was controlled by the WH has fallen & can’t seem to get up any time soon.

  • Anonymous

    can you explain specifically how this abomination will cause more harm than good?

  • Anonymous

    “…according to a 2009 study by the Congressional Budget Office, the total cost — “malpractice insurance premiums together with settlements, awards and administrative costs not covered by insurance” — makes up just two percent of our health care costs, and Republican proposals to limit payouts would reduce the cost of American health care by just one-fifth of one percent. When the CBO included the indirect effects — doctors performing defensive medicine to ward off lawsuits — they concluded that tort reform would only reduce health care spending by half of one percent.”

    did you even read the article?

  • Anonymous

    I’m ambivalent about the ACA, not sure how great it is. But even if the ACA is 99% crap, you have to accept the other 1% of the law was the federal govt offering states new money to pay for more healthcare. Republican leaders in 25 red states CHOSE not to take the medicare expansion money. Supply and demand being what it is, insurance companies are now charging 15% higher rates in those 25 red states. A lot of people are paying too much for insurance, and some people are still going without. Some of those people will certainly suffer and die for lack of medical care.

    Do you really think those republicans who CHOSE not to take the medicare money looked into some magic ball? You think they said “the website will crash and the rates will climb. We should let poor people in this state suffer and die without medical care. We should take actions that further drive up the price of insurance.” The ACA offered those states a SOLUTION, and republicans CHOSE to create problems instead. Its downright machiavellian that they are now trying to blame the problems that resulted from THEIR callus decision on the ACA.

    Frankly its stunning how short people’s memories are. Yes rates are climbing and people are being dropped from their policies. But isn’t that exactly whats been happening for years, BEFORE the ACA went into effect? Honestly I could imagine a solution that would be simpler, more effective, and less expensive than the ACA. But I’m not going to pretend that insurance companies were doing a fantastic job until the ACA came in and ruined everything. Healthcare in this country was totally F’d for years. You think the D team just pulled healthcare reform out of their butts for no reason??

  • Anonymous

    Dude, do you even remember before the ACA? Rates were skyrocketing, the fine-print in these policies was a mile long and would screw you ten ways til tuesday, people were suffering and dying without the medical care they needed. THAT was a mess. THAT was a failure. Insurance companies had literally DECADES to show they could handle things properly without interference and THEY FAILED. Who you gonna blame for THAT? Obama?

  • Anonymous

    Yup. Private health insurance companies have been hiking their rates and dropping people from their policies for years but YOU PEOPLE denied it. Now that there is finally some intervention, suddenly YOU PEOPLE noticed it. Now you just blame it all on the intervention.
    SO
    F”N
    STUPID

  • Anonymous

    So true. I had a pre-existing condition in CA in 2011. If I wanted to keep my insurance with Blue Cross, my rates would double. At that time I had to drop my insurance, but health-wise, it was a risk. Now, I have insurance again on my husband’s policy because my PE condition didn’t matter. Monthly we pay 1/5th of what we’d have paid in 2011, but Blue Cross in it’s infinite greed, boosted the deductible. Our new plan’s deductible is $1500 PER person. It’s the insurance companies who are screwing everyone. Maybe after ACA is fully implemented and we get another Democrat as (hopefully you-know-who) President, we’ll get single-payer. Medicare for all. That’s what I pray and pray for. My adult kids need this to happen.

  • Anonymous

    Abomination means vile, viscious, disgusting. So, please explain how ACA is that? And how will we be worse off? (I was booted from my medical insurance because of a pre-existing condition). You are just repeating Fox News talking points. You know how I know? I watch it too (mostly just to laugh).

  • Anonymous

    Generally, I am in complete agreement with this comment., But right there at the end, I must point out a couple things: One, the ACA is not about health *care* reform, it is only health *insurance* reform. Two, while the Democrats didn’t pull the ACA “out of their butts,” neither did they come up with it after careful study. They got it from republicans – it was dreamed up by the head of a conservative think tank back in 1989. Of course, this only makes the current conservative objections even more ironic. In any case, If the ACA were a true liberal solution, it would have been single-payer or an expansion of Medicare, or would have at least contained a public option.

  • Anonymous

    No. It can’t be explained. Must be taken on faith. It’s like creationism in that regard.

  • Anonymous

    That is such a racist statement, and not true. Oboohoo is responsible for this mess and the GOP is letting him stew in his own juices.

  • Matt

    The more and more people who realize that the ACA works, and they get better, cheaper insurance under it, the worse and worse it will be for the GOP. This is something people will remember.

  • http://mollysmiddleamerica.blogspot.com/ Middle Molly

    So it’s an abomination that someone like me, without health insurance for 3 years and with some symptoms that need testing, will actually have health insurance and will be able to get those symptoms evaluated? You think it’s an abomination like the Patriot Act that someone like me might actually escape death because I can now get medical testing and care? How do people living vs. dying become an “abomination” to you? Can you possibly explain that?

  • http://mollysmiddleamerica.blogspot.com/ Middle Molly

    Good heavens. Read the article. Malpractice is only a small part of our problems in this country. And many doctors guilty of malpractice DO get their licenses suspended or yanked. I don’t see how your proposal would do much of anything to lower health care costs.

  • http://mollysmiddleamerica.blogspot.com/ Middle Molly

    I will say that Medicare isn’t all that it is cracked up to be. My husband is eligible for Medicare now and we are a bit confused with all of the options for supplemental, Plan D, Medicare Advantage, etc., and it’s not as cheap as I thought it would be. He’ll be paying about $250-$300/month to deal with all of his various medications and necessary doctor visits, which is more than he pays now without insurance. It might be cheaper if he could sign up for the ACA instead. Medicare is not a panaceae.

  • Pam Driscoll

    The Republicans have done everything in their power to shut down Obama’s efforts for the Affordable Care Act. What we REALLY need- and Obama agreed when campaigning the first time—is a universal, single-payer system; perhaps by expanding Medicare to all citizens. Our entire system has been corrupted by the influence of Big Money in elections….from health care to climate change….

  • Anonymous

    There are some healthcare reform aspects built into the ACA. These reforms are there to encourage better practices and better costs to consumers.
    If not for the rampant, flagrant abuse of the filibuster by the Party of No, there would probably be a public option within the ACA.

  • Anonymous

    I’m not saying you’re wrong. But do realise that spending control is an inherent and perennial problem with single payer systems the world over. You have to doubt the US government’s ability to control this efficiently whilst still delivering a good and effective service to citizens.
    If you’re not careful you’ll end up with civil servants in DC making decisions about the number of open heart surgery procedures Peoria Central Hospital can do next year.
    The trick here is finding the golden middle and it’s not easy.

  • Pamela Zuppo

    Perhaps it went unnoticed, just reading through many of the comments, there is a HUMAN side to this. In other words, equating costs to saving lives is a true false equivalency. Additionally if it’s gone unnoticed to the so-called “fiscal hawks”, emerging quickly within the U.S. and within the populations of others nations, greedy and excessive capitalism, intrinsically tied to sociopath is being shunned as those of all generations are embracing a holistic approach to civil society. Those who continue to fight it; who listen to the greed of the 1% like good puppets, will continue to be marginalized. Progressive economists and investment firms are expressing a trend toward another and deeper layer of risk management.

    Finally, for all the sociopaths commenting on here, this article written by Mr. Holland has gone viral in a very big way. Perhaps for those who have internalized greed and not caring for other human beings need a little self-analysis to discover why, when, and how it came about they grew into selfish and morally bankrupt adults. The time to change happens every moment; jump on that next moment.

  • scat

    If the administration “knew” years ago that this ACA mess would occur, why would they be so stupid as to not correct the problems earlier? And what evidence do you have that they “knew” this would happen? Do you have some inside sources? It makes no sense that they would just keep going along ignoring what you claim they “knew”.

    This is a huge and complicated piece of legislation and there will be a lot of changes by the legislature as we gain more experience with the ACA. That is true of all large pieces of legislation.

  • scat

    Most people just don’t want to deal with hard, fast numbers. And most people would rather be hung by thier feet over an alligator infested pond than read thier insurance policy or understand the concept of spreading the risk. It’s just easier to accept talking points at face value.

  • Anonymous

    No denial for pre-existing conditions. No cancellation when you need coverage most. No lifetime caps. These three ACA components will save countless citizens from financial catastrophe and premature and agonizing death. Also, unburdened from untreated illness and the terror of medical bankruptcy, Americans can free up some capital and move more freely in the labor force to become more productive. Thank you President Obama.

  • Noelle Fairweather

    Wow..you’re more stupid than i previously thought.

  • Rich Jones

    Great perspective Bill, unfortunately you’re probably preaching to the choir…

  • Anonymous

    This is the kind of thoughtful, nuanced argument we’ve come to expect.

  • Carlos E. Meza

    Just like we have civil servants cutting cost by denying care at the VA? The main problem with the US care system is the profit motive that private ensurers have. If we had universal healthcare, this would not be the case. Spending control would be easier as well since the government would have enormous spending power, that is, unless the Republicans don’t sneak in a bill saying we can’t negotiate drug prices (which has happened many times already).

  • Manor Mess

    This article is insulting and could use a reality check: Let me share the facts of my personal experience w/ Obamacre to date: I was one of the
    “lucky” recipients of the cancellation letter w/ a family of 5 &
    about to my lose insurance. My “crappy” plan as Obama calls it was working just fine for my family – I have a $2million life time cap per person therefore my plan does not comply w/ Obamacare. If I want the same coverage w/ no cap my premium is 5X more! or I can pay the same premium w/ an annual deductible of $5,500 per person! Why even bother signing up – I will be wasting my money would rather pay the $95 fine. I need to pay $25K out of pocket before I get $1 of insurance benefit!
    Thanks Obama for lying to me and thanks for making my decision that my
    plan was “crappy” – I am clearly not capable of making my own decisions. My best option given thus far: opt for zero coverage, pay the fine, pay for Dr. visits out of pocket as you go and if someone gets ill sign up for a plan at that time as you cannot be turned down for a pre-existing condition. This was the advice I have
    been given directly from the “obamacare helpers”!! Nice huh ! The irony in all of this is there will be less people insured in the US by the end of the year than before
    Obamacare – the government could not even run a lemonade stand

  • Anonymous

    “If I want the same coverage w/ no cap my premium is 5X more! or I can pay the same premium w/ an annual deductible of $5,500 per person! Why even bother signing up – I will be wasting my money would rather pay the $95 fine. I need to pay $25K out of pocket before I get $1 of insurance benefit!”

    Who exactly do you think you are fooling?

  • Anonymous

    I look forward to the day when people look at the fact that we’re spending more and more of our collective wealth on healthcare and say “Good.” Right now the argument seems to be “We could be using that money on bombs.”

    Imagine a world where the major powers weren’t building up for a war that should never happen, and instead spent all that money on healthcare. I’m curious why the world doesn’t demand it.

  • Anonymous

    “The irony in all of this is there will be less people insured in the US by the end of the year than before Obamacare – the government could not even run a lemonade stand”

    That’s simply inaccurate. And the rest of what you wrote doesn’t respond to the points raised above.

    But sorry you’re in that situation. You were being subsidized by insurers’ ability to deny coverage and avoid paying for services, and that’s no longer the case. It does hurt, though, to lose that subsidy.

  • Jack Jitsu

    The ACA is a disaster. Premiums are way up in the majority of states, and insane deductibles averaging $5000-$6000 for bronze plans makes it impossible for the struggling working poor to actually get any coverage. This is a terribly thought out idea. Wait until the employer mandate kicks in and everyone ELSE takes a huge hit.

  • scat

    That is the kind of comment that lets people justify stupidity. You can either do some actual research or just accept the politically motivated talking points.

  • Lastb0isct

    Did you even look anywhere else? Did you, you know, shop around for the best deal?

  • Kevin Schmidt

    BS. The insurance companies are their friends who give them lots of money in the form of legal bribes to sabotage ACA.

  • Kevin Schmidt

    I agree. The Republicans should take responsibility for creating a mess of ACA in red states and should fix it.

  • Kevin Schmidt

    The ACA is only an abomination when compared to what we could have had, which is Single Payer Medicare for All.

  • Anonymous

    You obviously don’t live in Colorado as your annual maximum out of pocket and deductible costs are wildly overstated.

    For a family of 5 you could get Gold-level coverage in Colorado with no subsidy for $673 per month with a $5,000 annual deductible (which covers all five of you and is not rated on a per-person basis) and a $12,000 maximum annual out of pocket cost. If you took a Silver plan that amount would drop to $559 per month, and that would be if you and your wife were age 57 and 53.

    Your prescription drug coverage is exempt from the deductible as are office visits, which have a copay of either $25 or $40 depending on the plan selected. If you took Kaiser here you and each member of your family would get a free annual checkup and a free flu shot too.

    What is your maximum annual out-of-pocket cost? Hint: It is not 5 times the deductible. Things could be worse you know, as you could excluded for life like my wife and I are, and have no plan unless the ACA becomes law, in our case, neither due to fault of our own either.

  • Anonymous

    You obviously don’t live in Colorado as your annual maximum out of pocket and deductible costs are wildly overstated.

    For a family of 5 you could get Gold-level coverage in Colorado with no subsidy for $673 per month with a $5,000 annual deductible (which covers all five of you and is not rated on a per-person basis) and a $12,000 maximum annual out of pocket cost. If you took a Silver plan that amount would drop to $559 per month, and that would be if you and your wife were age 57 and 53.

    Your prescription drug coverage is exempt from the deductible as are office visits, which have a copay of either $25 or $40 depending on the plan selected. If you took Kaiser here you and each member of your family would get a free annual checkup and a free flu shot too.

    What is your maximum annual out-of-pocket cost? Hint: It is not 5 times the deductible. Things could be worse you know, as you could excluded for life like my wife and I are, and have no plan unless the ACA becomes law, in our case, neither due to fault of our own either.

  • Anonymous

    This maybe true but somehow this real life example doesn’t pass the smell test.

  • Anonymous

    So why aren’t you keeping your insurance if it meets all basic requirement? Mine does and I don’t have to do a thing and no cancellations to phony up and excuse to raise my premiums. And a large percentage of those 5 million are crap and little more than 10% discount cards sold for $79/month.

  • Anonymous

    The “let’s blame the Republicans again because we can” attitude is outrageous!! Those who are trying to stop this piece of socialism called the ACA represent ME !!! …..and, apparently, millions of others who trying to keep their heads above the drowning waters of socialism!! People who are really trying to help others( as the designers of this piece of crap say), don’t try to foist something on the public with the problems this so-called “affordable care act” has…shrouded in documented lies and secrecy, there is nothing affordable about it. Lies always appeal to those who have a vested interest in the lie being true somehow.

  • Anonymous

    It is inaccurate that you will pay $25K out of pocket before getting a dollar of coverage. Preventative services are covered. You might not want or need this coverage, but your statement is false.

  • BillD

    I was wondering how long it would take before the Republicans got blamed for this mess. Just saying…you should have said it was the fault of President George W. Bush.

  • Anonymous

    The deductible per person is only up to the family out-of-pocket maximum. Sorry if you were confused, but the maximum possible cost is only half of what you stated.

  • Anonymous

    Also you get preventive care for free from the first day, not subject to any deductible.

  • Anonymous

    read the article next time prick.

  • Pamela Zuppo

    Oh my, there are so many imbeciles in the U.S. wherein confirming that the 1% and the far-right psychopathic nut jobs have been successful in their campaign to dumb down Americans; turn Americans into blabbering idiots who are incapable of forming an original thought; who have learned to internalize sociopathy and selfishness while blindly hating democracy and unity…who actually make statements that are in essence self-sabotaging. We would be very fortunate for an asteroid to strike this planet and end this nightmare of corporate-built idiots.

  • Anonymous

    Having for profit insurance companies as the main ingredient of the ACA is “Socialism”?? Are you for real? Do you even have a clue what that is? Or, did you hear that word used on FOX and thought it was cute?

  • Anonymous

    AND…….. where did that $400B come from? Hmmm?

  • Anonymous

    What’s the alternative?

  • Anonymous

    Troll paradise. You are lying.

  • Anonymous

    Koch Bros. trolls abound, right?

  • Anonymous

    Right on!

  • Anonymous

    Do you EVER think it’s time to target the rates INSURANCE COMPANIES charge??!!? It’s insanity and complete BS!!!

  • Anonymous

    You are so mis-informed. You had a POS policy. Get your head out of your arse and read it

  • Joanie

    Great article but there’s more to it than this–I’ve talked to some insurance experts who say first, they’ve not secured the financial health of insurers in the way they set up the ACA and Pelosi drove it through without fixing that major error. I’m all for single payer, but sense it’ll be a rocky road there as insurance companies go under–but then, it’s already a rocky road for my friends with preexisting conditions so six of one, half dozen of another. Second, the hidden cost of not having tort reform is overtreatment/overtesting. I don’t trust the CBO’s figures one jot–talk to risk managers who have bought insurance in this climate. Third, we have to have transparency on provider costs–that’s another hidden thing that if brought to light, would bring about massive changes as companies, insurers, and citizen activists pushed back against the outrageous provider charges (covered in a recent Time magazine article). Listen to the insurance experts and write about what they say. They have CRUCIAL insights we have to consider in fashioning a workable system. Pelosi ignored them, understandably, because we were under the gun to get this sucker passed. But now we have to fix crucial flaws. I say that as a progressive who will be eternally grateful to Obama for the ACA because I have affordable healthcare on the private market, as a self-employed head of householder, for the first time in 15 years!

  • Joanie

    Have you tried the private market? Every year for about 20 yrs., my insurance premiums went up as copays disappeared, and my deductible swelled to 10K per individual 20K per family. I could NOT get my family into a group because DH and I are self-employed. Thanks to the ACA, a large group opened up to us. Went from $450/mo. to $300 mo., no copays, no deductibles, RX coverage for the first time in many years, preventive care covered, dental, hearing, vision. But that’s probably because we have no preexisting conditions yet and we’re getting up there in years. Keep searching. Policies are opening up every day. And yeah, my premiums will probably go up because short-sighted kids who live on junk food, smoke, and are obese think they’re immortal and entitled not to pay in–and to have ME cover their butts with services that have been overpriced to make up for their emergency health care. I hope you get affordable insurance–I hope the same for my health nut friends who have preexisting conditions who lost their insurance due to our Repub governor refusing federal monies for state insurance. I hope the same for everyone. But as long as it’s all about ME ME ME, we won’t get there, and responsible folks will get screwed.

  • Joanie

    Indeed. ACA pays for preventive care and you MUST consider that. Before ACA, I couldn’t get birth control coverage and had to buy pills from a Canadian online pharmacy to afford them. After the ACA went through, my scummy insurance insisted pills weren’t covered because “they’re not contraception, they’re pharmaceuticals, and you don’t have coverage, nyeah nyeah.” So I got a $6000 tubal ligation instead. Nyeah nyeah. BTW, they paid my surgeon $75 for doing the procedure, so I bought her a $50 Whole Foods Gift Card by way of apology. Nice insurance company–hope the bastards go under. She dropped my insurance but takes my new one, a group policy I pay peanuts for given the coverage and the reimbursement rates for my docs. Otherwise, I would’ve just paid her out of pocket for preventive care in order to keep her–and keep her in business as a self-standing ob/gyn.

  • Anonymous

    I already blamed some of it on Bush… and Bill Clinton.

    http://billmoyers.com/2013/10/21/the-healthcare-gov-debacle-spare-some-blame-for-bush-and-clinton/

    Hey, they deserve a little!

  • Roland

    A European/Canadian style National Health System is the only sensible solution. Single payer would better than the ACA which is better than what we have had, but many would still need to deal with companies like Humana and Tenet that sacrifice patient care for profit. Prohibiting gouging by the pharmaceuticals is also needed under any approach, or just revoking Medicare part D and letting people by their drugs from Canada again.
    Roland

  • Roland

    I think you may be confusing commercial “medicare supplement” plans with medicare itself. Insurance salesmen sometimes make things seem confusing, but I have never known one to lie unless it was absolutely convenient.
    Roland

  • Manor Mess

    First, thank you to those who provided constructive comments – I am not interested in debating and responding to those that are ignorant and/or baiting a fight. My wife & I both work and I never have really posted anything but this situation has really hit “home” for us. We are both self employed and while we are not part of the demonized 1% we have worked hard and are fortunate our hard work has paid off. I have spent no less than 5 hours of my time this past week trying to find a path forward to do the right thing for our family and after doing the math, the bottom line: there is no way to keep the same coverage w/ a 277% premium increase ( yes I was frustrated when I posted 5X to the “fact checkers”). I created a spread sheet and basically there is no plan available that makes sense for us to sign up for that does not support opting for zero insurance and paying out of pocket for preventative care, pay the fine for the 5 of us and only sign up for insurance when someone is ill – since u can’t be turned down for pre-existing conditions. I feel no compelling need to “subsidize others” by paying the high premiums – I choose to donate my time and $$ in other ways. This article was particularly bothersome to me as it does not address the real issue of how this law was passed: with outright lies, and political rhetoric by our president and this is not something I can simply rollover and forgive – it has created a lot of stress during an already stressful time of year & effected my family in a terrible way. I know I am not the only independent voter that feels this way & there are plenty of others I know in a similar situation. Have a great weekend

  • Asok Asus

    test for censorship

  • Roland

    The few doctors who lose their licenses just move to another state and continue practicing. Malpractice is sold only on a group basis; Barney the Butcher pays the same premium as Marcus Welby. The states must take a more active role in regulating the practice of medicine rather than leaving it to the profession.
    Abolishing malpractice insurance would mean a life of hardshiip and poverty for patients maimed by botched procedures.
    Roland

  • Asok Asus

    Nothing offensive in my post. Just raw censorship all right. But that’s to be expected here, right?

  • Asok Asus

    Nothing offensive in my post. So, yep, just raw censorship. But I guess that’s to be expected here, right?

  • Roland

    On the other hand, hospital profits (which were virtually nonexistent forty years ago) add over ten percent. And the care and feeding of the flocks of little MBAs running hospitals (which were also nonexistent forty years ago) add another ten percent. Typically hospital CEOs get about $60 a day for ever bed in their fiefdom, but through the miracle of modern accounting, that can be turned into $10 aspirin tablets.
    Roland

  • Roland

    The insurance companies do not dislike the ACA. Sure, they had to trim their cut to 20% from 40%, but the no longer need to pay so many commissions, which tend to run around 25%.
    Roland

  • Roland

    “Who you gonna blame for THAT? Obama?”
    Sure, why not. He is also responsible for mosquitoes, sunburn and crying babies. After all, he IS a BLACK man living in the WHITE house.
    Roland

  • Roland

    Taking responsibility is against their policy. We must take responsibility to put them ALL out of a job.
    Roland

  • Roland

    “… both sides are taking us to the cleaners …”
    Bull!
    While neither corporate party is any prize, only one is single mindedly trying to destroy the middle class (which was created in industrial America by the New Deal, another bete noir for Rs)
    That “they’re both guilty” argument is the same as claiming that shoplifters are as bad as murderers and rapists.
    Roland

  • Roland

    “You can’t explain that.”
    … unless you went to a real high school.
    Roland

  • Roland

    Foul! Rs just sling words. They cannot explain (or understand) them. It is most unfair to try to hold Rs to any standard of civilized discourse.
    Roland

  • Anonymous

    LOL!

  • Roland

    Absolutely. If you were not born rich, then you should die when you get sick. That is just Nature’s way. Mitt Romney told me so.
    Roland

  • Roland

    Get a clue.
    Roland

  • Roland

    “They know more about buying cars.”
    You do not set the bar very high, do you?
    Roland

  • Roland

    Dewey Wins!
    Roland

  • Roland

    “Mommy, Billy MADE me do it1″ – Republican mantra

  • Roland

    And just look at how hard the Rs are fighting against their own plan; nothing else would have had any chance at all. And nothing else will until the last of these traitors is twisting in the wind under a lamp post.
    Roland

  • Roland

    That makes it PRIVATE.

  • Roland

    The problem is with the website, which could not get funding from the House.
    Roland

  • Roland

    “conservatives would intentionally let people suffer.”
    Of course; that is their core belief! That is why they like to start so many wars and videotape them. The tape of a mother and her children being incinerated affects them the same way a Pamela and Tommy tape affects normal people.
    Roland

  • Anonymous

    Shouldn’t the 2nd sentence in the 11th paragraph read “… Paul Ryan’s plan for Medicare …” not Medicaid??

  • Roland

    “with no deductibles or co pays.”
    Both are useful to prevent over-utilization, e.g.: seeing a chiropractor instead of a masseuse.

    “… vouchers
    & let them buy their own insurance is absurd & anyone that
    supports that idea has to be out of their mind.”
    Or in the insurance business.

  • Roland

    ” There are a lot of layers to this onion that doesn’t come out.”
    … on Faux news.
    There, I fixed it for you.
    Roland

  • Roland

    “I have grown so weary with the obtuse masses.”
    Me too! I think we should deport them all back to Kolob.
    Roland

  • Roland

    Let us hope so. Unfortunately Americans have short memories. Nixon was very shrewd to begin the dismantling of education.
    Roland

  • Roland

    Clues! Clues! Get your red hot Clues!

    Roland

  • Anonymous

    Important point to keep repeating: Republicans are actively trying to keep poor people uninsured and as a result thousands die.

  • Roland

    So maybe we should blame YOU! Or you and all the other idiots who watch Faux News.
    Roland

  • Roland

    There IS a problem with implementing a NHS or single payer system in the US because as a people we are so thoroughly corrupt that good results from either the public or private sector in any field are highly unlikely.
    Roland

  • Asok Asus

    So you think censorship is funny or that I’m foolish for expecting anything otherwise from this site? Why won’t my REAL post appear, then?

  • Anonymous

    Yes, good catch. Thanks.

  • Roland

    ” so-called ‘fiscal hawks’ ” is right. Last New Year’s Mitch McConnell gave his favorite pharmaceutical half a billion of our dollars. The F-35 has cost us over three trillion already and it will never be used except at airshows. Medicare part D is a half-trillion dollar gift to the pharmaceutical industry. And maintaining hundreds of bases overseas and fighting unending wars is not cheap.
    Morality aside, these programs are putting us in the poorhouse. So where do the Rs want to cut? Food stamps.
    Roland

  • Roland

    “If you are a Republican supporting the current group of extremists, you
    are … [one] … of the biggest traitors our country has ever seen,
    and … [we] …. will judge … [you] … as such.
    There, I fixed it for you,
    Roland

  • Roland

    Well, we DO see through you!
    Roland

  • Roland

    See! There are decent, honest conservatives. Not in Congress, but in the real world.
    Roland

  • Roland

    Do not confuse him with facts.
    Roland

  • Roland

    “But sorry you’re in that situation.”
    Why? He was just posting something he got from the Kochs.
    Roland

  • Roland

    No, they are expert at ignoring facts.
    Roland

  • Asok Asus

    OK, guess the joke is on me! My post finally DID appear! Thanks!

  • Roland

    Insurance has always been that way.
    Roland

  • moderator

    Asok Asus,

    Your original post was not censored. It was placed in the pending file due to two factors: 1. Use of a link (healthcare.gov) 2. Your “Low Rep” from Disqus due to a high number of spam comments.

    Sean @ Moyers

  • Roland

    Times are tough. $0.10 per post is salvation for some.
    Roland

  • moderator

    Asok Asus,

    Your original post was not censored. It was placed in the pending file due to two factors: 1. Use of a link (healthcare.gov) 2. Your “Low Rep” from Disqus due to a high number of spam comments.

    Sean @ Moyers

  • R. Kemp

    In a way, he did. He created the deficits that conservatives are using to justify cuts to everything from Medicaid to Social Security. Anyone with half a brain can see that the wars, the tax rebates and the incompetence of GW all contributed to the fix we’re in now. As I always say, the Republicans cause problems that (they say) only they know how to fix.

  • Roland

    You should dump that lemon of a group policy and buy an individual policy yourself. Fortunately, the ACA has made that a piece of cake. Insurance pricing is all over the board, so a little shopping is definitely worth the trouble. That is why agents selling the lousiest policies make seven figure incomes. (The MDRT designation should be regarded as a cobra’s hood.)
    Roland

  • Roland

    Insurance is regulated by the states, and only New York has taken the job seriously consistently. For many years Elliot Spitzer was the only cop on the beat.
    Roland

  • Roland

    The Rs fought almost as hard against Social security and Medicare. And they never stop. Just five years ago they were trying to “privatize” Social Security.
    Roland

  • Roland

    Well, the Rs got caught loading the swag into their pickup, but W was not with them this time. W has been staying out of the spotlight in Crawford with his lover “bulldog”.
    Roland

  • Roland

    “… campaign to dumb down Americans”
    It is not just the Rs; Madison Avenue started it. I remember that TV was very timid in the fifties, most programs ending with “thank you for letting us come into your home.” Advertizing was crude, somewhere between a door-to-door salesman and a carney. Back then people just did not need to go out and buy crap. And there were NO teenagers.
    This is not to take anything away from the Rs and their unflagging and aggressive crusade to promote anti-intellectualism started by Spiro Agnew (US VP, not a bacterium).
    Roland

  • Roland

    “they’ve not secured the financial health of insurers”
    The financial health of insurers has never been secured. And this was the ACA, not the Insurance Company Protection Act. Looking back over the past ten years, I should think no one would want to guarantee ANY industry regardless of their cupidity.

    “I’m all for single payer, but sense it’ll be a rocky road there as
    insurance companies go under”
    There is no place for insurance companies under single payer. If any go broke it will be because they ran out of suckers to fleece.

    “cost of not having tort reform is overtreatment/overtesting”
    The answer is to make those injured by malpractice pick up the tab? I think a better answer would be a better and less bureaucratic practice of medicine. (n.b.: not all bureaucracy stems from government.) And when the practice is particularly egregious, as with Tenet, the entire company should be seized under RICO and let the unethical investors pay.

    “we have to have transparency on provider costs”
    Granted. But since the providers became for profit and investor owned obfuscation is the order of the day.

    “Listen to the insurance experts”
    Unless you are an actuary, the only insurance experts you are ever likely to hear will be of the PR sort.
    Roland

  • Anonymous

    You might want to read the piece!

  • Anonymous

    OK, you may be right. But some people are in fact unhappy about paying more, even if the coverage is better, and in this economy, I can certainly understand that.

  • Roland

    Legislation works better without involving traitors. But the traitors were able to hobble enabling legislation, deny funding and prevent administrative appointments. If these traitors differ from the Taliban only in their greater ignorance and lack of mental powers, why should we treat them any differently?
    Rokland

  • Roland

    You should expect it everywhere. Have you never noticed people trying to avoid you? Everyone can make others happy; some when they arrive, others when they leave.
    Roland

  • Roland

    Or, more simply, the Rs are trying to take us back to the twelfth century, but are likely to overshoot and land in the eighth.
    Roland

  • Roland

    I am sure there are. But I expect most would be even unhappier when they try collecting on a non-trivial claim.

    Others may be unhappy about changes to their policies that the insurer dishonestly blames on PPACA. Many garages say customers are not allowed in work areas by their insurance coverage, but none can show you that restriction. It has become the American Way to blame someone else when behaving dishonorably.

    There are a lot of sleazy insurance companies out there that their victims seem to love, at least at first. One such advertizes “end of life” coverage heavily on TV. The beneficiaries of anyone who buys such a policy will have reason to wish the premiums had been put into a credit union instead.

    Boutique companies are usually so bad one wonders why they are permitted. Many people think their insurance is great because their agent has a million dollar smile, rides in a limousine and offers them free donuts. That their policy is almost worthless when they need to use it does not seem to matter.
    All policies contain a “whole contract” clause stating that the promises of the agent mean nothing.
    Roland

  • http://www.waynecaswell.com Wayne Caswell

    Republicans are actively forcing middle-income people into poverty and making the plight of the poor worse in a way that might be described as a slow and cruel form of genocide. That’s because public health officials have seen average lifespan differences of more than 20 years between affluent and low-income neighborhoods in the same town.

  • Asok Asus

    10-4. thanks for the explanation. 99.9% of the time when a post is marked “pending” on most sites, it really means it’s being thrown away never to be seen. Glad you guy’s are different!

  • J. Mark Soveign

    Today’s Republican party is driving the nation toward a corporate sponsored neofeudalistic dystopia populated by a beaten down class of insects of labor.

  • Anonymous

    Roland, I refuse to accept that Americans as a people are corrupt. Rather do I think that America is held in the grip of a corrupt clique. That grip must be broken. In order to achieve that it must first be exposed and shown for what it is for all to see.

  • Roland

    Ok. What institution or component in our society is not corrupt?
    Roland

  • Anonymous

    The American people themselves. As long as you’ve got them, there’s hope.
    Americans have been more or less enslaved by a corrupt cartel made up of big business and politicians, but that doesn’t mean that all resistance has ceased. Give ‘em hope and they’ll fight.

  • Roland

    So what part of our society is not corrupt?
    Roland

  • Roland

    Look at Paul Ryan. Does he look like a deranged Eddie Munster?
    Roland

  • Anonymous

    Yah, I noticed that years ago. It just adds a surreal touch to a surreal era.

  • Anonymous

    Would you rather have a flawed health care system that saves many more lives, or stick with what we had? The ACA is a work in progress. Obama never promised rainbows and unicorns. What he actually HAS achieved (albeit often without credit from the left or right) was more than informed grownups could have reasonably expected (such as reversing Clinton’s policies against disabled workers). Obama stated back during his original campaign that there was nothing he could achieve unless the people, the masses, got to their feet and MADE Congress listen. Under our form of govt, with rare exception the president can only put forth proposals, while Congress actually makes all the decisions. People have to make themselves heard if they disagree with Congress. And you know, we almost did just that, with Occupy. Tragically, before we even had time to catch our breath, liberal media redefined Occupy as a movement of middle class workers alone, the better-off. The discussion became all about, only about, the middle class. So the rest of us walked away, and Occupy died.

  • Anonymous

    To a large degree, it already is one. We don’t even know how much labor has been subcontracted to super-cheap workfare labor, prison labor, etc. But you dare not risk your job by complaining, much less going on strike.

  • Anonymous

    Disagree about Republicans. It is Democrats who took a machete to the safety net, made it cool to “get tough” on the powerless poor while creating a glut of super-cheap replacement labor. Today’s Dem Party has worked long and hard to remove poverty from the discussion, remaining focused on pandering to the middle class, their campaign donors. Bill Clinton’s policies, in particular – both workfare replacement labor and NAFTA – have served powerfully to phase out the middle class, thereby phasing out any voice that people had in govt. (increasingly, not only do the poor have NO representation in govt, but increasingly no longer even have their right to vote). This actually isn’t the first time we’ve been in this mess, where the richest few took control of the country. Each time before, the poor and middle class united to push back, to everyone’s benefit. Not this time. Finally, the masses were divided and conquered.

  • Anonymous

    When one is really poor, and I know this from past experience, insurance is not their greatest concern. When a poor person collapses in the streets, he/she is scooped up and taken to a hospital, patched up and sent back out on the streets. We can ask what the point is to ensuring medical coverage for those to whom we refuse the most basic needs of food and shelter. It is the deprivation and relentless stress of poverty, in a country that despises the poor, that is killing people.

  • Anonymous

    With Ds leading the way. Democrats threw the poor off the cliff, and made it cool to regard the poor as something less than human. It was Bill Clinton who wiped out poverty relief, and with rare exception, liberal media shrugged with indifference. Our “bold progressives” in govt (Elizabeth Warren, Alan Grayson, Deb Wasserman-Schultz, etc.), who began as strong advocates for the poor, suddenly cut poverty out of the discussion to wave the Middle Class Only banner. The Rs just sat back and enjoyed it.

  • Anonymous

    The idea of Dems “buying” votes really no longer applies. Most of the very rich will vote Republican, and (what’s left of) the middle class will be divided, as always. Dems deeply alienated a large portion of their voters. Millions of the poor did vote for Barack Obama, not because they could reasonably expect conditions to improve, but because they did believe Obama (unlike the last Dem president) wouldn’t worsen conditions for them. So far, they were right. I’m not aware of a single Dem coming up to the next election that the poor will vote for, though. Joe Biden is supposed to be the candidate, but the Clinton Dems seem to have other ideas — and the millions of poor are guaranteed to NOT vote for her, based on her own record of contempt for the poor.

  • Anonymous

    Put simply, you give some very sensible and clear advice.

  • Anonymous

    Did the dumbing down start as far back as Nixon/Agnew? Seriously. I was a teenager then, and what I remember was an era of questioning and demanding straight answers, with people actually getting off their butts to organize and push back (and not just for the sake of the better off, the middle class). Then there was Reagan (after Jimmy Carter), and the onslaught of “news media consolidation,” etc., etc., when the public message was (or appeared to be) dictated/controlled by the right wing, and we learned that we dare not question or criticize government. We must all work hard and play by all the rules, “quit whining,” shut up, and obey, and sell our souls to the corporate state.

  • Anonymous

    Our current mess IS the result of years of Republican legislation, from Reagan’s deregulation frenzy onward. Without question, Bill Clinton was an active participant, passing more right wing legislation than any Republican president. Deregulation, if you recall, amounted from liberating corporations from rules and oversight so that they would have the freedom to grow, creating a mass of those “good, family-supporting jobs.” The Republican agenda required the redistribution of our collective wealth — taxpayer dollars — to do this, taking money out of maintaining and growing the US and handing it over to corporations. Under years of Republican rule, in a nutshell, we looked at all those policies and regulations that took the US to its height of shared wealth AND productivity, from WWll until Reagan, and reversed course.

  • Roland

    “It was Bill Clinton who wiped out poverty relief”
    No, it was the Republican Congress during the Clinton administration. Eliminating all New Deal programs has been a Republican crusade for eighty years. Since the public does not seem to care, sometimes they have victories. Would you berate Washington for losing Boston, New York and Philadelphia?
    Roland

  • Anonymous

    I appreciate very much that Mr. Holland wrote, “Because, in this country, we do ‘let ‘em die’ – we let the poor and the uninsured die from treatable illnesses every day.” With our repeal of poverty relief, we have also left the poor far more likely to contract and die from such illnesses as pneumonia This generation got very, very tough on the poor. The least horrible fact to come out, sadly enough, is that the overall life expectancy of America’s poor has already fallen by 5-7 years since Clinton wiped out welfare. Both deprivation and relentless stress has been taking a heavy toll on America’s poor.

  • Roland

    Actually, the dumbing down was in progress in the mid-forties, but gradually. It speeded up with Nixon. First a lot of kids with no interest in academia wanted to go to college to get out of the draft; then they demanded a weakening of standards. Education funding was cut, and when nineteen year olds could not handle forty six year olds, the children were drugged. When Nixon started drafting college students many men changed their majors to education to avoid carrying a rifle through the jungle. Then Agnew began targeting anyone associated with the anti-war movement. From our perspective it might seem that anyone with any sense at all would have been opposed to that war, but that was not the case. Nixon’s ‘moral majority’ was openly contemptuous of education. So a lot of good teachers lost their jobs for opposing the war. My school was one of those that found cannabis safer than aspirin; Nixon demanded his money back and targeted those responsible for the report.

    I presume you know much of the story after 1980.
    Roland

  • scat

    Insurance is based on spreading the risk. So in a sense, those who end up not needing to use their insurance because they do not sustain damage from the insured risk do end up “subsidizing others” who do sustain damage. If you seen paying a premium for someone else, then you are missing the concept altogether. Personally, I would much rather be one of the insureds who do not suffer the risk than one who does. Just ask anyone who has suffered a serious illness if they would rather be one who never needs to use thier insurance.

  • Roland

    I forgot another thing. In addition to changing to exempt fields, most of the best and brightest boomers were lost to the war itself, emigration or prison. In toto, at least half of the best and brightest boomers were lost. The professions and industries had quotas to fill, so they just lowered their standards.
    Roland

  • gma7574

    Obama has used Executive Privilege and mandates before, he could have used them here. From that point on, Congress could have amended his Health Care bill and we could have avoided all this turmoil.

  • scat

    There is potential for corruption in any group of two or more people. There is always someone who is willing to cut corners or step over a line in any endeavour. The question is whether the group as a whole bends to such behaviour.

  • scat

    The difference is that private insurors are answerable to its shareholders. Government agencies are answerable to all of us.
    Even though the roll-out of the ACA has been a mess, one good thing that is happening is that people are finally being forced to learn more than they ever wanted to about insurance. People are actually being educated, and that is a good thing. I think the administration should have had someone with an insurance background as a spokesman from day one. Someone who could answer questions more accurately and with more depth.

  • scat

    Brandon — Yes, insurance companies have had so-called “death panels”. It really is an actuarial exercise in calculating the potential costs of treatment and all companies are required to do it in order to set accurate “reserves”. Reserves are the amount of money that must be set aside to pay potential claims. There are also decisions that need to be made about what kind of treatment, usually outside of the norm, would be reasonable under the particular circumstances.
    As a medicare member, I have had some medical issues that were unique and my HMO had to get permission to prescribe medicine not normally used for that particular problem. They have always gotten the permission and in a very short period of time. My HMO has a great reputation and I expect that carries some weight. The point is that this talk of “death panels” should not be used as some kind of scare tactic.

  • scat

    Talk about “hatred,blame-laying and name-calling”!

  • scat

    Yes, yes and YES! What you describe is called spreading the risk. An explanation that most people can understand goes like this. Let’s say a village of 100 people decide they run the risk of fire damage to their homes. They figure out that the odds are that four homes will suffer various degrees of damage. Since you can’t know who will suffer the damage they all kick in some money to cover the loss of whoever is hit with the risk. And everyone else is happy that their own house did not burn down. It costs very little to each member compared to what it would cost for the individual without the insurance process. Without spreading the risk, some individuals bear the total loss and in many cases never recover from the loss. This is recognized as undesireable for the community as a whole.At least it is recognized by people who can see a picture bigger than their own little place in the world.

  • Anonymous

    Right or wrong I have come to believe that writers like Mr. Holland who make projections and assumptions about what others think, in this case the GOP, are not able to make their case. Judging others for doing wrong instead of writing about what would be right says more about the writer imho.

  • GregoryC

    My current premium for the Kentucky high-risk pool is $618. Next year the premium drops to $412, but ALL other costs rise. Deductible increases from $1,000 now to $2,500. Out of pocket maximum increases from $2,500 now to $6,350. Co-payments to see a Primary Care Physician increase from $10 now to $50. One prescription, brand name, no generic available, increases from $30 month to $700 month (35% coinsurance). Lab costs are free now, next year 35% coinsurance. I thought prescription drug coverage was one of Obamacare’s Ten Essential Health Benefits? Not if they’re moved to the Specialty Drug Tiers. That is a discriminatory practice motivated by reducing cost for insurers, shifting cost to patients.

  • GregoryC

    Except for those same patients with pre-existing conditions will now have to pay coinsurance for life saving prescription drugs rather than a fixed co-payment. AARP in a 2009 study, found that Specialty drug prices increase at 3 times the rate of inflation with annual costs to patients ranging from $5,000 to $300,000 per year. Specialty tiers do not advance quality care or increase access to medications. They create a financial burden to the chronically ill. Specialty drug tiers are discriminatory. Nationalhealthcouncil.org sent a letter to Leon Rodriguez, Director of Office for Civil RIghts, DHHS, September 30, 2013, raising these very issues.

  • GregoryC

    My ‘POS’ state operated high-risk pool charges higher premiums, but covered more of my costs than ACA. My prescription drug coverage, one of the 10 EHB, will cost more in 2014, charging 35% coinsurance for Specialty Drugs. I pay $30 per brand name drug currently.

  • Roland

    So only corruption by acclamation counts? Do shark attacks count only if the water is full of sharks? I think that the corruption of most municipal governments, small businesses and charities and the fact that anything not locked up is likely to be stolen is more than enough to paint us as a thoroughly corrupt people. That we keep scaling back education for our children is proof by itself; what can anyone say about any people unwilling to care for their own children?
    Roland

  • Gregory Pruett

    it is not republicans or democrats. it is BIG GOVERNMENT republicans and democrats(think progressives) and there are more big government dems than repubs now a days. if the tax cuts of the 80′s had also seen a reign in refit of government spending then we would not be having alot of the issues we have now. We are starting to see the burgeoning problem of spend and tax or just plain deficit spending. it takes along time to have its effects know to the general populace but now that it is on the horizon, its a scary freight train that some of us saw coming A LONG TIME AGO. Remember, all of this over spending affects the poorest among us first and the very policies that politicians say are keeping us from a recession(great or not) are at the cause of it. WE CANNOT SPEND THIS MUCH AND NOT EXPECT TO NOT SEE SUFFERING. By this, of course, i mean spending without prioitization. we want to protect everyone but if you do that you end up protecting no one(or just the very wealthy)

  • Anonymous

    Now for the Truth – Obama Speech to the AMA July 16, 2009
    ‘So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what. My view is that health care reform should be guided by a simple principle: fix what’s broken and build on what works.’

    Obama didn’t fix what was broken, he scrubbed our whole Healthcare System and started with a ‘one size fits all’ approach. That FORCED Americans to buy the Government version of Healthcare at higher Premiums and deductibles or face IRS fines, and penalties. Republicans knew Obama wasn’t telling the truth in 2009. What we are witnessing now is the lefts basic strategy of DECEIT, DENIAL AND DIVERSION.
    a) DECEIT:(keep your plan, doctor, and lower premiums) b) DENIAL: (Obama didn’t realize you would lose your doctor, insurance and have higher premiums, he didn’t know the Web site would fail, etc.) C) DIVERSION: It’s the Insurance Company fault or it’s the GOP fault.

  • Anonymous

    The most recent studies of the UK National Health System found that patients have a 47% better chance of survival in a US Hospital. Government Health Care is substandard Health Care for all, not just the few.

  • scat

    Corruption of an entire organization usually comes from the top down or someone with an agenda and a lot of influence.. The same holds true for operating in a non-corrupt way. I have associated with enough organizations to see it go either way depending on the leadership of the organizations. I have seen many organizations run by leaders who are principled where corruption just is not tolerated. I can’t accept that all the world is corrupt.

  • Roland

    Not the world, just the US.
    Roland

  • Anonymous

    True!

  • Anonymous

    We are on the same page. Medicare for all, right?

  • Anonymous

    But it’s better than nothing, eh? Because for the first time in my life, at age 53, I had nothing and a medical condition…after paying into Medicare for 30 years, I can’t use it yet. What a joke.

  • Roland

    That would be a start.
    Roland

  • Anonymous

    except that what you have posted is wrong, it looks nice in print.

  • Anonymous

    we do not know that the President lied, he didn’t know that the insurance company would prefer to cut customers off instead of covering them with the basics. It is highly unlikely that he went out and read all of our policies to see what was and wasn’t covered. All he meant is that the ACA didn’t mean they had to give up their insurance……the insurance companies choosing to screw customers over are responsible for this mess.

    They don’t want to pay up to 80% of premiums on patient care, they want to make people blame the ACA to try to get it repealed so they don’t have to cover people for what they pay for.

    Presidents do lie, everybody lies. But we have nothing to show that Obama lied and that he just wasn’t counting on the greed of the insurance companies…..or that he was misinformed or mistaken.

    Lets not let conservative trolls get away with yet another distortion of the facts.

  • Anonymous

    there is one thing left out of the discussion of tort reform. A big business calculates the cost for putting defective products right. Think of the cars that caught on fire, the tires that were defective, and other things. What they worry about is very large jury awards to the victims. Tort reform is all about taking away our right to have a jury decide the financial award for the injuries from defective products, lies in advertisements, and for pain and suffering. They want the awards to be as low as possible so it isn’t worth it to them to care if a defective product gets marketed.

    We have the right to have a jury decide court cases, NOT the companies causing the trouble in the first place. That is what tort reform is all about.

    If they wanted real reform that would help people, they would put a limit to the percent of the award that a lawyer could charge over the costs to prepare for the case. They don’t care about that, they just want to protect business.

  • Anonymous

    Did he lie or did he repeat what he had been told as truth? We may never know.

  • Edward Moriarty

    What recent studies? And, 47% better chance of survival in a US Hospital…..survival from what? Nursing homes, ALF’s, Hospice facilities and home are the places most people actually die in the US. These are not connected to hospital cost in the US, but are included in National Health Care figures in Europe and UK. Using figures that measure different sources of expenditure do not reflect actual mortality rates.
    The UK Nat. Health Care reimburses all of the places that people die in the UK. Comparing that to % of Hospital deaths in the U.S. is not even Apples to Oranges………more like grapes to window drapes. Using numbers to prove a point must take into consideration the source of the numbers to be relative.
    There is no arguing that the U.S. Health Care System has the BEST HEALTH CARE MONEY CAN BUY! That clarifies the PROBLEM in a nation where 40% of the population has no access to good health care. In the UK all of the population has access to excellent health care. We should should ashamed that our system lags behind most of the economically developed nations on this planet in the % of population with access to good medical care. Recent Studies! What a source……..

  • Mark Cohen

    Not true. Greg chose only to look at the lowest premium KY ACA silver plan in his analysis. If you look at an ACA plan that is roughly equivalent to Greg’s current plan, one finds NO coinsurance for specialty tier drugs, only the deductible need be met, then 100% coverage.

  • Mark Cohen

    Greg’s story is complete BS. And, in this particular retelling of it, he is changing the numbers around to suit his needs. The cost of the plan he is referring to is $285, NOT $412. AND, it isn’t his current plan. The details he describes are all from the lowest premium silver plan in the KY ACA exchange and NOT his current high risk pool plan. Check his post history and you will see in other posts he admits the details are from the silver ACA plan and not his high risk pool. In those posts, he suggests somehow that he needs to change his plan and the silver plan is worse than his current plan. However, there are two problems with that new assertion: 1) His current plan (the High Risk plan offered by the state) is 100% in compliance with the ACA, so there is no need for him to be looking at ACA plans if he likes his current plan. 2) All of the information he provides about the silver plan is about a plan that is not appropriate for his situation. The other available plans are a much better fit.

    I went to the KY ACA site and chose a KY silver plan for a 51 year old male making 100K per year. Greg chose to look at the plan with the lowest montly premium. Well OF COURSE taking a dramatically lower premium is going to raise the costs of all coverage used. Greg is currently paying 600/mo and trying to compare that coverage with a plan that is listed at $285.55/month. However, compare with some of the ther plans costing in the $400-500/month range and you find $3600 MOOP, no specialist copays, combined med/drug deductible of $3000, $40 copay for brand name drugs, $15 copay for generics, and a 0% coinsurance after you hit your deductible for specialty. 0% coinsurance!!!! In other words, no additional costs, not even your current $30 copay once the deductible has been reached. I had been giving Greg the benefit of the doubt and assuming it was possible that he was just the world’s worst shopper for health insurance. However, given that I now see how his story has evolved starting with this post 16 days ago, to his more recent posts 2 days ago, it is clear that he is just another rightwinger trying to make a persuasive horror story about the ACA out of thin air. Shame on you for trying to scare folks with yet another false ACA horror story.

  • Oldiebutgoodie

    From my research about ACA, I can’t afford monthy premiums for even
    lowest ‘bronze’ plan, or the IRS penalty, slated to escalate each year.
    Going through savings after a lay-off. It was hourly- retail, but helped w/everyday expenses. My meager savings used only for utilitys and R.E. taxes.
    Unemployment ran out, stil looking for work. Can’t even sell my humble home(which IRS will lien) fast enough to pay on-going premiums. Then?
    No such thing as cheap rent.
    What’s the sense of having health ins – and end up homeless?l!

  • Anonymous

    So you will ignore “2. Your “Low Rep” from Disqus due to a high number of spam comments.” ?

  • Anonymous

    I live in a state that is using ACA and I can now see a doctor. Unfortunately by now with out care, I have several health problems

  • Anonymous

    We will never get meaningful reform with republicans blocking progress. They are puppets of the top 1%. Paul Ryan receives the most support from the Koch Brothers, because he can influence other politicians. He is popular in Congress, because he can bring bribe money into the Congress. And around and around it goes.

  • A Qui Tam Relator

    To late Roland most patients already live in abject hardship and poverty !

  • Anonymous

    The motivation is clear and unchanging. Get rid of the ACA. By not participating, they are willingly tilting the numbers that will be used to measure success or failure. Too much money in politics……for the people?