USian health care

Krugman has always been very sensible and detailed on this issue;

http://www.nytimes.com/2014/02/03/opinion/krugman-delusions-of-failure.html?src=me&ref=general&_r=0

Everyone knows about the disastrous rollout, but that was months ago. Since then, health reform has been steadily making up lost ground. At this point enrollments in the health exchanges are only about a million below Congressional Budget Office projections, and rising faster than projected. So a best guess is that by the time 2014 enrollment closes on March 31, there will be more than six million Americans signed up through the exchanges, versus seven million projected. Sign-ups might even meet the projection.

But isn’t Obamacare in a “death spiral,” in which only the old and sick are signing up, so that premiums will soon soar? Not according to the people who should know — the insurance companies. True, one company, Humana, says that the risk pool is worse than it expected. But others, including WellPoint and Aetna, are optimistic (which isn’t a contradiction: different companies could be having different experiences). And the Kaiser Family Foundation, which has run the numbers, finds that even a bad risk pool would have only a minor effect on premiums.

Now, some, perhaps many, of those signing up on the exchanges aren’t newly insured; they’re replacing their existing policies, either voluntarily or because those policies didn’t meet the law’s standards. But those standards are there for a reason — the same reason health insurance is now mandatory. Health reform won’t work if people go uninsured, then sign up when they get sick. It also can’t work if currently healthy people only buy fig-leaf insurance, which offers hardly any coverage.

And what this means, in turn, is that while we don’t know yet how many people will be newly insured under reform, we do know that even those who already had insurance are, on average, getting much better insurance. Since the goal of health reform was to make Americans more secure — to reduce their risk of being unable to afford needed health care, or of facing financial ruin if they get sick — the law is doing its job.

[...]

     conservative politicians aren’t just deceiving their constituents; they’re also deceiving themselves. Right now, Republican political strategy seems to be to stall on every issue, and reap the rewards from Obamacare’s inevitable collapse. Well, Obamacare isn’t collapsing — it’s recovering pretty well from a terrible start. And by the time that reality sinks in on the right, health reform will be irreversible.

it is a big big program, with more than its share of problems;

when you find one like this, you meet the partners and negotiate negotiate negotiate

most problems can get solved that way

ygtbk wrote:

Approval for Obamacare is now at an all-time low:

http://capsules.kaiserhealthnews.org/index.php/2014/01/health-law-is-a-t...

Apparently, with apologies to Nancy Pelosi, you have to implement it to see whether you like it.

Since you mention Nancy Pelosi, I'll ask you quite plainly, do you think the Repbulicans deserve any blame for problems in the implementation?

wage zombie wrote:

ygtbk wrote:

Not everyone agrees with Paul Krugman, apparently:

http://www.washingtonpost.com/business/economy/labor-union-officials-say...

I can understand why you're so upset about this as you've been such a staunch union advocate over the years.  I'm sure IF Obama gave the unions what they wanted and the Washington Post was reporting that unions are double dipping you wouldn't be rushing here to breathlessly report that one too.

I would have thought that the quotation:

Quote:

“We want to hold the president to his word: If you like your health-care coverage, you can keep it, and that just hasn’t been the case,”

was plain enough: both Republicans and people who are almost certainly not Republicans are angry that Obama misrepresented his plan. Paul Krugman, on the other hand, doesn't seem concerned.

part of the general complain-a-thon atmosphere about ACA, now dimming a bit, is that it is a new thing

people hate paperwork (insurance especially), and this new ACA thingy can involve a fair amount of paperwork, so it is stressful for many ;

for example, we moved to a new city recently, and when every single item in your daily life -- where you sleep, how you go to work, where you shop -- is a new thing and calls for choices, it is stressful and you express opinions about them; only when life becomes more routine do you have a balanced view of what works or not

my guess: by mid-2014, ACA will have turned from a Big Negative to a neutral, veering toward a clear positive in public opinion for the Democrats as people see the sensibly expanded coverage it affords

 cliché, yawn

back in reality, Obama under unrelenting pressure and hopes he fails:

http://www.washingtonpost.com/opinions/bill-oreillys-obama-interview-showed-a-nation-still-divided/2014/02/03/7fad180a-8d2a-11e3-833c-33098f9e5267_story.html

as Krugman noted, some are still cheering for ACA to fail: he says winners will steadily outnumber "losers":

http://www.commentarymagazine.com/2014/02/02/state-obamacare-glitches-ma...

[Minnesota governor] Dayton and Obama—and Congressional Democrats who are saddled with the problem of running this year—all seem to be ignoring the fact that the problem with the health-care law transcends computer glitches. In Minnesota, as well as elsewhere, ObamaCare has benefitted those with pre-existing conditions and the poor who are now getting insurance they might not have obtained without it. But it has also created a new interest group that may turn out to be just as large, if not larger, than the ObamaCare winners: the ObamaCare losers. These are the people who are losing their policies, being forced to change doctors, and facing higher costs for coverage that—contrary to the Democratic talking point about ObamaCare canceling only “junk” insurance—isn’t as good as what they had before.

As more Americans, including those whose employer-based plans are being affected by the altered insurance environment created by ObamaCare, face similar problems, the number in the “loser” group is increasing. That creates an unhealthy political climate for Democrats at every level who bet their careers on the law but who now wish only to change the subject to a discussion about income inequality or anything they hope will divert the public from ObamaCare.

http://m.washingtonpost.com/blogs/fact-checker/wp/2014/02/04/no-cbo-did-...

And at this point I have to agree with others who have voiced the sentiment before: satire is dead.

http://www.nytimes.com/2014/02/05/opinion/freeing-workers-from-the-insur...

Because reducing employment is just the right thing to do.

wilfully stupid debate? a good point:

http://www.realclearpolitics.com/articles/2014/02/06/must_the_obamacare_debate_be_stupid_121482.html

Glenn Kessler, The Washington Post's intrepid fact checker, replied firmly:  "No, CBO did not say Obamacare will kill 2 million jobs." What the report said,  as The Wall Street Journal accurately summarized it, is that the law "will  reduce the total number of hours Americans work by the equivalent of 2.3 million  full-time jobs."

Oh my God, say opponents of the ACA, here is the government encouraging  sloth! That's true only if you wish to take away the choices the law gives that  64-year-old or to those moms and dads looking for more time to care for their  children. Many on the right love family values until they are taken seriously  enough to involve giving parents/workers more control over their lives.

And it's sometimes an economic benefit when some share of the labor force  reduces hours or stops working altogether. At a time of elevated unemployment,  others will take their place. The CBO was careful to underscore -- the CBO is  always careful -- that "if some people seek to work less, other applicants will  be readily available to fill those positions and the overall effect on  employment will be muted."

The only think Republicans hate more than Obamacare is when its implementation gets delayed.

nonsense, the Krugman article below makes very clear that the CBO report did NOT say what you report,

you are parrotting a second-hand Republican talking point; good luck with that here ...

http://www.nytimes.com/2014/02/07/opinion/krugman-health-work-lies.html?...

On Tuesday, the budget office released a report on the fiscal and economic outlook that included two appendices devoted to effects of the Affordable Care Act.

The first appendix attracted almost no attention from the news media, yet it was actually a bombshell. Much public discussion of health reform is still colored by Obamacare’s terrible start, and presumes that the program remains a disaster. Some of us have pointed out that things have been going much better lately — but now it’s more or less official. The budget office predicts that first-year sign-ups in the health exchanges will fall only modestly short of expectations, and that nearly as many uninsured Americans will gain insurance as it predicted last spring.

This good news got drowned out, however, by false claims about the meaning of the second health care appendix, on labor supply.

It has always been clear that health reform will induce some Americans to work less. Some people will, for example, retire earlier because they no longer need to keep working to keep their health insurance. Others will reduce their hours to spend more time with their children because insurance is no longer contingent on holding a full-time job. More subtly, the incentive to work will be somewhat reduced by health insurance subsidies that fall as your income rises.

The budget office has now increased its estimate of the size of these effects. It believes that health reform will reduce the number of hours worked in the economy by between 1.5 percent and 2 percent, which it unhelpfully noted “represents a decline in the number of full-time-equivalent workers of about 2.0 million.”

Krugman said the "job-loss" annex to the report was seriously misreported, that is all I am saying, Reuters would be among those misreporting, if he is right

his point: people will of course work less if there is less insecurity and/or fear of losing company coverage

ygtbk wrote:

He is wrong. He has been wrong before.

Reuters hewed so very closely to the way that the CBO reported that it was positively uncanny - almost like they didn't want anyone to accuse them of bias.

Krugman was the guy who predicted the 2008 crash that all the other economists said "nody could've seen it coming."

They've all been wrong before, but being wrong is ok if you are republican.

@WZ - directly from Appendix C of the CBO report we have:

Quote:

The reduction in CBO’s projections of hours worked represents a decline in the number of full-time-equivalent workers of about 2.0 million in 2017, rising to about 2.5 million in 2024.

Quote:

Although CBO projects that total employment (and compensation) will increase over the coming decade, that increase will be smaller than it would have been in the absence of the ACA.

Quote:

Because the largest declines in labor supply will probably occur among lower-wage workers, the reduction in aggregate compensation (wages, salaries, and fringe benefits) and the impact on the overall economy will be proportionally smaller than the reduction in hours worked.

So I think Reuters was accurate. And, if you put that last one together with "inequality is the defining issue of our time", you have quite a combo.

@WZ:

My general argument is that politicians are usually mendacious and that journalists are often untrustworthy. But you likely knew that already.

My specific argument in #130 is that the CBO says very clearly that hours worked will decline because of Obamacare, and that's what Reuters reported, so the Reuters reporting was accurate.  

@DaveW: the article you linked makes a good point:

Quote:

The law’s defenders are finding it necessary to fight battles on its behalf they had no idea they would have to fight and for which they are understandably ill-prepared. It’s one thing to say the law is necessary, and that it will have good effects; it’s quite another to have to say it’s OK that it will lead people out of the workforce in order to collect government benefits—and nyah nyah nyah Republicans and conservatives. ObamaCare is now law, and the degree to which is is a badly-designed, jury-rigged mess is mostly what people are coming to know about it. That is why I said this report may mark the moment its doom was sealed—because it’s springing leaks in places no one ever thought he was going to have to patch, even as Obama and his people continue to try to plug the holes that everyone already knows about. 

Another link detailing the degree to which the law both a problem and being incorrectly enforced:

http://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/02/11/anoth...

"this report may mark the moment its doom was sealed"...

hubris, the ACA is being implemented, problems and all, and will likely have millions of new adherents by fall ... it's not going anywhere

below my viewpoint, too:

http://www.usatoday.com/story/opinion/2014/02/11/cbo-obamacare-health-care-jobs-column/5372293/

Basically, to have access to anything resembling affordable insurance, one had to obtain it through an employer, whether or not that employer was especially generous with respect to how much of the bill they actually picked up. You didn't necessarily need your employer to pay the premiums, but you did need them to negotiate the plan.

Now, with the individual exchanges set up by Obamacare, people have a more realistic chance of obtaining affordable quality health insurance. This is, in part, due to subsidies available for lower income people and, in part, due other aspects of the law, including ones which remove discrimination based on pre-existing conditions and limit the degree to which plan prices can be based on age.

Looks like a straw bunny.

I would think that with all the deaths due to death panels, the total working hours will have to drop.

Obamacare Small Business Goldmine

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For progressives it is no new story that astonishingly malnourished messaging by the Obama administration compounded by egregiously misrepresentative coverage by the mainstream media has allowed an unending flow of air to feed the anti-ACA (Obamacare) gluttons. Personal, anecdotal stories, many against and a few supporting the ACA have been around for months. What has been lacking are the “it worked for my small business” stories so I thought I would throw this onto the table for general consumption.

I own a small manufacturing business and we have always provided health insurance to our employees. This has come at great expense to our firm as the cost of our policy increased by double-digit percentages every year. In recent years, much to our shame, we could no longer survive the full cost of the insurance so we had to pass twenty percent on to all participating employees. That percentage was, in turn, enough to cause several employees to have to drop coverage entirely. We were horrified and crushed but no amount of shopping around seemed to get us close enough to be able to overcome the huge mountain of cost. Ultimately, we ended up covering seven employees for a cost of, brace yourselves, $6570.58 per month!!! Please forgive me my scoff when I hear people complain about the high cost of their coverage under the ACA. Quality insurance has, for many years, cost an obscene amount and anyone who doesn’t know that wasn’t really paying attention to all the details.

Quote:

Before the ACA we were covering seven employees at a cost of $6570.58 per month. Now we are providing for the coverage of eleven employees at a cost of $1863.76 per month. This is a savings of $56,481.84 per year!!!

...which we are using to hire a new employee and purchase some, much needed, new tooling.

The ACA is a boon for small business and we, for one, are using it to grow. There’s the small business messaging that is missing from, well, everywhere. Spread the word.

If a business can offload healthcare costs, why not? It is a completely rational decision to do that.

But yes, the taxpayers are fu*ked. And Obamacare will make sure that there are fewer taxpayers, as noted above.

This is a feature of the system, not a bug.

@DaveW: didn't figure you for an ironist, well-played...

ygtbk wrote:

If a business can offload healthcare costs, why not? It is a completely rational decision to do that.

What do you think is being offloaded here?

Quote:

But yes, the taxpayers are fu*ked. And Obamacare will make sure that there are fewer taxpayers, as noted above.

This is a feature of the system, not a bug.

Obama wants to make sure by design that there are fewer taxpayers.  He hates America.

Are there any real Obamacare horror stories?

Quote:

After the latest debunking of an Obamacare horror story, the LA Times' Michael Hiltzik adds them up, and wonders why the Right insists on manufacturing these extreme stories.

Boonstra's case is just the latest of a very long line of deflatable horror stories. We've debunked a passel of them here, from Florida resident Diane Barrette, who didn't realize she'd been empowered by the ACA to move from a costly junk insurance plan to a cheaper real insurance plan; to Los Angeles real estate agent Deborah Cavallaro, whose "unaffordable" premiums turned out to be eminently affordable; to San Diego business owner Edie Sundby, whose cancer coverage was safeguarded by Obamacareafter her insurer bailed out on her for financial reasons; to "Bette," the supposed victim trotted out by Rep. Cathy McMorris Rodgers (R-Wash.) in her response to the State of the Union message last month, and who turned out to be an ACA "victim" because she couldn't be bothered actually to investigate her options for affordable care on the Washington state enrollment website.

And there are many more, including the extremely dubious personal narratives ofHouse Speaker John Boehner and Sen. Tom Coburn.

The thing is, Hiltzik notes, that there are plenty of people health care reporters have talked to who do have to pay more, possibly for less coverage, who have a valid beef with Obamacare, but aren't making it. That could be because they realize with the added costs (and when haven't insurance premiums increased for people?) come a lot of protections. That includes the certainty that they won't be bankrupted if a medical disaster strikes.

Those are the stories with nuance, that acknowledge there's much good in the law. The right has to keep pushing the far-out, emotion-laden horror stories—true or not—because they've staked out a position on the law that can't allow for any nuance. They have to try to keep up the momentum for full repeal, and the only way they can do that is by keeping people scared to death of the law. If they have to lie to do that, well, that's hardly a problem for the likes of the Koch brothers and Boehner. Because, as Hiltzik says, that "is how an American public gets convinced that a program manifestly in their best interests is something bad."

@WZ:

I do not like the Republicans or the Democrats. I am a Canadian libertarian (admittedly a rare species). I therefore have massive distrust for all statist parties. OT: This is why I'm slightly concerned about CPP expansion. Last time this happened the govt was off by a factor of almost three for contribution rates. I would like to believe that they'll get it right this time...

Having said that:

1) Treating a Kos story as a debunking suggests naivety.

2) I would like to see actual data, not an anecdotal story, on the tax brackets of the employees. My suspicion, though I could be wrong, is that many of the employees are getting the "below x% of poverty line" subsidy and so the entire reason that the business owner can say "Yay! Less cost!" is exactly because it's coming out of general revenue.

Now, you might be happy with 2). It's not obviously wrong to favour redistribution, although a good argument is always helpful. But to assume that dollars to pay for health insurance policies appear out of thin air is kind of hard to believe.