Originally Posted By ecdc <a target="blank" rel="nofollow" href="http://nymag.com/daily/intelligencer/2014/01/obamacare-no-longer-doomed-will-become-scandal.html">http://nymag.com/daily/intelli...dal.html</a> Jonathan Chait, as usual, nails it. >>Obamacare will neither collapse, nor will Republicans accept its legitimacy, but the nature of their opposition will instead slowly morph. Gleeful predictions of imminent collapse will give way to bitter recriminations at the nefarious tactics used to make the law work. Obamacare will cease to be the something certain to destroy Obama and become something Obama has gotten away with. In recent weeks, it has begun to dawn on some conservatives that the actuarial death spiral they confidently predicted for years — in which the young and healthy shun the exchanges, leading to sicker and costlier patients and rising prices, in turn driving out the remaining healthy customers — may not actually transpire. It won’t for several reasons, one of them being a set of protections embedded in the law itself called "risk corridors and reinsurance," which compensate insurance companies that wind up with a sicker customer base in the first three years of the law’s operation, thus preventing a death spiral.<< Worth a read...or to use an old phrase, much more at the link!!!
Originally Posted By skinnerbox "It won’t for several reasons, one of them being a set of protections embedded in the law itself called "risk corridors and reinsurance," which compensate insurance companies that wind up with a sicker customer base in the first three years of the law’s operation, thus preventing a death spiral." Which is precisely why the GOP was desperate to repeal Obamacare before its implementation. They knew right down to their bone marrow that these protections were in place, and that the insurance companies wouldn't be taking a financial hit lest they be saddled with a sicker base of customers. Coupled that with tens of millions of Americans actually getting healthcare for the first time, as well as tens of millions getting more affordable healthcare, and you have a program that will be viewed as mostly successful. Exactly what the GOP cannot compete with in the voting booth.
Originally Posted By SuperDry <<< compensate insurance companies that wind up with a sicker customer base in the first three years of the law’s operation >>> It's interesting that this sort of negative outcome has been repeatedly predicted by those that oppose the ACA. But, when you think about it even just a bit, would that outcome (in a hypothetical situation we don't have where it wasn't taken into consideration already) be possible only in a situation where there are sick people on a large scale that were not getting care before the ACA but now are? I thought we've been told repeatedly that these people don't exist in any significant numbers.
Originally Posted By SuperDry And to make another obvious observation, how is it that (at least when measured by talking points) the piece of the ACA that is designed to prevent exactly what is predicted above (i.e. the mandatory nature of coverage) is the piece that's most opposed?
Originally Posted By mawnck I'm afraid I have to take issue with the facts in Mr. Chait's article. One of the main GOP talking points all along has been that it is the GOVERNMENT'S coffers that will be hammered by Obamacare … BECAUSE they'll have to bail out the insurance companies after young people don't sign up. It's a valid point, and I can hardly blame Republicans for bringing it up. I'm not too thrilled with it myself. I've always said "single payer and nothing are the only two workable options", and so far I have no reason to change my mind yet.
Originally Posted By SuperDry <<< it is the GOVERNMENT'S coffers that will be hammered by Obamacare … BECAUSE they'll have to bail out the insurance companies after young people don't sign up. >>> But any person that doesn't sign up will have to pay the penalty tax, which will after a small number of years escalate to the point where it's the same as what the person would pay to buy the insurance. At that point, there will be no incentive to not sign up, and for those that for whatever reason continue to do so and thus making providing care for those that do on the average more expensive, there will be money to pay for that from the tax.
Originally Posted By mawnck >>But any person that doesn't sign up will have to pay the penalty tax, which will after a small number of years escalate to the point where it's the same as what the person would pay to buy the insurance.<< Oh, that'll go over big with young voters! Prediction: Won't happen. Not in a million years. Obviously it needs to for the thing to work, but our illustrious Congress will take a quick glance at their poll numbers, and wuss the heck out.
Originally Posted By SuperDry ^^^ I suspect that any action to undo the ACA won't take place for at least 3 years, and then only if there's a GOP president sworn in in January 2017. By then, I think the ACA will be a fait accompli. I think that some of the people balking now will wake up and realize that they can actually get affordable insurance if they simply sign up for it. I think those that are steadfastly against having insurance will be far outnumbered by those that have benefited.
Originally Posted By SuperDry <<< I've always said "single payer and nothing are the only two workable options", and so far I have no reason to change my mind yet.>>> You seem to want the ACA to fail just so you can get single payer.
Originally Posted By ecdc >>I'm afraid I have to take issue with the facts in Mr. Chait's article.<< I'm afraid I have to take issue with your taking issue of Chait's taking issue. You're not so much disputing the facts but disputing Chait's interpretation of them, which is fine. But it's easy to be Michael Moore and talk about single payer and how our insurance system is broken and Obamacare doesn't fix it. It's much harder (impossible, even with the 60 vote majority democrats had in 2009) to actually pass single payer politically. See, there's this group of people called Congress.... I'm all for single payer too. But when it comes to Obamacare, I think it's essential to always start with the same basic set of understanding: 1) The previous status quo was unacceptable, both morally and economically. 2) Single payer was politically unfeasible at the time. So the question then becomes, is Obamacare better than the previous status quo? Why don't we ask the 10 million people who now have insurance thanks to it?
Originally Posted By mawnck >>I suspect that any action to undo the ACA won't take place for at least 3 years<< They aren't going to undo the ACA, just the penalty tax. You don't seriously think the Dems are going to magically grow a backbone when that increase hits, do you? The young people are their constituency, you know. >>You seem to want the ACA to fail just so you can get single payer.<< Man, what is it with people putting words in my mouth these days? What I said was "single payer and nothing are the only two workable options", and that's exactly what I meant, nothing more and nothing less. What I want has nothing to do with it. (For what it's worth, what I WANT is single payer, but only for limited services. I don't believe in government blank checks for anything, including saving grandma. In other words, I'm in favor of death panels, and that's DEFINITELY not going to happen.)
Originally Posted By ecdc Also, because this time I just have to be "that guy," I'd like to remind everyone of that time when Obama was a failure and the website was going to doom democrats and healthcare and fairies were dying by the pound and.... Gosh, we've sure heard a lot about that lately, haven't we?
Originally Posted By mawnck >>is Obamacare better than the previous status quo?<< Yes, it is. For some people, anyway. But it's just as unviable as the previous status quo. If it don't work, then it don't work. Complaining about Congress is beside the point.
Originally Posted By mawnck >>I'd like to remind everyone of that time when Obama was a failure and the website was going to doom democrats<< Be careful of premature celebrations of victory.
Originally Posted By ecdc >>But it's just as unviable as the previous status quo.<< I've been hearing that for the past five years...so far, that's just not the case. In the long-term, it may prove to be so, and then hopefully it'll have put us on the path to single payer. >>Be careful of premature celebrations of victory.<< No celebration of victory here, just a reminder that too many people are missing the forest through the trees.
Originally Posted By Dabob2 <One of the main GOP talking points all along has been that it is the GOVERNMENT'S coffers that will be hammered by Obamacare … BECAUSE they'll have to bail out the insurance companies after young people don't sign up.> First, that assumes young people don't sign up. It's only one state out of 50, but KY seems to have the best functioning system so far, and the most complete stats released - and young people there are at the target percentage. Also, didn't the CBO estimate take "risk corridors and reinsurance" into account (since there WERE written into the law) when it projected the ACA saving taxpayers 100B over 10 years? Now, maybe most of those savings are projected for the back end, with losses in the early years, I don't know. If that happens, Republicans will surely scream bloody murder - but they've screamed bloody murder (aka "wolf") about the ACA so many times now it's hard to take them seriously - particularly if short-term losses/long-term gains were part of the CBO projections.
Originally Posted By ecdc >>Complaining about Congress is beside the point.<< You know I think you're mighty swell, mawnck, but the more I think on this, the more I realize it is emblematic of the problem with the way Americans think about their politics. I wasn't complaining about Congress--I was just noting the reality of the situation. I personally would've liked a Congress that would've passed single payer, but I recognize that's impossible. That involved Democrats and Republicans; I'm not being partisan with my observation. This is the way Congress has always been to one degree or another: a dysfunctional set of divergent beliefs and divergent interests. Granted, right now, it's more on the dysfunctional side than not. So the attitude embodied in your post, which is basically, "Either government does precisely what I think it should do--because what I think it should do is the only possible solution--or it does nothing at all," is the problem. Our government has never, ever worked that way. And yet, more Americans than ever, including pundits who ought to know better, are behaving as if that's the right way. That's no better than the Fox News way. That's the "compromise is a dirty word," attitude. Our government has always operated by passing compromised legislation to one degree or another. The very fact that the ACA passed is at least a recognition that there was a problem and something must be done. That's usually how these things start, and they are never, ever perfect.
Originally Posted By mawnck >>I was just noting the reality of the situation.<< As was I. Not sure what we're arguing about here. >>So the attitude embodied in your post, which is basically, "Either government does precisely what I think it should do--because what I think it should do is the only possible solution--or it does nothing at all," is the problem.<< That's not my attitude. It IS the only possible solution. I think that's self-evident, and is not a political statement. As long as we force the involvement of third party private payers, the system will be inefficient and ineffective. There are some measures where compromise won't work. "Do we cross the street or not?" is one of them. This is another. Obamacare is ONLY useful as an intermediate step toward single payer.
Originally Posted By fkurucz >>So the question then becomes, is Obamacare better than the previous status quo?<< A lot of people just don't get it. For example: My next door neighbor was let go after working for 30+ years at IBM. He's almost 60 and has pre-existing conditions. Under the old system he was uninsurable outside of a group. He had a new job at a 5 man business (he isn't a techie) running the office. And, yes, you guessed right, no employer provided health insurance. I encountered him while shoveling snow over the weekend and he mentioned that he was uninsured. I mentioned that he was in luck, as he pre-existing conditions wouldn't be a hurdle anymore to get insure. He reluctantly agreed, but then moaned about having to subsidize poor people's ACA plans. I didn't say anything, but it clearly didn't occur to him that others would be subsidizing him and his family with his pre-existing conditions. The only thing that crossed his mind was that his precious tax dollars might be subsidizing some imaginary welfare queen riding around in her brand new Escalade. What also rubbed me the wrong way was how easy he had it in life, yet he looks down upon the poor today. He was hired by IBM, with just a HS diploma. They trained him to do white collar work and they even sent him to college later, on IBM's dime. Nowadays you'd need a masters degree to get hired for an entry level position. Had he been coming of age today his life would have turned out very different. So instead of being grateful for his good fortune (he has an IBM pension waiting for him) and wanting to help the less fortunate, he has the all too common "mine, mine" attitude. And before I forget, he's a devout fundy who is more than happy to fund what I call "junket missions" for kids at his church. By "junket mission" I'm referring to the 3-4 week vacations that many fundy kids take when they go to the third world and pretend they are missionaries.
Originally Posted By ecdc >>Obamacare is ONLY useful as an intermediate step toward single payer.<< Why? Cause you and Michael Moore say so? Obamacare could conceivably work well for twenty or thirty years, before another change is necessary. I'd say a generation or more of getting people health insurance is pretty impressive. Of course, it's already working really well for some things, but we don't ever talk about those....
