“Obamacare’s Secret Success”: Health Reform Is Starting To Look Like A Bigger Success Than Even Its Most Ardent Advocates Expected
The law establishing Obamacare was officially titled the Patient Protection and Affordable Care Act. And the “affordable” bit wasn’t just about subsidizing premiums. It was also supposed to be about “bending the curve” — slowing the seemingly inexorable rise in health costs.
Much of the Beltway establishment scoffed at the promise of cost savings. The prevalent attitude in Washington is that reform isn’t real unless the little people suffer; serious savings are supposed to come from things like raising the Medicare age (which the Congressional Budget Office recently concluded would, in fact, hardly save any money) and throwing millions of Americans off Medicaid. True, a 2011 letter signed by hundreds of health and labor economists pointed out that “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending.” But such expert views were largely ignored.
So, how’s it going? The health exchanges are off to a famously rocky start, but many, though by no means all, of the cost-control measures have already kicked in. Has the curve been bent?
The answer, amazingly, is yes. In fact, the slowdown in health costs has been dramatic.
O.K., the obligatory caveats. First of all, we don’t know how long the good news will last. Health costs in the United States slowed dramatically in the 1990s (although not this dramatically), probably thanks to the rise of health maintenance organizations, but cost growth picked up again after 2000. Second, we don’t know for sure how much of the good news is because of the Affordable Care Act.
Still, the facts are striking. Since 2010, when the act was passed, real health spending per capita — that is, total spending adjusted for overall inflation and population growth — has risen less than a third as rapidly as its long-term average. Real spending per Medicare recipient hasn’t risen at all; real spending per Medicaid beneficiary has actually fallen slightly.
What could account for this good news? One obvious answer is the still-depressed economy, which might be causing people to forgo expensive medical care. But this explanation turns out to be problematic in multiple ways. For one thing, the economy had stabilized by 2010, even if the recovery was fairly weak, yet health costs continued to slow. For another, it’s hard to see why a weak economy would have more effect in reducing the prices of health services than it has on overall inflation. Finally, Medicare spending shouldn’t be affected by the weak economy, yet it has slowed even more dramatically than private spending.
A better story focuses on what appears to be a decline in some kinds of medical innovation — in particular, an absence of expensive new blockbuster drugs, even as existing drugs go off-patent and can be replaced with cheaper generic brands. This is a real phenomenon; it is, in fact, the main reason the Medicare drug program has ended up costing less than originally projected. But since drugs are only about 10 percent of health spending, it can only explain so much.
So what aspects of Obamacare might be causing health costs to slow? One clear answer is the act’s reduction in Medicare “overpayments” — mainly a reduction in the subsidies to private insurers offering Medicare Advantage Plans, but also cuts in some provider payments. A less certain but likely source of savings involves changes in the way Medicare pays for services. The program now penalizes hospitals if many of their patients end up being readmitted soon after being released — an indicator of poor care — and readmission rates have, in fact, fallen substantially. Medicare is also encouraging a shift from fee-for-service, in which doctors and hospitals get paid by the procedure, to “accountable care,” in which health organizations get rewarded for overall success in improving care while controlling costs.
Furthermore, there’s evidence that Medicare savings “spill over” to the rest of the health care system — that when Medicare manages to slow cost growth, private insurance gets cheaper, too.
And the biggest savings may be yet to come. The Independent Payment Advisory Board, a panel with the power to impose cost-saving measures (subject to Congressional overrides) if Medicare spending grows above target, hasn’t yet been established, in part because of the near-certainty that any appointments to the board would be filibustered by Republicans yelling about “death panels.” Now that the filibuster has been reformed, the board can come into being.
The news on health costs is, in short, remarkably good. You won’t hear much about this good news until and unless the Obamacare website gets fixed. But under the surface, health reform is starting to look like a bigger success than even its most ardent advocates expected.
By: Paul Krugman, Op-Ed Columnist, The New York Times, November 28, 2013
“Highlighting The GOP’s Worst Qualities”: For Democrats, Raising The Minimum Wage Is Good Policy, Better Politics
As Congress considers raising the minimum wage for the first time since 2009, Democrats have a golden political opportunity to pressure congressional Republicans on an issue that splits the GOP’s base — and highlights the GOP’s worst qualities.
The battle is currently being led by Senator Tom Harkin (D-IA) and Rep. George Miller (D-CA), who have crafted a bill that would raise the federal minimum wage to $10.10 per hour, up from the current level of $7.25. The bill, titled the Fair Minimum Wage Act of 2013, would immediately raise the minimum wage to $8.20 an hour, then to $9.15 an hour after one year, $10.10 an hour after two years, and tie it to the Consumer Price Index thereafter.
There is a litany of evidence backing up the value of such a proposal. The current minimum wage of $7.25 an hour has lagged far behind productivity growth over the past decades, and falls short of most living wage standards. A worker employed full-time at the current minimum wage would make $15,080 for a full 52-week year, 19 percent below the poverty line for a family of three. As over 100 economists agreed in a June 2013 letter supporting a $10.50 hourly minimum wage, raising the wage “will be an effective means of improving living standards for low-wage workers and their families and will help stabilize the economy. The costs to other groups in society will be modest and readily absorbed.”
Opponents of raising the minimum wage generally argue that such a policy would hurt job growth. “When you raise the price of employment, guess what happens? You get less of it,” House Speaker John Boehner (R-OH) declared in response to President Obama’s call to raise the minimum wage at his 2013 State of the Union address. Contrary to the Speaker’s claim, however, there is little to no evidence that modest increases in the minimum wage actually eliminate jobs.
As strong as the economic case for raising the minimum wage is, however, the political case is even more persuasive. The Harkin-Miller bill has almost no chance of becoming law during the 113th Congress; it will almost certainly be blocked in the Senate, and even if Democratic leadership can round up 60 votes, the bill stands no chance in the Republican-controlled House of Representatives. But the GOP could pay a steep price for killing the measure.
Americans strongly favor raising the minimum wage. According to a Hart Research Associates poll conducted in July, an overwhelming 80 percent of Americans support raising the minimum wage to $10.10, then adjusting it for the cost of living, as the Harkin-Miller plan proposes. The basic parameters of the bill are supported by 92 percent of Democrats, 80 percent of Independents, and even 62 percent of Republicans.
The poll also suggests that the issue could prove critical in the 2014 midterms. The Hart poll found that 74 percent of registered voters believe that raising the minimum wage in the next year should be an important priority for Congress, and 38 believe it is very important — 51 percent of registered voters would be more likely to support a candidate for Congress who favored raising the minimum wage to $10.10 an hour, while just 15 percent said they would be less likely. Furthermore, 37 percent believe that — should Congress fail to raise the minimum wage this year — Republicans would be to blame. Just 15 percent would blame the Democrats.
In the wake of the Republican Party’s disastrous government shutdown strategy, it finds itself in a very precarious political position — especially on the critical question of whether they are actually interested in what’s best for the country. A high-profile act of obstruction to block a minimum-wage hike — a raise that is supported by four-fifths of Americans, and almost two-thirds of Republicans — would surely compound that problem. If Democrats want to paint congressional Republicans as elitists who are out of step with the needs of average Americans, this is how they do it.
On Friday, the Obama administration signaled its support for the Harkin-Miller bill, and it would be wise to be very vocal about that position. If the White House throws its full weight behind congressional Democrats’ efforts, then the minimum wage could form the backbone of an effective economic pitch for the 2014 midterms.
By: Henry Decker, The National Memo, November 8, 2013
“Another Banker Scam”: Can Wall Street Buy Redemption?
Goldman Sachs churns out enormous profits from its high-rolling, casino investment schemes, while also churning out fat paychecks for its top executives. They literally sack up the gold, even as their speculative gambles have wreaked havoc on our real economy.
But, finally recognizing that their public approval rating has sunk lower than mad cow disease, Goldman’s banking barons now want you to know that they feel your pain and are eager to “give back” to the people. So — ta-da! — they’ve transformed themselves into philanthropists, having goosed up the bank’s foundation in order to flash their “charitable side.” Goldman’s chief of staff noted that “people said we weren’t doing enough” to address the gross inequities created by Wall Streeters, so they’ve turned their foundation into the fourth-largest corporate charity in America. In an orchestrated show that the New York Times dubbed “reputation redemption,” the bank’s charitable arm doled out $241 million last year, including grants to women in developing nations and small-business projects here in the U.S.
That sum would be impressive, except for a couple of ugly hickies on it. First, the foundation spends an unseemly amount on slick videos and PR efforts to extol Goldman’s new “generosity,” diverting philanthropic funds from altruism to corporate promotion. One Goldman banker, who’s appalled at the self-congratulatory splashiness, said of the charity: “It’s run as if it’s a Broadway show.”
Second, $241 million sounds like a lot — until you see that the financial empire’s income last year topped $34 billion. Do the math, and it turns out these “bankers with a heart of gold” actually allocated less than one percent of Goldman’s income to its widely ballyhooed beneficence.
How pathetic. Even poor people put these multimillionaires to shame, regularly donating 3.2 percent of their meager incomes to charity. Trying to buy redemption on the cheap is just another banker scam, but why aren’t we surprised that they would even view charity as a self-serving hustle? After all, on Wall Street, it’s assumed that anything can be bought and sold — from fraudulent investment packages to congress critters.
It’s no surprise, then, that the wizards of Goldman Sachs assumed they could purchase an image makeover, convincing us gullible rubes that they’re not just a pack of malicious, money-grubbing narcissists, but at heart, are huggable bankers who want nothing more than to serve humanity. Hence, the Goldman Sachs Foundation spreading a few of its millions hither, thither and yon in a flashy show of charity designed to mask the bank’s voracious ethic of greed.
But whom do the Goldman Sachers think they’re fooling? By putting a pittance of their billions into charity, they’re merely updating the old PR shtick attempted a century ago by the billionaire robber baron, John D. Rockefeller, who went around in public passing out dimes to a few children in the vain hope of buffing up his sour public image. But, worse, Goldman’s sly executives are not even donating their own dimes! It’s the shareholders’ money that these bankers are doling out. Worse yet, it’s also our money. By ours, I mean that Goldman’s so-called “gifts” are deducted from the income taxes the bank owes, thus, shorting America’s public treasury of funds that We The People need for schools, roads, parks, clean water and other essentials to advance our society’s common good.
Also, what is “charitable” about funneling $375,000 into one of Bill Clinton’s show-and-tell PR events? This donation by Goldman’s foundation went to Clinton’s Global Initiative conference in September, allowing the banking giant to plaster its brand on the event, including being the “host” of a panel moderated by Chelsea Clinton. Come on, that’s not charity — it’s advertising.
The more Wall Street bankers try to purchase morality, the less they have. We don’t want their false “charity” — we want honest accountability for their destructive greed, and we want a restructured, decentralized and ethical banking system based on fairness and common decency.
By: Jim Hightower, The National Memo, November 7, 2013
“Replace The Sequester, Not Sebelius”: While She Tries To Fix A Broken Website, Congress Allows Rest Of Government To Crash
An embarrassing mistake, which should be considered a scandal, has caused the Internal Revenue Service to perform far fewer tax reviews and cut back its fraud investigations, costing the Treasury billions of dollars. Have there been any angry House hearings? No.
That same mistake has forced the National Institutes of Health to cut more than 700 advanced research grants, delaying the progress of vaccines and experimental treatments. No hearings.
And it has cost the economy hundreds of thousands of jobs, according to the Congressional Budget Office, but there is no sign that Republicans want to investigate what went wrong.
That’s because the mistake is called the sequester, and Republicans know what went wrong: they caused it by threatening default in 2011 and then refusing any budget agreement that included new taxes the next year. They’d much rather investigate a serious bumble by the Obama administration in rolling out the health-care website — which will eventually be fixed — than examine the effects of their own actions.
The paradox of Republican complaints about the website’s failings has been widely noted: They are pretending to care about the technical problems of a law they want abolished. But in fact the hypocrisy goes much deeper than that. In virtually every department of government, the right wing has used the sequester to encourage government to stumble, creating backups and denials of service that will be far more damaging than the ones going on at www.healthcare.gov. The sequester, which has been the Tea Party wing’s sole legislative victory, is evidence that its members want government to do less with less, and that they aren’t interested in having it work efficiently in delivering services to the public.
Any lawmaker who came to Washington to improve government, rather than shrink it, would do everything possible to reverse the sequester, as Democrats will try to do in a budget conference beginning this week. (They will be joined in that effort by a few Republicans who want only to turn back the cuts to the Defense Department.) But most Republicans, ranging from Senate Minority Leader Mitch McConnell to the furthest extreme in the House, have said they have no intention of letting the budget caps expire, and certainly aren’t interested in replacing them with higher revenue.
The only thing they have clamored to replace is Kathleen Sebelius, the Health and Human Services secretary. While she tries to fix a broken website, Congress is allowing the rest of government to slowly crash.
By: David Firestone, Editors Blog, The New York Times, October 28, 2013
“Another Great Anti-Obamacare Lie Exposed”: Data Proves ACA Not Responsible For Growth In Part-Time Jobs
One of the more popular economic myths spun by the anti-Obamacare forces is the suggestion that employers are avoiding the law by moving to an employee model based on part-time workers rather than full-time employees.
For those committed to destroying the Affordable Care act by any means possible, who can blame them for seeking to misdirect based on using only a small part of the data as it pertains to employment when telling the full story blows up the entire meme? Such a claim is, after all, ear candy for an audience looking for any reason to hate the law, even if they don’t quite know why they so are so displeased.
The problem, however, is that this popular line of attack comes with a rather significant flaw—the claim is provably false.
While there are, no doubt, a few companies out there moving to increase part-time employees at the expense of full-time workers—mostly involving retail and fast food companies that have always depended heavily on a part-time employee model—it turns out that the frantic claims arguing that the ACA is causing some massive loss of full-time work is simply not supported by the empirical data.
While we will get to that data in just a moment, to better understand how the opponents of healthcare reform are selling this bit of disinformation, it is important to know the basis of their claim.
It begins by acknowledging that 27 million Americans are currently employed in part-time jobs—a number that is, in fact, well above the historical norms.
Left on its own, that bit of information ties in quite nicely with the suggestion that we can hold Obamacare responsible for these numbers when one considers that employing full-time workers holds the potential for greater benefits obligations for a company with 50 or more employees.
However, when one looks just one layer beneath the surface—a bit of research one might expect honest brokers to perform before informing the public that the sky is falling—a very different picture emerges.
There are—as defined by the Bureau of Labor Statistics (BLS)—two classifications of part-time workers.
Those who are working 35 hours or less because they cannot accomplish the full-time employment they desire are called “part-time for economic reasons”, while those who work 35 hours or less because that is all the work they want are part-time by choice.
A more careful review of the latest BLS jobs report out last week—a review in which the anti-Obamacare forces do not want you to engage in—reveals that while we do, indeed, currently have 27 million part-time workers in the economy, only 8 million of these people are working part-time because they cannot find a full-time job.
That means that 19 million Americans are working part-time because that is all the work they desire to have.
What’s more, not only does the September jobs report reveal that the number of part-timers wishing for full-time work showed no increase when compared to the previous month’s numbers, the report provides a piece of data far more important—
In September of 2012, the number of part-timers seeking full-time work comprised 6 percent of the workforce. One year later, the September jobs report reveals that the number has shrunk to 5.5 percent.
Thus, not only has this supposed employer desire to avoid Obamacare not increased the number of part-time workers in the country; we actually see that the numbers are on the decline.
Now, before you launch into a cynical attack on the numbers as something ‘fudged’ by the Obama Administration, you might want to bear in mind that the opponents of the ACA have based their own argument on the very same numbers—albeit using only the top-line figures to make their misleading point rather than conveying the full data that shows a very different result.
As the old saying goes, what is good for the goose is good for the gander.
There is something else you should probably know when attempting to make sense of the part-time worker picture—
As the following BLS chart reveals, the number of part-time workers as a percentage of the entire workforce has been on the decline since the numbers peaked with the onset of our deep recession in 2008—well before the concept of Obamacare entered into the public lexicon and conscious.
Does it surprise anyone that, as the economy has improved—even if far slower than we would like—the number of part-time workers have declined?
Yet, to hear the anti-Obamacare forces tell the story, not only is part-time work increasing—when it very clearly is not—they have chosen to pretend that this is the result of the Affordable Care Act rather than obvious impact our economic circumstances would naturally play in the part-time versus full-time worker scenario.
Clearly, more part-time workers seeking full-time employment have found more success as the economy has improved.
So, should we give Obamacare the credit for the reduction in part-time numbers? I don’t think so as, to do so, would be as ridiculous as the efforts to blame Obamacare for the large top-line number of part-time jobs.
More liberal babble from an Obamacare apologist?
While you are entitled to think so if this brings some measure of comfort, you should probably know that even the staunchly anti-Obamacare publication, The Wall Street Journal—relying on data rather than right-wing hysteria—has reached the very same conclusion.
If you find yourself surprised that so much of the part-time workforce is comprised of people preferring a shorter workweek to a full-time job, you might ask yourself who, typically, seeks part-time work?
Many of us can recall our younger days as students in need of some spending money. We were not the least bit interested in full-time employment at that time, only that weekend job to earn some gasoline and date money.
Nothing much has changed in this regard for today’s high school and college students as they continue to occupy their spot in the count of part-time workers by choice.
So, where did the growth in part-time workers by choice come from following our recession?
The answer can be found in two categories—
First, we have the homemakers who elect to make the children their priority when allocating their time.
When the recession hit, many of these people found that the breadwinner in the family was being adversely affected by the poor economy and resolved to help the family finances by getting a part-time job to augment income. Now, as the economy slowly improves, some of these people are able to leave the workforce entirely and return full-time to their desired day job—”stay-at-home” mom or dad. This is, no doubt, playing a role in the declining number of part-time workers in the workforce.
Secondly, we have those who hit retirement age only to discover that their savings and Social Security payments were insufficient to support the lifestyle they had hoped to experience during their sunset years.
It is no secret that the lack of sufficient savings to support of seniors in retirement is turning into an epidemic problem. If you are, somehow, unaware of this, I recommend that you read a piece entitled, “The U.S. To Face A Married Couples Retirement Crisis” written by my Forbes colleague, Richard Eisenberg, to get up to speed.
As a result of the difficulties facing retirees, it can come as no surprise that, as the baby boomers have reached the age of retirement, they play—and will continue to play—a major part in increasing the number of part-time workers in the country. These are people who want to, at the least, accomplish semi-retirement if they cannot afford to fully retire and opt to augment their savings and Social Security with part-time work.
When you consider how and why the numbers of part-time by choice employees grew following the onset of the recession and the arrival of baby boomer retirement, only the hardest of heads can fail to see how the top-line number of part-time workers grew, why it is now decreasing and why a full two-thirds of the part-time work force chose to be part-time workers. It would also take a very committed ideologue to avoid the stark fact that these part-timers by choice are not relevant to an analysis of the impact of Obamacare on the availability of full-time work.
What is relevant to the question are the eight million part-timer for economic reasons.
Given that the data is crystal clear that these numbers are falling year-to-year, it defies logic to claim that Obamacare is forcing these numbers upward. Indeed, even if the number of people forced to work part-time because they cannot find full-time work was on the rise, it would not make the case that Obamacare is to blame as the weak economy would present a better explanation. Such a result would, however, at least give some basis for the possibility that the ACA is as fault.
But with the numbers of those who are part-time because they can’t find full time work falling, the argument becomes absurd.
As I often note, there are some valid arguments—even if I might disagree with the much of the logic behind theses arguments—to support those who wish to take a stand against the Affordable Care Act.
However, when the opinion-leaders who seek to guide your point of view away from a fair, reasonable and rational assessment of the law by feeding you false arguments and half-stories easily disproven by readily obtainable data, it defies reason that anyone—whether for or against the law—would believe anything else these people are trying to peddle.
Simply put, if you are going to hate this law, don’t you think you should hate it based on actual information and data rather than half-truths and misrepresentations?
By: Rick Ungar, Op-Ed Contributor, Forbes, October 27, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 