“Stupid Obamacare!”: Profit Maximizing Private Insurance Companies Got You Down, Blame Obama
It has been said many times over the last few years that now that Democrats successfully passed a comprehensive overhaul of American health insurance, they own the health-care system, for good or ill. Every problem anyone has with health care will be blamed on Barack Obama, whether his reform had anything to do with it or not. Your kid got strep throat? It’s Obama’s fault! Doctor left a sponge in your chest cavity? Stupid Obama! Grandma died after a long illness at the age of 97? Damn you, Obama!
OK, so maybe it won’t be quite as bad as that, but pretty close. Here’s an instructive case in exactly how this plays out. Take a look at this article that ran in yesterday’s Washington Post, telling how in order to keep premiums down and attract customers, some insurers are limiting their networks. “As Americans have begun shopping for health plans on the insurance exchanges,” the article tells us, “they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.”
So insurance companies—private actors seeking to maximize profit—are making decisions that some potential customers find less than perfectly appealing. The article itself is clear about why this is happening, but in the newspaper’s print edition, the subtitle read, “Exchanges Exclude Doctors, Hospitals.” Of course, that’s completely false. The exchanges haven’t excluded any doctors and hospitals, the insurance companies offering plans on the exchanges have made a decision to exclude them. The insurance companies are perfectly free to make a different decision, but they’ve decided not to.
So the newspaper runs this story, with the headline writers mistakenly portraying what for some small number of people is an unwelcome development as a decision made by the Obama administration. Conservatives will then take articles like this and others like it, and say, “See? Obama said you could keep your doctor! He lied! This law is a disaster!” Barack Obama never said that he’d forbid any insurance company from ever changing anyone’s policy or offering policies that provide something less than spectacularly gold-plated coverage at absurdly low prices. But now, every profit-maximizing decision by a corporation becomes Barack Obama’s fault.
The second component of Barack Obama coming to own all the problems with the health-care system is that with the rollout of the ACA, you suddenly have a lot of political reporters doing stories on health care, and many of them have only the thinnest understanding of the law. That limited understanding makes it easier for them to just focus on whatever negative things are happening in health care, blaming them on the ACA, and assuring themselves that they’ve been appropriately “tough” in their reporting.
There’s nothing wrong with reporters fully exploring all the changes our ever-evolving health-care system goes through, so long as they do it accurately. But you might notice that they are completely uninterested in the stories of people who are being helped by the Affordable Care Act. Harold Pollack estimates that there are over 10 million uninsured Americans who have significant medical issues like a cancer diagnosis or diabetes, and thus find it difficult or impossible to get insurance on the individual market under the pre-ACA system. These people will now be able to get reasonably priced insurance, which for many will be literally life-saving. But journalists find these people boring and not worth talking about. They’re much more interested in people who find something problematic in the new system, and they’re working hard to find every last one of those people’s stories and share them with the country. And that’s how Barack Obama ends up owning the health-care system.
By: Paul Waldman, Contributing Editor, The American Prospect, November 22, 2013
“Feigning Outrage”: The GOP’s Health Reform Playbook
The last thing Republicans want right now is to repeal the Affordable Care Act.
They may claim it is destroying the country, but they need it, and desperately, to rebuild their party. They even have a detailed playbook to exploit it, outlining how and when to stage attacks against Democrats who support it in order to inflict maximum damage in the months before the 2014 midterm elections.
As Jonathan Weisman and Sheryl Gay Stolberg reported in this morning’s Times, House Republicans have been organizing their strategy behind closed doors for the last month. They began by capitalizing on the gifts given them by the White House in the form of the malfunctioning health care website and President Obama’s false promise that no one need lose an insurance policy. Then they moved on to claims that personal data is insecure on the insurance exchanges.
Next, according to the playbook, will come criticism of premium price hikes, and breast-beating about changes to Medicare Advantage plans, as well as the possibility that people will lose their doctors under some policies.
Republicans will also hold hearings, and come armed with anecdotes from outraged citizens who suddenly find their new health insurance options aren’t perfect.
Reform has given new life to a party that was in the depths after the shutdown debacle just last month.
This deep concern about Americans’ access to quality insurance is entirely new and utterly insincere, of course. Nearly one in 10 people on Medicare — 4 million people — are dissatisfied with that program, according to surveys, but you don’t hear their complaints broadcast at hearings or at Republican news conferences. In 2010, long before the health reform law took effect, 20 percent of people on employer-based insurance expressed dissatisfaction with their plans, as did a third of people on the individual market. They complained about high deductibles and constrained networks of doctors and hospitals, just as many of them will under the new system. And they complained about cancelled policies.
Republicans never cared about those concerns before the Affordable Care Act came around, and they don’t really care now, even though they’re doing a great job of feigning outrage. They’re simply using these grievances, magnified by anecdotal media coverage, to batter Democrats who are still standing up for the president’s program.
Some of those Democrats are fighting back. They’re pointing out, as the White House did yesterday, that the growth in health care costs is slowing significantly. They’re trying to highlight people who are saving money on their new policies, or who can buy insurance even if they are sick. And they will try to broadcast the voices of the previously uninsured, who have never appeared in a Republican diatribe and never will.
But the most attention, as always, will be paid to the shrillest critics. Just remember, as their attacks pick up in volume in the months to come, that they were prepared long in advance, as cheap as canned laughter.
By: David Firestone, Editors Blog, The New York Times, November 21, 2013
“The Real Roots Of The Filibuster Crisis”: This Is About Whether Barack Obama Is Legitimately The President Of The United States
We’re about to have ourselves a little filibuster crisis, and the only surprising thing is that it took so long. We’ve now reached a point where Republicans no longer accept that Barack Obama has the right, as president of the United States, to fill judicial vacancies. Unlike in previous battles over judicial nominations, we’re not talking about the nominees’ qualifications or their ideological proclivities. It’s merely a question of the president’s constitutional privileges. Republicans don’t think he has them. This is only the latest feature of a long descent for the GOP away from considering any Democratic president—but particularly this one—as a legitimate holder of the office to which he was elected.
There has never been a president, at least in our lifetimes, whose legitimacy was so frequently questioned in both word and deed by the opposition party and its adherents. Even today, many Republicans, including some members of Congress, refuse to believe that Obama was born in the United States. Right after he was re-elected, 49 percent of Republicans told pollsters they thought ACORN had stolen the election for Obama, a decline of only 3 points from the number that said so after the 2008 election, despite the fact that in the interim, ACORN had gone out of business. Think about that for a moment. How many times have you heard conservatives say that the Affordable Care Act was “rammed through” Congress, as though a year of debate and endless hearings and negotiations, followed by votes in both houses, followed by the president’s signature, was somehow not a legitimate way to pass a law? In short, we’ve seen this again and again: it isn’t just that Republicans consider Obama wrong about policy questions or object to the substance of one or another of his actions, it’s as though they don’t quite accept that he’s the president, and everything he does carries for them the taint of illegitimacy.
If that’s where you’re coming from, it seems perfectly justifiable to upend the norms that have traditionally determined how things work in Washington. One of those norms is that while it’s common to fight against the judicial nominees of a president from the other party, you have to at least have a gripe about each of those nominees. But Republicans are no longer bothering with that. The current argument is about three vacancies on the D.C. Court of Appeals, widely understood as the second most important court in the system, because it deals with many cases concerning government’s powers (four of the nine current Supreme Court justices came there from the D.C. Circuit). Republicans argue that by attempting to fill those vacancies, Obama is engaged in an unconscionable act of “court-packing,” and besides, the D.C. Circuit doesn’t have enough work to do anyway, so the seats should just remain empty.
Until there’s a Republican president, of course! Though they haven’t said so explicitly, here’s a suggestion for Capitol Hill reporters: Next time you’re interviewing a Republican senator who says he’s filibustering these nominations because the D.C. Circuit doesn’t have enough work to do, ask him if he’s willing to make a pledge, right there and on the record, to filibuster any appointment the next Republican president makes to that court. See what he says.
Anyhow, Harry Reid is now threatening to eliminate the filibuster for judicial nominees altogether, something he can do with a simple majority vote. But he’ll need to get 50 of the 55 Senate Democrats to vote for it, and there’s a good deal of reluctance to do so, particularly since Democrats won’t be in the majority forever, and whenever they’re back in the minority they’ll want to have the filibuster for themselves. But according to recent reporting by Greg Sargent and others, Reid thinks he has the votes and is just about ready to pull the trigger if Republicans don’t relent on these three nominees.
But the threat of the “nuclear option” of eliminating the filibuster for nominees could be just a negotiating tactic. The outcome Democrats would probably most prefer is what happened the last time we went through this, in 2005. In that case the controversy was over a group of Bush appointees who were true radicals, none more so than Janice Rogers Brown, who calls the New Deal a “socialist revolution” and says things like, “In the heyday of liberal democracy, all roads lead to slavery.” That controversy ended with an agreement in which Bush got his nominees—Brown now sits on the D.C. Circuit—and Democrats promised to use the filibuster only in “extraordinary circumstances.” In other words, it was a complete win for the Republicans. The biggest difference between then and now is that Democrats never questioned whether Bush had the right to fill judicial vacancies; they had specific objections to particular nominees.
In the various flare-ups of the birther controversy, reporters would occasionally ask Republican members of Congress very basic questions, like “Do you think the President was born in the United States?” The answers were incredibly revealing. Some simply said yes, but others hemmed and hawed, saying things like “It’s not my responsibility to tell people what to think” or “I take him at his word,” as though there were still some doubt. It’s time they got asked the same kind of questions about this crisis. If you asked Republicans, “Does Barack Obama have the right to fill judicial vacancies?”, I honestly have no idea what they’d say. But it would be interesting to find out.
By: Paul Waldman, Contributing Editor, The American Prospect, November 20, 2013
“Such Noble Sentiments”: Why Republicans Suddenly Care, Deeply, About All Those Canceled Health Policies
Amid the current national uproar over the troubles of the Affordable Care Act, it is almost uplifting to hear the deep concern expressed by politicians, pundits, lobbyists, and corporate leaders over cancellation of existing health insurance policies. They empathize loudly with the millions of potential victims, whose plight infuriates these worthy observers. They fill hours of television and pages of print with expressions of outrage.
Suddenly everyone in Washington is intensely concerned about Americans who are losing their health insurance.
The outpouring of noble sentiment would be laudable — indeed, long overdue — if only there was any reason to believe these protestations are sincere. Sadly, the evidence points in the opposite direction, for a single obvious reason: Millions of people in this country have been losing health insurance for many years, resulting in untold thousands of serious illnesses, bankruptcies, and early deaths – but until insurance cancellations became a political embarrassment for Barack Obama, the usual right-wing reaction was silence. (Except for that awkward and revealing outburst during the Republican debates of 2012, when a live audience howled its approval for the “let him die” plan.)
For anybody who ever honestly cared about people losing their health coverage – for instance, President Obama or his Democratic predecessor Bill Clinton – the depressing statistical reality has long been plain. Every day of every year, thousands of people leave the rolls of the private insurance industry in this country, almost never voluntarily.
People often forfeit insurance after losing a job, which happened to millions during the Great Recession. At the recession’s height, when the Tea Party Republicans were fighting to kill Obamacare in the cradle, more than 44,000 people were losing their health coverage every week. In May 2009, the policy journal Health Affairs published a projection that nearly 7 million Americans would lose coverage by the end of 2010.
People also lose insurance because their insurance company doesn’t want to pay the cost of a grave illness (having gorged on costly premiums for years), which has happened to many thousands more. The most recent congressional report on the subject found that three major insurance companies had saved at least $300 million through “rescission” of policies held by 20,000 seriously ill clients, while their profits mounted.
Or people lose insurance because the cost rises and they can no longer afford it, which happens routinely to nearly half the population at some point during every decade. A report released by the Treasury four years ago found that “nearly half of non-elderly Americans” had lived without health coverage at some point between 1997 and 2006, a period of relative prosperity and high employment.
The consequence, as everybody ought to know by now, is that upward of 45 million Americans have gone without health insurance at any given moment since 2007. And the further consequence is that many of those uninsured – men, women, and children — go without needed health care, leading to untold suffering and premature deaths for as many as 45,000 annually, perhaps more.
But such dismal facts have never seemed to trouble the Republicans who are screaming so loudly now about the terrible toll of Obamacare. The perennial GOP attitude was set forth by neoconservative eminence Bill Kristol back in 1993, when the prime objective was to kill the nascent Clinton health plan. “There is no health care crisis,” Kristol famously declared, and for him — then a well-paid flack in the Murdoch empire — that was true enough.
After two decades of medical costs skyrocketing above inflation, threatening fiscal and economic ruin, while millions went without insurance, such smug right-wing complacency remains largely intact. The only “health care crisis” ever feared by Republicans like Kristol is the prospect that reform will help Americans – as Obamacare is already doing, despite their worst efforts.
Let’s hope that the president’s team swiftly solves the inherent problems of providing universal coverage through private insurers. It is certainly possible, if never optimal, as Massachusetts and other states seeking to advance that goal are already proving.
And meanwhile, let’s please have no illusions about this momentary flurry of concern on the right over insurance lost. It would disappear instantly and permanently — if only Obamacare could be repealed.
By: Joe Conason, Featured Post, The National Memo, November 15, 2013
“Nobody Died”: No, Obamacare’s Flaws Are Not Like Hurricane Katrina
It’s one thing for former George W. Bush flack and Sarah Palin staffer Nicolle Wallace to make a silly and self-serving link between the troubled rollout of President Obama’s Affordable Care Act and her boss’s handling of, wait for it, Hurricane Katrina. It’s another for the New York Times to pick up the cudgel and seriously make a comparison between the Affordable Care Act’s acknowledged problems and the deadly 2005 tragedy.
But that’s what the paper did Friday morning, with Michael D. Shear’s “Health Law Rollout’s Stumbles Draw Comparisons to Bush’s Hurricane Response.” Other media are using the Times piece to make the same comparison. ABC’s “Good Morning America” did a whole segment on it; as I write, the chyron on MSNBC asks “Obama’s Katrina?”
Shear put it this way:
The disastrous rollout of [Obama’s} health care law not only threatens the rest of his agenda but also raises questions about his competence in the same way that the Bush administration’s botched response to Hurricane Katrina undermined any semblance of Republican efficiency….
“The echoes to the fall of 2005 are really eerie,” said Peter D. Feaver, a top national security official in Mr. Bush’s second term. “Katrina, which is shorthand for bungled administration policy, matches to the rollout of the website.”
No, Mr. Feaver, Katrina isn’t shorthand for “bungled administration policy.” It’s an actual tragedy in which at least 1,800 people lost their lives. Thousands of others were left stranded without food or water in their flooded neighborhoods, on freeway viaducts, in hospitals and nursing homes, and in the televised hell-hole of the Superdome. A million people were displaced, some of them permanently. Whole neighborhoods remain unrestored eight years later. There was at least $123 million in destruction, twice as much as in Hurricane Sandy.
In the ACA holocaust, by comparison, an undetermined number of people may lose health insurance policies they like. Many more, perhaps millions, have been frustrated by a kludgy website. On the other hand, at least 100,000 have signed up for insurance through the exchanges and another 500,000 or so have been newly covered by Medicaid expansion.
Oh, and there have been zero deaths as a result of the ACA woes — unless you count the death of credibility among journalists and pundits who would make such a lame and cruel comparison.
In Katrina, a toxic mix of indifference to the plight of poor, black New Orleans residents and genuine colorblind incompetence made a natural disaster worse. Bush, you’ll recall, threw a birthday party for Sen. John McCain, and then flew over the ravaged Gulf region without stopping. When he did visit, he praised his lame FEMA director Michael Brown – whose job as a commissioner of the International Arabian Horse Association had been great training for running the nation’s disaster preparedness agency – with the iconic “Heckuva job, Brownie.”
Obama, by contrast, stepped forward when the website troubles emerged. “Nobody is madder than me about the fact that the website isn’t working as well as it should, which means it’s going to get fixed,” he told a crowd Oct. 21. It’s still not fixed, although it’s working better, and the president has continued to push his staff for answers and apologize for the rollout woes, last week in an interview with NBC’s Chuck Todd; last night in a press conference. “There were times I thought we got slapped around unjustly,” the president said. “This one is deserved. It’s on us.” There has been nothing close to a “Heckuva job, Brownie” moment.
Finally, in Hurricane Katrina, most of the victims were poor African-Americans. In the current ACA controversy, the vast majority of people losing their private insurance policies are young and middle-aged white men who aren’t affluent, but are doing well enough that they don’t qualify for federal subsidies. That makes the Katrina-ACA comparison particularly outrageous, especially for journalists.
All that will ultimately matter is whether and when the site gets fixed, and the turmoil in the individual market, where some people are losing policies they want to keep, subsides. We still don’t know if the president’s proposed “fix,” which should let at least some of those folks hold onto their existing insurance, is meaningful enough to quell the political panic among some Democrats and people losing insurance, yet limited enough that it doesn’t undermine the goal of getting a bigger pool of people into the individual market for ACA-approved health insurance plans (rather than the junk insurance that currently dominates the individual market).
It’s clearly a mess, with genuine political and public policy implications. It’s fine for shrill Republicans to call it Obama’s Katrina, or his Iraq, or his Iran Contra – when it comes to this president, they have no credibility and they have no shame; they’ll say anything. But for the media to pick up on the GOP narrative and sincerely compare the ACA rollout stumble to a national tragedy like Hurricane Katrina?
Someone might call it the media’s Katrina — if it was fair to use a tragedy in which thousands died as a metaphor for mere incompetence. So I’ll just call it incredibly lame.
By: Joan Walsh, Editor at Large, Salon, November 15, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 