“By The People, For The People”: Proof Obamacare Puts Control Of Healthcare In The Hands Of The Consumer
One of the key talking points consistently mouthed by opponents of the Affordable Care Act is their declaration that the law wrests control of healthcare out from the hands of the consumer and places it squarely under the control of the federal government.
And yet, the meme—like so many others employed by dedicated Obamacare bashers— is simply not true.
Now, we can prove it.
You have likely never heard about the section of the ACA that provides federal loans to help launch consumer owned and controlled health insurance plans. The money is available for insurance plans showing a reasonable chance for success, are owned by the membership (people like you and I) and operated by a board of directors where members comprise the majority -not passive investors looking to make a buck.
It is health insurance by the people and for the people.
Tufts Medical Center in Massachusetts—along with their physician group and a company which owns and operates two hospitals in the region—has acted on this provision of the law and received $88.5 million in federal funds to create the state’s first member owned and controlled health insurance plan. While the program is being put together by a panel of experts, once the insurance plan is qualified to do business by the state’s insurance regulators, they will begin signing up individuals and small businesses who will not only become the owners of the plan, they will ultimately end up running the company.
How’s that for putting control of our healthcare back into the hands of the consumer?
The not-for-profit plan entitled the Minuteman Health Initiative—which expects to offer health insurance coverage in Eastern and Central Massachusetts beginning in 2014—is looking to bring down the cost of premiums to its members by streamlining the billing process and allowing providers to work directly with employers.
According to Dr. Jeff Lasker, chief executive of the Tufts physician group, New England Quality Care Alliance, “Imagine working closely with an employer who can help us gather data and, with employees’ permission, to be able to share that data with their primary care providers. “
Imagine, indeed.
Physicians, hospitals and consumers working alongside one another to design coverage options that better meet the needs of all the participants in the healthcare equation in the effort to bring about a better result for everyone—and done in an environment where the consumer is in control of the board of directors rather than profit driven executives whose bonuses are determined by how much money is left in the till at the end of the quarter.
Can there be anyone who does not see the great potential in this concept?
We are a nation where our health care is, for most of our citizens, controlled by private insurance companies—not the United States government. If you don’t believe that, just ask your physician what he or she must go through to get an insurance company to approve a treatment or procedure you need and how you end up paying for all this time your doctor invests in fighting for your care.
Will the Minuteman Health Initiative work? Will it accomplish the goal of lowering costs and providing appropriate benefits to consumers while allowing for a workable compensation structure to health care providers—all under the direction of the very people who depend on the plan for their health care needs?
We’ll see.
But if you don’t try something, you never find better solutions. And should the Minuteman plan work out, we can expect to see similar programs launched in every state in the union—insurance plans designed to work for both provider and beneficiary and all under the control of the people who actually pay the premiums and depend upon the benefits for the security of their families.
I don’t care how much you think you detest Obamacare. If you aren’t rooting for success in the case of the Minuteman Health Initiative—and the law that made it possible—you simply are not paying attention.
By: Rick Ungar, Contributor, Forbes, September 1, 2012
“Romney And His Fictional Obama”: A Man Who Exists Only In The Imagination Of Mitt’s Ad Makers
Here’s a chance for all who think Obamacare is a socialist Big Government scheme to put their money where their ideology is: If you truly hate the Affordable Care Act, you must send back any of those rebate checks you receive from your insurance companies thanks to the new law.
This is just common sense. If you think free enterprise should be liberated from Washington’s interference, what right does Uncle Sam have to tell the insurers they owe you a better deal? Keeping those refunds will make you complicit with Leviathan.
And here’s a challenge to Mitt Romney: You are running a deceitful ad about waivers the Obama administration has yet to issue based on rules allowing governors to operate their welfare-to-work programs more effectively. Will you please stop talking about your devotion to states’ rights?
Up until now, you were the guy who said that wisdom on matters related to social programming (including health insurance) lies with state governments. Five governors, including two of your fellow Republicans, thought they had a better way to make welfare reform work. The Department of Health and Human Services responded by proposing to give states more latitude. Isn’t that what honoring the good judgment of state governments is all about?
Oh, yes, and if Romney thinks President Obama is gutting welfare reform, I anxiously await his criticism of Brian Sandoval of Nevada and Gary R. Herbert of Utah, GOP governors who requested waivers. If Romney means what he says, doesn’t he have to condemn those who asked Obama to do what Obama did?
Political commentary these days is obsessed with the triviality of this campaign. Most of it is rooted in the refusal of conservatives to be candid about the implications of how their beliefs and commitments would affect the choices they would have government make — and how they differ from the president’s.
In Romney’s case, this often requires him to invent an Obama who exists only in the imagination of his ad makers. So they take Obama’s statements, clip out relevant sentences and run ads attacking some strung-together words that have a limited connection to what the president said. In the welfare ad, Romney lies outright.
But this is part of a larger pattern on the right, illustrated most tellingly by conservative rhetoric around the Affordable Care Act. In going after Obamacare, conservatives almost never talk about the specific provisions of the law. They try to drown it in anti-government rhetoric. “Help us defeat Obamacare,” Romney said after the Supreme Court declared the law constitutional. “Help us defeat the liberal agenda that makes government too big, too intrusive, and is killing jobs across this great country.”
Well, the new law does intrude directly in the insurance market. It requires that at least 85 percent of large-group premiums and 80 percent of small-group and individual premiums be spent directly on clinical services and improving the quality of health care. Imagine the radicalism: The government is telling insurance companies that they must spend most of the money they take in on actual health care for the people and businesses paying the premiums.
If the insurers spend below those levels, they have to refund the difference. According to Health and Human Services, 12.8 million Americans will get $1.1 billion in rebates. That comes to an average rebate of $151 per household. In 12 states, the rebates will average $300 or more.
Here’s your chance, conservatives. Big, bad government is forcing those nice insurance companies to give people a break. From what you say, you see this as socialism, a case of the heavy hand of Washington meddling with the right of contract. You cannot possibly keep this money. So stand up for those oppressed insurers and give them their rebates back!
As for the waivers on welfare, Romney’s position is dispiriting. Here’s a former governor whose Massachusetts health-care plan — the one that resembles Obamacare — was made possible by federal waivers; who, like other governors, wanted flexibility to do welfare reform his way; and who has said he would roll back Obamacare through the waiver process he now assails. He’s turning away from what he claims to believe about state-level innovation for the sake of a cheap and misleading campaign point.
I’d also be curious to know whether Romney got a rebate on his health insurance premiums courtesy of Obamacare and whether he plans to return it. But given his attitude toward disclosure, we’ll probably never find out.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, August 8, 2012
“Sending A Message To White Moderates”: Mitt Romney “Expected” Boos From People Who Want “Free Stuff”
Members of the NAACP will no doubt be excited to know they weren’t just used as props to send a message to white moderates that Mitt Romney would be all inclusive and stuff—they were also used to send a message to the Republican base that Romney is not afraid to talk sternly to and be booed by the colored people:
“I think we expected that,” he said on Fox Business Network, referring to the audience’s negative response. “I am going to give the same message to the NAACP that I give across the country, which is that Obamacare is killing jobs.”
See that, Republican base? Mitt Romney really really hates Obamacare, no matter who he’s talking to. Does that not light your hair on fire? Well, I hope you saved some of your hair, because here’s another hair-lighter: Speaking at a Montana fundraiser later in the day, Romney took it a step past having expected the boos, saying:
When I mentioned I am going to get rid of Obamacare, they weren’t happy … That’s okay, I want people to know what I stand for, and if I don’t stand for what they want, go vote for someone else, that’s just fine. But I hope people understand this, your friends who like Obamacare, you remind them of this, if they want more stuff from the government, tell them to go vote for the other guy—more free stuff. But don’t forget nothing is really free.
So he was making a stand at the NAACP convention, making sure people knew they were not going to be getting any free stuff from him, no sir (not unless you’re super rich and by “free stuff” you mean giant tax breaks). Steve Benen puts this in context with a reminder that black people aren’t the only ones whose desire for free stuff Romney likes to talk about. In fact, he also thinks women needing preventive health care and young people struggling to pay their college tuition are just in search of free stuff.
To an outsider, Romney is doing a pretty good job looking like the asshole the Republican base wants its candidate to be, but the fact that at this late date he is still forced to send signals to the Republican base that he’s one of them, rather than being able to take their commitment to him for granted and focus solely on making white moderates think he’s inclusive, is a sign of weakness no matter how he tries to spin those boos.
By: Laura Clawson, Daily Kos, July 12, 2012
“An Implausible Argument”: Mitt Romney’s Other Health-Care Contradiction
In vowing this morning to do what the Supreme Court didn’t—repeal Obamacare—Mitt Romney trotted out all his arguments against the newly constitutionally sanctioned health care law. Among them were these two points: First, that Obamacare would cause 20 million Americans to lose their health insurance, and second, that it would be a job-killer to boot.
Problem is, these two arguments directly contradict each other.
The 20 million Americans who presumably would lose their health insurance would do so because their employers would decide to cease offering it, letting their employees fend for themselves on the health-insurance exchanges. Why would these employers opt to do that? The only conceivable reason is that it would be cheaper for them to do that. And if it was cheaper for them to do that, they’d then have more money to hire more employees, creating rather than killing jobs.
You can argue, with serial implausibility, that Obamacare will cause millions to lose their health insurance or that it’s a job-killer. You can’t argue both.
With today’s ruling, the fate of Obama’s health-care reform will be up to the voters in November’s election. For voters who hate Obama and all he stands for, that’s one more reason to go to the polls—but those voters are probably going to the polls in any event. If Romney decides to ride this issue, it’s not clear he’ll gain any more votes than he already has locked up. He may motivate some Republicans who don’t particularly care for him but will vote out of their hatred of Obama to care for him somewhat more. (Polling shows that a higher percentage of pro-Obama voters support the president because they like him than pro-Romney voters like Romney.) But I doubt that raising his positives among voters who are already determined to vote for him anyway matters.
Republicans will doubtless exploit the court’s upholding the mandate under the Congress’s power to tax rather than under the Constitution’s commerce clause. There’s that t-word again! It’s unlikely that more than a couple percent of the American people, those with incomes adequate enough to decline to buy insurance, will ever be subject to that tax, but you can count on Republicans to depict it as a mass confiscation worthy of Lenin. Obama and the Democrats need to be able to counter this with real numbers—in Massachusetts, the one state that has already adopted a similar law, just 1 percent of taxpayers are subject to the penalty—even as they focus on the benefits most Americans will derive from the law, which was the tack the president took in his statement this morning.
By: Harold Meyerson, The American Prospect, June 28, 2012
“Illusions Of Care”: Romney’s Healthcare Plan That Isn’t
If someone asked you to come up with a good reason that Mitt Romney—the boring one-term governor of a state he left with high debt, poor job-creation and low approval ratings—became a credible national candidate, you might have a hard time doing so. The fact that he is wealthy and could self-finance his way into the top tier of Republican presidential contenders helped, as did the fact that he had won in the bluest of states, Massachusetts.
But the main reason, ironically, is that he was associated with a policy achievement—healthcare reform—that he has completely come to oppose. Back in 2007, Republicans still pretended to care about the crisis of 45 million uninsured Americans and costs that keep spiraling upwards. And so they looked to the one Republican who had tackled that problem at the state level and had done so with a program that harnessed the private sector rather than creating a massive new entitlement program. Conservative organs such as National Review, which would later inveigh against the Affordable Care Act (ACA), cited Romney’s experience with reforming the health insurance system as one of his most valuable credentials.
Throughout this campaign Romney has walked a tiny tightrope on healthcare: he attempts to make amends for passing the state level template for the ACA by issuing over the top denunciations of socialist, unconstitutional “Obamacare.” Meanwhile he has studiously avoided saying anything of substance about how he would address the massive market failure that defined the pre-reform American healthcare system.
On Tuesday in Orlando Romney gave a speech intended to create the false impression that he intends to replace the ACA with something that would provide the same benefits through other means. Here is how the Washington Post summarized the speech: “Romney fleshed out a plan he proposed earlier that would apply free-enterprise principles to the nation’s health-care system rather than operate it like a ‘government-managed utility,’ letting competition drive down prices and increase quality.” The “earlier” they refer to is Romney’s big healthcare speech last May that was meant to make it clear how different he is from Obama on the subject.
That was the main thrust again on Tuesday. Romney repeated the usual right-wing shibboleths: that the ACA has hamstrung the economic recovery by placing “unaffordable” cost burdens and new taxes on families and businesses. He has been at this for a while, using misleading anecdotes, such as his blatant misrepresentation of a passage from Noam Scheiber’s book that he claims shows the White House knew healthcare reform would damage the recovery, when it only shows that it knew more stimulus might have been more valuable to the short-term recovery. Of course, had Obama proposed more stimulus spending instead of healthcare reform in the fall of 2009, Romney and other Republicans would have opposed it.
In fact, the Romney campaign appears to disagree with the Post that Romney offered much more substance than he did last May. When I asked for details of what he is proposing, the campaign said he laid it out last year and the program is available on the campaign website.
The healthcare page on Romney’s site does not, in fact, tell you much about what Romney would do. Instead it mostly offers vague, inoffensive sounding principles such as “Ensure flexibility to help the uninsured, including public-private partnerships, exchanges, and subsidies” and “Offer innovation grants to explore non-litigation alternatives to dispute resolution.”
Some of the principles are more blatantly ideological and potentially quite troubling, such as “Limit federal standards and requirements on both private insurance and Medicaid coverage.” Those federal standards and requirements are in place to protect citizens from rapacious companies and miserly state governments that would deprive recipients of necessary treatments. Any given federal requirement might be too costly or unnecessary. But Romney doesn’t specify which federal requirements he would eliminate so as to avoid inviting scrutiny of what his policy would do to the vulnerable.
The few specifics Romney offers could reduce, rather than expand, medical coverage. Romney would turn Medicaid into a block-grant program. That way, if poverty increases the federal government would not be on the hook for covering more Medicaid recipients. It would be the state’s problem. And what would the states do? Reduce the quality of coverage, or tighten eligibility rules to reduce the number of people covered.
The only other major change to the health insurance delivery system Romney offers is this: “End tax discrimination against the individual purchase of insurance.” That’s a euphemism for creating an expensive new tax deduction. That’s pretty hypocritical coming from someone who promises to cut tax rates and somehow magically make up for the lost revenue by eliminating tax expenditures.
Currently employer-provided health insurance is not taxed as income. Consequently, we overspend on health insurance by favoring that compensation over money employers pay to workers and the workers spend on anything else. This is actually not a very good policy for anyone. Employers are stuck with escalating healthcare costs, employees see their wage increases get diverted to healthcare, and the individual insurance market offers inferior, expensive coverage that unfairly disadvantages the self-employed and thus discourages risk taking.
These are all good reasons to get rid of our current system and switch to a universal, single-payer approach, such as making everyone eligible for Medicare. The alternative way to eliminate the current market distortion would be to end the tax deductibility of employer-based health insurance. That’s the program John McCain ran on in 2008. Back then, conservatives made sensible arguments in favor of doing so. For example, the Family Research Council complained in 2007 that employer-sponsored health insurance enjoys the single largest subsidy in our tax code.
But Mitt Romney is not John McCain. He is a coward, who lacks an iota of McCain’s political bravery. Consequently, Romney fears the backlash that would ensue if he took the principled position in favor of removing this inefficiency. So instead he proposes to equalize the treatment by making it also tax-deductible for individuals to buy their own insurance. That’s good for them, but it does nothing for the market. (The advantage to the market of McCain’s proposal was that it would move millions of health working-age Americans into the individual insurance market, much as the individual mandate would.) The ACA creates a flat tax credit for buying insurance. Romney would repeal that and offer a tax credit based on how much you spend on health insurance, so it would disproportionately benefit richer people who can afford more expensive tax plans.
In a similar act of falsely telling voters they can have their cake and eat it too, Romney promises to keep the most popular provision of the ACA, the rule preventing insurers from excluding prior conditions, without explaining how he would prevent the insurance market from a death spiral of cost increases. (The current mechanism for preventing that, the individual mandate, is the core of what Romney promises to repeal if the Supreme Court doesn’t do so first.)
As a freelancer who pays for his own insurance, I stand to benefit. But as American citizens, we all stand to lose.
By: Ben Adler, The Nation, June 12, 2012
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