Here’s what happened. Reid was interviewed by PBS on Friday about Obamacare. He was asked if his goal was to get America into a single-payer system. His answer was: “Yes, yes. Absolutely, yes.”
OMG!! I KNEW IT, BOEHNER AND THE RINOS BETRAYED US something something OBAMACARE!
cough cough Sorry, that slipped out.
Anyways, it's never been a secret that progressives want a European-style single-payer system... because that works so well. //rolls eyes. And Reid explained that when they started with Obamacare, they wanted to impose a single-payer system, but they didn’t have the votes. So they instead tried to insert a public option into Obamacare, which would have eventually caused a single-payer system because private insurers can’t compete against a government-run insurer and they would have all been driven out of the system. But again, they didn’t have the votes, particularly after Joe Lieberman opposed it. At that point, they needed to pass something because they had hung their hats on delivering healthcare reform. Reid didn't say this part, but it was obvious: Obamacare would be their only achievement despite having a supermajority, so failing to deliver something would have been suicide. Hence, they abandoned the single-payer idea and they passed the Insurance Company Subsidy Act known as Obamacare.
Reid then described Obamacare as “a step in the right direction,” the phrase you'll hear misinterpreted over and over today with orgasmic delight both on the right: "OMG!! HE CALLED IT A STEP! SEE, IT'S ALL PART OF A FIENDISH PLAN!! FARGLE FARGLE KNEW IT ALL THE TIME, GODD*MN BOEHNER TRAITOR buy my book" and on the left: "Nondenominational Hallelujah! Nondenominational Hallelujah!". Willful idiocy aside however, what this really was is face-saving. Obamacare is not what Reid wanted. To the contrary, it actually makes a single-payer system much less likely. But what was Reid going to say? “Yeah, that thing we passed and told you was great... it sucks donkey balls and boy was it a mistake.” -- Harry Reid. No way. He can't admit that they blew their chance to give his constituents what they want. So he made standard noises about this being a step in the right direction humma humma, but never fear, we know what the ultimate goal is and we'll get there blah blah blah.
Now, this is where it gets interesting. Reid made it clear that his goal remains a single-payer system, and to make that happen, he said they need to find a way to “work our way past” insurance-based systems. Think about that. To get a single-payer, they need to break the public away from insurance. BUT, Obamacare goes the other way and entrenches the current health insurance model even further because it forces employers to provide insurance or face fines and it forces individuals to buy insurance or face fines. In other words, it tries to make everyone get into and become accustomed to the insurance system. That’s a bit like someone whose goal is to stop people from eating meat forcing everyone to buy ten years worth of McDonald's gift certificates. Thus, by passing Obamacare, Reid made it much, much harder for them to ever get a single-payer system. In effect, Obamacare is more like a Trojan condom preventing a single-payer plan than a Trojan horse meant to cause it.
Of course, talk radio has already worked out how this is all part of the master plan to bring about the Boehner/Obama Single Payer System. See, Reid and the Democrats know that Obamacare will fail, they're actually counting on it. Their fiendishly clever plan in passing Obamacare was to make insurance so expensive that no one will be able to afford it. Then those suckers, the American public, will naturally join hands in union and ask Obama/Reid to fix the system they just ruined. It's manical! DAMN YOU RINOS!!
Devious, isn't it? Yeah, it's also retarded. Humans don't go back to the person who broke something through their own incompetence and beg them to double down on their solutions... "Please sir, can we find a bigger cliff." Doesn't happen. Look it up. What actually happens is people turn to their opponents and say, "That other guy is a dipsh*t. You fix it." Seriously, do you really think that the people who will lose their insurance over the next couple years, or those who will find themselves unfairly fined, or those doctors and hospitals who find that even more of their bills go unpaid are going to turn to Obama/Reid to double-down on the thing that just caused their problem? Hardly.
That "theory" also fundamentally misunderstands how Obamacare works. Obamacare is the insurance exchanges... that's it, but more than 71% of the public gets their insurance elsewhere (this could be as high as 87% actually). If the exchanges completely implode or their rates skyrocket, the 71% who get their insurance through work won't be affected at all. Thus, they sure as heck aren't going to go to anyone and beg that Obamacare be fixed by wiping out the private insure they continue to enjoy and overwhelmingly report being happy with. "Please sir, take what has been working for me and toss me into that mess you just created." The 17% who currently buy their own insurance and will probably be forced into the exchanges aren't going to ask for a single-payer system either. They're going to want a return to what they had... before Obama ruined it for them. The 11% currently uninsured are likewise made up of people whose sole concern will probably be to get the fines cancelled. Most of them aren't going to care about universal coverage and they aren't going to be in the best mood if Obama comes calling with a new solution. The insurance companies aren't going to ask to be wiped out either. Doctors aren't going to ask to be made de facto employees of the state. Heck, even unions now see the danger of universal coverage. So where exactly is this wave of Americans who will come begging Obama to rape them even harder this time? That wave starts and stops with around the 7% of the public that is leftist ideological and maybe about 5 million people who are uninsurable... that's it. Everybody else is going to want to go in the other direction.
You know, now might be a good time to start suggesting an alternative path actually... something other than the awful and many-times-rejected "let insurers compete across state lines."
Oh well. Go enjoy the idiocy because I'm sure they'll be in fine form today. Just don't take it internally. Remember that when they tell you that ObamaBoehnerCare is the most fiendishly clever plan Saul Alinsky ever invented, that they are ignoring the fact that both Reid's Plan A and Plan B failed, that Obamacare was all he could get, and that it actually entrenches the system Reid needs to destroy to achieve his goal. That's hardly a master plan, except perhaps in the eyes of a Marxist... a Groucho Marxist.
I saw a poll stating 63% are unhappy with the roll out of Obamacare, and want it changed. As you point out, it is a winning issue, but only if you have something plausible. People that have insurance like it, but they want it to not cost so much. As we have often discussed in the past, the only way to do that is tackle why those costs are too high. Insurance companies will stay in as long as they can pass the costs along to the policyholders via higher rates. I saw an interesting article in National Review about how much more our hospitals cost than elsewhere in the world for the same procedures. Hospitals claim they have to charge more to make up for the freebie care they give, but that doesn't explain the amount of the high charges. As you have discussed, part of that is simply the overuse of tests, but there are many factors.
ReplyDeleteJed, I think that's absolutely right. People are generally happy with the current system except that (1) it costs too much and (2) some people have problems getting insurance.
ReplyDeleteWe need a proposal that reduces the costs and then we can focus on helping those who are still unable to afford it. Obamacare is not the answer. But unless we come up with something better than "insurance companies will fix it," then we aren't going to win on this issue.
The big thing is to start proposing a plan now so that people know there is an alternative. Otherwise the only alternative is "Obamacare or nothing" and most people will never choose nothing... they'll try to fix Obamacare. And that is when the Democrats can cause more mischief.
On the costs, you're right, hospital costs are not the result of freebies. They are most likely the result of Medicare tinkering.
What about government decisions about what can and can not be treated (alias "death panels")? If so, wouldn't that be another factor which would make it more difficult to blame "pursuit of profit" for defining care cut offs and therefore take another talking point away from the single payer advocates?
ReplyDeleteK, Exactly. Obamacare has created this problem for the Democrats because they've sold this as a total fix with the Democrats reining in the insurance companies -- "they can't deny you, they can't cap your benefits, and they need to offer what we tell them to offer you... minimum level of benefits, baby."
ReplyDeleteThe end result is that people will blame the government, not insurance providers, whenever their claims get denied. And insurers will happily run with that... "yeah, this is what Obamacare requires."
So if things go wrong the single-payer people will need to fight that, but they will have the problem of all this rhetoric and several years of impression created by the Democrats that they were holding the reins on the insurance companies. In fact, the argument I would make is, "If the government couldn't afford to treat you with an unlimited supply of other people's money at their disposal, what makes you think it's going to improve things by switching to a limited supply of tax dollars?"
Don't get me wrong, I think Obamacare is a disaster. But the more I think about it, Reid really drove a huge stake into his dream of a single-payer system. It's not impossible, but he made it a heck of a lot harder.
Obamacare is more like a Trojan condom preventing a single-payer plan than a Trojan horse meant to cause it. -- Hilarious! But this metaphor won't work for the "condoms fail 150%" crowd.
ReplyDeleteRE: alternative solutions -- the sales pitch is already written. Obamacare has done nothing to reign in costs and has only exacerbated the problem. Daily I hear news stories designed to convince you that those 20% - 40% rate increases your insurance company is warning you are coming are really massive cuts because some granny in NYC got a $100 one-time rebate. I don't think anyone's buying it.
All the Republicans have to do to sell any plan is to claim to have a fix for what Democrats made worse and just enough blah-blah to make the claim convincing. Of course I don't mean that the GOP should pull a plan from their rears; the point is that the pushback on O-Care is not an uphill slog. Actually, it's practically a toboggan run.
Oh geez, I just realized something. Remember how Rush was saying (still does sometimes) that he wants Obama to fail? Well, slowly the entire media field is coming to agreement that ObamaCare is a failure. Does that mean that Rush wanted ObamaCare? Or just outrageous insurance premiums?
ReplyDeleteAndrew - your comment about medicare and medicaid is spot on. let me direct readers to a couple of interesting stories about the history of cost explosion in our health care system. The first, oddly enough, is from the NYTimes: http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?smid=fb-share&_r=0
ReplyDeleteThe other is an article in the August 5 issue of National Review titled "An Arm and A Leg" by Avik Roy which I cannot seem to link. In that article, he recalls how prior to LBJ, The AMA twice defeated liberal attempts to impose 'single payer.' Southern Democrats had always been opposed. LBJ had enough votes for Medicare, and the southern Dems got on board giving him an even grander program than he originally proposed. The AMA signed on after Johnson promised to remove ANY cost controls from the program. As always, the federal government was big on benefits to voters and indifferent to cots which could be either passed on to current tax payers (unpopular) or deferred to the future. Excessive bureaucratic waste is hidden away, just like pork.
Historically, anyone who tries to control costs is seen as evil, and waging "war" on (fillin the blank.)
I have only two words to say...Tort reform. I know some other words too, but those are what I am using today...
ReplyDeleteBev, Those are indeed fine words, but that's only a tiny part of the problem. There was an interesting article the other day, which I can't find now (grrr), which outlined the difference in what Medicare pays for the same procedures around the country. They focused on knee and hip replacements.
ReplyDeleteThey found that in hospitals that did a lot of these, not only were the results better -- less infections, less mistakes, quicker recovery times -- but the costs were as much as 10 times cheaper. Seriously. At the top costing places, Medicare was paying up to $200,000 to do a hip replacement. At the low cost places it was as low as $17,000. The national average was around $30,000. Just fixing things like that would go a long way toward reining in costs.
tryanmax, Thanks! I liked it. :) I had fun writing this one. I was forced to listen to Mark Levin twice this weekend... I swear the man is a concern troll. So I was in the mood to poke a little fun at him. Do you know that over the course of two shows all he did was smear Republicans?
ReplyDeleteAnyway, you are correct that the Republicans only need to promise a fix, even if they don't deliver. The public takes promises at good faith. Of course, it would be better to actually have a fix.
Unfortunately, they keep going back to the "let insurance providers compete" crap which makes no sense to anyone and won't work. This has become dogma and as long as that is what they are offering, they will continue to be ignored.
tryanmax, I am seeing more and more people seeing that Obamacare is/will fail. In fact, they seem kind of desperate about it. But I would expect them to circle the wagons until 2014, when the higher rates make it impossible for them to keep defending the program.
ReplyDeleteAs for Rush, well, he's one of the ones who keeps repeating the dogma.
Jed, Here's your link: LINK
ReplyDeleteThe problem with things like Medicare/Medicaid, as always is that they have no idea how to cut costs. So they largely don't. They allow anything, no matter how useless or how expensive. Thus, things that should be elective/cosmetic (ED treatments? sex changes?) suddenly get covered. Things that should cost X suddenly cost 50X because there's no control.
Then people notice the mess, so they go about "fixing it." Rather than trimming out the cosmetic stuff and getting smarter about the truly expensive stuff, they do what the government always does -- they try to nickle and dime everything else. So rather than drop a million dollar procedure with questionable benefit, they instead tell the guy charging $150 for a vital procedure that costs $149 to perform to cut his costs.
That's how the government works and it's stupid. And they do that on issue after issue. Air pollution was the perfect example. 5% of cars produce 95% of the pollution. Rather than take out those 5%, they tell the 95% of cars that barely pollute to try to pollute less... they squeeze that 5% down to 4.9% rather than taking a slice of the 95%. That's how government thinks.
o.k., Andrew, inquiring minds want to know: " oh, wait ... wrong question. "by what magic were you forced to listen to Mark Levin?"
ReplyDeleteIF Reid and Obama was trying to use ACA to get to a single payer, not only did they fail but they are cowards as well. As a physician, there are days when it would be nicer to deal with only one pain-in-the neck payer. What I always find interesting is how naive the "single payer" crowd is. They don't understand how it works. In those countries, physicians are paid less BUT they have no overhead. In addition, there is no incentive to work late. People think nothing would change but why would I ever answer my phone after 5pm? You have no other choice but to see me (or someone in my group). You can go to another group but they will do the same thing and we will just see it as getting rid of noisy pain. The other thing they don't think of is that there won't be a US to prop up their crappy, under-funded system. If Canada cannot treat a patient due to ability that patient can go to the US and the Canadians pay for it. Let me just say they pay more than Medicare, which is often price controlled.
ReplyDeleteGovernment thinks?
ReplyDeleteJed, Spent time with family and they're part of his legion of zombies. If you consider Levin performance art, then he's entertaining. But when you realize that people actually take him seriously, then it's pretty sickening. He spent the whole time blasting Republicans with fantasy conspiracies and not a thing he said was even close to accurate.
ReplyDeleteI love how he claims to be a constitutional scholar too, but doesn't know the first thing about it.
Koshcat, "thinks" for lack of a better word. "Slogs around acting randomly" is probably the more accurate description.
ReplyDeleteKoshcat, Exactly true. Britain is going through that right now. They had a law that forced doctors to be on call for after-hours work. They recently abolished it to save money, i.e. salary costs. They replaced them with a call-in 911 type number that was supposed to clear you to go to the hospital or tell you that you're ok and you can wait.
ReplyDeleteOnce they did this, people started dying. They have found that people died in hospitals during these periods from lack of attention, people died after being told not to come in, and their emergency rooms became so packed that people ended up waiting outside because the line was so long.
The government solution? Deny the problem. Then act outraged when it gets exposed in the media.
The thing the single payer crowd doesn't get is that once you shift from the consumer to the government making decisions, the care available to you will fall dramatically.
Here is the bottom line for me. What is my incentive to work? If I work more to earn more and earn enough to support myself, I have to pay more to support others not related to me. It is only because I have a strong work ethic and a strong sense of self-respect that I do. But why?
ReplyDeleteBev, You've just put your finger both on the flaw in liberalism AND the one thing that keeps it from collapsing societies immediately.
ReplyDeletePeople work to support themselves. When you start taking that away to support other people, you end up killing that incentive and people stop working. Welcome to why every socialist country fails.
On the other hand, the reason they don't fail right away is because most people still have a strong work ethic and a sense of self-respect which keeps them working long after it stops making economic sense. That's the only thing that keeps liberalism from causing an immediate collapse... because the lazy ones ride the backs of the non-lazy until the non-lazy finally break.
BTW, I see that you've learned more than two words?! :P
ReplyDeleteAndrew - Oh, I've learned a lot of new words lately, none I can use here. :-)
ReplyDeleteBut what happens when others like me decide it's not worth it too?
You know, I actually got a raise this year. The first in 5 years. Yey for me and Yey for my employers. Not a big raise, but just enough that I ended up making $10 less take-home that I was earning BEFORE I got my raise. Why should I work when any gains I make are only sucked up to pay for slackers? I can't even help someone in my own family who might need it because I am too busy working to pay for strangers?
Ugh...I'm ranting.
Bev, I feel your pain. Trust me. I've run into that my whole life. Every time I've made money, the government took it to give it to someone else was too lazy to work for their own... or to some obscenely rich bank. When I haven't made money, they told me "too bad, go earn it." Our system is sick.
ReplyDeleteI can relate in a different way. As I've mentioned before, my daughter has special needs. Fortunately, there is no amount of income I can earn that would preclude her from receiving services in school. However, I am still too "rich" to get her anything outside of the public schools (which is why I'm scraping together to get into a better district). So, literally, my choice is between food on the table or treatment for her autism. I can't afford both.
ReplyDeleteOn top of that, the Head Start (poor, foster care, ESL) and the Early Childhood (special education) programs (both pre-K) are commingled--at least in my current district--meaning the shared resources given to all are going to be inevitably inappropriate.
Obviously, I have no philosophical objections to such programs, but I do object to the piss-poor management. It's that sort of thing that makes people say it isn't worth doing.
You know, I don't mind helping people in need. I willingly and freely give for others in need. There will always be a certain segment of the population that will always need help. That is just the way it is. But when there are more of them than us, that is not "just a certain segment of the population" anymore. When there are more grasshoppers than ants (See: Greece, Spain, Portugal, Italy et al.) where will we be?
ReplyDeleteI know I am "preachin' to the choir", but when do I get excused for [fill in the blank]?
My rant won't end...
Bev, I really do sympathize. I have gotten screwed year after year by Uncle Sam. I am quite happy to help people who need it, but not the government. At this point, they're just lucky I haven't decided to claim my pound of flesh.
ReplyDeleteAs for being excused, I refuse to accept the guilt. They are greedy, selfish, amoral thieves. They lack the moral standing to accuse me of anything.
tryanmax, I think all of our social services are mismanaged. They go to people who don't need it, but not those who do. They reward sloth and failure, but not striving to improve. They are managed by incompetents and thieves.
ReplyDeleteI think a lot of the problem is that need gets defined very narrowly with boxes to be checked on a form. (Not quite literally, but in essence.) In such a system, one can be in very genuine need, but if there is no box, there is no help. All the formulas are very simplistic in the variables they examine.
ReplyDeleteI'm not saying there is some panacea to be found, but how does one justify denying therapy to an autistic child on the grounds that her parents can afford groceries?
I just shudder to think that, before I'm ready, the question will be whether to care for aging boomers or autistic 20-somethings.
Oops! I just realized: it's not piss-poor management that makes people opposed to social programs.
ReplyDeleteIt's racism.
I forgot.
I think the real problem stems from bureaucracy. These people (social workers, etc.) are bureaucrats. They live and die by procedures. There is no discretion. And there is no responsibility. Thus, they do not see themselves being to blame when money gets blown on a crackhead or when they fail to help a genuinely needy person... "ve are just followink orders." Then you add the twisted ones who start using the rules to play games, and you have a really nightmarish system.
ReplyDeleteAnd don't forget the two political parties. The Republicans want to hurt people under the guise of "tuff luv" and the Democrats want to absolve their sins by giving money to people who don't need it just to show how magnanimous they are.
It's a mess.
Yeah, there's that too: insulting people who don't want to hand over the money we're stealing from them so we can use it to make ourselves feel better. "Get to work, Bev! I need to spend your money so I feel like a better person. And if you don't let me, then you're a racist." Sickening.
ReplyDeleteThe reason I think about forms and boxes is because autism is still in this nebulous phase as far as being considered a disability. If my daughter had Down's, I could be Scrooge McDuck and still get an actual cut check, but not so with autism. But I guess that all goes back to the slow machinations of bureaucracy.
ReplyDeleteIt does. But autism also suffers from moochers. Basically, everyone whose kid has gotten into trouble in the past decade now declares them autistic... it used to be ADD, then ADHD, and now autism. So there is a problem getting recognized politically because there are too many people faking it.
ReplyDeleteAnd we are just all stuck in middle. The people who try very hard to help themselves and their families are frozen out and the ones who contribute nothing toward their own welfare are rewarded.
ReplyDeletePardon me for being Debbie Downer...bad day.
ReplyDeleteYeah, I know about them, too, and they piss me off as well. They're the ones who make the general public think all autism is is a bunch of Sheldon Coopers (Big Bang Theory).
ReplyDeleteFortunately, the folks who maintain the Diagnostic and Statistical Manual of Mental Disorders (DSM) recently updated the criteria by narrowing them. That should help some. Of course there was some moaning, but the major autism organizations have universally endorsed the changes as improvements.
tryanmax, That's a step in the right direction. Hopefully that will push out the people who are just trying to cover their bad parenting.
ReplyDeleteBev, The Debbie Downer people called. They're suing for infringement. :(
ReplyDeleteIn all seriousness, it could be worse. You could be a candidate for office in New York. Then you'd be in jail or on your way and you'd be surrounded by politicians! The horror the horror.
And if that thought doesn't cheer you up, then how about a little Shark Kitty. Very mesmerizing.
Is that who called? I was wondering...
ReplyDeleteGood point! It could be much worse. At least I'm not a NY politician! LOL!
SHARK KITTY! That made my day! Nothing like a little kitty humiliation to make me feel better. THANKS!! 8-D
Bev, Yeah, I told them they had the wrong number, that this was Contentarama.
ReplyDeleteThat shark kitty thing is bizarrely compelling. I have no idea why.
I don't know either, but it makes me laugh! Maybe it's that confused duckling running around...
ReplyDeleteRobo-Sharkitty is the next SyFy Original.
ReplyDeleteThursday night... Ghost Shark. "If you're wet, you're dead."
ReplyDeleteI'm strangely looking forward to this.
Bev, I wonder how they keep the cat, the dog and the duckling all living happily in the same house?
ReplyDeleteCONTENTARAMA! That's what we tell the IRS auditors when they call! "Why you must be confused. We LOVE the government!"
ReplyDeleteBev, I wonder how they keep the cat, the dog and the duckling all living happily in the same house?
ReplyDeleteKitty Xanax...lots and lots of kitty Xanax.
Bev, No doubt. I don't know what else would stop the cat from eating the duck.
ReplyDeleteThat's my plan when the next time the IRS calls. Oh, you have the wrong guy.
Andrew
ReplyDeleteThe government does not need to install a single payer system with Obamacare because they already have what they want over insurance agencies, managerial control. Telling Catholic Insurance Providers they have to provide contraceptive devices is a managerial decision.
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Normally such a decision is left to the parties to a contract. The customer who wants insurance and the provider who is offering it. In a free market the provider is free to offer the service, coverage for contraceptive devices and the customer has the choice of buying the policy or choosing another policy or another provider. Obamacare does more than create "death" panels to make the decisions as to which treatments are offered or not (a decision which was the provider and the contract prior to Obamacare, someone has always been making those calls). It, as I understand it goes to the level of telling insurance companies your policies will have this, will not have that and will be written as we say they shall be written because everyone knows the Vogons write the best insurance contracts.
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This is why insurance has already jumped 198% in Georgia's exchanges and the insurance companies are willingly leaving Exchanges in certain states. The product they are mandated to offer is something they can't afford to offer in that region.
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This will have two effects. The first is to oligopolize the insurance industry. We will have fewer providers but those providers will be much more massive in scope. The second will be to damage the cost structure in the Health Insurance Industry which is already bloated due to the effect of price controls.
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The system gets put in and really the GOP can't offer any solutions as they will be shot down by Obama no matter what they are. Repeal, replace, recreate won't matter because they don't want it. Once it becomes funded then you can't eliminate it because all those government workers who will lose their jobs are voters too. So from my perspective, that boat has sailed off from port already.
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This is the scenario I am worried about most. Insurance agencies under the weight of this bureaucracy start to cut corners. The "Death" panels start delaying care and all those wonderful things they do in England only the government will not take the blame. OFA will create the talking points to be blasted on MSNBC that "evil" insurance companies are not provided benefits. So laws get written to force the Providers to offer benefits even though the know they can't afford to. Just as CIRA forced banks to give NINJA loans that could not be paid back. One or more of these Too Big to fail Insurance Conglomerates will end up in Chapter 11 and Uncle Sugar will ride in with a bailout and take stock interests under the table. The resulting players in the industry will like Goldman Sachs be indistinguishable as to where the company ends and the Government begins.
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Won't happen right away.. may take years but hey with any luck the entire government will have collapsed by then and we won't have to worry about it.
Indi, The thing is this has always been the system. The government has always regulated and controlled this market. It decides who can sell and under what terms. This has never been a free market system. That's the problem.
ReplyDeleteObamacare imposes some new, very costly regulations, but it doesn't fundamentally change the relationship between government and insurance companies. The biggest change is really imposing minimum coverage requirements on firms who don't participate in the exchanges. That's probably the most egregious power grab.
In the end though, I think the exchanges will implode the whole system.
Andrew
ReplyDeleteYou are right...this has been around since the new deal but there is one huge difference between pre- Obama care and post Obama care
Pre-Obama care it was state legislators who had this power. Now it is solidly under the guise of the Federal government. Centralized Control. This is why it will be worse. One screw up will screw up everybody.