● The numbers... oh, the numbers: Every time we turn around, it turns out that the numbers are worse than expected. First, note that team Obama steadfastly refuses to release any numbers of real signups (though they will release visitor numbers) until November and they’ve forbidden the insurers from releasing numbers. Why? Well, because the numbers suck. According to one insurer, less than 20 people have signed up in North Dakota. Yes, 20 people. Zero have signed up in Alaska. One leak placed the overall number of people signing up in the first two weeks at 52,000, but then that number was dropped to 31,000. That would mean a signup rate of 2 million, whereas Obama need 7.3 million to save his skinny ass.
And it gets worse: it turns out that most of those 31,000 aren’t actually signing up for insurance... ha ha!... they are new Medicaid signups. See, to boost their numbers, Obama decided to run Medicaid signups through the same system. The problem with this is that none of those people count toward the 7.3 million because they don’t pay.
As an aside, more people signed up in one week for a one-way trip to Mars then signed up for Obamacare since it began... and their website was able to handle the traffic.
● Too Little Information: Insurers are also complaining that they are getting useless data: spouses identified as children, people with multiple accounts, random closing of accounts, etc. Insurers continue to say that only a tiny percentage of the applications they have gotten are useable.
● More Harm Than Good: People keep losing their insurance because of Obamacare. Over a million policies are being cancelled in Florida and New Jersey this week. The number of people losing their insurance dwarfs the number getting insurance from Obamacare. Nice work, dipsh*ts.
● Freak Out!: The Democratic freak-out has begun. You can see it all over the papers and blogs. They are terrified that this thing is imploding. Their concerns are that (1) signing up has proven to be so difficult that people are being turned off and won’t come back – Jay Leno quipped that it’s easier to sign up for al Qaeda than it is to sign up for Obamacare, (2) that Obama has no plan to fix this disaster and doesn’t know whose ass to kick (hint: it’s black, skinny and can usually be found on a golf course), and (3) that the numbers coming back are so low that the “insurance rate death spiral” I’ve told you about is inevitable. Because of this, every red-state Democrat is calling for a delay of the program and others are demanding a scapegoat.
● A Workaround: With signup nearly impossible, people have started contacting insurers directly. This has led to an interesting discovery. Apparently, said insurers are offering better deals with more options if you contact them directly than they are if you go through this “best deal imaginable” offered by Obamacare. If word of that spreads, then Obamacare is beyond doomed. The reason is that these people don’t count toward the 7.3 million because they aren’t paying into those pools.
Making this worse, the insurers are taking the good (paying) candidates and shipping the rest back to the exchanges where they get subsidies. In effect, the insurers are cherry picking the good clients and leaving the dregs to Obamacare, which will make the insurance rate death spiral even worse.
At this point, the media is kindly calling these people a “lost opportunity” for Obamacare, but look for them soon to become traitors and the insurers to be accused of fraud by Defenders of the Democratic Realm like 60 Minutes.
● Stop! In the Name of Law: The lawsuit to stop the subsidies in states that didn’t join Obamacare voluntarily continues. If that succeeds and it has a good argument (though I can’t see it succeeding), then rates will rise for Obama’s core audience.
● Senior Citizen Surcharge: So it turns out that I was wrong when I told you that they want to charge me $270 a month for crap insurance. Another glitch that has been discovered is that the rates being quoted to people aren’t being adjusted for age until they actually submit applications for insurance. At my age, that means something like a 25%-50% higher rate than the one actually quoted to me by the website. Ah, sticker shock. Anyway, twice way-too-f***ing-much is still way-too-f***ing-much.
● No Penalty, huh?: The issue of the penalty has now been examined by the Wall Street Journal, and just as I told you, the IRS has no real ability to collect. They can only take the money from refunds owed to you (or they could sue you, which they won’t unless you owe millions because a US attorney needs to bring the suit and they are too busy). So if you adjust your withholding so you don’t get a refund, then you’re immune. And after ten years, the debt is automatically forgiven. But never fear, say liberals, 75% of the public gets a refund... yeah, as if those people won’t change that once they realize how to avoid paying this.
What I love about this whole situation is that it’s like watching a top notch presentation of Don Quixote. All of the silliness and fantasy the Democrats usually bring to their plans are on full display and reality is proving to be a harsh mistress as each of their fantasy ideas gets blown apart as soon as it meets reality...
1. You can’t hide lies forever.I guess that makes Obamacare “a teachable moment.”
2. You can’t lie to someone right up to the point they are asked to sign on the dotted line and still expect them to sign.
3. You can’t make people buy something they don’t want just to support your stupid ideology.
4. People don’t give the incompetent an unlimited number of chances.
5. You can’t plan a system around people acting against their own self interest.
6. Government can’t even build a website, yet we’re supposed to trust it to guide our lives?
As an aside, a new glitch brought down the Obamacare website on Sunday. Ha ha.
ReplyDeleteHa, Ha, indeed. Call me cruel, but yes, I am taking pleasure in seeing this, although I will feel terrible for folks that get caught up in the cancellation, that have emergency major medical issues. Republicans should be pressing for legislation that will retroactively allow people whose coverage was cancelled because it didn't meet Bama minimums to be re-nstated. The best thing I learned from your article is that a direct contact won't count in the pool :) Knowing how some people are, there may be some who won't bother to change their withholding, at least the first year. It might be a wonderful irony if the "signature" legislation of B.O. brings down the Dems (including Hillary) for a decade or more (Just wishing here, I'll admit.)
ReplyDeleteJed, I'm taking pleasure in this too. It's nice to see the public get a full on blast of what happens when you let the Democrats have their way. They are doing more damage to their image now than they've done in the last four decades combined.
ReplyDeleteOn withholding, the real problem for the Government will come if people start adjusting that because they rely on the float to finance the government on the cheap.
Yep, direct contact won't help the pools. :)
I hate to be a Debbie Downer but (saw that coming, didn't you?) it's hard to enjoy the schadenfreude so long as the Republicans don't have a plan beyond "repeal, repeal, repeal." The radio/blogosphere fret all along has been that this is all planned to collapse so the Dems can step in with single-payer. While I don't buy the conspiracy crap, I do believe that the Dems would present such a plan as a fix to the mess they've already made. And os long as Republicans don't have a fix of their own, people will naturally go with the only idea on the table. I realize there is still some time for the GOP to devise something, and they best better. Anything at all. After this fiasco, anything remotely plausible from the GOP will get picked up over letting the Dems have another crack. But that is provided that something remotely plausible gets put up,
ReplyDeletetryanmax, True. And that is the fly in the ointment. Unfortunately, they think that chanting "let insurers compete across state lines... ohm... let insurers compete across state lines" is enough. They seem to forget that they've been saying this since 2008 and it hasn't worked.
ReplyDeletetryanmax, As an aside, Rush actually got himself caught in this trap on Friday. A woman called him to ask what happens if Obamacare causes insurers to drop people with pre-existing conditions by cancelling their current plans to force them onto Obamacare. Then we repeal Obamacare, cancelling those plans. What happens to them then?
ReplyDeleteWell, the answer is that they are screwed unless the Republicans have an alternative plan. Rush danced and danced and danced without answering and then patted himself on the back without ever answering the question or seeing the flaw the current "strategy."
Ya know, Obama apparenlty didn't know that the website for the ACA was in this bad a shape; he didn't know about Benghazi; he didn't know about spying on our allies...What the Hell does he know? He is either the biggest liar ever in the White House or he's a mushroom; kept in the dark and fed BS. Either proves he's not fit to run this country.
ReplyDeleteAndrew, what you're not taking into account is that the caller was probably an Obamacare/OFA/SEIU/Acorn plant, so Rush didn't really have to answer her. In fact, preexisting conditions are just a liberal fabrication concocted by George Soros and promulgated by the main stream media. I think the Heritage Foundation is working to disprove that "conditions" can "preexist" right now.
ReplyDeleteWell I had a feeling this was coming. Our insurance premium is going up yet again. It went from $362.00 to $410.00 and is going to be $478.00 starting January 1st. My insurance company admits that there are a lot of reasons for premium increases, including our ages (my husband is 53 and I'm 50), but they also cite additional fees and taxes due to Obamacare.
ReplyDeleteAlso, the young brown-haired lady who's picture is splashed all over the ACA website has requested that her picture be taken down....I don't think she likes being linked to failure.
ReplyDelete>>People don’t give the incompetent an unlimited number of chances.>>
ReplyDeleteDon't be so sure. If the last five years have cemented anything in my mind, far too many in the Democrat Party morphed it into the Cognitive Dissonance Party. Bumming a line from Chuck D, because as a music lover I take immense joy in turning lefty artists/bands words around on them, stuck on stupid and twice on dumb.
Critch, My mother said something the same this morning. They are reporting that Obama claims he didn't know that NSA was spying on Merkel, and now that he knows he's angry about it. That's what he always says -- didn't know about this problem, but I'm angry about it.
ReplyDeleteSo my mother said that, "That's his presidency... ignorant and angry."
LOL!
tryanmax, Yep. Must be an Obamacare plant. In all seriousness, this is a perfect example of the kind of problems the Republicans will face if they don't adopt a plan that will fix these problems. They need to be able to tell these people, "Here is how we'll make sure that you're covered." If they can't do that, they will look like fools, like Rush did.
ReplyDeleteTJ, I'm sorry to hear that, but this is what happens when the government "helps" people. People are freaking out everywhere right now because their premiums are going up around 30% across the board, because their plans are being cancelled (over 1.5 million in three states alone) and are being replaced with more expensive plans with less coverage, and because people are being put into limbo by this whole process. This is a mess, there is no disputing that and unfortunately people are getting hurt by it.
ReplyDeleteI really wish the Republicans would wake up realize that, that it's actual people who are being hurt -- not numbers. They need to offer a plan to fix this problem without hurting people... a plan to cut costs, increase coverage, and expand people's choices. "Let insurers compete" doesn't even start that process. I seriously wish they would adopt the plan in my book because it would help everyone.
Critch, I hadn't heard that. That's funny.
ReplyDeleteEric, Sadly, that is true. The Democrats are very good at completely re-writing reality in their minds to fit their desires. But the public at large isn't, and even the Democrats get upset when it hits them personally -- like the guy at DailyKos who freaked out when he learned that HIS rates were skyrocketing. So there are limits.
ReplyDeleteI don't know about Rush Limbaugh but I have a plan.
ReplyDeleteFirst: Letting Insurance companies compete across state lines is not a bad idea. It won't fix the problems but it will help and it can't have "not worked" because it hasn't been implemented. Sorry Andrew but this my pet peeve about we "conservatives" who worry so much about winning and strategy. It is the propensity to abandon an idea because it nev3er got traction and is therefore not a "winner" politically. This is a good idea. So is private pension plans from Social Security. These ideas will work and I am going to keep stating that even if the hoi polloi have been duped otherwise by a pandering press that has a political agenda (cue Mr. subliminal saying "New York Times" under his breath.
Secondly I would take all the money paid into medicare in the SSN which is 2.9% of America's salary, all the tax money allocated to Medicaid and the tax money now to be allocated from Obamacare. I'd figure out how much that is....
I'd then figure out all the costs of providing catastrophic medical care (in the country) factoring out private charities such as St Jude that provide cancer treatment free on their own. I would not mess with them since they seem to go good work without government interference. I'd then divide the money we collect by the cost of providing this service and determine a percentage.
I would then go to the insurance companies and I would ask the question. If the government had a pool of $x and was willing to subsidize (x/y)% of your costs y$ could you provide insurance without regard to pre existing conditions to the public at a reasonable price without affecting your profitability.
I would include in these percentages adjustments for the indigent and people without financial ability to pay for healthcare from the pool relying on hospitals and doctors willing to charge less to the poor to help with this. By the By most doctors have 50% collection rates on Accounts Receivable because the write off bad debt for those who can't pay. This should not be "messed" with by the government either.
I would eliminate most of the medicare schedules and the regulation and the forms and instead let insurance providers handle that on their own dime. I'd take the indigent and medicare and let Insurance companies manage their health care the way some companies hire these providers to manage plans that they self insure.
Once a year congress would take the pool to support the preexisting conditions and dicker with the insurance companies based on the years performance how much they would get. I would keep the micro managing out of it realizing that there is always fraud and abuse and the best deterrent is not complicated regulations that will force people to lie and cheat just to handle the red tape but rather putting bad actors in prison form a very long time. We have a court system for that, we don't need more "bureaucrats to help. fire the bureaucrats and hire more FBI agents with legal and accounting certifications.
To those who whine about the people falling through the cracks and the need for government laws to force the system to work I would say we have only so much money. The best way to allocate that money efficiently is a free entrepreneurial system where providers have to compete with each other for business. We can give them money to assist the poor and needy but regulations and bureaucracy will take away form health care provided not add to. People will "fall through the cracks" in any system, I think this is one that minimizes that.
Anyway that is my two cents.
Indie, the question isn't really what will work. It's what will sell. So my question to you is, how do you intend to sell that idea? Hint: saying we only have so much money and that people will fall through the cracks in any system won't sell anything. Pragmatism never sells. That's where conservatives really fall down. It's the crippling honesty. They don't know how to speak fluff.
ReplyDeleteQ: Will this plan cover everybody?
A: Yes! This plan will cover virtually everybody!
On things like selling across state lines and the private pensions, it's not that they won't work. It's that they are not a sales pitch. The GOP marketing department is staffed with R&D guys. They're trying to sell specs under the assumption that the marketplace will understand the benefits. But that just leaves the competition to explain the specs--and the competition won't describe your features as benefits.
This, folks, is why I am staying on my parents' insurance as long as I can. :)
ReplyDeleteIndi, Ok, let's burst this bubble shall we.
ReplyDeleteThis argument about "compete across state lines" has not worked and it's silly to argue that we should continue to rely on it. Conservatives have been pushing this like a religion since 2010 and not a single person in the public outside of the conservative echo chamber has bought into the idea. At what point do we finally admit that after years of conservatives pushing this thing over and over and the public NOT voting for us that the public isn't buying it?
Seriously, this has become the problem with the fringe across the board. They are blind to reality. They push something, it gets rejected. They push it again only louder, it gets rejected again. Then they start screaming about the public being too stupid to get their point, they start inventing fantasies about "no one having ever pushed the idea," about "RINO betrayal," and "the MSM stopped people from knowing about it." And they claim that the public would buy it if only the Great and Powerful John McCain hadn't said that thing or the MSM didn't stop the public from hearing our words. And then, they insist that we push it again.
The definition of insanity is to keep trying the same thing and expecting a different result, but that seems to have become the SOP on the fringe. Wake up.
Any why doesn't the public respond? Simple: (1) Big Insurance caused the healthcare crisis and this plan says, "If we just give Big Insurance more power, maybe they can fix it?" But no one in their right mind is going to buy that. Seriously, who looks to the people who caused the problem to solve it? (2) Moreover, no one gets how this is supposed to help anything anyway -- even the people advocating it don't have a clue how it will actually lower costs or increase access or keep people from losing their insurance if they lose their jobs or cover people insurance won't cover. And why don't they have a clue? Because it does none of those things. Indeed, let's talk about how stupid this idea really is, shall we?
ReplyDeleteFirst, the only part of the problem it MIGHT solve is rising costs (which is only part of the problem). But it won't even solve that. Why not? Because the whole thing is premised on bullshit.
Conservatives are acting like insurers are somehow kept out of markets by meanie bureaucrats, which results in the creation of monopolies. Well, guess what, there are no barriers. Any insurer who wants to compete in any market can right now. If Blue Cross wants to be in every state, they have that right -- and they actually do compete in most, as do most of the majors. So "letting them compete across state lines" is nothing more than a mantra to solve a problem that doesn't exist... it is an invented problem.
Secondly, let's assume we completely un-regulate insurance, will that change anything? No. For one thing, the reason these companies don't compete everywhere is because it's not profitable... not because some state bureaucrat keeps them out. They already compete where it's worth their time and they aren't going to suddenly compete for western Kansas or Nowhere, Indiana just because we drop some imaginary barrier.
Moreover, the people who say this don't understand how health insurance works. One of the talk radio guys was ignorantly blathering this same point last week and he said, "If someone offers cheap insurance in Texas, why shouldn't they be allowed to offer the same cheap insurance to someone in California." Well, because it's impossible.
Insurance rates depend on the deals that are struck with local providers. So that cheap Texas insurer can't just tell Californians they will cover them at Texas rates. Instead, they will need to go to California and negotiate with thousands of California providers unless they are intending that their clients drive to Texas for treatment. When they get to California, they are going to find that they end up paying the same rates as other California insurers. The result will be that they charge the same rates as other California providers... not what they charge in Texas. In other words, it is an economic impossibility to bring Texas rates to California. Again, the whole premise behind "compete across state lines" is a myth.
So this idea is premised on a myth that insurers are kept out of state markets, premised on a faulty understanding of how insurers establish their rates and wrong assumes that a Texas doctor competes with a California doctor, and it's being pushed by people who are incapable of grasping that the public has heard this bullshit time and again and just doesn't buy it.
Kit, Smart move.
ReplyDeletetryanmax, "Selling across state lines" won't work. See my comment above.
ReplyDeleteOn your other point, that's exactly right, the first and most important issue is selling the public on your ideas. Something like "compete across state lines" is unsellable. For one thing, outside of the talk radio bubble, the whole thing makes no sense to people. They don't see how it lowers costs, they don't see how it improves access, how it keeps you from losing your coverage if you get sick or change jobs, keeps you from being hit with a lifetime cap or being declared uninsurable. Moreover, "the optics" are horrible because it instantly translates to "let's trust Big Insurance to fix this mess they made." People instinctively hate that.
And yeah, the idea of "well, some people will just fall through the cracks" will never sell. That's a nonstarter. In fact, imagine if you were Coke talking about the various safety inspections you do of your plants and you said, "Well, yeah, some bottles just fall through the cracks, but you know, that's life and whoever ends up with those will just have to deal with it." Talk about horrible marketing... so why do we think it's a good sale pitch to say the same thing in politics? Reagan never said, "A rising tide lifts most boats and f**k the rest."
Andrew, maybe my construction was poor. My point was that efficacy doesn't mean a thing until after the sale. Look at Obamacare. It sold and works like an Edsel. (My apologies to Edsel.)
ReplyDeletetryanmax, I agree. Selling is the key in politics, whether or not the end product works. My point above though, was that (1) this has been pitched time and again and no one is buying it, and (2) one of the reasons the pitch isn't working is because the public knows it won't work because it doesn't even pretend to address the problems that need to be fixed -- so the pitch doesn't even address the public's concerns, and (3) despite the fact conservatives repeat this like dogma, the public is right that this idea is nonsense.
ReplyDelete"Nobody is as _______ as me about _______". There's a great compilation video of Obama using this phrasing for every failure, and nobody was as angry, interested, concerned, etc. about X as he. I think his recent speech on Obamacare went something like this:
ReplyDelete"Just know that the ACA is more than just a [failed] website; it's a great [non-existent] product that everybody can [not] afford regardless of your age or preexisting conditions [because we'll just stick you on Medicaid instead.]"
I added some clarifying comments in there for readability.
With regard to selling insurance across state lines, most Republicans don't understand that insurance companies aren't in the business of insurance. They are finance and investment companies whose capital comes from carefully constructed risk pools of participants that are attracted by the prospect of hedging their future health care bills. Their money is made by investing and leveraging that capital in addition to ensuring that premiums exceed payouts.
As such, insurance companies fundamentally must be both large, yet selective. Republicans have this fantasy that smaller companies will be able to jump in to the fray when they compete over state lines, but small companies don't last long in the insurance market. You've got to be big to attract thousands of participants that you select, can provide adequate service to so you can be selective, so that you raise the capital to make those real investments that will make your shareholders happy.
Any company that big is already operating across state lines.
wahsatchmo, "Nobody is as _______ as me about _______." LOL! We should call that the Obama template because he does say that about everything, doesn't he?
ReplyDeleteExactly right on competing across state lines. If you look at where the health insurance companies compete, you will see that the majors are in almost every large market in every state. And you're right, they make their money buy picking people who are least likely to need the insurance and then by setting the premiums higher than what they pay out... which is roughly equivalent to what everyone else is paying because the costs are set by what local doctors and providers charge. So no matter how many insurers you add to this location, you will get about the same premiums because it's the location that sets the price, not the insurer -- the insurer just passes it through.
And you are correct that the idea of small insurers is a fantasy. For one thing, they have no power to get cheaper premiums except by signing up doctors the others won't touch... which means lawsuits. And small insurers are one or two major payouts away from bankruptcy.
Tinkering with insurance is not the answer, and the public understands that. We need a better plan... a more sellable plan.
Interesting article on why big insurers will stay out (or slowly leave) Obamacare. The author doesn't go all the way to saying how it all comes crashing down, but the scenario he paints will cause that because of the cost.
ReplyDeleteLINK
And I am laughing all the way.
ReplyDeleteSeriously, all these Obama-supporting liberals and moderates in California and places who are suddenly shocked to find their insurance rates going sky-high under ACA are providing me with some awesome Schadenfreude.
Andrew
ReplyDeleteThe problem is that insurance companies are not the reason that Health Insurance has risen. Medicare is ....
Government regulation of the Health care industry through price controls have destroyed this system and it started with Nixon with Wage and Price controls that eventually led to then Misery index under Carter.
As I understand it the problem is that states each write their own set of laws that dictate what will and what won't be covered. This leads to a provider in Kansas being unable to sell their Kansas Policy to a guy in Florida. If the states did not have the rules then there would be no need to worry about where someone was when they called.
As an aside one of the selling points of the European Union was that by forming the alliance the European companies would no longer worry about trade barrier between their members. One of the discussions in my economics calluses as to how this promoted more trade was that insurance companies in one country could sell to people in other countries and this led to more competition and increased the industry. Now if that worked in Europe why would it fail here.
I don't think this fixes the problems we have now but it is a sound idea to standardize rates and let more companies compete. Under Obamacare we have the exact opposite. Under many exchanges providers who once sold insurance in a state have dropped out. This will raise costs and to my mind it is why insurance providers have adopted Obamacare. The few large companies left will be unassailable.
Tyranmax
ReplyDeleteYou are under the assumption that you cannot sell to the American public the idea that government bureaucrats don't know what they are doing.
Fact of the matter is the health care crisis did not exist in 1960 when we did not have the4se laws and people bought private insurance plans.
Under Nixon companies were forced to offer healthcare insurance in lieu of granting raises because of government regulation. This led to the patient no longer being the insurance providers customer.
Medicare and Medicaid has created cost schedules and price controls that have skyrocketed health costs and further separated doctors from their patients. When I had an elective surgery I asked the doctor how much it was because under my HSA deductible I'd have to pay for it. The doctor and the hospital could not tell me. I had to wait three months for the insurance company even though I told them I wanted to pay for it up front.
You sell this to the public by BLAMING GOVERNMENT CORRUPTION and how ever hard you might think that is there is one ace on the line you have. IT'S TRUE.
Competition will work because it increases the number of players in the industry. The large players today feed off the regulation because it creates barriers to entry. It oligopolizes the market and that leads to poorer more costly service.
I guess the way to sell it this. If a Hollywood Director makes crappy moves what do you the public do... you see movies by another director. If the cable company screws you over what do you do.... nothing! you've no other option.
You are much better off with 100 insurance companies that are not regulated then you can replace bad ones. If you have one or two government sponsored providers on the approved exchange what can you do... save money ... go to the Bahamas ... pray you can find a good surgeon there.
Andrew as to the preexisting conditions if there is a pool for the insurance companies to take from to subsidized catastrophic care then they can't deny them and would have incentive bot to... part of that money is profit. If the company is not doing what it is supposed to with the money they can still be investigated and forced into compliance.
You don't need a law to define every single medical procedure that must be covered to do that. You don't need to micro manage to a level that is not possible. Why do you think this is falling apart now. It is too complicated.
Nowhere Indian will be made profitable because the subsidy pool is 40% which I am thinking is a conservative estimate of the percentage of the total cost of all healthcare taxes raised and monies spent by congress and the states under medicare, Medicaid and Obamacare to the total cost of healthcare procedure provided for necessary care.
If you simply gave the insurance companies this money they would easily halve their rates for the in order to get more business. Mind you the subsidy is paid by person on insurance.
Tyranma, once people see how many people fall through the cracks under Obamacare I don't think that concern will be an issue
Indie, incorrect. I am not assuming that you cannot convince the people of bureaucratic incompetence. In fact, that's a very easy sell--most Americans believe it. What you cannot sell is that one bureaucracy is better than another.
ReplyDeleteThe Democrats have been selling bigger and bigger government on the promise of making everyone's lives easier. Republicans try selling smaller government on the promise that they'll let some other bureaucracy handle the hard stuff--and you'll just deal with them instead. See the problem?
Regardless whether the problems are real or fabricated, when the people turn to the political parties for a solution, it's like putting out a bid for a contract. If you put out a bid, would you give the job to the company that says "we can fix it" or the one that says, "that's not really a problem so we're not going to do anything"?
At their very best, the Republicans are the company that tells you exactly how they plan to subcontract the whole thing, and I don't think you'd want to hire them either.
The bottom line is that the Republicans have no product that the public is interested in, the product they do have is uninteresting and confusing, and it's not even packaged all that well. Even if what they have is panacea, they are putting it in a plain brown box and passing out photocopied flyers. Meanwhile, the Democrats are taking out a double-glossy cover spread to hock their turd in the contoured, injection-molded, process printed plastic blister pack. It just happens to be opaque, so you have to open it to find out what's in it.
T-Rav, You and me both! It's great watching liberals finally get what's coming to them.
ReplyDeleteIndi, The reason why health care costs have rising is the payment structure created by insurance. Unlike every other form of insurance, health insurance steps between buyers and sellers and negotiates prices. Thus, patients have no incentive to keep prices down and doctors have no incentive to compete on price.
ReplyDeleteMedicare then comes along and just makes a bad situation worse with its crazy pricing structures. But even if Medicare vanished tomorrow, the problems still would not go away. The only solution is to get people to start paying for things out of pocket again and for the insurance to become like with car insurance - for catastrophes only.
As for the European example, we already have that. Just as with every other product, anyone can sell in any state they want to, they just need to satisfy some local rules, that's all. And the big players already do that. So the idea that opening the borders will change things is a myth because the borders are already open.
Am I in favor of standardizing some of the rules? Sure. But that's not ultimately a solution to the problems. It's a minor improvement.
Indi, A couple points.
ReplyDeleteFirst, trying to spin this as "the government ruined your healthcare" is pointless. For one thing, people don't accept that (and for the record, almost no one had private insurance in the 1960s, that came along after Medicare and it is the rise of private insurance which tracks with healthcare cost inflation). More importantly though, blame does not equal solutions. So that fails as a selling point.
Secondly, you are wrong about the public. The public has a list of three general concerns -- (1) price, (2) access, (3) ability to keep the insurance if things go wrong. Any idea that doesn't address all three is a nonstarter. The idea of "compete across state lines" only potentially addresses one of those three points, and even then it's connection is nebulous. Thus, it cannot be sold to the public because it does not purport to solve the problems the public wants solved. And it has been routinely rejected already by the public at every turn for that reason. So until you come up with a plan that sounds like it fixes all three parts, you cannot win the public... they will stick with Obamacare and hope someone works out the kinks.
Third, what you are proposing has a name, it's called Obamacare: the creation of a (quasi)national market into which any number of providers can jump, all playing by identical regulations, each receiving generous subsidies from the government. And the result is exactly what you expect -- it doesn't work. The only solution is a private market solution, not a government/industry reach-around.
tryanmax, I agree completely, though let me add something. You said this:
ReplyDeleteThe Democrats have been selling bigger and bigger government on the promise of making everyone's lives easier. Republicans try selling smaller government on the promise that they'll let some other bureaucracy handle the hard stuff--and you'll just deal with them instead. See the problem?
Keep in mind that for most people, their experiences with their health insurers before Obamacare was generally unpleasant -- premium hikes, long waits on approvals, randomly denied claims, friends/family kicked off insurance when they got sick or rejected because of their medical history.
Now compare what is being offered:
The Democrats are offering to have an incompetent but disinterested bureaucracy solve the each of the three parts of the problem the public has identified, with the promise of constant fine tuning to make the incompetence go away.
The Republicans are countering with a slogan that does not explain how it will work, but can at best only partially fix 1/3 of the problem. It is a black box solution... "trust us, it will work like magic." Moreover, they are saying that the people who will come up with the solution are the very incompetent bureaucracy you struggled with for years and who tossed Uncle Joe on his butt because he got sick, and who have an incentive to be as cheap and as unfair as possible so they can make a profit.
Who's going to win that?
Now compare that to the plan in my book, where I talk about freeing up the doctor-patient relationship, setting doctors free from constraints, solving access with vouchers for everyone, fixing costs by letting people/patients save money by comparison shop their doctors, guaranteeing coverage regardless of medical condition. Etc. That is a solution you can sell because it addresses all the issues and it does so in ways that people instantly grasp how it will work.
Having not had time to review all the commenting, I will simply say in regard to Andrew's last post that in the short term, having the Democrats screw up so badly that people start wishing for their old health care plans back is certainly not the worst thing in the world. But in the long term, yes, there needs to be a proactive plan from the GOP to make health care more efficient and cheaper while demonstrating the benefits of smaller government: something like "CommentaramaCare," perhaps.
ReplyDeleteT-Rav, Exactly, and the sooner we are ready to offer something the better. Not right now because the focus should be on the implosion of the website, but once that starts to fade, then we need to be ready to offer an alternative for people to rally around.
ReplyDeleteHa ha. NBC is calling Obama a liar about the "if you like your insurance, you can keep it" lie. LINK
ReplyDeleteAndrew, I think any solution that starts with "you can deal directly with your doctor" would gain quick traction.
ReplyDeleteAnd you're right, the Republicans are offering as much of a black box solution as the Democrats did. In regards to bureaucracy, a good way to knock Obamacare (assuming you are presenting an alternative at the same time) is to point out how it promised to simplify the insurance bureaucracy, but instead just created a new bureaucracy to manage the old bureaucracy which it leaves in place.
I'm sure it could be stated more simply, but you get the idea.
Andrew,
ReplyDelete"When I've lost the NBC, I've lost the American people."
Now, Republicans, there is a way to handle this news about the Administration knowing that millions would lose their insurance: Do nothing -for now.
ReplyDeleteJust wait, wait and let the anger build and only then take advantage of it. And just hold one big hearing and then wait for the next cut. And run ads next Fall.
And Obama has generously granted an extension to sign up for Obamacare...
ReplyDeletetryanmax, That's the thing, when you create any sort of platform, you need to start with the premise of "what would people want from this reform." When you think like that, things like "you can deal directly with your doctor" become obvious. But it's shocking how little ideologues actually think about people.
ReplyDeleteBev, All of six weeks. So generous.
ReplyDeleteKit, You wouldn't scream impeachment? ;-P
ReplyDeleteThis is why I prefer a voucher system. It takes care of the access to basic care problem and the worries about losing health care with an illness, job loss, or job change. It would also change the governments approach to health care from a defined benefit (like a pension) to a defined contribution plan, which would be much easier to budget. It would also get the government out of policing fraud, which every politician tries to pay any expansion of medical programs but "eliminating fraud". As with most things in government, the rules are so convoluted and complex that you could be committing fraud without intent or even knowledge.
ReplyDeleteIt could be a bipartisan plan easily sold to the public especially with the current mess.
Koshcat, I agree. The voucher system really wipes out the access problems and moves the government out of healthcare in a big way. It's truly an excellent solution.
ReplyDelete