We're Better Off With ObamaCare?!!

    You'd never know it to hear the spin: the Democrats are nervous about Obamacare and the inevitable reference to Max Baucus' quote. 

    It strikes me that GOP Obamacare implementation triumphalism is a tad premature.

Here is how the Times characterizes the sentiment in Dem circles about the coming war over implementation:

Democrats are worried about 2014 — a president’s party typically loses seats in midterm years — and some have gone public with concerns about the pace of carrying out the law. Senator Harry Reid of Nevada, the majority leader, told an interviewer last week that he agreed with a recent comment by Senator Max Baucus of Montana, a Democratic architect of the law, who said “a train wreck” could occur this fall if preparations fell short.

The White House has allayed some worries, with briefings for Democrats about their public education plans, including PowerPoint presentations that show areas with target populations down to the block level.

“There’s clearly some concern” among Democrats “that their constituents don’t yet have all facts on how it will work, and that Republicans are filling that vacuum with partisan talking points,” said Representative Steve Israel of New York, head of the House Democrats’ campaign committee. “And the administration must use every tool they have to get around the obstructions and make it work.”

     "Quotes like these are widely held up as evidence that Republicans are right that Obamacare implementation is shaping up as a major problem for Dems. But this amounts to a fundamental misreading of what it is these Dems are actually saying. Democrats are simply doing exactly what they should be doing — that is, calling for care and caution in the implementation of Obamacare, and calling for a serious effort to educate the public about the challenges and potential pitfalls it entails. This is not tantamount to running away from the law wholesale; nor is it a concession that implementation will amount to a major political albatross."

     http://www.washingtonpost.com/blogs/plum-line/wp/2013/05/07/the-morning-plum-dems-shouldnt-take-gops-bait-on-obamacare-impementation/

     One of the problems with ACA is that no one knows what's really in it. The GOP was quite successful in 2010 with it's various urban legends. However, not so much in 2012. There's a good piece at Angry Bear that points out that we really are better off with ACA-that the out of pocket expenses are topped out at some decent levels:

    "There are quite a few blogs in the blogosphere who tend to get the PPACA wrong and conflate the issues of it well beyond what is reasonable and truthful. Maybe they just do not know what the facts are and miss the benefits of the PPACA to dwell on the negatives exclusively.  Many  tend to dwell  on the amount of money one has to pay out in insurance and deductibles,  what the PPACA does not do, and why we should go back to  . . . ahh nothing? For the record, the PPACA is not single payer nor is it even universal healthcare. It is a convenient compromise which has many positives which did not exist previously. Some thoughts for those who think differently .  .    ."

     "Maggie Mahar at The Health Beat Blog: “Even if you do not qualify for a subsidy, your out of pocket spending is capped at about $5,500 for an individual; $12,000 for a couple. (That includes deductible and co-pays under a Bronze plan–or any other plan)."

     "A couple earning $65,000 joint might not have $12,000 lying around –especially if they were young. But they could work out a payment plan with the hospital or surgeon– paying, say $5,000 up front as a sign of good faith, and $7,000 over time. If they had to, they could borrow the $5,000 from relatives or friends or a credit card.(These days it’s pretty easy to get a credit card that charges 0% interests on cash withdrawals for 6 months to a year)."

    "Bottom line: they don’t lose their house, and they don’t go bankrupt. A $12,000 bill is the worst that can happen to them, even if they’re in a horrible accident and in the hospital for 3 months. 

There will also be no annual limit or lifetime limit on how much the policy will pay out. 

This is why the ACA is a boon—even for people who don’t qualify for subsidies. You can’t be ruined by medical bills, and they can stop paying even if you have a very expensive chronic disease."

     "As for poor people –if they’re below 133% of poverty, they’ll be on Medicaid (once all of the states expand Medicaid which, eventually, they will).If they’re above 133% of poverty, the subsidies are rich enough to make insurance comprehensive  affordable.”  Maggie Mahar in an email."

     

     http://angrybearblog.com/2013/05/what-is-the-out-of-pocket-maximum-you-will-pay-under-the-ppaca.html#more-14333

     By the way, another Angry Bear piece gets it right regarding that Oregon Medicaid study. It's never been clear what the takeaway is supposed to be. Is it that Medicaid doesn't improve health, but Medicare and private insurance do? Or just private insurance? As neither of these have been studied how can you know?

    If taken the way conservatives want to take the study it seems the implication is not just that health insurance is useless but healthcare itself. If you are sick don't go to the doctor, don't go to the hospital. Your chances of getting over it are just as good either way. 

    "The study is being widely interpreted as showing that healthcare insurance does not improve actual health, and has lead some people to suggest that this means that we should not have healthcare insurance at all, whether publicly or privately financed."

    "But that’s ridiculous. Or at least it’s insufficient as a response.  What the study obviously shows is not simply that we shouldn’t have healthcare insurance but that we shouldn’t have healthcare. We should not have medical care.  At all.  No doctors, no hospitals, no prescription drugs, no medical devices.  None of it.  We’re spending huge amounts of money on healthcare, and now we know that it doesn’t improve health!"

     http://angrybearblog.com/2013/05/in-the-short-run-we-are-all-dead-at-least-according-to-that-new-oregon-medicaid-study.html

     Unless they're making this-absurd-claim what's the point? They'd have to explain the huge increase in health, longevity, and old age in the 20th century thanks to modern medicine otherwise.