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Saturday, April 19, 2014

So When Does the GOP Stop Trying to Repeal Obamacare and Start Trying to Save it?'

     I'm not sure and clearly we're not there yet, but the predictions of gloom and doom for the ACA just are just looking embarrassing already. They've been insisting that Obamacare would miss the target of sign ups and then when that was discovered to be not the case they claimed that it's only older people doing that or people who already have insurance. This prediction has also fallen flat.

      http://krugman.blogs.nytimes.com/2014/04/17/what-eight-million-means/?_php=true&_type=blogs&module=BlogPost-Title&version=Blog%20Main&contentCollection=Opinion&action=Click&pgtype=Blogs&region=Body&_r=0

     For now, they're trying to claim that the numbers are fraudulent but obviously this  crutch can't last forever. What happens when the ACA becomes like Social Security and Mediare-an entitlement that Americans don't want touched? Obviously they'll have to give up repealing it and start 'saving it' like they do for SS and Medicare-Ryan recently released another terrible budget including his plan to destroy Medicare-he claims he merely saves it. Let's hope this is the last Ryan budget we ever have to see.

   http://www.nytimes.com/2014/04/02/us/politics/paul-ryan-budget.html

    Here is Sumner on the ACA:

    "The share of the population that is uninsured has dropped sharply since last summer.  On the other hand the share of Americans lacking health insurance has risen in the 5 and 1/4 years since Obama was elected, from 15.4% to 15.6%.  On the other, other hand 3 or 4 million more Americans will have health insurance by 2014:3.  On the other, other, other hand that’s less than 2 percent of adults.  So the share lacking health insurance will still be almost as high as in the summer of 2008.  Or am I missing something?"

     "Now let’s consider the goal of Obamacare.  If the goal is to eliminate uninsuredness, then it seems to have failed.  But perhaps the goal is to eliminate involuntary uninsuredness.  After all, all of the sad stories we were told before the law was passed tended to focus on people who were unable to get treated for illness, or perhaps were financially devastated by the cost of treatment.  If I’m not mistaken that will no longer occur, as no one can be turned down for having pre-existing conditions.  Or is that assumption false?  If there is no involuntary uninsuredness, can we consider the problem solved?"

     "One objection might be that we need everyone covered, as otherwise the uninsured will tend to overuse emergency room services.  But unless I’m mistaken there are studies showing exactly the opposite, that when given health insurance people tend to use the ER more often.  Is that true?  If so, why do we need to have everyone covered?  Why isn’t it good enough to eliminate involuntary uninsuredness?  Is the fear a “death spiral” that drives the insurance companies out of business?”

     "In my view Obamacare did lots of bad things and two very good things.  The good things were eliminating involuntary uninsuredness and the Cadillac plan tax. I opposed the program, but have an open mind on how it will pan out.  We’ll know much more in 10 years. One key test is whether Congress will avoid “doc fixes” to the Cadillac plan tax."

     http://www.themoneyillusion.com/?paged=2

     So he's on record as not guaranteeing it will fail. My guess is that in 10 years the GOP will be promising to fix Obamacare while accusing Democrats of trying to destroy it. By then they may even look back on fondly at Obama-this seems pretty remote right now but then it seemed remote that they'd ever embrace Clinton even less so his wife yet by 2010 there were in love with her too. 

       The GOP rule is you have to hate curent Democrats especially the one in the White House-in the future you can invoke them to criticize the current Democratic President of that time. 

2 comments:

  1. Obamacare hasn't fully matured yet.

    Here's whats gong to happen:

    The current list of covered essential services is too rich, too expensive.

    As a result, we have skinny networks.

    As a result, we have people who are paying full boat, getting no subsidy, and not able to see: 1) their good doctor, 2) the good hospital 3) some combination of 1 and 2.

    This won't stand. When the real shift occurs, meaning when employers are forced to put their workers into these new skinny plans, there will be a huge chunk of middle and upper middle class who will get pissed.

    As such, the essential services will be dialed back.

    The real issue is that poor people are super unhealthy - they are the ones who need drug help, they need mental help, they are obese, etc.

    So helping them requires a basket of essential services that most of the haves simply don't need.

    So here's what we got:

    In order to make sure poor people get expensive treatments related to personal control or issues that either cause them to be poor or their poverty causes them to manifest...

    The people who have money and more personal control CANNOT see their doctors.

    As a realist, what do you really think is going to happen, Saxie?

    Obamacare will be altered, so that essential services FOR THE SUBSIDIZED instead becomes: good healthcare for poor people.

    It will be about lower cost treatments, XRAYs and out of patent medicince, student doctors etc. They will still get mental and drug coverage, but the networks wil be where THEY ARE NOW - in poor areas. One of the things most people don't get is that US crime policy for 15+ years has been about doling out mood stabilizers in the ghetto like tic-tacs. Go read The Last Psychiatrist on the subject.


    And the people getting subsidies will only be able to buy these plans.

    THEN, the norms, who don't get subsidies, will be offered plans that cover less things, but deliver HIGHER quality care. The good doctors, hospitals, drugs, etc.

    This make sense?

    ReplyDelete
  2. Mike O/T:
    http://delong.typepad.com/sdj/2014/04/monday-delong-smackdown-scott-sumner-could-we-have-had-a-severe-recession-without-the-2008-financial-crisis.html

    ReplyDelete