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Call for hard questions at an ObamaCare town hall

A reader writes (though I've edited the mail):

My local TV station asked for questions for their "healthcare town hall". I gave them some really hard ones. The NYTimes article, estate recovery, subsidy clawback, "affordability glitch". Can you think of any
others? LOL, I'm sure they were expecting people to ask what color their pony was going to be and how many gradations their rainbow would have. But sorry, they got me!.

Readers?

It couldn't hurt to phrase the questions as pointedly as possible. And maybe we can circulate the list....

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Alexa's picture
Submitted by Alexa on

That's probably the main reason that I found Krugman's suggestion, or hint at following the Medicaid "model" to be absolutely appalling.

He has to be knowable enough to realize that this model is anything but "free"--with Medicaid's now very stringent asset recovery program.

But I'm glad that you (or the reader) brought it up.

Again, I would be flabergasted if THIS policy (MERP) ever makes it into the national discussion.

As I recall, the ONLY reporting during the healthcare "Kabuki" was on "horse-race aspects"--D versus R.

When does the mainstream corporatist media ever delve into policy?

Oh, that's easy to answer--they don't!

I'm beginning to wonder if ALL the elites don't simply despise poor and low income folks, and just wish them "out of the way."

I do take Krugman's piece seriously, and I believe that the progressive community would be foolish to just look the other way. This is the way they always start a conversation (propaganda)--get one of the so-called "liberals" to trot out a trial balloon!

And sadly, I'm beginning to believe that by far the majority of Americans don't even know about MERP.

Question is: How does one educate the masses on this topic (particularly those who are not likely to be reading progressive blogs)?

I hope to post some of Rahm's big brother's outrageous (and very specific) policy proposals regarding "rationing of healthcare," sometime this winter.

Ezekiel is a bioethicist, I believe. And somehow, he manages to make Rahm look like a "nice guy." (Not an easy feat!)

;-)

Splashoil's picture
Submitted by Splashoil on

In my spare time, I "reach out" to orange satan. Yes it is very frustrating but I don't know how else to get information out. There sure are a lot of shills over there! Others are just "enthusiasts" w/o a clue. MERP is always fun to explain to young folks who think Medicaid will be happyville. Oh did you know I am a RW troll! Of course I don't have an original thought either so keep blogging!

nihil obstet's picture
Submitted by nihil obstet on

1. If you are covered at work by an employer plan but lose or change jobs during the year so that you are no longer covered, when do you become subject to the insurance purchase requirement and when do you become eligible for subsidy?

2. If you have insurance but find it inadequate, when can you change? For example, if you are on a bronze plan, but develop a condition that requires more visits with copays than you had expected, can you switch to a plan that requires lower copays during the year? Or if you are prescribed a medication that your insurer doesn't cover, can you switch to an insurer that does cover it? Are you locked in to initial choice as though it were for a mobile phone contract?

Submitted by MontanaMaven on

I don't even understand MERP (not Middle Earth Role Playing kind) , let alone average non Senior Americans. If the spouse is alive, they can't take your assets or can they? My understanding of health care is that if you are rich, you can afford it and if you are destitute, they have to pay except when they don't feel like it and dump you on the street. But it is the rest of us, most of us, who are caught in a bureaucratic hell and not having any sense of rational expectations for easy access to basic healthcare. It should be "easy" . "Easy" should be the operative word.

a little night musing's picture
Submitted by a little night ... on

On the left, NOT the right.

My dear friend who has MS has been denied insurance (already) by moving to NM from NY - and "insurance" does not equal "care" as we know. So she'll have no care - despite having MS.

I don't even care why this is happening. Making a system dependent on private "insurance" is a recipe for disaster, as we had a lot of evidence to convince us.

Private insurers have a fiduciary responsibility to maximize their clients' income. Guess how they do that?

Up until this post, I've replaced the four-letter f-word with euphemisms like "frack". But as of today, I'm well fed up. So Fuck Obamacare. Yes, there are worse fates than having sucky insurance.

Alexa's picture
Submitted by Alexa on

Hey, Splashoil--I blog there, as well.

Heck, the people over there are the ones that "need reaching," LOL!

I've never seen so many "fluff pieces" on the ACA. I admit, I can only take it in small doses, but sometimes I just HAVE TO jump in, to counter the DNC and Administration propaganda. ;-)

letsgetitdone's picture
Submitted by letsgetitdone on

Someone in my family shared something mildly favorable to Obamacare in Facebook. Before I knew it I had responded with this rant:

I think it's a mistake to see the ACA as just starting. It was passed in March 2010; incorporating many features designed to meet Republican objections to the Bill. Yet in the end, they gave away Medicare for All, and a public option, and many other features and did not get a single Republican vote in either chamber.

They even saw to it that the bill was fiscally neutral over a 10 year projection at a time when the tanked economy needed more deficit spending and the jobs that would have brought. And to do that, they postponed implementation of most of the bill for more than three years, until now, allowing people to go without care, to die, to divorce, and to lose their homes due to medical bills, just so they could argue that the bill was fiscally neutral. In gauging the record of the bill, these 3 to 3.5 years of waiting for its implementation and their real costs to the people of the United States must be taken into account.

It also, must be taken into account that in the year before the bill was passed there were some 45 million Americans uninsured, and they were dying at the rate of 1,000 more for every million than in the general population. That is, lack of insurance was causing more than 45,000 fatalities per year.

When the bill was passed it was estimated by its proponents that it would cover 35 million more people than before. Now these same proponents are using the figure 31 million new people covered instead. Meanwhile the population of the United States has grown by 15 million people, and due to the effect of the crash of 2008, millions of people who were insured before the crash are now uninsured. So, though there are no hard figures on this it is likely that we now have 55 million still uncovered and are getting 55,000 avoidable fatalities as the ACA finally goes into effect.

Even if the projection of 31 million new people covered is accurate by say 2017, we will still have as many (assuming further population growth) as 28 million uncovered people then, because the Democrats chose to pass the ACA rather than the Conyers/Kucinich enhanced Medicare for All bill, HR 676. So, 9 years after the effort to pass universal health care started in 2017, we would still have 28,000 fatalities per year to cope with and 28 million going to emergency rooms for care that is too little and often too late.

Furthermore, it's perfectly possible that the current 31 million new coverage projection is still too optimistic about the future. Many states are still fighting the ACA and will not implement its Medicaid provisions. Some 17 million out of the 31 million new people covered were going to go into the expanded Medicaid program. But with State Governors in Southern and some Western Red States refusing to allow that Medicaid expansion to occur, we may end up with only 9 million new Medicaid enrollees nationwide. Many others will try to game the system because they willing to accept the risk of mandate violations and fines rather than pay the cost of the lousy insurance offered for basic plans in the ACA.

All in all that 31 million may well turn into 17 million or so before all this is done. And then we would have taken 9 years of passage, waiting, and implementation and would still have as many as 40 million people uncovered in 2017, and 40,000 annual fatalities. That is the measure of the possible failure of the ACA.

Is that better than nothing? Sure, superficially, but you also have to take into account the opportunity cost of what was done in 2009 to work towards and then pass the ACA in 2010. In 2017, it is likely that we will still have an enormous problem of many millions of uncovered people after 9 years of effort. What if the Democrats had ignored the Republicans in 2009, and used reconciliation or elimination of the filibuster and their big majorities in both Houses to try to ram through HR 676?

I think they would have succeeded because Nancy Pelosi had full control of the House, and with elimination of the filibuster and even reconciliation they would have needed only 50 votes + 1 (the VP) in the Senate to have passed that bill in the Spring of 2009, and implemented it by January 2010. Then there would have been no rise of the tea party, no sabotaging of the ACA, and full coverage for everyone with no co-pays.

That's what we've lost by not trying to pass HR 676 and by trying instead to take a bipartisan insurance company conciliation approach to passing the ACA. In this post I've totaled the anticipated opportunity cost comparing Romney's 2012 alternative to Obamacare, the baseline of no reform at all, the ACA, and Medicare for All over the period 2010 - 2022.

Bottom line: the ACA is projected to cost 286,500 lives through 2022, assuming no change. That's a lot better than the baseline and a lot better than Romney's 2012 alternative. But it's still terrible compared to what we might have had if we had a President who really represented people rather than Wall Street.

What if an effort to pass HR 676 had failed in 2009 because too many Democrats in the Senate would have defected to pass it? Well, I think this would have been very unlikely with the very large Democratic majority and the popularity of the president at its height, but even if it would have failed, then the Democrats could still have compromised with members of their party to pass enhanced Medicare for All for everyone under 26 and over 45, or under 26 and over 50, or whatever compromise would have moved those wayward Democrats up to the 50 vote mark.

Such a compromise bill would still have lowered the fatalities substantially by providing insurance for those who needed it most and by enhancing the Medicare program for seniors (full coverage and no co-pays). It would also have been something Democrats could have run on and built upon in each successive election year, rather than having to defend the sorry ACA with its package of inadequate goodies, silly mandate, IRS enforcement, and still high insurance costs.

Again, there would have been no tea party because tea partiers like Medicare, in case you haven't noticed. And there would have been no Republican nationwide sweep in 2010, no gerrymandering, no voter suppression, no anti-woman bills, and none of all the rest of the nonsense we've seen because the Democrats did what they did.

Submitted by lambert on

ai thonk I'll just outsource to you now.,.,

Rainbow Girl's picture
Submitted by Rainbow Girl on

... "healthcare.gov" and any exchange marketplace website that does/will similarly track a visitor's activity on such website(s)?

N.B. This question arises from Alexa's and Lambert's posts earlier this evening about an interesting (un)privacy twist -- shocking, I know -- in the ObamaCare WebGoldberg Machinery.

beowulf's picture
Submitted by beowulf on

Someone in my family shared something mildly favorable to Obamacare in Facebook. Before I knew it I had responded with this rant:..

Yeah I know what you mean Joe. The politics of Obamacare are insane, Obama went for literally the most right wing proposal possible (which is why GOP hasn't been able to come up with an alternative in 4 years), as a result nearly everyone, in both parties, is completely confused by it.


"Can I opt out of the tracking function on..."

Ultrasurf is a product of Ultrareach Internet Corporation. Originally created to help internet users in China find security and freedom online, Ultrasurf has now become one of the world's most popular anti-censorship, pro-privacy software, with millions of people using it to bypass internet censorship and protect their online privacy.
http://ultrasurf.us/

Rainbow Girl's picture
Submitted by Rainbow Girl on

Ultraserf = What you turn into if Michael R. Bloomberg is Mayor of your city for 12 years.
(Sorry, could not resist.)

Bummer about the no OS X version ... I hadn't seen that yet :(