Category Archives: the ACA

Is the Media Trying to Kill the ACA?

 
 
Why are we so critical because a giant complex health care overhaul doesn’t run perfectly after only two months? Is this all about the mandate and the penalties? Do we expect to see the perfect mix of signers after only two months? Are we nuts?

The media has been brutal about the difficulties with this roll out. Maybe this has been positive in a way because it has forced the administration to pour energy into making the health care web site work. The media is still hyping this crisis, although I am not sure why. They have set this up so that if the web site is not perfect by December 2, 2013, then this whole new insurance framework will have failed forever. We know that in the past the larger the program, the rougher the roll out. This program, although it was only designed to provide insurance for 30 million or so uninsured individuals, also attempts to solve some thorny insurance problems which have been created by a risk-adverse industry – problems like pre-existing conditions and lifetime caps on treatment costs, problems like placing insurance costs beyond the reach of many younger Americans or the self-employed. In order to ask the industry to cover these high-risk areas it became important to reach a new pool of young healthy Americans to serve as a counterweight. The media reports the so far “desperate” failure of the plans to pull in these young buyers because they have been turned away by a nonfunctioning web site and they are not convinced of the value of this insurance to begin with, so once they have tried and failed, they will be lost to the market forever. Is this real panic or media created panic? Only time will tell, but I can’t help but wonder what stake the media has in the failure of the ACA beyond a blatant attempt to improve ratings. Even if the marketplace has not sorted itself out by March, 2014, it is entirely possible that dispensation will be given in the form of a later deadline for those tax penalties to kick in.

How much will these difficulties affect the 2014 election? We are all so fickle, or disenchanted by government, or so ADHD that it is impossible to guess how voters will jump until we are much closer to the election. We all know that big programs require generous start-up periods with an expectation of frequent glitches. Isn’t this the first large government/private partnership that has had a digital roll out? Of course it did not help that that oft-repeated statement the President made about keeping your insurance plan and your doctor was almost immediately proved wrong, or false, depending on your point of view. Did the President deliberately lie to get us on board? This really makes little sense as an explanation. Why would anyone whose life belongs right now to the public make such a public statement if he knew that it would soon be proven very publicly as false? I don’t believe any President would do that which leaves either 1) the President did not understand all the ramifications of his own plan, or 2) the President did not understand the calumny of the insurance industry.

The media is free, of course, to be as dramatic as they wish to be and to crank up their dismay at the “failures” of the ACA start up to operatic proportions, but they must accept that they may be helping the opposition party destroy a program that really would have eventually improved our health insurance. I also understand that it is not the media’s job to tout a program just because of inherent social values it might have; the media is not an advertising agency. However, reminding people that there is real history behind that old cliché, no pain, no gain; reminding them of the difficulties that have accompanied other roll outs; reminding people that mistakes are made and can often be forgiven, should also be covered regularly as part of this story.

The fact that Congress does nothing and is especially quiet and inactive right now may be forcing the media to focus on the ACA roll out because it is just about the only news in town. In fact, the media could be feeding right into one of those GOP game plans that the New York Times exposed, was it just last week? So the Republicans could have strategized to have the media dissing the ACA for them so they can really kick back and revel in that doing-nothing thing they are doing. We the people need a way to fire Congress but the only way we can do this is to elect Democrats in 2014.

This is the view from the cheap seats.

This blog post is also available at www.brissioni.com

 

 

I Trust Obama More Than I Trust Insurance Companies

 
 
What insurance companies have done since “Obamacare” registration went live, using loopholes in the law to cancel or raise prices on insurance policies people liked, has most likely been done deliberately to cause chaos and hopefully make the ACA look like a bad law. I am guessing lots of strategy meetings happened in health insurance circles to discuss how the industry could continue to maximize profits under the ACA and how they could make sure that the President’s promises (which admittedly he probably never should have made in the first place) were broken. I’m also surmising that this could have been devised as a campaign to undermine the law and put private insurers back in the driver’s seat. In fact, given the collusion among health care insurance providers in the old insurance market, colluding to deal with this new threat to profits seems more than likely.

We must steel our hearts and minds to resist these attempts to put health care back in the private sector. I know we are sort of fickle these days, with rather short attention spans, but surely we remember the way benefits under private insurers had been getting narrower and narrower with risk management winning out over good coverage. If insurance companies truly cannot cover patients with pre-existing conditions because they cannot make a profit, then we will get a chance to see this more clearly under the ACA. We may have to come up with a fund for catastrophic health care which we all pay into in the same way we pay into Social Security or Medicare. We just cannot go back to totally private health insurance again.

The bottom line in any privately owned company always has to be the profit margin, not the people the company serves. We know this by now and we know it well. How many companies have left our communities because they had to please stockholders and pay attention to profits? We aren’t happy about it but we are good little Capitalists and we understand it. We even believe that Capitalism presents the best environment for entrepreneurs and for competition and for overall economic health.

However, in the case of private health insurance the spiral of coverage went consistently downward and the prices spiraled consistently upward. Health care should not be a for-profit business in the same way that other businesses which sell products or services are. We need to hang in there for a while with the ACA because the advantages, if we can get this thing to fly, outweigh the disadvantages under the health care insurance marketplace that existed previously. As for the newest demands to delay the ACA for six months, we just cannot take that chance. Given the extreme opposition from the GOP and knowing that they will somehow turn a delay into the demise of the ACA, we have to try to fix the website while it is live.

I’m not absolutely sure who is to blame for the fact that people who did not want new insurance and who wanted to keep their doctors are finding that they must get a new policy or pay more for their old policy and that they may not be able to keep their doctor, but if I had to choose among the blameworthy, however, I would cast my suspicious eye on the private health insurers. I find it hard to believe that Obama wants to derail his own plan, and I find it hard to believe that he would lie quite so loudly and often to the American people when it is clear that such public lying always rebounds against the liar. I am guessing that Obama believed he was saying something that was true. Actually now, although no one ever likes to be told lies, it doesn’t really matter whether he lied or not; it is beside the point and the only person who really knows the answer is Obama. But, because the ACA looks like a step forward in terms of affordable and comprehensive health insurance that will provide almost all Americans with the medical care that allows us to stay healthy and solvent as medical costs rise and rise we have to stay with it and hope that it either works or that we get Universal Health Care if it doesn’t. It would seem to be in the interests of the private health insurers to help the President with the roll-out of the ACA because most of us are convinced that going back to all private coverage is not the answer.

Responses to the Anti-ACA Obsessed

 
 
When Republicans say that the ACA will turn people in to slaves they are using that Paul Ryan/Ayn Rand view that when the government takes care of people it turns them into unmotivated dependents who remain perpetually at the bottom of the economy.

Perhaps offering “respect” to these people the Republicans call “takers” in the form of actually caring about their health care will not rob them of initiative; perhaps it will actually tell them that they are valued by their society. Isn’t it possible that this new regard could help people value their own health and eventually their own future and actually serve to lift them up rather than keep them down?

The absolutely adamant opposition that has stalked the Affordable Health Care Plan since its inception seems several degrees tougher than laws that were stonewalled in the past. Most of those bills raised strong protests only until they became laws and they were usually opposed by those who labeled them “socialist” and those who keep constant eyes on America’s bottom line instead of on the citizens who struggle at the bottom of America’s economy (in other words, by the same people who oppose the ACA). The antipathy to the ACA has been several orders of magnitude more intense than was the disapproval campaign leveled against Welfare, or Medicare, or food stamps.

Of course we are talking about people who are just as interested in dismantling WIC (Women, Infants, and Children) a combination of citizens that it seems particularly cold-hearted to remove from the social safety net. I suppose the reasoning is that women, so supported, will continue to produce offspring that they could never afford if limited to their own resources. Of course, it still seems true that very few women will pull out a calculator before getting pregnant and this is still unlikely to happen even when help with prenatal vitamins and formulas is taken away. Most of us thought that America funded WIC because we are people who do not starve babies and young children, and because healthy moms produce healthier babies.

Clearly the web site for the ACA has been a terrible disappointment because it frustrates those who need health insurance and it provides fodder for the haters to continue crabbing about what a “disaster”, “train wreck” “everything horrible” this program, the Affordable Health Care Act, will be; it won’t work, it will be too costly, there won’t be enough doctors, forget getting scheduled for that procedure you need. Having a non-working web site lends credence to all of these arguments and makes us doubt this law. However, we realize that it  also just went into effect, that it has been hyped as the worst thing to happen to America, ever and that the House of Representatives has voted to repeal it 40+ times. Is the law cursed? Should Kathleen Sebelius be fired?

Is there any way on earth that we could just stop talking about this law for a while and let it roll out if it can and have all the good effects we hope it will have on people and on our economy and fail if it will? We are thoroughly sick of listening to the GOP harangue us about this program they call Obamacare. We are done with it, the law is law, the roll out has begun. We will see if it works or fails soon enough. I don’t need to see Katherine Sebelius get fired. We are also sick of all this “heads will roll” stuff. We are not completely sure that you haven’t hired people to sabotage the Health Care website (although I accept that this is really just wishful/paranoid thinking).

I’m not sure why there isn’t a table in every pharmacy where people can look over the plans and do the kind of registering that is needed. If we can give flu shots in Walmart and sell cable in Walmart why can’t we wheel in a locking file and a table and register people in Walmart, or at the grocery store? If new tech won’t work, why can’t we go old school? The news about the computer sites just keeps getting worse. On the evening news this Sunday we were told that Verizon had an outage and the web site was down again. I don’t really want a blow by blow description. Let’s talk about something else, please. Maybe if we aren’t commenting on every move the process will come together. Let’s talk about this NSA stuff for a while. That needs to have some light shined on it and some guidelines discussed that will not put our personal privacy at DEF CON 1 for at least another 50 years.

Here’s an interesting link about alternate ways to apply for health insurance under the ACA:

 

GOP – Strident and Shrill Equals Desperate

 
 

There are basically two reasons Republicans are desperately against the Affordable Care Act and neither of them have much to do with the health care needs of the American people.

1)    They hate the way the law was passed with no or almost no Republican votes. This is the party that has perfected the strategy of passing unpopular bills with overwhelmingly Republican votes on Fridays or in the middle of the night. However, Republicans try to convince the American people that Obama and the Dems are the only party which uses this “trick” which was actually borrowed directly from the GOP Playbook. This has irked them to the extreme ever since the law passed Congress and was signed by the President.

 

2)    They are also looking ahead to the 2014 election. If “Obamacare” does well they may lose the House and not be able to take the Senate. It is not their base that they are afraid of, although they claim that is who is calling the shots. It is the wealthy, the top donors, who are the real power brokers they must kow-tow to. These guys who head all those ultra Conservative think tanks and who are the corporate backers of the Conservative movement; they are the ones who can “primary” them, threatening to replace them with a candidate with a more “pure” adherence to the party platform. These money men may also be responding to the base, however, when their interests coincide with lesser beings. After all the Tea Party spent the summer whipping the base into a frenzy about Obamacare.

Does the fact that the Affordable Care Act is complex necessarily make it bad? Obama left private insurance companies with a role in health care. I wouldn’t have. Yes, he hemmed them in with rules and regulations but they will eventually find the loopholes and weasel around with them. They will find shifty, selfish ways to make a larger profit and they will continue to call this just good creative Capitalism instead of the greed that it will actually be.

The Republicans newest cry is “give this to us; we’ll do it much more simply”. Well simple is not necessarily better. Vouchers and interstate plans sound like a plan that is basically no different from what we already had. The GOP is not known for its love of rules and regulations, at least not when they affect big businesses.

I don’t know if the ACA will revolutionize health care but I don’t think forcing parents to go to the ER every time a child has a fever, exposing them to dangerous germs and adult trauma, is the answer to health care in America. I am willing to wait and see. This is not the life or death crisis it is being shrilly touted to be. The Republicans have put America through this huge drama for selfish reasons and we will not forget it. We know what to do. Elect Democrats in 2014!

This blog post is also available at www.brissioni.com
 

American Government: Now a Spectator Sport

 
 

Here we are, back at that place we keep getting to that we don’t like, which is the one where the Republicans use the purse strings to control the political agenda (or at least they try). They have made sure that Americans have heard almost nothing good about the Affordable Health Care Act and that has been easy for them since it does not even start to show its true colors until January of 2014.

Controlling Kings and Queens by pulling the strings on the purse was always common, whenever the power of the purse and the actual power did not reside in the same person. But America is not ruled by a King or a Queen; it is supposed to be ruled by the people. In the case of America, the President has the power to execute the laws passed by the people as represented by the Congress. But Congress has power over the purse strings. This power is usually wielded lightly, but theoretically can be used to force less spending or more spending as the people or circumstances direct. But traditionally, it has not been used the way Republicans have been using it since Obama was elected.

 

The continuing resolution is not generally used as a bargaining chip because if Congress does not continue to fund the government then the government shuts down and this is not at all desirable. After that Congress is required to look at our debt ceiling and decide whether or not it needs to be raised, which it generally does. Waiting until the actual deadline for raising the debt ceiling arrives before insisting on budget rewrites is not considered good politics as really good budget cutting does not usually happen in times of stress. Budget cutting needs to be done in a considered fashion and there are committees designed to do just that. We expect our government to use brain power and negotiation, not threats and insults.

In 2013 we are facing the unthinkable; we are facing a forced showdown which is shockingly un-American because it flaunts the Constitutional process in order to try to erase a law that is an actual law of our nation, a law which was supported by the Supreme Court (without enthusiasm, but still supported). I do not believe that the America people want to go back to the health care system we had before the ACA, which did not cover legions of Americans and left Americans at the mercy of private, for-profit insurance companies. The argument is being twisted by Republicans to say that Democrats are to blame if the government shuts down because they won’t give up Obamacare (as they call the ACA). This is obviously semantics and does not change who is actually trying to defund the ACA and willing to shut down the government to do it.

What I am not sure about is whether the media should be spending so much time discussing this disgraceful behavior and making it somewhat legitimate and very exciting. Of course, the media is not about steering political policy; it is about ratings. This kind of suspense is intoxicating. Will the government shut down? Who will blink (how old are we)? Will Obama abandon the ACA? (please don’t Obama) What will happen if America shuts down?

This is not a spectator sport. We are not in the Roman Coliseum watching the slaves or the Christians fight tigers for their freedom, although this is about as close as we get to that outside sports arenas. This is our nation. Are the Tea Partiers the only people who have strong feelings about what America wants? If this is true then we will deserve what we get, but I don’t think we will like it much. Maybe the media should find some way to stop turning the Republican “nutburgers” into the tigers who will vanquish the slave (oops, that would make them racists) make that the “weak” President who seems to be all on his own without the will of the people behind him, even though he was elected by a majority of the popular vote. Does the President have to get re-elected every day? That’s ridiculous and no way to run a country.

 Perhaps the media could find a new way to present the upcoming battles over the purse strings, to at least present these rogue legislators in an even more negative light than we have so far heard. Perhaps the people, who don’t agree with Obama in every way, but who do not like the way Republicans are subverting their power over the purse strings could find some way to let their displeasure be heard. Maybe I am wrong and the public does not want the ACA and does not mind if America destroys its credit so that the minority party can have its way. I, however, am disgusted by the behavior of these people who are trying to pull off what amounts to a political coup. Let’s go back to structured government that abides by tried and tested rules and which does not lead America to the brink of disaster over and over again.

IRS, No IRS, the ACA and the flat tax – Sexy

 
 
While watching Bill O’Reilly on Tuesday evening, June 5, 2013, my ears were sort of quiescent as they were being assaulted with more of the usual Republican bile about the 157 times that Mr. Shulman of the IRS visited the White House during the past four years, and the sad tales of small-time Tea Party 501(C)(4) filers who got audited, and Bill O’Reilly opining that all this definitely gives powerful credence to Obama’s involvement in profiling and targeting right wing political groups. The problem is that the clues are not adding up the way the GOP would like. It turns out that Mr. Shulman of the IRS was cleared to attend meetings at the White House 157 times, but he only appeared at the White House 11 times over the past four years. Apparently people have to sign in when they actually enter the White House and its precincts. As to the tears of Tea Partiers we can all relate. Not one of us would enjoy being audited by the IRS, especially with the intensity of perusal these folks were subjected to. But most of us would not file a 501 (C)(4) either. Because of the nature of this tax form and tax classification and because of the huge number of these organizations that have filed since Obama took office, it makes perfect sense that the IRS would do an in-depth investigation of these groups. So, although this may look like something a person trying to win an election might do, no connection to the President has been found so far. As for Bill O’Reilly’s opinion and the footage he aired of Senator Issa convicting Obama because of what his gut tells him, neither of these things represents any empirical data nor even a concrete lead.

However, all of a sudden my ears perked up because I heard something new, something I hadn’t thought of. I heard a Senator say that given the chaos within the IRS it would be impossible for the IRS to perform the new duties connected to the Affordable Care Act. This brought me to a real ah-ha moment because I know how hard the Republicans have worked to get rid of Obama’s Health Care plan. I am astounded that I didn’t see this coming. If the GOP cannot connect the dots between the IRS and the oval office, they can still win by driving a huge IRS wedge in front of the ACA, hopefully postponing the ability of the IRS to add the people it needs to add in order to deal with the additional load that Health Care documentation will require. And so, for logistical reasons, the administration might have to postpone implementation of the Affordable Care Act and, if the GOP can stop this plan which they call Obama Care, then the Party will not need to vote for repeal for the 38thtime, and they will have succeeded in derailing Obama’s biggest accomplishment. They just keep pulling these rotten apples out of their pockets and displaying them as if they were fresh fruit. I’m still a bit astounded by this tactic which I did not see coming. If only all this Machiavellian strategy was at work to create jobs and invent clean energy solutions and better schools, then America would be winning instead of watching a bunch of old men turn Washington into a mud wrestling pit. Elect Democrats in 2014. It is our only hope.

Following fast on the heels of Tuesday night’s exercise in creative governance we see a movement to do away with the IRS completely! Yikes! First of all think about the soaring unemployment. A lot of people work for the IRS or in IRS related businesses. Second of all, we would still pay taxes, even in a same-flat-tax-for-all scenario. Who would we pay our taxes to? Who would make sure we paid our taxes correctly? Who would go after people who did not pay their taxes? If there were no IRS, taxes might seem optional. Despite these rather hefty disadvantages, this plan would have one great advantage, at least if you are a Republican, it would finally, once and for all, end Obama Care, aka the Affordable Care Act. Getting the drop on Obama obviously trumps continued employment for Americans. If we are going to have smaller government all these people need to find jobs elsewhere anyway, so let’s just dump them all into the job market at once and see if they sink or swim. It will be a real test if we also take away all the “taker” programs and see if these ex-IRS people can become “makers”. If you dread this extreme social experiment, then elect Democrats in 2014. It is our only hope.