If Not Obamacare, What?

We don’t have to go back to the old insurance industry monopoly of the past if Obamacare is scrapped. Now that the nation is engaged and better informed, an upside of this debacle, let’s have a real debate about real reform.

Perhaps a bit deviously, conservative Peggy Noonan writes that “the trauma of the past few weeks will likely, and ironically, leave Americans more open to a simple single-payer approach — but they [Democrats] should give up on ObamaCare. And they should always call it that, to distance their own future programs from it.”

Liberal columnist Eugene Robinson says Obamacare could still work but acknowledges “Obama’s keep-your-insurance concession may further depress enrollment, as some people choose to stick with their cheap, no-frills coverage rather than upgrade to more comprehensive care through the exchanges. Lobbyists for the insurance industry warned Thursday that if fewer young, healthy adults buy policies than originally projected, rates will have to increase for everyone else.”

The Chicago Tribune: “In this country we don’t change bad laws by presidential fiat. We change them by having Congress rewrite them or by starting from scratch. Obama doesn’t want to reopen this law for fear that Republicans and some Democrats will substantially rewrite it. But that’s what has to happen.”

Washington Post’s Ezra Klein: “Obama’s frustration runs deep. At this point, he realizes that HealthCare.gov’s problems don’t just threaten his poll numbers. They threaten his core political project.”

71 thoughts on “If Not Obamacare, What?

  1. That whole legacy thingy is looking a little iffy right about now, but I suspect that the stories about the demise of the ACA have been greatly exaggerated.

    Depending on your political persuasion this can be either a woo hoo or a boo hoo. ;-)

  2. I think we are premature. Let’s not cave-in until we are forced to when the October agreements expire in January.

  3. The Trib has it right. Laws originate in Congress. Presidents either veto them or sign them and sometimes say they are going to ignore the parts they don’t like. Their departments author regs to implement the laws.

  4. Hey, maybe now that Obama is crippled, can we have the debate that he kept trying to side track before?
    Jack

  5. There are so many models worldwide for health care payment and delivery. I know American exceptionalism created the ACA, but trying to fit the square peg into the round hole isn’t working. Medicaid is being treated as the public option and there are not enough funds to help the poor in each state.

    Get rid of open enrollment as this will really piss-off the insurance companies. Staggering the enrollment, not adding the cancelled market to an already bulging system and the healthcare.gov might have had a chance. Enough servers to support an onslaught.

    I still think Obama looks like a fool and his hurried press conference yesterday was a political hail mary pass to stop legislation he didn’t like.

  6. The cave i is happening. It is time to run for the exits. At least for the Democrats if they stay and try to support this rickety building they will get buried in the collapses.
    Hello, President Perry

    Jack

  7. The first people Obama met with after the ACA roll-out debacle were insurance execs? Insurance cannot handle all the business nor do they want it. They just want profit. Healthcare for profit will never work for everyone.

    Keep trying to put everything into the insurance greed model.

    I really wish things would have worked out like they did in the auto insurance industry. I look forward to some witty commercials involving health care. I look forward to vanishing deductibles. I look forward to the US becoming entirely “in network.” BTW, I like the current Nationwide commercial with the big baby as a car. Adorable.

    Of course, the next commercial after the cute auto insurance commercials are for lawyers to fight the insurance companies for your money from an accident!!! Insurance ads keeping advertising going….the networks love that revenue.

  8. Maybe we can talk about some. basic reforms.
    Like the price gouging that happens to cash customers. A cash customer will pay anywhere fro 50 to 300 percent more that the large insurance customer.
    It is time to do some serious regulation.
    Cash customers get the best commercial rate you offer.
    And what is this stuff about requiring those of us who have chosen to be childless to subsidize all the folks who decide to have children.
    I’m on the wifes family plan meaning I’m paying for your childrens healthcare. I can’t even get out from under it if I buy on the private market now as all policies have maternity coverage.
    Not something I’m ever going to use.

    Jack

  9. The wifes company is starting a stay healthy program where they try to second guess you and your doctor.One of the requirements if you participate is they get access to your medical records. fortunately right now it is only voluntary with a paid incentive if you do. but some companies are making it mandatory. How long till information about your chronic health conditions become part of the promotion and layoff decisions?
    We need some regulation here!!!

    Jack

  10. The health insurance in Missouri exchanges cost $150 a month more than those across the state line in Kansas.

    Jack

  11. “can we have the debate that he kept trying to side track before?” -WJack

    …don’t be so cryptic.

    “Hello, President Perry” -WJack, again

    I’m moving to Switzerland and marrying Tina Turner (love’s got nothing to do with it).

  12. whskyjack,

    Jack

    If you ever need Viagra some single woman’s policy is going to help pay for it, not to mention prostate cancer and anything else that happens to you.

    That is the way insurance works. The more people in the pool and the wider the coverage, the lower the rates for all concerned.

    It’s like cable TV. Just because you don’t watch Duck Dynasty doesn’t mean it shouldn’t be there since it helps pay for your favored SyFy Channel.

  13. Part of our problem is that people like Peggy Nooner are still treated as though they are serious thinkers. She thinks Ronnie still talks to her

    It’s obvious to everyone that the most efficient would be single payer however, since we are free market people (who knew) then we must go forward with private industry to pay for our medical care.

    It should be everyone’s goal that anyone has access to medical care especially preventative services and that services are not denied to you because someone is of a different faith.

    So the problem is money. On today’s open market hardly anyone can afford the insurance that actually is insurance.

    The overwhelming majority of people get their
    insurance through their employers and it keeps going thru retirement. Unfortunately it is the reason many people stay in jobs they hate but it will pay for health insurance unless of course you are a public employee in which case your benefits are always at risk

    .It turns out there are unintended consequences of this policy. And by the way
    Katrina and this are not the right comparison

    It’s this and Iraq. Still waiting for Shrub’s acknowledgement that he screwed up big time.

    Nash’s point about the skating goopers do when they lie. Why are serial liars invited to lie again on national television. Michelle Bachmann is a serial liar for profit. ..

    And Senator Bob Corker what a disgusting piece of garbage. He won by being a racist and now wants to pretend he’s the new south
    he’s nothing but a re-enactor He should be made to listen to his own ramblings and contradictions he should be shunned

  14. Jeb Bush he scammed money working with Lehman Bros. No one can seriously think he can win. His brother Neil the actual bank fraudster would have a better shot.
    And people would spend all their time talking about Shrub and what a terrible president he was…and no matter how many hospitals he builds in Africa — he will always be the worst president

    And we have had enough of the Bush family
    so forget it George P

  15. Sorry Jamie, It ain’t the same thing.

    I have no trouble with the insurance paying for your estrogen therapy, your mammograms or treating your cervical cancer.

    Jack

  16. The beneficiaries of this are the hospitals doctors etc who aren’t writing of bills because of medical bankruptcies and of course the insurance companies

    why aren’t they helping out — because they are stupid venal turds who actually believe medical care should be a for profit business.

  17. “That is the way insurance works. The more people in the pool and the wider the coverage, the lower the rates for all concerned”
    And that is the lie that has caused Obama more problems than anything.
    Fact, you get lower rates by keeping sick people out of your pool that and high consummers of healthcare like those that want me to pay for their $10000 babies. You might convince me to pay for it once but the fifth time?

    Jack

  18. Jack does make an excellent point about the exchanges and state lines. $150.difference? Originally, the exchanges were to cross state lines so that more competition in the free market would help. The big lie fairy tale. You know it is the same insurance company in each state, but they know they can charge more in that state because the insurance lobbyists were more effective in that state.

    It pisses me off that Obama meets with Aetna about the debacle and they are not participating in any of the exchanges? Aetna must have contributed greatly to his campaign.

  19. People who are healthy should grateful for the most part the big things are genetic or environmental and beyond your control

  20. As I said, there are many working models for healthcare worldwide. Australia always comes to mind as we will never rid ourselves of insurance. To give them the traditional 20% of the business while the government Medicare covered 80% USED to work for those over 65. We do need insurance for those catastrophic surgeries, illnesses, etc. But for the preventative care, annual exam, etc., that should be covered for every human in this country. In a down economy where people are underemployed and unemployed, the employer based health care is not working. It can’t.

    Climate upheaval, insurance and economic downturn will run our lives for some time in the future. I was so looking forward to the singularity. But, I fear it may be like my experience with insurance and the healthcare.gov website. A clustermess lockout by machines with no where to get honest answers. Sort of like when Google ads dropped Craig because of their spying drones. No one to contact, no way to reach the machine. Singularity might be such a bummer.

  21. I’m sitting here looking at the Journal’s editorial page. It’s clear that the editorial board had apoplexy over the President’s ‘fix’ when they gave marching orders to the lead editorial writer.

    These two conclusions jump out:

    —”You still can’t keep your plan, but Democrats get political cover.”

    —”Mr. Obama’s gamble is that he and the Democrats can dissemble and shift responsibility long enough to muscle through the “transition” while the website gets fixed and more people can sign up for subsidies.”

    Actually, their reactions are much more thoughtful than the ones on teevee. Clearly, I believe that they think the opponents to ACA have been had.

    It’s well worth reading.

    ObamaCare’s Nonfix, The Wall Street Journal, pg A14, 15 November 2013

  22. I remember the good old days when banks couldn’t operate beyond the borders of a single county in Ohio.

  23. Obama could still have a great legacy
    He could change the criminal justice system in a big way. He could legalize pot

    It would both reduce expenses and bring income

    For Obama the most important factor is the impact on minority communities who suffer disproportionately from cops who use mj to harass kids.

    It is a stupid stupid stupid policy expensive and achieves nothing.

    There is nothing wrong with getting high. as Michael Pollan said every society has an inebriates. Has making it illegal caused people to stop smoking? No. Pot has not ruined anyone’s life. The fact that it is illegal has.

  24. Ugh Nicolle Wallace wouldn’t wanna be her having to defend Shrub you can see why she might have rubbed Palin the wrong way.
    She didn’t make it as part of snuffy’s crowd but she’s seems very at home in crazytown with her uncle morning jerk

  25. There oughta be a law
    anything with Koch-roach money has to be labeled

    More money to fool you

    Other corps are in bed with the Kochs. The Kochs may not care about public opinion but some of these others do: Reynolds American, Altria, the e-cigarette company NJOY, Microsoft, Verizon, Facebook, the for-profit online education company K12 Inc., GlaxoSmithKline, Kraft Foods, Express Scripts, Comcast, Time Warner, and the Koch- and tea party-connected DCI Group lobbying and PR firm—

    facebook and microsoft in bed with the Kochs..wow that certainly makes Bill Gates and Zuckerberg two of the biggest hypocrites on the face of the plante

  26. Iggy… sorry about you getting sick… but it did make me stop my procrastinating. I got my flu shot this morning at my local pharmacy.

    And yes…. my insurance co. did pay for it.

  27. Let me see if I’ve got this right

    Obama wanted people to be able to keep their old bad insurance with a warning letter but he couldn’t ask for a legislative fix because of the contrarian nature of his opposition

    So today the house passed the fix ..

  28. whskyjack,

    Well of course if you are willing let people die in the street without treatment then paying for it is no problem. Just call the garbage truck for a Wednesday pick up.

    If they go near a hospital, then the taxpayer will still foot the bill and the bill will be higher because they didn’t get preventive care or treatment when they first got ill.

  29. The ACA doesn’t need to be “fixed.” The WEBSITE needs to be fixed.

    The ACA is working fine on a dozen state websites, like Kentucky, California.

    Once again, Obama is trying to seek a “compromise” with the GOP, and once again they are going to spit in his face.

    He never learns.

  30. Obama always thinks he is walking a middle path between liberal and conservative, but the more he moves to the right, the faster the GOP moves away from him, out to the crazy extremes.

    The liberals can’t help Obama because he never listens to them.

  31. I personally think that they are going in the entirely wrong direction with comprehensive coverage for all.

    That’s the main problem with Health insurance costs now. They are so comprehensive that the price is through the roof.

    No other type of insurance even comes close to health insurance. No-one has insurance on their home for yearly a/c maintnenance or fixing a broken window. No-one has auto insurance for replacing a headlight or fixing a tire. No….that insurance is for major/catastrophic occurances.

    Universal coverage for all should just cover major/catastrophic occurances.

    Basic everyday medical expenses should be born by the individual or family.

    That would be my change…cover everybody for major occurances and let the individual carry the everyday expense and reinject competitive market economics back into basic medical expenses.

  32. The debate at Trailmix is better than what’s on CNN.

    Is there a rule at CNN that they have to have at least one idiot on every discussion panel?

    I guess if you want to articulate the “GOP position” on anything these days, you need one.

  33. Jamie…
    I think I get Jack’s point. He’s not questioning paying for healthcare. He’s questioning having to pay for someone’s choice to have children. Getting sick is never anyone’s choice.
    He’s saying he doesn’t mind paying for the first baby… but after that the parents need to foot the bill.

    We’ve had this same argument concerning income tax breaks. If I remember correctly… you and I were in the camp that we didn’t mind the tax break on the first 2 children… after that we believed people shouldn’t get a tax break for continuing to have children.

    I don’t agree with him on his premise concerning paying for deliveries. Too much can go wrong, IMO. But I do get his point.

  34. There’s no need to worry about Obamacare, as intelligence will soon “saturate the universe,” (with the exception, I assume, of some southern states).

    What follows is from Wikipedia…

    “The Singularity Is Near,” (2005) by futurist Ray Kurzweil.

    Kurzweil describes his law of accelerating returns which predicts an exponential increase in technologies like computers, genetics, nanotechnology, robotics and artificial intelligence.

    He says this will lead to a technological singularity in the year 2045, a point where progress is so rapid it outstrips humans’ ability to comprehend it. Irreversibly transformed, people will augment their minds and bodies with genetic alterations, nanotechnology, and artificial intelligence.

    Once the Singularity has been reached, Kurzweil predicts machine intelligence will be quintillions times more powerful than all human intelligence combined. Afterwards, Kurzweil says, intelligence will radiate outward from the planet until it saturates the universe.

  35. Or it could be cultural fugue, Nash.

    “cultural fugue” (a state of terminal runaway of cultural and technological complexity that destroys all life on a world via a singularity)

    Right now we are in insurance fugue with healthhcare.gov.

  36. Nash…it has taken me ten days and an inquiry to the republican’t head of human services for NM to find out state webpage is a sham. I think I signed a petition against this woman earlier this year. She responded regarding the NM Be Well site (NMHIX) and nothing is coordinated. NM took all of the federal Medicaid money, but the site is a page with numbers and advice sending you in different directions. Nothing cohesive.. Each entitiy at the site is not related and cannot help the other. For example, individuals are using healthcare.gov (New Mexicans MUST use the federal site for the first year) and it is not working correctly for New Mexicans. It you call the 800 number for the NMHIX, they will not help with any accounts created through the ACA. Medicaid is handled separately by the same avenues as before — low income in person, online application or 800# install. No interface betweem agencies…on purpose, of course. Roadblocks everywhere.

    The biggest mistake was the cancellations of the individual health plans at the same time newbies are trying for insurance. I repeat, my plan is superior to any of the ACA metal plans. It was the best I have had in years. Loading all the uninsured and individuals at the same time. Insurance wanted this to fail.

    Jax…if you help poor people with preventative care they usually do not require expensive surgeries. Look at Herman Cain…asshole has stage four cancer and he never went for a preventative colonoscopy or scan. Treatment must have been through the roof for the pizza man. I think you have it backwards.

  37. Nash 2.5: Once again, Obama is trying to seek a “compromise” with the GOP, and once again they are going to spit in his face.”

    Nash, correct the misspelt word in the quoted sentence, and I shan’t delay your graduation at the end of the Spring term.

    Or, did you intend spelling ‘shit’ with a ‘p’?

  38. Blonde wino:

    I have no idea what’s happening in New Mexico, so please don’t take my comments as applying to your case. You are getting a bad deal.

    I haven’t offered you any advice because I have observed that there are many other Trailmixers who know more about your options than I do. I have read their comments with interest.

    My understanding of the overall situation nationwide is that for most people Obamacre is a little better than what we had before (once they can get on the website, which is supposed to be fixed in 2 weeks.)

    I hope you can get coverage at least as good as what you lost.

    That’s what happened in Massachusetts, and Obamacare is essentially the same system.

  39. Flatus: I couldn’t find my “spelling mistake.”

    Compromise? It looked OK…

    (You got me.)

  40. RebelliousRenee,

    RR

    To a certain extent I agree. Don’t get me started on the Duggans … Nothing quite like litters because God told you so.

    Still (and this is part of the catastrophic only argument as well). Well care prevents the much more expensive catastrophic events and any pregnancy without pre natal care can turn into toxemia and death.

    I can see dividing the types of policies -- A well care policy that covered basic family practice and a catastrophic policy that covered the horrific whether accident or disease.

  41. Blonde wino:

    Have you looked at the website of (HANM) Health Action New Mexico? (Do a Google search. I have trouble inserting links here. Half of the time they don’t work.)

    They seem to have lots of information and they have a “contact us” function where you can ask for help.

  42. Goopers should not be gloating. Only a few weeks ago they were on death watch

    And their problems are not over -- they still have a civil war to go through and it did not turn out well for them this last time

    And really whomever thought it was a good idea to haul out the Romneys all they do is make Obamarama look good —

    Next week some tea party moron will start talking about how women should not have property rights

  43. Clinic with hospital referrals which is what we have in Tacoma works beautifully. You walk into an emergency room at St. Josephs or Tacoma General and the waiting room is empty. There are two ways to be admitted: Ambulance arrival or walking up to the desk to present your insurance card and pay your co-pay. If the latter you are almost immediately sent to a triage nurse to either be admitted or referred to an affiliated physician or clinic.

    Well care is either through the clinics or physicians group practices. It really is a beautiful system. I can see why it might be difficult to have it in small towns and rural areas but at least the nearest city should have it with maybe a nurse practitioner with computer in the small towns.

    Virtually everyone has insurance either through business, individual, medicare, or medicaid well 86% of everyone and they’re working on the stubborn 14%.

  44. GOP talking point: “Wolf”

    MSNBC: “Reliable reports indicate there may be a wolf.”

    CNN: “Special report: what you can do to deal with the wolf crisis.”

    Fox: “Wolves are eating blonde babies, and Obama does nothing but smoke crack!”

  45. GOP talking point: “The sky is falling.”

    MSNBC: “Is the sky falling? You want to hear what our panel has to say.”

    CNN: “The sky is falling, and CNN is there.”

    Fox: “Tonight,Bill O’Reilly interviews people hit by pieces of Obama’s falling sky.”

    Congressional Democrats: “OMG. We won’t get re-elected because of the falling sky. We have to vote with the GOP to save ourselves.”

    White House: “We are sorry about the falling sky.”

  46. Nash…. LOL… but, you are spot on!

    Jamie… the Duggans… I live in a town full of them… only they have Finnish names. There is a sect of Finns (NON progressives) that moved here about 80 yrs ago. They fervently believe in “be fruitful and multiply”. Their average family size is 14. I think they should have to pay federal income taxes…. but I don’t blanch at paying property taxes for their kids to go to school (IMO, everyone deserves an education).
    And IMO, they deserve healthcare… including pre-natal and maternity care.

  47. rene:

    There are Finnish-Americans in Maine, also.

    You’d think, if they took the trouble to come here, they’d move to a warmer climate, like Florida.

  48. I dont think Mike Rodgers R Mich chr of some house committee will be going on the Megan Kelly show.or should we just call her Bill jr.

    He is the chair of the house Intelligence committee and she kind of insulted his intelligence she made a whole bunch of statements which he was forced to contradict

    she sucks

  49. Nash 2.5,

    My relatives like snow and cold. I prefer sun, surf and warm. My relatives like to go into a sweat box, flog themselves with sticks then roll in the snow. I prefer a nice hot tub and cute blue drinks with umbrellas.
    Sisu

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